Re-thinking the way we deliver health care

A picture of a skeleton
A local Scarborough health care centre is working to address barriers that face Black Canadians seeking medical care. (Photo by Nino Liverani)

Kevin Vitorino

Malvern-based TAIBU has a simple mission: change the way we deliver health care, particularly to Black communities across the GTA and other racialized communities.

The health needs of Black people in Ontario are misunderstood and underserved. Health care providers often don’t understand the cultural needs of people from the African diaspora, and the systemic barriers that racialized people often face.

TAIBU Community Health Centre is responding by changing the ways we think of health care. Its priority population is Black communities across the Greater Toronto Area.

“When it comes to racialization, people don't understand that racialized identity is a determinant of health,” says Rashelle Litchmore, President of the Board at TAIBU and U of T Scarborough alum (BSc, 2008). She says the process of racialization, that is, the process of how people are racially categorized in society and the meanings associated with these categories, has implications for their health outcomes.

TAIBU, a Kiswahili greeting that means “Be in Good Health,” challenges deep-rooted systemic barriers that Black Canadians often face, addressing common hurdles that the community encounters.

“Through an Afrocentric lens and anti-Black racism framework, we try to address these barriers. Whether it is through programming, awareness and capacity building, to engaging in research and education, as well as contributing to policy making and decision-making processes,” says Liben Gebremikael, executive director at TAIBU.

“TAIBU exists as a political statement as well because we are the only health care centre in Canada that has an explicit mandate to serve Black communities.” says Litchmore.

The community health centre wants to challenge the ways we approach society's common biological understanding of health. Instead of intervening when ill health is already present, TAIBU wants to intervene before an acute condition arises.

“We recognize the impact of the social determinants of health on the health of Black Canadians and we are providing services that intervene at an earlier stage, that help people to understand how these social determinants impact their own health,” says Litchmore.

“Social determinants” is a term for the different conditions that shape a person’s or community’s health status. These determinants are usually responsible for health inequities and play a large role in almost all aspects of life.

Instead of having patients shoulder the entire responsibility for their ill health, TAIBU provides services and programs that help alleviate the common social and economic factors that lead to health problems in the first place.

One particular issue that TAIBU targeted through an initiative was the disproportionately higher rates of suspension and expulsion that Black students experience compared to other students in the TDSB. The organization was able to start a program where they provide legal advice to students and parents, they arrange capacity building anger management and conflict resolution support for the students, and educational tools for students and parents. In order to be part of the solution they also created an advisory committee with the TDSB where this program could be implemented in schools.

“When it was piloted we had about 63 cases that we dealt with around suspension and expulsion, about 85 per cent of those suspensions or expulsions were either withdrawn or suspension was reduced,” says Gebremikael.

Services such as TAIBU are rarely located outside of downtown, Litchmore says. Having the community centre located in Malvern allows for the community to have a culturally appropriate space near their homes.

TAIBU has also been able to extend services to the Francophone and Indigenous communities. TAIBU and the Central East Local Health Integration Network were able to identify a gap in services for these communities in Scarborough and continue to fulfill their needs through TAIBU’s extensive set programs and services.

“They (the founding members) wanted a centre of excellence that deals with Afrocentric services and capacity building programs,” says Gebremikael.

TAIBU has several partnerships with U of T Scarborough, including the L.E.A.R.N. and Imani youth mentorship programs. While these programs help young Black students improve their academic performance, Gebremikael says they have also helped high school students consider post-secondary education as an achievable goal.