February is Black History Month. While we should celebrate Black history and excellence every day, this is an opportunity for a focused, intentional and elevated reflection and recognition of Black history and achievement – and the many historical and contemporary contributions of Black Canadians, Black British Columbians and Black students, faculty and staff at UBC. To mark this occasion, we reached out to the SPPH community to learn what Black History Month means to them.
The following reflection was provided by Hayley Lawrence, PhD student at UBC’s School of Population and Public Health.
My journey into population and public health began with the COVID-19 pandemic. One of the defining challenges of the pandemic was the urgent and often daunting decisions physicians were required to make, including the use of do-not-attempt-cardiopulmonary-resuscitation (DNACPR) orders, at times in ways perceived as discriminatory. These practices sparked intense public debate and led to a special review by the Care Quality Commission; however, the resulting report did not explicitly address the role of resource scarcity. In contrast, physicians consistently identified limited resources as the most influential factor shaping end-of-life decision-making. To navigate these constraints, clinicians often adopted a utilitarian approach, seeking to maximize benefit for the greatest number by allocating scarce resources to those most likely to derive therapeutic benefit. This approach exposed widespread discomfort with the outcome and a lack of clearly articulated alternatives. This unresolved tension underscores a critical gap in evidence-informed strategies for managing scarcity in health care and motivated my move to Canada to work with Dr. Craig Mitton, a leading expert in health-care priority setting.
Black History Month educates the public about the history of slavery and racism, highlights the ongoing struggle for equity and justice, and celebrates Black brilliance. Equity and justice are central to my public health practice and are foundational to my research. My thesis, The Impact of Canada’s “Pharmacare” Policies on Equity-Denied Communities, reflects this commitment by examining how health policy can perpetuate or mitigate structural inequities. In the context of population and public health, Black History Month represents not only recognition but a call to sustained action to address structural determinants of health, confront anti-Black racism within health systems, and translate evidence into equitable policy and practice.
Being part of the SPPH community has helped me imagine a future in which transformative health policy is more than well-intentioned design; it demands deliberate attention to how policies are implemented, evaluated, and held accountable in practice. Using implementation science and robust evaluation ensures that policies do not simply look effective on paper, but meaningfully reshape systems and improve lived experiences. Equally important is prioritizing data governance and ethical approaches that centre affected communities, rather than privileging institutional convenience or efficiency. Embedding accountability mechanisms, such as equity-focused metrics and continuous feedback loops, into policy design creates opportunities to monitor unintended consequences, correct course, and ensure that commitments to equity translate into sustained change.
If I could offer advice to future Black students in public health, it would be to intentionally find or build community. Seek mentors, peers, and networks, both within and beyond UBC, who affirm your goals, values, and lived experience. Collective support is often what sustains those working at the intersection of racism, health, and systems change, particularly in spaces where that work can feel isolating.
Originally posted on SPPH website.
