Dr. Chandrakant Shah’s 2023 memoir, To Change the World: My Work With Diversity, Equity & Inclusion in Canada, offers a unique and poignant account of his journey as a public health practitioner and faculty member at the Dalla Lana School of Public Health at the U of T. 

Spanning several decades, Shah’s career reflects his dual role as a primary care physician and an immigrant who used his expertise and lived experiences to address the challenges faced by Indigenous peoples across Canada. Through compelling narratives of his encounters with colleagues, leaders, and politicians, he portrays a daunting yet hopeful picture of his mission to improve the lives of those most often marginalized by the Canadian healthcare system. 

From humble beginnings to a pioneer in Canadian public health 

Shah opens the memoir by recounting his early life in rural India and his immigration to Canada, where his passion for public and Indigenous health as a clinical physician took root. He offers intimate details of his professional and personal journey in Canada, highlighting moments such as meeting his wife and committing to Indigenous health. Despite his long and influential career as a physician, educator, and activist, Shah emphasizes that his work is far from over.

Shah emphasizes the importance of understanding the social, political, and historical climate that shapes decisions impacting the health of minorities in Canada. He underscores that public health is a multi-faceted and intersectional approach to promoting the physical, mental, and social well-being of communities. Shah guides readers through various Indigenous concepts of health and community, thoughtfully contextualizing them within the history of colonialism and its enduring effects on Indigenous lives. 

Canada’s colonial legacy and continued systemic abuse of Indigenous peoples continue to compromise their physical, mental, and social health. Factors such as limited access to care, inadequate economic investment in health services, and internalized health stigmas contribute to these challenges, resulting in lower life expectancies for First Nations, Inuit, and Métis. Public health aims to counteract these inequities by investing in society — such as through vaccines and health education — to prolong life, optimize health, and ensure that everyone has the opportunity to thrive. 

A life of service beyond the doctor’s office: Shah’s activism

Shah’s contributions to Canadians’ and minorities’ quality of life extend beyond medicine, and encompass cultural and educational spaces as well. Drawing inspiration from his lifelong activism for Indigenous peoples, he emphasizes the arduous nature of advocacy work, as reflected in his multiple retirements and subsequent returns to service. 

Shah shares candid experience of time spent away from his family, working in remote areas in Northern Ontario, and navigating bureaucratic hurdles to improve health outcomes for Indigenous communities. Despite these challenges, he finds solace and motivation in his work, reminding advocates that helping others is both exhausting and exhilarating, and that balance is essential in sustaining the work of activism. 

Shah reflects on how his faith has shaped his role as a doctor, educator, activist, father, and husband. He emphasizes the importance of different communities coming together to share their beliefs and knowledge and fostering stronger social cohesion: something he argues is sorely lacking in modern society. Shah presents his approach of bridging differences through goals and values as a source of hope and a pathway for change within a prejudiced system that marginalizes people based on appearance. 

He also addresses difficult topics such as systemic racism with grace and detail, highlighting the severe health issues it causes. Systemic racism is race-based discrimination that exists in society through long-standing policies and white superiority. In a striking example, Shah recounts the story of a “sixty-five-year-old Indigenous woman with early symptoms of stroke, who was labelled ‘drunken’ in two emergency rooms in Toronto and discharged” without proper care. 

Recognizing the need for educational system reform, Shah also advocates for greater diversity in both teaching staff and curricula to ensure that future generations can build on his progress. He provided advice to the founders of the Public Health Agency of Canada, helped establish public health as a medical specialty for physicians, and wrote an influential, comprehensive, and widely used textbook that addresses the Canadian public health landscape. 

While Shah’s work may seem like a drop in the ocean of health disparities among minorities, his philosophies, lived experiences, and knowledge continue to ripple through the lives he has touched as an educator and activist.

A book for seasoned practitioners and novices alike

The book is invaluable for both seasoned health practitioners and novices interested in public health. Newcomers will find that Shah’s concise explanations provide an accessible and easy-to-understand overview of the healthcare system and its impact on Indigenous communities. Meanwhile, those already working in healthcare can draw on Shah’s gathered knowledge, skills, and experiences to navigate their interactions with colleagues, researchers, government officials, and patients within the dynamic social ecosystem of health. 

Shah’s accessible writing and his approach to complex topics, such as medical injustice and systemic oppression, make for an informative and compelling read. His work prompts readers to reflect on how history, policy, culture, and science intersect to shape something as personal as health, both physical and mental. 

However, unless one is already familiar with the healthcare system for Indigenous people, the many events and people Shah encounters provide only a glimpse into its complexity. In my opinion, I felt that Shah’s memoir reads like a continuous stream of successes. While these successes are certainly worth celebrating, the emphasis on them seems disproportionate and somewhat diminishes the role of obstacles and failures in shaping both our professional and personal lives. 

Ultimately, Shah’s memoir presents a portrait of a professional deeply committed to his work — whether in the clinic, at advocacy events, teaching, or working directly with the communities to improve the lives of the most underrepresented and underserved in our society. Change-makers can learn from his example that intent must be matched by action, and that working toward change is the cure for the heaviness caused by the issues plaguing our society.