Assessing the Representation of People of African Descent on Nova Scotia’s Community Health Boards

Abstract

According to the Health Authorities Act (Section 62), Community Health Boards (CHBs) in Nova Scotia are intended to “contribute to health-system accountability by facilitating an exchange of information and feedback between the community and the provincial health authority.” The present situation, however, is one in which health boards may not represent the demographic diversity of the community. This challenge may be particularly prevalent within African Nova Scotian communities. This paper will quantify whether people of African descent who serve on CHBs match the demographics of the community and discuss whether any discrepancies may affect policy initiatives within Nova Scotia Health. To answer these questions, we conducted a demographic analysis of 31 CHBs. The representation of African Nova Scotian participants on CHBs (5%) exceeds their representation within the total provincial population (2.4%); however, by removing the Southeastern Board, the representation of African Nova Scotians mirrors their representation in Nova Scotia as a whole. African Nova Scotians are overrepresented, to some extent, on CHBs. This overrepresentation is a factor of small sample size and skewed distribution. Even in historically African Nova Scotian communities like the Southeastern Board (with 85% of residents identifying as African Nova Scotians), the board demographics do not match the demographics of the communities they serve. Given the unique challenges African Nova Scotians face within Nova Scotia’s health system, representation on all boards may be necessary. The challenges of robust engagement of marginalized communities could be addressed by dedicated recruitment efforts by Nova Scotia Health. Further, the lack of demographic information collected by either CHBs or by Nova Scotia Health presents an inability to address critical concerns within the African Nova Scotian community.