Purpose of the Survey
The Chatham-Kent Ontario Health Team’s (CKOHT) Anti-Black Racism/Anti-Oppression Action Team is conducting this survey to learn about individuals’ experiences with accessing different health care services in Chatham-Kent. The purpose of this survey is to understand individuals’ experiences of anti-Black racism and racial discrimination in the health care system in Chatham-Kent. The CKOHT will use information learned from this survey to understand how the health care system can be more inclusive, welcoming, free of racism, discrimination, stigma, bias and stereotypes.

What Will We Do With Your Information
Only the CKOHT staff will have access to your anonymous survey data stored in Survey Monkey and will not publish any identifiers so that persons completing the survey will not be identifiable. We will share this anonymous summarized information in a report with recommendations amongst CKOHT’s partner organizations so that they can learn more about experiences of racism and discrimination in order to improve positive health care interactions and outcomes with racialized groups including Black individuals.

Instructions to Complete the Survey:
This survey should take approximately 10-15 minutes to complete. You do not need to indicate your name, you will remain anonymous. In order to complete this survey, you must have received health care in Chatham-Kent within the past 5 years. The due date to complete this survey is Friday September 6th at 11:59pm. You will be entered into a draw to possibly win a $100 Grocery Store Gift Card at the end of the survey. If you have any questions about this survey, please email info@ckoht.ca Thank you.

Before You Get Started:
This survey includes words which are important to define:

Racism – Harmful beliefs, actions, and attitudes directed at individuals due to their race.

Anti-Black racism - Harmful beliefs, actions, and attitudes directed at people who are Black or African descent.

Discrimination - Treating a person or particular group of people differently, especially in a worse way from the way in which you treat other people, because of their race, gender, sexuality, etc.

Stereotypes – An assumption about what someone will do or how they will behave based on what social groups they belong to, such as race.

Microaggressions - Subtle and prejudicial racist and discriminatory actions targeted at a marginalized group or individual. A microaggression can be intentional, premeditated or unintended (subconscious due to bias).

Culturally responsive care - Creates a culturally safe environment, and considers the impact of culture on things like: a person’s food choices, attention to time, etc. Cultural values and beliefs are also taken into account when providing health care to patients.

Representation - In the context of diversity, equity and inclusion (DEI), it is the degree to which an organization or institution is reflective of the many diverse people that make up society in its staff and leadership. It means seeing people of all backgrounds making meaningful contributions throughout every level and department within your healthcare system.

Disclaimer: This survey includes questions which ask you about your experience with racism and discrimination in health care settings in Chatham-Kent. These are sensitive in nature and may trigger negative emotions. At the end of the survey, you will be provided with supports and services available if you would like to access them.

Please tell us a bit about yourself:

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* 1. How old are you?

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* 2. What is your ethnicity or cultural origin?

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* 3. Do you identify as a person whose race is Black or of African descent?

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* 4. Are you a newcomer to Canada within the last 5 years?

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* 5. Are you a newcomer to Chatham-Kent within the last 5 years?

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* 6. Do you identify as 2SLGBTQIA+ (Two-Spirited, Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, Intersex, Asexual, Plus additional sexual orientations and gender identities)?

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* 7. What is your gender identity? (select all that apply)

The next set of questions will ask you about your experiences with healthcare services in Chatham-Kent.

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* 8. Have you received health care services in the last 5 years in Chatham-Kent? (doctor, bloodwork, x-rays, specialists, been to the hospital, mental health and addiction services, etc)

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* 9. Do you have a health professional that you see for regular check-ups and when you are sick or have a health concern? This could be a family doctor, a general practitioner, or a nurse practitioner.

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* 10. Do you have a health professional that you see for regular check-ups and when you are sick or have a health concern that represents your race, ethnicity and/or culture? This could be a family doctor, a general practitioner, or a nurse practitioner.

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* 11. How important is race/ethnicity/cultural representation in healthcare to you?

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* 12. When I access health care in Chatham-Kent I worry about anti-Black racism and/or racial discrimination:

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* 13. In the last 5 years have you experienced challenges or barriers to accessing health services in Chatham-Kent that may be attributed to anti-Black racism or racial discrimination?

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* 14. In the last 5 years has anti-Black racism or racial discrimination prevented you from accessing health services in Chatham-Kent?

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* 15. If yes, please indicate the type of health care setting in which you have experienced anti-Black racism and/or racial discrimination (Check all that apply):

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* 16. What types of anti-Black racism and/or racial discrimination have you experienced in the healthcare system in Chatham-Kent (please check all that apply):

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* 17. If you are comfortable sharing, please describe the nature of the events in which you experienced anti-Black racism or racial discrimination in a healthcare setting in Chatham-Kent (please leave out any personal health information or personal identifiers to remain anonymous):

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* 18. Would you describe healthcare settings in Chatham-Kent as inclusive and welcoming to all people?

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* 19. Are you aware of diversity, equity, and inclusion (DEI) practices, policies, or programs in any of the healthcare settings you currently access?

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* 20. If yes, please indicate which health care setting has diversity, equity, and inclusion (DEI) practices, policies, or programs (Check all that apply):

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* 21. Have you experienced examples of culturally responsive care where healthcare providers took into account your values and cultural beliefs when receiving care in Chatham-Kent:

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* 22. If Yes, please describe your experience with culturally responsive care you received:

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* 23. If No, please describe your experience where you wished you received culturally responsive care:

The next set of questions will ask your opinions on what you want health care providers or organizations to know about your experiences, and how we can make healthcare more inclusive, free of racism and discrimination in Chatham-Kent. Please provide examples and ideas where possible. Please leave out any personal health information or personal identifiers to remain anonymous.

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* 24. What do you want health care providers and/or organizations to know about when you are accessing health care services in Chatham-Kent?

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* 25. What do you think health care providers and/or organizations can do to make healthcare more inclusive, free of racism and discrimination in Chatham-Kent?

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* 26. Do you have any additional information you would like to share about your health care experiences you have received in Chatham-Kent?

That is the end of the questions as part of the survey. To find out more information about reporting racism and getting support:

  • Chatham-Kent Victim Services provides support to victims of hate. This form allows you to report acts of hate as well as identify if you wish to receive support. https://ckvictimservices.com/report-hate/
  • If you wish to file a police report, please contact the Chatham-Kent Police Service at 519-436-6600 ext. 0 or go to Police Headquarters at 24 Third Street in Chatham or a local Police Service Centre. If this is an emergency, please call 911.
  • If you require immediate support, please call the CMHA Chatham-Kent Mental Health Crisis Line: 1-866-299-7447.
Are you interested in participating in a 1 hour virtual focus group session to talk more about your experiences of racism and discrimination in the health care system in Chatham-Kent? If so, please click on the link to register for the focus group of your choice:


FOCUS GROUP #1 - Wednesday August 21 from 2 - 3pm - Open to Anyone

FOCUS GROUP #2 - Thursday August 22 from 12 - 1pm - Focused session for 2SLGBTQIA+ community members

FOCUS GROUP #3 - Tuesday August 27 from 11am - 12pm - Focused session for Older Adults

FOCUS GROUP #4 - Wednesday August 28 from 4 - 5pm - Focused session for Newcomers & Immigrants

FOCUS GROUP #5 - Thursday August 29 from 7 - 8pm - Focused session for Younger Adults

FOCUS GROUP # 6 - Saturday August 31 from 10am - 11am - Open to Anyone

FOCUS GROUP # 7 - Thursday September 5th from 12pm - 1pm - Open to Anyone
Thank you for taking the time to fill out the survey. If you would like to be entered into a draw for a grocery store gift card, please click HERE.

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