By Ana Gajic

Approaching research through an equitable lens is a core principle emerging at Unity Health Toronto. Vast inequities in healthcare experiences and outcomes surrounding who is cared for, how treatment is administered, and how illnesses are prevented are results that can emerge without this approach.

We engaged two members of the Research Equity, Diversity and Inclusion (REDI) Task Force, researchers shaping our strategy at Unity Health, to learn about their work and goals.

To get started, can you please share information about your social location? These reflect intersections of a person’s experience based on social characteristics such as (and not limited to) race, gender, and sexual orientation.

Galo F. Ginocchio, a research coordinator in the St. Michael’s Hospital Emergency Department and MAP Centre for Urban Health Solutions: I am an able-bodied, Queer, Latino, cisgender man, and a second generation Canadian graduate student.

Dr. Cheryl Pritlove, scientist at the Applied Health Research Centre: I am a young and healthy cisgender woman of European decent, born in Canada to a working class family. I am a feminist, I am left-leaning in my political views, and I am university-educated in a socio-cultural health sciences stream.

Why is it important for research to have a focused task force on equity, diversity and inclusion (EDI)?

Ginocchio: Equitable lenses and approaches can be powerful routes to identify and reduce inequities in healthcare experiences and outcomes. Our scientists aim to incorporate these responsibly, and a task force like ours empowers our network to identify opportunities to integrate emerging best practices, and directly apply the knowledge and research findings we produce locally.

Dr. Pritlove: Researchers are producers of scientific knowledge and we know that knowledge generated affects health outcomes and experiences. We are aware of the very real dangers when the power and privilege afforded to this position are predominated by a demographically homogeneous group.

It is important to have a task force committed to addressing EDI in research because if we fail to create more diverse, equitable, and inclusive spaces in the fields of medicine and health science, then the biology, lived experiences, needs, and preferences of many members of our society will continue to be inadequately and inappropriately represented in the science that ultimately informs healthcare and its delivery.

Ginocchio: One of the things I like about REDI is we’re always seeking views and experiences from racially, sexually, and gender-diverse staff, physicians, and learners to help us ensure that our academic environment is a place that everyone can participate and feel safe in, to learn and grow together.

What drove each of you to choose to participate in the task force?

Dr. Pritlove: My research is focused on critically interrogating issues of EDI in healthcare contexts, from both patient and staff perspectives. Through this work I’ve accrued knowledge about the complex contributors to the inequities we’re seeing in research and medicine. It can be disheartening to sit with this information and not have an accessible path through which to affect change. I was driven to join REDI because I saw it as a potential pathway through which to translate knowledge to action.

Ginocchio: I’ve been involved with health equity and activism for much of my life, and my scholarly work focuses on public health for communities that struggle with mental health and addictions. I thought REDI could be a great route to support these groups. It had not occurred to me that I would work alongside colleagues with globally renowned expertise, informed by our own lived experiences, to create thoughtful solutions to longstanding inequities together. This is a space where we can hear each other, and discuss what community members are experiencing in an authentic, and honest way.

We’re doing equity, rather than just talking about it. It’s cool to see new international best practices being applied here – we’re effecting meaningful changes in our approach to health research and by extension, the healthcare system, starting at Unity Health. Examples of this are the new three-tiered Patient and Community Engagement in Research Guide developed at Unity Health, and the innovative work the Knowledge Translation Program creates, such as advancing gender equity in medicine.

What would you like to achieve through REDI?

Ginocchio: Employment equity is a topic that we are presently discussing. We are exploring approaches to integrate these ideas here at Unity Health. We have been examining these topics, and are navigating how we might apply our own findings on economic justice in the research institute. In this case, advocating for employment equity, and establishing a living wage across Research.

Dr. Pritlove: Big picture, I hope our work leads to greater representation in the research institute across all levels. I would love to see improved opportunity and equity in both position and pay for our people. I hope our work helps foster an environment where people feel safe, respected and valued. And, I hope we can contribute to the development of a suite of resources to better support individuals in adopting EDI principles in their research.

In order for these big picture changes to happen, we need to first disrupt and dismantle the very strong, political and historically charged foundations that contribute to the production and maintenance of the inequities that we see in medicine. In the immediate, I hope we can chip away at, unsettle, and start to rebuild this foundation in ways that will permit for a sustainable commitment to EDI within the institution.

What are some of the projects that REDI has taken on?

Ginocchio: The bulk of our work has been identifying barriers to health equity in Research, and developing collaborations across Unity Health to align our current internal practices with newly emerging global research standards. Like Cheryl said, the labour that we have put in is about chipping away at the foundations – it’s about scrutinizing things that haven’t been questioned before, and asking uncomfortable, unpopular questions and being bold in that exploration. In the setting of a pandemic, it’s been pretty remarkable how much we’ve accomplished in such a short time.

Dr. Pritlove: We’ve been consulting with different groups within the organization, like the Office of Research Administration, Human Resources, the MAP Centre for Urban Health Solutions and the Anti-Racism, Equity and Social Accountability Office to discuss issues like job description, compensation rates, community engagement, and our hiring practices.

We have provided feedback to the Grants and Awards Office for creating materials that will support researchers in thinking about and integrating EDI into their grant applications and research studies. We are also in the process of creating a Distinguished Lecture Series which will help with education and knowledge raising.

What do you hope the impact of the projects REDI takes on will be?

Ginocchio: We should begin to ask ourselves the perspective and the identity that we are approaching research questions from, and how historical lenses and routine practices can perpetuate injustices. Doing so will mean that we can begin to decolonize healthcare research, and act upon the calls to action put forth by the Truth and Reconciliation Commission of Canada.

I hope we succeed in creating a space where everybody – regardless of who they are, where they come from, or what their identity is – feels that this is a welcome space that they can learn, grow, and conduct scientific activities in.

Dr. Pritlove: My hope is that the work that we are doing will promote better education and awareness. Inequities and -isms are often invisible, and that’s by design. The work we are doing will be critical to drawing these inequities out of the shadows. With education will come greater dialogue, and potentially discomfort. I hope we as an institution lean into, rather than shy away from, this discomfort, as it is an essential building block of change, and in my view, a sign of progress.

What have you learned during your tenure with REDI so far?

Ginocchio: Decolonizing how I approach and see the world is a continual process that doesn’t happen overnight. You need to deliberately seek out knowledge about health equity, and not put the emotional labour on people from diverse communities to do the work for you. It’s about taking responsibility for your own education, and doing the hard work for yourself through reflection.

Part of that looks like speaking out when you hear that racist comment your colleague expresses, or recognizing when something you have said is oppressive to say and causes preventable harm. The good thing about equitable tools is that they allow you to scrutinize your behaviour so that you can be mindful of how to support and empower the communities you seek to support. In the context of research, this is essential because it puts the integrity of the work at risk if you’re if you’re unwilling to empathize with populations under study in ways beyond the superficial.

Dr. Pritlove: Meaningful and sustained change doesn’t, can’t and probably shouldn’t happen overnight. It takes time, patience and resolve. While it is challenging to remain patient when change is long overdue, I’ve learned that meaningful change requires a great degree of critical thought and diverse wisdoms. It involves the dedication of many people and ongoing collaboration across diverse departments, committees and communities. It is the undoing of a deep-seated history that continues to affect people differently; it is complex and it takes time.

This interview has been condensed and edited.

Ana Gajic, senior communications advisor at Unity Health Toronto