Chatham-Kent chief medical officer talks about breaking taboos to improve health care

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Multiracial young people are one of the fastest growing demographics and Chatham-Kent’s acting medical officer of health believes there needs to be more discussions about racial and ethnic backgrounds to provide better healthcare.

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Dr. Shanker Nesathurai said his presentation of the status of multiracial people at the CK Black Symposium on Saturday “is the most important talk I’ve ever given because the topic is so important to public health.”

The event was organized by the Chatham-Kent Black Historical Society.

“We know so little about the health status of multiracial people,” Nesathurai said is a quote from his colleague and friend, Paul Beninger, a professor of public health at Tufts University in Massachusetts, who he interviewed in preparing his presentation.

He said part of the public health service’s job is to break taboos, which is why sex, unplanned pregnancies and birth control are talked about.

His message is a positive one, Nesathurai said, “These are about some ideas that really advance equality and we all win when equality is advanced.”

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However, when looking at the literature for the largest growing demographic, Nesathurai said, “We’re not spending a lot of time and energy trying to figure this out.”

He recalled as a young doctor, the story of baseball hall of famer Rod Carew’s 18-year-old daughter Michelle, who died of leukemia, resonated with him.

Nesathurai said her obituary in the New York Times stated her mixed ethnic background was an obstacle to her finding a bone marrow donor.

Since Rod Carew was Black with West Indian and Panamanian roots and his wife was white with Russian and Jewish roots, there was no one in the registry that fit their daughter’s profile to find a bone marrow donor.

“This was the first time I had ever seen in any popular media saying, ‘Oh mixed race or multiracial children have gaps in care,’” Nesathurai said.

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Talking about race and ethnicity can be a taboo subject, he said. Not only is there a stigma for being a person of colour, “but there’s a particularly additional personal stigma for being of multiethnic, multiracial background.”

This has been seen in different forms, including “colourism,” which is an advantage of disadvantage based on a person’s skin colour, Nesathurai said.

“In our culture at the current time and in the past, the more European features or the whiter features you have one would get more perceived advantage.”

Nesathurai said a Black female surgeon he knows told him this situation occurring for people seeking medical care is something medical professionals of colour also might impute.

“It is part of something we all own together,” he said. “That internalized prejudice or racism that we all have is part of our culture.

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“We all own it, there’s no perpetrators there’s no victims, it’s that we have to be sensitive to that I think, as we provide our services.”

Nesathurai, who for the first time shared photos of his adult children from an interracial marriage, told those attending his presentation, “I’ve got skin in the game here.”

He said health is more than a doctor diagnosing a disease or ailment, it is about wanting every person to live to their full potential.

This can be achieved by talking about things, because “concealment is barrier that leads to stigma” and prevents people from getting better, he said

Surveys show the majority of multiracial children do not think they have much in common with other multiracial individuals, he said. Many multiracial people also report being rejected or confused about their racial background, he said.

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Nesathurai recommends multiracial people tell their doctor or healthcare provider the details of their background.

“Certain diseases are more prevalent among certain ethnic and cultural communities, so telling (health providers) your ethnic and cultural background may help them in organizing a treatment plan for you,” he said.

Nesathurai added it should be acknowledged that historically, some people have been uncomfortable making this disclosure, “because they feel they would potentially suffer discrimination and bias.”

It is also important for a doctor to build an alliance with patients to get this type of information.

“It is the doctor’s job to get a good history on the patient.”

eshreve@postmedia.com

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