Beyond the reckoning: Addressing structural anti-Black racism in population and public health

The absence of historical context in public health has contributed to the persistent neglect of structural racism as a major determinant of health inequities. This commentary critically highlights the omissions of the Lalonde Report, a foundational document in population health, and explores the enduring impacts of slavery, colonialism, and systemic racism on Black health in Canada. Anti-Black racism continues to shape racial health inequities through economic, political, and social marginalization. However, public health research, policy, and practice have largely failed to address the structural dimensions of racism. Yet, Black communities in Canada have long resisted these injustices through grassroots movements, community advocacy, and systems transformation. A decolonial, anti-racist approach is necessary to disrupt these patterns, shift power and resources, and promote health equity. This requires interdisciplinary education, policy change, and investments in social systems that promote equity for Black communities. Centring community-led solutions, institutional accountability, and leveraging legislative tools are critical steps toward meaningful change. Public health must actively engage in dismantling white supremacy to achieve equitable health outcomes for Black communities.