Healthcare leadership is commonly seen as centred around making decisions and managing
resources. However, the reality is that authentic leadership in this field goes far beyond those
aspects. It’s about overseeing intricate systems that profoundly affect the health and well-being
of entire communities. For a healthcare system to work well for everyone, the people leading it
need to reflect the diversity of the populations they serve. When leadership includes a variety of
voices, it brings new perspectives, different life experiences, and cultural insights that make the
system more inclusive, fair, and effective. Understanding this history in Canada is essential as
we fight to achieve a future where health care is equally accessible and fair regardless of the
individual’s background.
A History of Discriminatory Health Policies in Canada
The Forced Sterilization of Indigenous Women
One of the darkest chapters in Canadian healthcare history is the forced sterilization of
Indigenous women. From the 1920s to the 1970s, and in some cases even later, Indigenous
women were sterilized without their consent, part of a larger eugenics program aimed at
controlling Indigenous populations.
Impact: Not only have these women been robbed of their basic rights, but they have also been
forced into trauma. Some may grow up carrying that trauma. Historical events have created
considerable distrust among Indigenous people toward the healthcare system, which has a
significant impact on how this community interacts with people in the healthcare sector even
today.
The Indian Hospitals
From the 1940s to the 1970s, Indigenous people were often sent to segregated “Indian
hospitals” instead of being treated in mainstream healthcare facilities.
Substandard Care: These hospitals were severely underfunded and lacked the necessary
resources and trained staff to provide proper care. As a result, many Indigenous patients were
neglected, mistreated, and subjected to non-consensual medical experiments.
Legacy: The scars of this system are still felt today. The historical exclusion and mistreatment of
Indigenous people continue to shape their health outcomes and their trust in the healthcare
system.
The HIV/AIDS Epidemic and Stigma Against LGBTQ+ Communities
In the early days of the HIV/AIDS crisis, Canada’s healthcare system was slow to respond,
largely due to the stigma surrounding the LGBTQ+ community.
Neglect: LGBTQ+ individuals already faced significant societal discrimination, and when they
turned to healthcare services, many were met with bias and a lack of understanding. The
healthcare system’s delayed response to their needs worsened the situation, ultimately costing
lives.
Maternity Care and Racism Against Black Women
The long history of systemic racism that Black women in Canada have faced within maternity
care has led to alarming rates of maternal mortality and poor birth outcomes.
Implicit Bias: Studies show that Black women often feel healthcare providers dismiss their
concerns. They are less likely to receive proper pain management or necessary interventions
during childbirth, highlighting a pattern of neglect and discrimination that continues to harm
Black mothers today.
Why Diverse Voices Matter in Leadership
Understanding Marginalized Communities
Leaders with different backgrounds are very familiar, through experience, with the problems
faced by underserved communities. For this reason, such leaders are likely to advocate for
policies addressing systemic barriers, such as language access, culturally competent care, and
the equitable distribution of resources to underprivileged populations.
Mitigating Bias in Policy
When organizational leadership is not diverse, they can easily design policies that do not
consider all communities. The best way to address this is by involving a diverse spectrum of
people to ensure that all voices are heard and that no policies inadvertently perpetuate
discrimination or inequality.
Restoring Trust
Representation matters. When people see healthcare leaders who share their experiences, it
helps build trust and a sense of belonging in the system. Diverse leadership sends a message
that fairness and equality are priorities, which is key to repairing relationships with communities
that have been historically excluded or mistreated.
A Healthcare System with Hope
Despite its troubled past, Canada’s healthcare system has the potential to lead the world in
promoting inclusion and equity. Positive changes are already taking shape:
1. Cultural Safety and Competency Training: Several healthcare institutions now train staff to
recognize and confront their biases to better serve vulnerable communities, including
Indigenous peoples, racial minorities, and LGBTQ individuals.
2. Indigenous Health Initiatives: Indigenous-led healthcare services allow communities to control
their health, ensuring care that aligns with their cultural values and practices.
3. Policy Reform: Important changes, like those proposed by the Truth and Reconciliation
Commission’s Calls to Action, are forcing the government and healthcare organizations to
address the long-standing health disparities Indigenous communities face.
4. Representation in Leadership: More women, racialized individuals, and LGBTQ+ leaders are
stepping into influential roles within the healthcare system, helping to drive the needed changes
from within.
The Path Forward
The future of healthcare leadership needs to hear from all kinds of voices, each playing a part in
building a system that’s fairer, kinder, and works better for everyone. It is not an easy journey,
but one we must embark upon. For Canada to have a realistic shot at developing a healthcare
system that provides for all people irrespective of their ethnicity or background, it is possible to
know the past mistakes and rectify them through implementing diversity in leadership.
Making our healthcare system more just and inclusive relies on our willingness to listen, learn,
and take real steps to make a difference. Diverse leadership isn’t just something nice to strive
for—it’s the foundation of a healthier, more equal society.
The real question isn’t whether we can make this happen but whether we’re ready to commit to
it. The time to act is right now.
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