Low-income neighbourhoods at higher risk of coronavirus

Over the course of the coronavirus pandemic, we’ve heard health leaders repeatedly say there are two specific groups at higher risk of COVID-19: seniors and those with underlying medical conditions.

During Monday’s update of modelling projections, a provincial health leader said another group also has an elevated risk of contracting COVID-19 — those in low income neighbourhoods.

“People living in low income neighbourhoods are at much higher risks, “ said Adalsteinn Brown, Dean of the Dalla Lana School of Public Health, University of Toronto.

“If you look into the evidence from the United States, there is a variety of factors about who people are that actually is very strongly associated with the likelihood of getting infection.”

Brown points to the evidence down south that shows African Americans and Latinx communities are disproportionately impacted by the virus, representing higher numbers of cases and deaths.

Brown said there are a number of ways to consider collecting data on how the disease is spreading: population and geography.

“There are two important ways though to think about communities, one is by geography — which is really critical in how you understand how disease spreads because it is spread by person to person,”  he said. “The other way you want to look at it though, is in terms of different groups of population. If we look at people living in low income neighbourhoods in Ontario, they are now at a higher risk of infection and cases.”

Health experts here in Ontario, have asked the government to collect race-based data to get a better understanding of how the virus is impacting all communities, especially those that face higher rates of poverty and systemic barriers.

The letter, posted on the Alliance for Healthier Communities, noted that these factors were contributors to poor health outcomes and specific measures are needed, especially during the pandemic, to respond to this growing problem.

“Ontario is home to the largest proportion of black people in Canada. Here too, as in the rest of Canada, race is a determinant of health,” read the letter. “We will not contain COVID-19 without bringing critical analysis and differential population health actions to our pandemic response.”

CityNews reporter Cynthia Mulligan asked the Premier about why the province doesn’t collect race-based data.

“First of all, I don’t believe per se in race-based data, but I do believe in postal code data,” Doug Ford responded. “Some communities are lighting up like a Christmas tree, and what that allows us to do is reallocate the resources, reallocate people to make sure that they’re informed and get the information that is needed.”

Premier Ford added that the province is monitoring the situation based on postal code, saying it is necessary to measure the data. In response, Black community health leaders are questioning how this approach would inform which communities require more COVID-19 testing.

In addition, they say many of these communities also face a diverse range of issues, including precarious housing, food insecurity and unemployment. Therefore, postal code data wouldn’t highlight these factors that determine the accuracy in numbers and the need for resources.

The NDP also criticized the Premier’s response to groups calling on the collection of race-based data, saying it is vital for “understanding COVID-19 and protecting Black, Indigenous and racialized people — and if Ford doesn’t believe in it, experts do.”

A number of centralized health networks in Ontario, that includes the Black-Creek Community Health Center in Toronto’s east-end, have already been collecting race-based data.

“We know scientifically that the virus will not discriminate according to race, gender, economic status but we do know that there are certain populations that are at more at risk because we have statistics,” says Cheryl Prescod, Executive Director of the health center. “We know that there are inequities around access to healthcare, particularly for racialized populations.”

That data has highlighted factors that put racialized communities at higher risk of certain illnesses, according to Prescod and a number of other health experts.

Black populations, in particular, are having the worst healthcare experiences; lacking access to healthcare, and facing higher rates of illnesses such as HIV, diabetes and stress related illnesses like heart disease and hyper-tension.

This then leaves the population at higher risk of contracting and dying from COVID-19.

“A pandemic only exacerbates what already exists in a society and within a system,” says Notisha Massaquoi, Health Equity Consultant with Nyanda Consulting. “When that system is being taxed, what we end up seeing is that the most marginalized will fall to the bottom. They will fall even further than they already are within that system.”

In the U.S., some states have reported extremely high rates of COVID-19 cases and fatalities in racialized communities. In New York, Hispanics and Blacks together make up 62 per cent of coronavirus related deaths in the state.

Helene Gayle, the President of the Chicago Community Trust,  says although African Americans make up about one third of the city’s population, they represent 70 per cent of COVID deaths and half of the overall cases.

Gayle, who is also a physician, says the data shows the burden the virus is having on communities of colour who are already disproportionately affected by the poor health, social and economical situations. The data also highlights an issue in the Latinx community.

“Because of a lot of issues, particularly the issue of people who are undocumented [who] may not be seeking healthcare, may not be willing to self-disclose what their ethnic identity is, there may in fact be a hidden epidemic that’s going on in the Latinx community.”

Gayle says the data collected in Chicago is advising city officials on how to create policies with these communities in mind, who are also involved in the response process.

“It also gives people the opportunity to speak on their own behalves,” she explains. “Getting the data to those communities so that they have the power within their hands to advocate for the things that make the biggest difference in their lives, is critically important as well.”