Black Canadians face significant systemic barriers to donating critical blood

Black people in Canada who want to donate blood face barriers to doing so, despite a critical need for specific blood types to treat sickle cell disease, according to new research published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.250123.

"Barriers were predominantly rooted in the restrictive and racist policies adopted by blood donation systems in Canada, in the individual, institutional, and structural experiences of racism in health care systems, and in the distrust that historical race relations have established in Canada," writes Dr. Jude Mary Cénat, a professor of psychology at the University of Ottawa and the University of Ottawa Research Chair on Black Health, with coauthors.

Sickle cell disease affects mostly people of African, Middle Eastern, and South Asian backgrounds and is often treated with red blood cell transfusions matched specifically. However, too few Black donors and donors from many other ethnic groups means needs cannot be met.

To understand the barriers to blood donation facing Black people in Canada, researchers from the Interdisciplinary Centre for Black Health at the University of Ottawa in Ottawa, Ontario, conducted a qualitative study with 42 Black adults. Most participants were highly educated, with a bachelor's degree or higher, and 57% identified as women.

Key barriers:

• Restrictive blood donation policies - Canada's policies differ from those of other G7 countries, where people who have been denied from donating blood in Canada have been able to donate. For example, previous malaria infections are a major barrier to donating blood in Canada, but many other countries, including the United States and France, have removed these restrictive policies that prevent Black people from donating blood.
• Institutional and systemic racism in health systems - Negative experiences with health care institutions created mistrust in blood donation systems and skepticism as to whether Black donors would be respected and treated fairly.
• Historic anti-Black racism - This has contributed to Black people feeling devalued and fearing rejection or harm during blood donation.
• Lack of confidence in blood donation systems - Lack of confidence is based on negative historical and personal experiences with health systems.

"Our study offers clear and novel insights into contemporary barriers to blood donation among Black people across Canada. The findings should be useful for the 2 organizations managing blood donation in Canada (Canadian Blood Services [CBS] and Héma-Québec) to remove these barriers, which expose would-be donors to anti-Black racism and harm Black patients in Canada, and to implement real communication and engagement campaigns to increase awareness among Black people, while respecting their cultural values and taking into account their history of oppression and their distrust of health care and blood donation systems in Canada," write the authors.

Héma-Québec manages blood donations in Quebec, and CBS is responsible in the country's other provinces and territories.