Toronto public health to start collecting COVID-19 data on race in a bid to track health inequities

Other cities and provinces to take note:

Toronto’s public health unit will expand its data collecting capabilities so that it can better assess the pandemic’s impact by race and income, the Star has learned.

The aim is to assess whether there are disparities in how COVID-19 is impacting some communities — an initiative the city is shouldering because “provincial officials suggest this is not a priority concern for them,” according to a letter from Toronto Board of Health chair Joe Cressy to board members, expected to be made public Wednesday.

“We know that the biggest indicator of one’s health status is their postal code — not because of where we live, but because of what it can say about who we are,” the letter says.

“This makes it clear just how important it is that we have access to comprehensive data.”

Ontario has drawn criticism from health advocacy groups for not collecting statistics on race and ethnicity after the province’s chief medical officer, David Williams, said earlier this month this kind of data collection isn’t currently necessary.

A 2016 government report on health inequities — authored by Williams — highlights the role factors like race and income play in determining health, and notes the importance of “data to understand health inequities and inform community development efforts.”

“To create healthy communities, it’s time for the public health sector in Ontario to champion health equity: to bring a wide range of partners together to develop policies and programs that reduce or eliminate social, economic and environmental barriers to good health,” the 2016 report said.

Early evidence from the United States shows Black and Hispanic communities have been disproportionately impacted by the COVID-19 pandemic. Preliminary data released by New York City last weekshows the virus is killing Blacks and Latinos at twice the rate of white people.

In a statement to the Star, a spokesperson for Ontario’s Ministry of Health said existing legislation does not “require or authorize health information custodians to collect race-based data.”

“Health was excluded from the Anti-Racism Act due to Personal Health Information Protection Act considerations,” the statement said.

“The ministry wants to understand issues of inequity, in terms of how the coronavirus pandemic and pandemic response may affect subgroups of the population differentially and is researching using data from other sources to better understand equity issues.”

In an interview with the Star, Cressy called the province’s response to the issue “flabbergasting.”

“This shouldn’t be groundbreaking. Nor should it even be necessary,” he said of the measures now being taken by the City of Toronto.

“It’s absolutely essential, as it has always been, that we have comprehensive data to fully understand and in turn respond to COVID-19. In the absence of appropriate disaggregate race-based data, we cannot properly respond.”

As a result, Cressy said, Toronto Public Health is now exploring ways to expand data fields in its current system — known as the Coronavirus Rapid Entry System — to include race and sociodemographic data.

Cressy said an early analysis cross-referencing the geographic location of early positive COVID-19 diagnoses with census data didn’t find concerning trends — but noted that initial cases often involved individuals returning from international travel who tend to have higher incomes.

“There are two stories to this pandemic. The first was early travel-related cases. And the second is how COVID-19 preys on the most vulnerable,” he said.

Steini Brown, the dean of the Dalla Lana School of Public Health, said low-income Ontarians are “now at a higher risk of infection and cases.”

“If you look into the evidence from the U.S., there are a variety of factors about who people are that are very strongly associated with their likelihood of getting the infection,” he said.

Research has already shown that the workers deemed essential to maintaining the country’s vital supply chain during the pandemic are significantly more likely to be low-wage and racialized compared to the rest of the labour market.

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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