Community organizing for Black health equity in Canada: a multiple-case study analysis

Context: Community organizing often plays a key aspect in voicing health inequities, improving health care access, implementing health promotion campaigns, or responding to public health crises. There is a paucity of research on community organizing for Black health in Canada.

Objective: To examine how Black communities in Canada have historically organized to address systemic racism, advance health equity and/or respond to a public health crisis. To use multiple case study design to identify factors that contributed to success and long-term sustainability of community organizing for Black health.

Study Design and Analysis: We searched the academic and grey literature from 1900 to present and included cases of community organizing and partnerships that were based in Canada, led by the Black community, and were an organized effort to improve health. From our pool of cases, we used purposive sampling and engaged community members to analyze three successful Black community organizing efforts for health: Women’s Health in Women’s Hands (local), the Health Association of African Canadians (provincial), and the Black Health Alliance (national).

Setting and Population: Black communities in Canada.

Conceptual Model: This study draws heavily from conceptual frameworks of Afrocentricity, Communitybased Participatory Research and Community Coalition Action Theory.

Results: Our literature search identified eight cases of Black community organizing. Cases varied in terms of chronology, contextual and process factors, experience delivering primary care and sustainability. The multiple case study analysis shed light on several key similarities in how Black community organizing operationalised and used the frameworks to advance Black health equity.

Conclusions: Community-oriented primary care can promote Black health equity by engaging Black community organizers and health care providers, advancing academic-community partnerships, and advocating for policy changes to address structural racism. Black community members draw on Afrocentric values of collective input, resistance, and strength to combat injustice and address health disparities. Using partnership principles and practices, these initiatives honor Black community knowledge and leadership, intersectionality, capacity-building, health literacy, and community transformation while seeking shared power to advance health equity.