Defining the Black population in Canadian health research: a scoping review

Inconsistent definitions, labels, and classifications of the Black population in Canadian health research raises an important question: Who is considered Black? This inconsistency can unintentionally hinder the comparability and effectiveness of studies, potentially leading to misinformed healthcare policies, ineffective interventions, and perpetuated health disparities. The purpose of this scoping review was to explore how the Black population is defined and represented in Canadian health research.

A scoping review was conducted following the methodology of Arksey and O'Malley and the methodological advancements made by Levac and colleagues. Databases, including MEDLINE (Ovid), PsycINFO, EMBASE, PubMed, CINAHL, Scopus, ProQuest, OAISter and Google, were searched from their inception until November 2023. Two reviewers independently screened titles, abstracts and full texts for inclusion, with discrepancies resolved through third-party adjudication. Studies were included if they were conducted in Canada, reported race or ethnicity-specific outcomes, and focused on health. Data were extracted using a customized form developed in Covidence software. Study characteristics were summarized in SPSS 29, and NVIVO 14 was used for reflective thematic analysis to identify terminologies and definitions.

A total of 11,935 records were retrieved, and 517 were included. Health researchers in Canada used various terms to describe Black participants, with "Black" being the most frequent, alongside terms like "Caribbean" and "African." Historical terms such as "Negro" also appeared in older studies. About 53% of the studies lacked descriptions of the terms used. Only a limited number of studies explicitly defined the terms they used, connecting their definitions of the Black population to historical events like slavery or migration from Africa to Canada. However, definitions of similar terms appear to be different across studies.

The findings highlight a significant inconsistency and lack of standardization in the terminology and definitions of Black populations in health research. This inconsistency not only undermines research validity but also poses a substantial barrier to developing effective health policies and interventions tailored for Black communities. The results underscore the urgent need for standardized guidelines and community-informed and culturally responsive frameworks in health research to ensure inclusivity, precision, and equity in studying Black populations.