Race-based data vital in fight against COVID-19

BY PAUL JUNOR

In Ontario, there have been 249 deaths in long-term care homes as of Friday, April 19^th, 2020 according to the epidemiological summary by Public Health Ontario (PHO). The fact that it is the sector of the population that are most vulnerable: poor, elderly, homeless and marginalized has raised alarms.

As we look at the United States and see the disproportionately high per cent of blacks and Latinos infected and affected, many health experts have raised concerns about the racial distribution in Ontario. The collection of race-based data would be helpful in guiding public health policy.

On April 16^th, 2020, Andrea Horwath (Leader of the Official Opposition NDP) served notice to the Ford government. “Black, Indigenous, and racialized Ontarians were already suffering from poorer health outcomes and barriers to access before the province was thrust into a pandemic. Now we’re seeing troubling signs in other places that these inequities – and the worst health outcomes that come with them – are unchecked with the spread of COVID-19.” She believes that the collection of disaggregated race-based data would lead to a positive health impact for black and racialized Ontarians during this global pandemic crisis.

The World Health Organization (WHO, 1998) defines health as “A positive concept emphasizing social and personal resources physical capacities. It is a multidimensional concept with physical, psychological, sociocultural, development and spiritual elements.” According to the Canadian Public Health Association (www.cpha.ca), social determinants of health (SDH) are social and economic factors that influence people’s health. They are apparent in the living and working conditions that people experience every day. They include:

• Income and income distribution
• Education
• Unemployment and job security
• Employing and working conditions
• Early childhood development
• Food insecurity
• Housing
• Social exclusion
• Social safety network
• Health services
• Aboriginal status
• Gender
• Race
• Disability

This current crisis has exacerbated the health status of many black, Indigenous, people of colour and racialized communities given the fact that many work in the service sectors with poor living and working conditions, often lacking benefits, precarious employment and lacking a living wage.

The press release from Andrea Horwath highlights data that shows the underrepresentation of African-Canadians in medical research, and the prevalence of racial bias and anti-black racism in the kind of medical care that they received. In addition, there is a high percentage of blacks in Ontario who have chronic conditions such as diabetes, heart disease, sickle cell anaemia, and hypertension. These pre-existing conditions would make them more susceptible to COVID-19. Unfortunately, there is no way of knowing the racial compositions from the current cases.

Public Health Ontario is a Crown corporation dedicated to protecting and promoting the health of all Ontarians and reducing inequities in health. It links public health practitioners, front -line workers and researchers to the best scientific intelligence and knowledge from around the world. As of Monday, April 20^th, 2020, there has been 11,082 confirmed cases of COVID-19 in total, including: 584 deaths and 5,515 recoveries according to the Ontario Ministry of Health (MOH) and the integrated Public Health Information System (iPHIS).

• 4,728(42.3%) were males
• 6,354(56.8%) were females
• Out of the 584 deaths, 66.3% were over 80, 28.3% between 60-79, 0.9% 40- 59,1% between 20-39, 0% less than 19
• 249 of these deaths were reported among long-term care homes.
• Most of the infections result from community transmission (41.7%), exposure (11.2%), travel (17.5%) and 29.6% from close contact of a confirmed case

It is indispensable that the Ontario government include race and socio-demographic data in order to find out where there may be health disparities and inequities in the Ontario medical system. This would go a long way to addressing systematic barriers in health care. According to Andrea Horwath, “It’s time for the province to start collecting data on how black and racialized Ontarians are experiencing COVID-19. Without a complete picture of how we’re doing, we can’t make decisions that ensure the best possible health outcomes for everyone so we can get through this pandemic together.”