New FHS associate professor brings expertise quantifying impacts of discrimination on health equity

by Sharon Mah 

New Faculty of Health Sciences (FHS) associate professor João Luiz Bastos has been shifting perspectives in public health – and public life – from almost the beginning of his academic career.

He was a PhD student when he proposed the Brazilian Explicit Discrimination Scale (EDS) for use in large-scale epidemiologic surveys. Developed using psychometric principles and models, the EDS allows investigators to estimate the health impacts of racial discrimination in a detailed, quantifiable way. More importantly, the EDS can also quantify the individual and intersecting health impacts of other factors, such as class, gender, and sexual orientation, providing researchers with the ability to measure the complex health experiences of survey participants.

Bastos created the EDS to address the lack of a standardized instrument to measure perceived discrimination in epidemiologic studies. “Up until the beginning of the 2000s, the health effects of discrimination were almost entirely neglected as a topic of interest within Latin American research on health inequities,” recounts Bastos. “Increasing the visibility of the health effects of discrimination in Brazil was the main objective of my [PhD] project. I developed the [EDS] in order to strengthen anti-discrimination initiatives within public health and related subfields of knowledge.”

In truth though, Bastos had been interested in making discrimination and the resulting health inequities visible in the Brazilian context long before his PhD research began. His interest in the topic began early, and is rooted in personal experiences of watching young Black family members, friends, and acquaintances being frequently targeted for discrimination, and/or mistreatment. While he and his family challenged perpetrators and supported their young relatives’ rights, those experiences awoke an interest in Bastos to better understand the impact of social inequities not only in his community, but in communities across the globe.

Bastos – who joined FHS during the Spring 2023 term – fully committed to an academic career in social epidemiology after two pivotal events occurred during his undergraduate studies in dentistry. Early in his university experience, he was introduced to professor Marcelo Tragtenberg, who initiated a series of public debates calling for affirmative action policies at Universidade Federal de Santa Catarina (UFSC), Bastos’ alma mater. They began a collaboration which resulted in a scientific paper recommending approaches to increasing the rate of Black students in university. A year after the paper was published, it was used to support policy changes to facilitate university entrance for Black students and other equity deserving groups at UFSC.

The second event that served as Bastos’ personal tipping point into social epidemiology occurred when he was invited to take part in a research project monitoring dental caries rates in children attending public school in a low-income neighbourhood in southern Brazil. “This experience played a pivotal role in my decision to pursue an academic career in the field of epidemiology, more specifically social epidemiology,” says Bastos. To this day, social epidemiology has remained a core area of research interest for Bastos, along with the interplay of racism, intersectionality, and health inequities.

Since then, Bastos’ research activities have evolved along three distinct but interrelated lines of inquiry. His projects explore topics involving: the health effects of racism and racial discrimination; racial classification and racial health inequities; and, the effects of racism on access to and provision of quality healthcare. “My work on racial classification examines why and how the various methods of racial ascription (e.g., self-identification and classification by third parties) are used to pinpoint health inequities, assess the size of racial gaps in health, and implement actions to address the problem,” explains Bastos. “Similarly, my investigations into racism and access to quality healthcare looks at how the training of healthcare professionals and the structuring of health systems using an equity lens are crucial for counteracting the health effects of racism and related oppressions.”

As Bastos settles into his new role at FHS, he will continue to lead several research projects started in Brazil, but also looks forward to collaborating with investigators and healthcare providers here in Canada. At FHS, Bastos is currently working on a research proposal to assess experiences with intersecting forms of discrimination across groups in Canada experiencing multiple oppressions. His main goal is to advance Canadian research on the health impacts of discrimination by increasing visibility of experiences with unfair treatment, as they are perceived by people lying at the intersections of race, gender, class, sexual orientation, and other social statuses and identities.