Paradkar: Unlike Canadians, Americans at least know how Black people are faring with COVID-19 (very badly)

Agreed but not only a Black issue.

Need better health data on all visible minority groups (and Indigenous) given that poorer health outcomes generally go hand-in-hand with more vulnerable socioeconomic outcomes:

“Let me rant,” said Angela Robertson, “because you’ve sparked me.”

As executive director of the Parkdale Queen West Community Health Centre, Robertson has long been a front-line witness to the lives of the most marginalized in the city — the homeless, the undocumented, the working poor — all of whom are also disproportionately racialized.

We are discussing the horrendous data streaming from the U.S. on the rates at which COVID-19 is infecting and killing Black people. In Chicago, African-Americans account for 70 per cent of the 86 recorded deaths, but make up 29 per cent of the city’s population. Louisiana saw the same 70 per cent of deaths among African-Americans who constitute just 32 per cent of the population.

What about Black people in Canada, I ask her. Are they better off here compared to the U.S because of universal health care and because — here I wave the red flag — Canada is not as bad as the U.S.?

“As much as we have critiques of the health-care system in America, they have done data collection, they can disaggregate by race within health care,” she said.

“We in Canada have been glacial in our movement in the collection of race-based data in our health-care system. As a result we will not be able to identify the disproportional access challenges, deaths, illnesses that Black communities will experience as a result of COVID-19.

“My fear is that the real health impact on Black community will be hidden.”

COVID-19’s impact on Black people is highlighting the similarities and differences between the U.S. and Canada. They collect data. We don’t. We have universal health care. They don’t. But underlying structures in both nations are deeply racist, which means Black people on both sides of the border live in circumstances that leave them more vulnerable to illnesses at the best of times — and now make them susceptible to the ravages of the pandemic.

These structures are unleashing what the American author and anti-racism scholar Ibram X. Kendi called “a racial pandemic with the viral pandemic.”

Last Friday, Black health leaders in Toronto released a statement that identified the underlying risk factors that COVID-19 would amplify. “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,” they said.

Who are the people who still need to use public transport to get to work? Who hold precarious jobs? Who don’t have the luxury to shelter at home and buy healthy provisions for a week or two? Who need rent relief? Who are most at risk from higher policing on the streets? Who are at risk in the prison system?

While race-based data exists around these social factors, hospitals and clinics don’t collect detailed demographic data including race as a matter of routine. Advocates have long railed against this lack of data, calling it harmful to Black women after research found they may be underscreened for breast and cervical cancer.

Andrew Pinto is a doctor at St. Michael’s Hospital. He is also the director of the hospital’s Upstream Lab — a research group that looks at interventions or remedies to the socio-economic factors that affect health.

The St. Michael’s Hospital Family Health Team, and other groups in Toronto including Toronto Public Health, was part of a pilot program to ask patients questions on income, race, gender, housing, religion, etc., and then use this data to identify health inequities, Pinto said. Researchers found doing such a survey was “feasible and acceptable.”

“Social factors are definitely associated with health outcomes,” he said. Many studies show income and race play a big role. “We lack the data that we need in Canada to really be able to pinpoint inequity by race. That’s what our work is trying to move toward.”

Why do we need the data if we know discrimination already exists? “Data helps with accountability. It’s not just to document inequity. We need to anticipate the inequity and think about how do we hold our systems to account.”

On the plus side of the ledger against the U.S, Canada has universal health care. Even then there are gaps.

While Ontario advocates who campaigned under OHIP For All managed to open health care for people regardless of their immigration status, “what we are concerned about while policy has changed, practices on the ground have not changed,” Robertson said.

Even during the pandemic, Robertson heard reports of people turning up in emergency departments and being asked to pay $500 for treatment.

What about the people who don’t turn to agencies for support? “For folks who because of fear walk away, they walk away ill,” she said.

Pinto points out that the “danger of data collection is it can convey that something is being done. Data alone is not sufficient. There has to be commitment that it should come with change.”

In a crisis like this, governments at all levels have to look at their response policies through the eyes of the most vulnerable and account for bias. This is particularly important for Black people who are among the most discriminated people here.

If this is not done, as the Black leaders’ statement said, “Black people will be exposed to greater harm.”

About Andrew
Andrew blogs and tweets public policy issues, particularly the relationship between the political and bureaucratic levels, citizenship and multiculturalism. His latest book, Policy Arrogance or Innocent Bias, recounts his experience as a senior public servant in this area.

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