Racial discrimination in healthcare services among Black individuals in Canada as a major threat for public health: its association with COVID-19 vaccine mistrust and uptake, conspiracy beliefs, depression, anxiety, stress, and community resilience.

Objectives: To examine the prevalence of major racial discrimination (MRD) in healthcare services and its association with COVID-19 vaccine mistrust and uptake, conspiracy theories, COVID-19-related stressors, community resilience, anxiety, depression, and stress symptoms. Study design: The study used a population-based cross-sectional design. Methods: Data from the BlackVax dataset on COVID-19 vaccination in Black individuals in Canada was analyzed (n ¼ 2002, 51.66% women). Logistic regression analyses were performed to examine the association between MRD and independent variables. Results: 32.55% of participants declared having experienced MRD in healthcare services. Participants with MRD were less vaccinated against COVID-19, presented higher scores of vaccine mistrust, conspiracy beliefs, COVID-19 related stressors, depression, anxiety, and stress, and had lower scores of community resilience. They were more likely to experience depression (AOR ¼ 2.13, P < 0.001), anxiety (AOR ¼ 2.00, P < 0.001), and stress symptoms (AOR ¼ 2.15, P < 0.001). Participants who experienced MRD were more likely to be unvaccinated (AOR ¼ 1.35, P ¼ 0.009). Conclusions: Racial discrimination experienced by Black individuals in health services is a major public health concern and threat to population health in Canada. Federal, provincial, and municipal public health agencies should adapt their programs, strategies, tools, and campaigns to address the mistrust created by racial discrimination.