Equity seems to have become a contentious word. We’ve all heard the anti-DEI (diversity, equity and inclusion) sentiment from the United States and, while such antipathy played much less of a role in our own recent federal election, it is not entirely absent in Canada.
Anti-DEI sentiment alarms me. As someone who has worked in cancer care at a systems level and directly as an oncologist for more than 30 years, I want to be clear: equity must be a core and non-negotiable component of health and cancer care.
Without addressing inequity, we will never be able to solve the cancer problem in Canada.
It is unlikely that the disease hasn’t touched each of us in one form or another. Cancer is the leading cause of death in Canada, with two of every five people being diagnosed in their lifetime. The economic impact is staggering: the total cost of cancer in Canada last year alone was $37.7 billion, according to recent data from the Canadian Cancer Society.
But while cancer affects us all, it hits some groups even harder than others. Where you live, how much you earn, what language you speak, your age and what you look like can affect your ability to access cancer prevention, screening, treatment and post-treatment support.
Despite this grim picture, there is good news: Canada has a plan – the Canadian Strategy for Cancer Control – and addressing inequities experienced within the cancer care system is a key part of this plan. As the team responsible for Canada’s cancer strategy, the Canadian Partnership Against Cancer collaborates with partners – including provincial and territorial ministries of health, First Nations, Inuit and Métis partners, cancer agencies and other health and community leaders – as they design and implement innovations that make everything from cancer prevention through to survivorship more accessible for all.
These investments and supports are making a real difference.
We are, for instance, on track to eliminate cervical cancer in Canada by 2040. To reach this goal, however, we need to prioritize equity-based approaches such as building relationships with communities that have historically experienced barriers and hesitancy in accessing HPV vaccination, screening and follow-up.
Canadians with a lower income or who live in a rural or remote area have the greatest chance of developing and dying from lung cancer.
Lung cancer is another example: Canadians with a lower income or who live in a rural or remote area have the greatest chance of developing and dying from the disease. The Partnership is supporting the implementation of organized lung screening programs in all 10 provinces, which puts the country on track to be able to detect as many as 2,500 new cases of lung cancer at earlier, more treatable stages every year. Many of these cases are among people from equity-denied groups whose cancer may have previously gone undetected – and untreated – until it becomes too late.
Given that Indigenous Peoples experience higher cancer rates than other populations in Canada, First Nations, Inuit and Métis community members and leaders have designed distinct cancer strategies that are now being developed and implemented in all 13 provinces and territories. The pan-Canadian cancer data strategy that we launched with the Canadian Cancer Society in 2023 also emphasizes the need to uphold First Nations, Inuit and Métis data sovereignty, ensuring communities have access to and control of their data – data that can inform efforts to close health equity gaps that exist between Indigenous and non-Indigenous communities.
These achievements with partners across Canada have been made possible because health equity is positioned as a central and measurable component in all of them. Without this foundation, our work in cancer care, and health care as a whole, becomes that much more challenging and incomplete.
Canada is making good progress in tackling cancer, but there is much work still to accomplish.
The ongoing trade war and threats to our sovereignty ignited a sense of unity among people across Canada and became a key issue in our recent election. Even though equity as a concept can sometimes be misconstrued, the fact is we live it in practice as part of our daily lives. We look out for our neighbours, especially in times of need, no matter who they are or what they look like. It’s why our universal health-care system, while not perfect, is a point of pride.
We need to remember that we are stronger when we do together what cannot be done alone. The fight against cancer is no different.
Thanks Dr. Earle for your piece.
I agree, poverty and inequity of access to healthcare are drivers for societal ills, but I disagree with the implication that DEI critics oppose addressing poverty/inequity. While DEI advocates may have good moral intentions for addressing inequity in a race-conscious way, for several (some valid) reasons, the ideology has become perceived as toxic and created significant backlash, and a wider dialogue is needed on how as a society, we should move forward to advocate for vulnerable people.
Your article equates “anti-DEI sentiment” as alarming and unacceptable, which inadvertently reinforces one central issue of mainstream DEI: the shut down of dialogue and valid criticisms, creating an “us vs them” dynamic. I think your article would have been more effective if you spoke directly to how we should address gaps in cancer care rather than stepping into the quagmire of DEI ideology.
“Anti-DEI” sentiment about mainstream DEI comes from (1) earnest criticism behind how DEI addresses inequity (ie. equity of outcome as opposed to opportunity; mainstream DEI’s incompatibility universal liberalism), (2) zealous rejection/shut-down of criticism (3) centres race and identity politics (concerns of soft bigotry and resentment from ?perceived exclusion) (4) attempting to shift blame onto groups based on immutable characteristics (ie. race, gender, sexual orientation).