Health agency reveals race-based data guideline as calls grow for nation-wide collection

2020/05/28 Leave a comment

Yes!

Will take some time given the coordination required to ensure consistent data across provinces, with Quebec unlikely to play ball unfortunately (CIHI data does not automatically include Quebec data. When I asked the Ministère de la Santé et des Services sociaux for the comparable birth tourism (non-resident) birth statistics, I was met by bureaucratic obfuscation and had to go to major hospitals directly):

In response to calls for better demographic data to understand health inequities and COVID-19, this week the Canadian Institute for Health Information is releasing an interim race data standard that public health agencies can use.

Many advocates, though, are pushing for more than advice, saying the federal government has a leadership role to play to ensure there’s consistent data, regardless of jurisdiction. That gap in information affects the provincial, territorial, and federal response to the pandemic and until the country moves forward with race-based and disaggregated income data, Canada “can’t possibly target resources” and care where they’re most needed, said Dr. Jennifer Rayner, an epidemiologist and director of research at the Alliance for Healthier Communities.

“It’s ignorance and blindness to where there’s gross inequities. Until we know where the discrepancies and inequities in health are, we can never tackle them,” she said, saying communities need action and the work needs to start somewhere. “I hate to keep waiting until we get it all perfect.”

The alliance is part of a national working table headed by Canadian Institute for Health Information (CIHI)—which the institute notes are not formal—that’s considering two things: what data to collect, and how to train health professionals so they’re comfortable asking these questions. While this work has been going on for years, the report on the interim standard noted a “heightened awareness and interest” in collecting such data to better understand COVID-19’s spread.

The lack of data on race in Canada makes it difficult to monitor racial health inequalities and CIHI’s interim standard was created in an effort to “harmonize and facilitate collection of high-quality data,” according to a copy shared with The Hill Times of the standard, “Race-Based Data Collection and Health Reporting,” to be released later this week.

It proposed two questions asking patients to identify their race categories (also giving the option of “prefer not to answer”) and whether they identify as First Nations, Inuit, or Métis.

Though the Public Health Agency of Canada (PHAC) has said it is looking into the possibility of collecting more demographic data related to COVID, most said it’s a matter of political will, under the direction of Health Minister Patty Hajdu (Thunder Bay-Superior North, Ont.) and Indigenous Services Minister Marc Miller (Ville-Marie–Le Sud-Ouest–Île-des-Soeurs, Que.).

When asked, neither of the ministers’ offices, the PHAC, or CIHI offered a position on whether such data should be collected nation wide.

However, Ms. Hajdu’s spokesperson, Cole Davidson, said in an email that “[d]emographic data collection and data sharing between the federal and provincial/territorial governments is crucial to advancing our knowledge of COVID-19 and understanding potential inequalities in our health care system. We’re working with provinces and territories to ensure we’re collecting the data we need to better understand this pandemic.”

And while these conversations are happening, advocates say it’s not leading to the outcome that is becoming more urgent by the day—a commitment and timeframe for nationwide data collection.

“As a national strategy, if you don’t value gathering the data it’s hard to motivate other places to do so,” said Aimée-Angélique Bouka, the College of Family Physicians of Canada vice-chair-elect for residents. “You’ll see disparity across the board if you don’t see proper federal leadership in the project.”

‘It’s all about political will’

Canada has a blind spot regarding its treatment of racialized groups and immigrants, despite the evidence, she said.

COVID-19 was thought to be “the grand equalizer,” but some populations have proved more vulnerable. In the United States, by mid-April nearly one-third of those who died were African American, an Associated Press report revealed, though Black people represent about 14 per cent of the population where they reported. Such disparities exist in Canada, though Dr. Bouka said society is uncomfortable with painful questions that reveal a pattern of neglect.

“COVID is only a snapshot and a clear representation of what happens in our country in a systematic way.”

She said she would add a question about immigrant status, and how long a person has been in Canada as other important markers that influence health, said Dr. Bouka, who wrote about that blind spot for Policy Optionsthis month.

Because we don’t have this self awareness we are slow to accept it, but once the outbreaks became evident, demographics became impossible to ignore, she said.

For more than two decades, Independent Senator Wanda Thomas Bernard has been calling for race-based data collection.

“It’s so frustrating and infuriating,” said Sen. Bernard (East Preston, N.S.), a former social worker and researcher who co-authored a 2010 book, Race and Well-Being, which she said demonstrated racism is an everyday experience for Black Canadians and has an impact on all forms of their health.

“I can’t help but ask myself, ‘How many more casualties do we have to see before there’s a true appreciation for why the collection of this data across all provinces and territories [is] essential?’”

Sen. Bernard said she has been asking these questions of Liberal ministers and their aides—she’s not comfortable divulging the details of these conversations—and while she remains hopeful, she said it’s “all the more urgent to make the decision now.”

“We need to be on the same page with this, and let’s cut through the politics,” she said, and look at COVID-19 as a starting point, an “awakening” for the inequities in health that long predated the pandemic.

Unfortunately, it takes more than proof to shift policy, said Dr. Bouka and it becomes about building more evidence and raising enough voices to make inaction impossible.

“It’s mostly us being reminded so politicians can’t ignore it. Ultimately, it’s all about political will. If your weaknesses are shown repeatedly, then you can’t just pretend that you didn’t know,” she said.

Though it’s left up to the individual jurisdictions, Sen. Bernard said it’s important to have data that’s consistent across the country, which requires leadership so that it is collected in the same way.

Alex Maheux, CIHI spokesman said by email it’s up to the provinces and territories to decide how to proceed, but it has expressed willingness to support jurisdictions in that data collection and is currently working with partners to understand race and ethnicity data needs.

Earlier this month, Manitoba became the first province to track the ethnicity of COVID-19 patients while Quebec and Ontario have said they will as well. At a local level, Toronto has also said it tracks demographics.

In mid-July, CIHI said it will also publish a broader discussion document, followed by ongoing engagement with relevant stakeholders to “refine” the standard, if needed.

Public Health Agency of Canada spokesperson Maryse Durette said by email the government is committed to working with the provinces and territories—as well as other partners—to improve data completeness and access, including demographic information.

“These indicators will help to further our understanding of COVID-19 among different population subgroups and to monitor trends going forward,” she said, and it plays “a critical role” in helping to understand disease severity and risk factors, to monitor trends over time, and to ensure that public health measures can be effectively designed and delivered where needed.”

Data collection on Indigenous people ‘distinct’

CIHI’s standard notes that though Indigenous groups are often considered alongside racial and ethnic categories, First Nations, Inuit, and Métis have “inherent and collective rights to self-determination,” including ownership and governance of their data. That warrants “distinct consideration” and must include engagement with Indigenous communities and data governance agreements.

Canada tracks on-reserve cases of the coronavirus, but with nearly half of First Nations living off-reserve, the picture is incomplete. Yellowhead Institute independently researched, and on May 12 published findings revealing more than triple the cases reported by Indigenous Services Canada. Mr. Miller has acknowledged the department’s data is insufficientand on May 9 announced $250,000 towards improving data collection—not enough, according to Yellowhead researcher Courtney Skye.

“If we’re going to recognize First Nations, Indigenous, and Inuit are more impacted and more at risk for poor outcomes because of COVID-19, there needs to be a multi-jurisdictional prioritization of getting proper information available to communities to make informed decisions,” she said.

“Communities have a right to that information and the federal government has a fiduciary responsibility to make sure this work is adequately funded.”

Rose LeMay, CEO of the Indigenous Reconciliation Group and regular Hill Timescolumnist, penned a plea in April for COVID-19 data that notes background and Indigeneity. A month later, she said she remains baffled there’s been limited movement to close the data gap.

“This is a once-in-a-lifetime data dump, if we were to access it, because this shows the inequities of the system”, she said, noting Canada has “substantial work” to build trust given its problematic history collecting information on Indigenous people, and declaring who is and isn’t status.

That could be addressed by involving organizations perceived as objective to lead the way alongside Indigenous groups, and would likely require building new partnerships to do it well.

The lack of trust shouldn’t stop this work from happening, she said, adding the “how” is a “purely technical exercise” that she said she thinks Canada’s health-care system is capable of managing.

Ms. Skye said the patchwork approach isn’t working and it needs to be led by Indigenous people and be properly resourced. She added that this is another indication that the Liberal government’s approach to reconciliation is more for “show” than addressing “tangible barriers,” like health, that impact the daily lives of Indigenous people.

“These realities are known, are well-documented, and have existed for a long time, and there hasn’t been enough of the practical work done on behalf of the federal government and provinces,” she said. “It does come down to the will of the government.”

Source: Health agency reveals race-based data guideline as calls grow for nation-wide collection 

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Matas and Cotler: Legal steps must be taken against China for initial inaction

2020/05/27 Leave a comment

Of note. Feasabiity of most questionable given international political realities but lays out the options:

In order to safeguard global public health, the world must take action against the Government of China for its role in this global pandemic crisis. The Chinese Communist Party of China (CCP) and the Government of China, which the party directs, bear a large measure of responsibility for the global spread of COVID-19.

In the early days of the pandemic’s spread and during the Lunar New Year travel season, the Chinese government downplayed the severity of the illness and its spread. Human Rights Watch said in January that Chinese authorities had “detained people for ‘rumor-mongering,’ censored online discussions of the epidemic, curbed media reporting, and failed to ensure appropriate access to medical care for those with virus symptoms and others with medical needs.” Amnesty International warned soon after that the withholding of information was putting at risk the medical community’s ability to combat the virus.

There is authoritative and compelling evidence – including a study from the University of Southampton – that if interventions in China had been conducted three weeks earlier, transmission of COVID-19 could have been reduced by 95 per cent.

Meanwhile, an analysis of Chinese censorship around COVID-19, by the Munk School’s Citizen Lab, found that “Censorship of COVID-19 content started at early stages of the outbreak and continued to expand blocking a wide range of speech, from criticism of the government to officially sanctioned facts and information.”

The Chinese government’s wrongdoing and the suffering of its victims within its borders and internationally calls out for justice and accountability. There are clear and compelling legal remedies that should be considered to effectively address and redress this matter.

International

The International Court of Justice through a request for an advisory opinion from the United Nations General Assembly

The United Nations Charter provides that the UN General Assembly may request the International Court of Justice (ICJ) to give an advisory opinion on any legal question. Any UN member state can ask the General Assembly to make such a request to the ICJ, and China would not be able to veto such a resolution. The General Assembly could therefore request that the ICJ determine whether the actions of Xi Xinping’s China regarding coronavirus were in breach of its international legal obligations.

United Nations Human Rights Council

The United Nations Human Rights Council can pass a condemnatory resolution, or even establish a commission of inquiry into China’s actions regarding the coronavirus. If such initiatives are unlikely to muster the necessary majority of votes by member states of the council, independent statements can be made at the council’s regular sessions. Under agenda item 4 — “human rights situations that require the council’s attention” — any country, whether a member of the council or not, can deliver an oral statement. The wrongdoing of the Chinese government in the global spread of the coronavirus should be a matter of continuing concern at future sessions of the Human Rights Council.

The UN Special Rapporteur on the Right to Health

The UN Special Rapporteur on the Right to Health, currently Dr. Dainius Puras, can consider individual complaints, issue annual reports and conduct country visits. Accordingly, he should be asked to address China’s culpability in the spread of COVID-19.

There is a sense of urgency to such a prospective path towards accountability, as the current Special Rapporteur on the Right to Health will be replaced at the Council Session taking place between June 15th and July 3rd.

China was appointed in April to the Consultative Group of the Human Rights Council. The group advises the President of the council on the appointment of special rapporteurs and holds final approval over council appointments. It is therefore unlikely that the council, with a member of the Chinese Communist Party as part of its makeup, would appoint to any specialized mechanism a person who may be critical of the government of China.

The World Health Organization

The World Health Organization (WHO) was critical in 2003 of the Chinese Communist Party for its secrecy, dishonesty and cover-up concerning the Severe Acute Respiratory Syndrome (SARS) outbreak in Guangzhou, Guangdong of 2002. However, the behaviour of the WHO in the current pandemic is disappointing.

One might have hoped that the Chinese government has learned the lessons of its failures from the time of the SARS outbreak. Instead, of China reforming its policies and practices, it is the WHO that has altered its approach, failing to stand up to China.

The WHO has an important ongoing mandate and responsibility for our health and security which becomes particularly urgent in a time of a global pandemic, such as SARS in 2003 and now with COVID-19. Therefore, the WHO must be a particular focus of accountability efforts and encouraged to do the right thing, which is also the smart thing, for global public health and effectively confronting the Coronavirus.

International Health Regulations

The International Health Regulations were adopted in 2005 by the World Health Assembly of the WHO, to protect humanity from the international spread of disease. The unprecedented global impact of COVID-19 has demonstrated the ineffectiveness of these regulations.

In particular, there are no effective mechanisms when a state party violates regulations. All measures are subject to the approval of the violating state party, an unrealistic expectation when it comes to Xi Jinping’s China.

Yet, these regulations should not be rendered inoperative merely because of the necessity of agreement from Xi Xinping’s China to make them effective. An effort should be undertaken to render these regulations operable, and the very pursuit of this objective will underpin accountability efforts, promote a truthful narrative and mitigate Chinese propaganda.

International Court of Justice through the World Health Organization

The Constitution of the WHO provides that any dispute concerning the application of the constitution not settled by negotiation or by the World Health Assembly shall be referred to the International Court of Justice. A dispute regarding whether Xi Xinping’s China violated the International Health Regulations would likely constitute a dispute that could be referred by any WHO member state to the International Court of Justice.

The World Health Assembly

More broadly, the systemic challenges of the WHO must be addressed, and its next gathering from May 17 to 21 in Geneva presents such an opportunity. Ironically, the assembly may be unable to meet due to the failings of the WHO and the International Health Regulations in combatting the spread of COVID19.

In the World Health Assembly, as in the United Nations General Assembly, Xi Xinping’s China does not have a veto. This an opportunity for the international community to prioritize public health and pursue justice regarding the pandemic.

The Biological Weapons Convention

The Biological Weapons Convention obligates state parties, of which China is one, not to retain biological agents other than for peaceful purposes. A biological agent has been defined under the Convention to mean any organism which can cause death, disease or incapacity. 

Repressing or misrepresenting information about the virus, detaining health practitioners who seek to sound the alarm, and arguing publicly against global travel restrictions, are forms of retention of the virus that have harmed global peace and security.

Any state party to the convention could therefore make a complaint to the U.N. Security Council. Given that the convention has 183 state parties, that includes nearly every country in the world. The UN Security Council, on receipt of a complaint of violation, must investigate the matter and produce a report.

National

Magnitsky laws

Magnitsky laws for global justice and accountability, named for murdered Russian whistle-blower Sergei Magnitsky, allows for the public listing of serious human rights violators – naming and shaming them – and subjecting them to visa bans and asset seizures, thus challenging the cultures of corruption and criminality, and the impunity that underpins them.

There are six countries with this law. None of them have targeted any rights violators in Xi Xinping’s China. More countries should enact such laws, and all those with Magnitsky legislation should consider implementing them to pursue justice and accountability for those responsible for perpetrating and perpetuating COVID-19.

Universal jurisdiction laws on crimes against humanity through prosecution 

Many countries have laws which allow for the domestic prosecution of those who have committed crimes against humanity abroad. While these laws typically apply to permanent residents and citizens, some may also apply to visitors.

The accused would have to be found in the territory of the country in order for the local courts to have jurisdiction. While it varies by country – with some allowing for the private initiation of prosecutions – it is most often the exclusive decision of public prosecutors. Prosecutors are, however, usually reluctant to engage in such prosecutions, due to the prohibitive costs and evidentiary obstacles inherent in a case where the criminality and material evidence is abroad. Where private prosecutions are possible, they should be vigorously pursued.

There are other states, beyond China, that have contributed to the spread of COVID-19 through bad public policy and poor governance. Any liability response should be compelling and comprehensive, holding all wrongdoers to account. Yet, in doing so, the intentional and particularly intensive wrongdoing of China should be duly considered.

The denial, coverup and counter-factual narrative surrounding COVID-19 – underpinned by the use of global political pressure abroad and the repression of whistleblowers and medical heroes at home – has become standard operating procedure for the Communist Party of China. Immunity and impunity invite repetition.

In order to safeguard global public health, the world must act. Short-term political or economic considerations encouraging the indulgence of wrongdoing in Xi Jinping’s  China come with a long-term cost. Preventing another pandemic and protecting humanity necessitates pursuing justice and accountability for the Communist Party’s actions.

Source: Legal steps must be taken against China for initial inaction

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Paradkar: (Mostly) white covidiots at Trinity Bellwoods think the rules don’t apply to them. They’re right

2020/05/26 Leave a comment

Not only white folks can be covidiots. Ottawa has its share of visible minorities and whites who don’t respect social distancing visiting Dow’s Lake to look at the tulips.

André Picard notes the more fundamental issue at play, the inability of Toronto to free up more space for people (Don’t blame those who gather in parks – blame the city):

One look at images of Trinity Bellwoods Park on Saturday and it was instantly clear that idiocy is not just an affliction of the American middle class.

As a person with the luxury of living with greenery around me, I appreciate how difficult it must be to be trapped in a condo, sometimes even without balconies. I don’t blame people for wanting to break out of their confines when the sunny outside beckons so cheerily.

I get that there aren’t a lot of open spaces in the core of Toronto — although, for perspective, compared to many parts of the world, the city is positively lush.

What is bothersome is that while people around the world and even in our own city have been weathering the pandemic in far tougher conditions, in crappy apartments and crowded homes and in poverty, it was in Trinity Bellwoods that people somehow collectively felt entitled to say to hell with social distancing.

Their pleasure trumped our collective safety.

Trinity Bellwoods is considered a “gentrifying” neighbourhood with a higher concentration of white folks compared to the city. Like in all of the city, nearly half the resident are renters, and the same proportion have a bachelor’s degree or higher, according to the 2016 census.

Based on social-media comments and real-estate agents’ descriptions, the 32-acre Trinity Bellwoods Park is a place to be seen. That’s a concept beyond my comprehension but on Saturday it meant that people could have gone to other parks (Stanley Park, Alexandra Park) but didn’t.

I wonder if the news about who is most at risk from COVID-19 — the racialized have-nots — has created a sense of inoculation among the haves. It’s affecting those people, not us, unless we’re old. Pandemics have always killed the poorest — mainly because those are the bodies the virus comes across. People who can’t afford to hunker down necessarily place themselves at risk to keep the rest of us in comfort. Gathering in large numbers simply offers the virus more bodies to feast on.

Photographs doing the rounds on social media showed thousands of what looked like white people milling around in crowds in the west-end park, as if millions of other Torontonians were not holding back from precisely that because common sense. And courtesy. And safety.

No doubt there were racialized folks among those gathered — fools come from all races — but they were protected by the overwhelming whiteness of those around them. Had that been a sea of Black and brown folks, we’d be having a very different conversation today.

While we may call Saturday’s hordes at Trinity Bellwoods covidiots or victims of squashed housing or poor communications by the province, to me they serve as a quick snapshot as to who feels entitled to the public space in this city, who gets scrutinized and who gets penalized for existing in it.

Of course, race matters, class matters.

A couple of weeks ago, a Tamil friend in our suburban neighbourhood was taking his children for a walk, observing all social-distancing protocols. A white man working on his front lawn chided him for being outside and told him to get off the sidewalk and walk on the road.

Last month, the father of a Black teen in Ottawa accused a trustee of harassing and photo-shaming his teenage son on Facebook for shooting hoops by himself. This was before there was clarity around the use of public parks.

In Brampton, Peel Police broke up groups of people who broke social-distancing rules by playing cricket and fined them $880 each.

It was also Eid this weekend when Muslims ended the month-long fasting of Ramadan. It’s a time of celebration, but Muslim Canadians shared stories on Twitter of a visible police presence in their communities to ensure they didn’t break social-distancing rules.

In Toronto, several homeless people have also been given $880 tickets for sitting on public benches, according to Policing the Pandemic, a map that tracks criminal charges across the country. The vast majority of police enforcement thus far has been about failing to comply with distancing rules, the researchers found.

So where was the weight of all that enforcement on Saturday? How many people were fined? Mayor John Tory said the people need to “do better” and sent in bylaw officers Sunday. Is that their only accountability? To be mocked en masse and face expressions of disappointment from our leaders but bear no individual responsibility?

What about community spread? Given that Ontario’s testing and contact tracing efforts are flailing — that we don’t actually know how community transmission is spreading — will we ever be able to track how many people were endangered by the indifference of the folks at Trinity Bellwoods Park?

Has the province sought the might of the police to keep all of us safe or only some of us safe? Why does the amount of melanin in the wrongdoer dictate who gets off, and whom we choose to perceive as wrongdoer in the first place?

Guess there’s no one quite like covidiots to expose the toxic hierarchies that operate under pretty ideals of egalitarianism.

Source: Shree Paradkar(Mostly) white covidiots at Trinity Bellwoods think the rules don’t apply to them. They’re right

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New data show that minorities and low-income earners are more susceptible to COVID-19

2020/05/25 Leave a comment

Yet another article on racial disparities, based upon Toronto Public Health census track-level data:

When the public image of Pearson International Airport turned from travel hub to petri dish in March, Rajinder Aujla’s friends and colleagues felt they had no choice but to drive toward it every day, again and again. As airport taxi and limo drivers, this is their livelihood.

A month later, Mr. Aujla, president of the Airport Taxi Association, started hearing about what may have been the consequences of all those trips. By his count, 10 drivers have died in the past month, at least six of whom tested positive for COVID-19. One was Karam Singh Punian, a close friend of Mr. Aujla, who died May 4.

He estimates that about 20 drivers contracted the virus since April. Most of the 1,500 drivers who make their living ferrying passengers to and from the airport are immigrants from places such as India, Pakistan and Egypt, he said.

“They’re all self-employed. They don’t have access to health benefits,” Mr. Aujla said. “Some of the people are the only breadwinners. Some of them have others in their family working, but their spouses are mostly out of jobs now. Everyone is staying at home.”

Preliminary data support the idea that COVID-19 is hitting marginalized communities harder than others. The situation will only worsen as provinces reopen, according to front-line health care workers and experts who study health inequities.

Public-health messages about staying home, which are aimed at curbing the spread of COVID-19, have largely ignored the realities faced by low-income workers, people who are homeless or other at-risk groups, said Andrew Boozary, a doctor who is executive director of health and social policy at University Health Network. He also works with Toronto’s Inner City Health Associates, a group that provides care to people living on the street and in shelters.

“Physical distancing is a privilege by postal code,” he said. “We’re seeing a public-health message that is speaking to a certain part of the population. There’s a completely separate curve that is … facing most of the cases and deaths now.”

A recent Toronto Public Health analysis of COVID-19 cases in the city showed that neighbourhoods in Toronto with the lowest incomes, highest rates of unemployment and highest concentrations of newcomers consistently had twice the number of cases of COVID-19 and more than twice the rate of hospital admissions.

That analysis was based on COVID-19 cases tracked up until May 10. It looked at census tracts throughout the city and divided Toronto into five groups for each category of analysis: income, proportion of newcomers and unemployment.

While the lowest-income group had 205 cases of COVID-19 and 34 admissions to hospital per population of 100,000, the highest income group had only 94 cases and 15 admissions.

Neighbourhoods that had the highest concentration of immigrants recorded 194 cases of COVID-19 and 31 admissions per 100,000 people, compared with the ones with the lowest number of immigrants, which had 93 cases and 12 admissions.

The same pattern emerged when it came to unemployment: Areas with the highest levels of unemployment had 198 cases and 30 admissions per 100,000, versus those with the lowest unemployment, which had 98 cases and 15 admissions.

Toronto Public Health is now tracking demographic data (including race and income) to give an even more accurate picture of who is getting infected.

Arjumand Siddiqi, Canada Research Chair in population health equity, said many of the essential workers keeping society going during COVID-19, including janitors, long-term care workers, grocery clerks and transit operators, fall into the at-risk categories.

“They tend to be lower wage, and they tend to consist of black and brown people,” said Dr. Siddiqi, an associate professor at the University of Toronto’s Dalla Lana School of Public Health. “Every time we see a long-term care worker on TV, it’s almost invariably a black woman.”

In Montreal, Canada’s hardest-hit city, many of those workers live in Montréal-Nord, which has the highest concentration of COVID-19 cases and has become the epicentre of the outbreak.

This low-income enclave is a “springboard” for immigrants from places such as Haiti and North Africa, many of whom live in close quarters in high-rise apartment buildings and work in the vulnerable health and service sectors. All these factors have contributed to its high rate of infection, said Bochra Manai, executive director of Parole d’excluEs, a social-services organization that works in the neighbourhood.

The area had 2,593 cases per 100,000 residents as of May 21, by far the most of any borough and well over double the city average. (In part because of its government structure, made up of 19 boroughs, Montreal has more precise neighbourhood data on cases and deaths.)

In Canada’s largest cities, points out Kwame McKenzie, the CEO of health-policy think thank the Wellesley Institute, accommodation is expensive, “and we know that people with lower incomes tend to be in more concentrated or overcrowded places where it is more difficult to physically isolate.”

That was precisely the challenge Fahim Sultana Rigi faced in late April.

After breathing difficulties landed her in hospital and she tested positive for COVID-19, Ms. Rigi was told to self-isolate at home for two weeks.

This was no small feat: She shares a three-bedroom apartment in an 11-floor housing co-op in the densely populated St. Lawrence neighbourhood in Toronto with her husband, Emad Hussain, and four children. Her eldest son was temporarily moved to a room with a sibling, Mr. Hussain shared a room with two of his other children, and Ms. Rigi was in a room on her own.

As his two-year-old cried and begged to see his mother, Mr. Hussain tried his best to help maintain the quarantine. His work ground to a halt as he took on the job of parenting his children solo.

His wife is only 41 but had pre-existing health conditions – thyroid problems and diabetes – so he worried about her recovery.

Research suggests immigrants and low-income earners are more likely to suffer from diabetes, high blood pressure and other chronic illnesses, and those with these pre-existing conditions can face higher rates of hospital admissions and worse outcomes if they are infected with COVID-19.

Just a few days into isolation, Ms. Rigi woke early one morning struggling to breathe. She summoned her husband to her side and frantically gestured to call 911. After spending nine hours in hospital and receiving oxygen, Ms. Rigi was discharged again, continued to isolate and has since recovered – though she still suffers from body pain and exhaustion.

Still, Mr. Hussain can’t forget the fear he felt in those first days that spurred some grim research.

“If I got infected, or if I passed away or my wife passed away, how could we manage those children? Those were the legal things I was looking for,” he said.

Source: New data show that minorities and low-income earners are more susceptible to COVID-19 ‘Physical distancing is a privilege by postal code,’ one doctor says of the dichotomy of infection rates between marginalized communities and wealthier neighbourhoods

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Calls grow for asylum seekers working on COVID-19 front lines to be allowed to stay in Canada

2020/05/22 Leave a comment

No surprise at the calls and reasonable for government to be non-committal at this stage:

The COVID-19 pandemic has shone a light on the crucial role asylum seekers and others with precarious status play in Quebec’s economy.

They work long hours in meat-packing plants and warehouses, or tending to elderly people in long-term care homes — low-paying jobs that are difficult to fill.

But they may not be able to stay in Canada when deportations, which have nearly ground to a halt during the COVID-19 crisis, resume.

There are growing calls, however, from community organizers, advocates and opposition politicians in both Quebec and Ottawa for that to change.”What we realize more and more is that those failed claimants are working in essential services most of the time,” said Guillaume Cliche-Rivard, the president of Quebec’s association of immigration lawyers.

About 30,000 asylum seekers who crossed into Canada between 2017 and December 2019 are still waiting for their refugee claims to be heard, according to the latest figures from the Immigration and Refugee Board of Canada.

Others whose claims have been rejected have applied for permanent residency on humanitarian grounds.

That process takes an average of 30 months, Cliche-Rivard said.

In the meantime, they are working.

While the province says it has no record of the total number of asylum seekers doing work in, for example, long-term care homes, Marjorie Villefranche, executive director of Maison d’Haiti, estimates that about 1,200 of the 5,000 Haitian asylum seekers the organization has helped since 2017 have become orderlies.Cliche-Rivard said the federal government should set up a program that speeds up the application process for permanent residency, and formally takes into account the contributions claimants have made to fast-track their application.

Doing so would offer “clear recognition of what those people have been doing for the province and for the country,” he said.

NDP wants a ‘special program’

The federal NDP is also calling on Prime Minister Justin Trudeau to create a special program granting permanent residency to those working on the front lines.

“They are risking their lives to support others in the face of the pandemic,” said Jenny Kwan, the party’s immigration critic and the MP for Vancouver East.

Her party has tabled a petition on behalf of a Montreal community group that calls on Trudeau to, “show leadership by implementing a special program to regularize the status of asylum seekers working to fight COVID-19, and therefore supporting the health and safety of all Canadians, for humanitarian reasons.”

Federal Immigration Minister Marco Mendicino has given no indication the government plans to change the way it processes applications or make any exceptions.

But he said in a statement that, “all eligible asylum claimants receive a full and fair hearing on the individual merits of their claim.”

“Asylum claimants are allowed to work or study and receive basic health-care coverage.”

Legault’s party votes down proposal

Peter Kent, the federal Conservative immigration critic, suggested that Quebec, which has jurisdiction over immigration when it comes to economic applicants, “could move to accept these people as permanent residents” given the “extraordinary circumstances.”

It’s not clear if Quebec would have the power to do that — or if Premier François Legault’s government, which cut immigration levels in its first year in office, would be willing to if it could.

Last week, on the National Assembly’s first day back in session, independent MNA Catherine Fournier tabled a motion to recognize the contribution of “hundreds of asylum seekers, mostly of Haitian origin,” working in long-term care homes.

She said the province should ask Ottawa to, “quickly regularize their status, in order to recognize the work accomplished during the current health crisis.”Quebec’s three opposition parties — the Liberals, Québec Solidaire and the Parti Québécois — voted in favour of the motion, but Legault’s majority Coalition Avenir Québec voted it down.

When asked why, Legault avoided answering directly, saying instead he didn’t want the border to reopen to asylum seekers any time soon.

“That doesn’t mean that asylum seekers, including members of the Haitian community — that there aren’t good people who work in our long-term care homes,” Legault said Friday.

Frantz Benjamin, the Liberal MNA for Viau, which includes Montréal-Nord, said Legault’s response was shocking.

“It was not based on the question asked by the journalist,” Benjamin, who was born in Haiti, said Tuesday.

“Those people that we call ‘guardian angels,’ we need them. We have to recognize the work of those people, most of them women.”

‘Let’s walk together’

Over the weekend, a group of activists, artists and social entrepreneurs released a video paying tribute to asylum seekers in essential jobs.

The video came out Monday, on Haiti’s National Flag Day, which fell on the same day as Journée des Patriotes in Quebec this year.

“Both celebrations are about liberation movements,” said Fabrice Vil, a Montrealer of Haitian background and the founder of Pour3Points, an organization that trains sports coaches to help support kids struggling at school and at home.

He helped produce the video, called Je me souviendrai – Marchons Unis — a play on Quebec’s official motto, “I remember,” followed by, “Let’s walk together.”

The song in the video is set to the melody of La Dessalinienne, Haiti’s national anthem.

“The current pandemic is really showing that we all depend on each other — and that there are people that sometimes we don’t see as being relevant to our own lives who are currently sacrificing their own lives to support the collectivity,” Vil said.

Source: Calls grow for asylum seekers working on COVID-19 front lines to be allowed to stay in Canada

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Concern about pandemic differs across gender and race lines

2020/05/22 Leave a comment

Some interesting public opinion research (check the article for the charts):

A common thread that connects all Canadians these days is worry. We worry about our senior relatives, children home from school struggling with online lessons, sky-rocketing unemployment, the safety of essential workers and working from home instead of well-equipped offices.

The current pandemic has most Canadians worried as COVID-19 touches every corner of the society and people valiantly try to do their part to slow the spread of the disease. In a recent survey by the Consortium on Electoral Democracy (C-Dem), we found that most Canadians are at least a little worried about how COVID-19 will affect their household.  As Figure 1 indicates, fears that someone in their household could contract the disease posed the biggest worry, with the economic impact also raising concerns. Fewer Canadians  worried about access to basic goods.

Yet, while everyone might be worried, we cannot ignore an important truth: the disease itself, and its vast societal consequences, are not affecting all Canadians equally. The current coronavirus crisis has highlighted the considerable care-taking roles of women in the home and in the labour force – in health care, long-term care, personal support work and essential service sectors. Women are on the front-lines helping to keep Canadians healthy and supplied with necessities.

At the same time, women have also been the hardest hit by pandemic-related job losses, as Statistics Canada’s March jobs report first revealed. Cutting across this gender difference, racialized and immigrant workers are particularly affected given their employment in industries with high COVID-19 infection rates, such as meat-packing plants and long-term care homes. Immigrant women, especially Filipino women, are concentrated in nursing and caregiving professions. Visible minorities make up nearly a majority of peopleworking as personal support workers in Ontario, of whom 96 percent are women.

Beyond the economics, COVID-19 also has differential infection rates in Canada. Early evidence from other countries provided little evidence of sex-differentiated COVID-19 infection rates, but reported higher fatality rates for men.

Canadian data seem to tell a different story. As of mid-May, women account for 55 per cent of confirmed COVID-19 cases and 53 per cent of deaths in Canada, though the trend varies across the country. Some provinces, including the two largest (Quebec and Ontario), report women-skewed infection rates, but some others (for example Alberta and BC) report essentially no difference.

Part of the story could be who is able to get tested – as more women work in health and long-term care settings, they have priority. And we do not yet have good data on racialized gaps in infection rates because provincial and federal authorities in Canada have not collected race-disaggregated data throughout the pandemic.  However, several provincial and municipal health authorities have started or are developing processes for this (for example, Ontario, Manitoba, Quebec, and the City of Toronto’s public health unit).

Preliminary evidence suggests that infection rates are higher in Canada among black and immigrant communities and a recent study suggests that neighborhoods with higher ethnic density had less testing but higher infection rates.

Because we know that people are being affected differently in material ways by the pandemic, does this extend to the mental burden of general worries as well? Are certain subgroups of society more concerned about the illness and the economic upheaval than others?

In our survey, women generally expressed more worry than men about contracting the disease and the economic impact on their families and follow-up analyses determined that this could not be attributed to parental status. Mothers were not distinguishable from fathers, or from women without children, once controls were added to our models. That said, gender-role norms that women are more maternal or caring than men could still drive the gender gap in worry, whether respondents have children or not.

In Figure 2, we explore these gender gaps in more detail by exploring how concerns varied by immigration and visible minority status. It shows the predicted levels of worry after controlling for a host of demographic factors. In other words, after controlling for differences among these groups in socio-economic status, age, etc., do we still see significant differences?

The most dramatic gender gap appears, as Figure 2 shows, with immigrant women, who show the highest levels of concern Still, visible minority immigrants that are men are almost equally as concerned across our measures of worry. The heightened level of worry is consistent with the observation that the front line of the pandemic response is gendered and racialized.

Academic studies argue that the workforce in long-term care homes is not well researched or understood. What is clear is that care aides perform the majority of direct care to clients in these facilities, and that this occupational group is predominantly female and in some cases half of them are immigrant workers.

Current figures place long-term care homes at the centre of the pandemic, with reports that they are connected to 79 per cent of COVID-19 deaths in Canada. In this context, it is not surprising that immigrant women are significantly more worried and concerned about their chances or their family’s likelihood of contracting the virus.

The messaging of the COVID-19 crisis so far has been important and effective. Government leaders and public health authorities have emphasized the importance of physical distancing, while maintaining solidarity and connection. The mantra has been that we are “in this together.”

Our data suggest an important corollary. Attention needs to be paid – now and after the pandemic has ended – to how worries and risks differ across social groups. We know that mental health risks are just as real as physical health risk during the pandemic, so paying attention to who is bearing the burden of worry is extremely important. Looking at the data this way not only documents differences and inequalities, but encourages empathy – and perhaps crucial policy responsiveness and accountability as society recovers.

Source: Concern about pandemic differs across gender and race lines

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Data linking race and health predicts new COVID-19 hotspots

2020/05/22 Leave a comment

While more of the same in terms of argumentation, some better data analysis than other commentary although the researchers should have made more explicit the correlation with lower socioeconomic outcomes which is largely the main driver:

Anecdotal stories about the COVID-19 pandemic suggest that Black, racialized and immigrant people in Canada have been disproportionately affected by COVID-19. This narrative tells the story of immigrants and racialized people pushed to the front lines of the economy, working in settings with greater exposure to the COVID-19 virus.

It tells the story of immigrant groups clustered in city neighbourhoods with high population densities who cannot practise physical distancing. It tells the story of temporary migrants who live in tightly packed communal quarters.

Reports have shown that Black and immigrant communities in the U.S. have been disproportionately affected by COVID-19. But many believe that Canada is different.

After all, Canada has universal health insurance coverage; the U.S. does not. Canada adopted a multiculturalism policy decades ago and racial discrimination is frequently — though wrongly — believed to be absent in Canada.

Under this narrative, many government officials in Canada have not seen a need to collect COVID-19 data on race. They have also excluded racial minorities and immigrants from their list of populations vulnerable to COVID-19.

Which of the two narratives reflect the realities of racial minorities and immigrants in Canada during the COVID-19 pandemic?

Until recently, there was no data to address this question. By making creative use of health and census data, we now know that Black and immigrant communities in Canada are disproportionately affected by COVID-19.

Combining COVID-19 and census data

Our research team based at the department of sociology at Western University tested these competing narratives by creatively combining existing data. We used COVID-19 data released by the Public Health Agency of Canada and census data about the racial and socioeconomic composition of health regions, units set up by provinces in Canada to administer health care.

Using these data, we assessed how racial and socioeconomic factors have shaped COVID-19 infection and death rates. Our findings paint a picture closer to the anecdotal stories

The COVID-19 pandemic is not the “great equalizer.” Black and immigrant communities in Canada are disproportionately affected by COVID-19.

Our findings showed COVID-19 infection rates are significantly higher in health regions with a higher percentage of Black residents. A one percentage point increase in the share of Black residents in a health region is associated with the doubling of coronavirus infection rates. We also found that a one percentage point increase in the share of foreign-born residents is associated with a three-per-cent rise in COVID-19 infection rates.

This may explain why Montréal, where Black residents make up 6.8 per cent of the population, has emerged as one of Canada’s COVID-19 epicentres. The same is also true of other cities with high immigrant and Black populations, like Toronto and Vancouver.

We also found the number of COVID-19 deaths tend to be higher in communities with higher shares of residents who are 65 and older. Many studies have shown COVID-19 is more lethal in older adults and we have seen the tragically high COVID-19 death rates in long-term care facilities.

COVID-19 hotspots

Health regions are large administrative units responsible for the health care of roughly 420,000 residents. They are too large geographically and too socially heterogeneous to adequately tell a story about local communities. So for our study, we subdivided health regions into smaller areas and predicted the spread of COVID-19 in local communities based on their racial, demographic and economic profile. This approach helped us identify several potential COVID-19 hot spots.

Black and immigrant communities like Hamilton, Vancouver and Montréal were particularly vulnerable. Also, other localized communities may be more vulnerable than originally thought.

For example, the oilsands in northeast Alberta, where the petroleum industry hired large numbers of temporary migrant workers who reside in crowded living quarters, may be a potential COVID-19 hotspot. Similarly, another potential COVID-19 hotspot may be found in western Québec, which includes mining sites that employ large numbers of temporary migrant workers.

Public health workers may have overlooked the higher infection rates in Ontario’s towns bordering Michigan, partly reflecting their geographic proximity to U.S. cities like Detroit.

Who is the most vulnerable?

Communities are home to different types of people. With the existing data, we cannot address questions like: are white residents who live in Black communities less vulnerable to COVID-19 than their Black neighbours?

Our study highlights the importance of collecting individual data about COVID-19 patients as well as for smaller geographic units. Having individual data is essential for determining how to direct scarce resources and how to contain the spread of the virus.

With our study, we underscore the importance of acknowledging the challenges of Black and immigrant communities in Canada, including their vulnerability to COVID-19. Without this acknowledgement, we risk exacerbating inequality between them and other groups.

For example, Blacks and immigrant groups were not classified as “vulnerable populations” in the Ontario government’s COVID-19 Action Plan for Vulnerable People. They were excluded even though their risks of infection and death are significantly higher than those of some groups identified as vulnerable under this plan.

Policies aimed at mitigating the consequences of COVID-19 target individuals as well as communities. If we do not address this oversight, the future health disadvantages of Black and immigrants groups may become more pronounced.

Closing one’s eyes to inequality along racial lines will not eliminate disparities. It just eliminates ways to address it.

Source: New COVID-19 hotspots predicted by data linking race and health

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2016 report warned about public health data reporting problems Canada is facing with COVID-19

2020/05/22 Leave a comment

Apparently, an ongoing issue, and hard to see any rationale for not having consistent national data across all provinces (Quebec will always be difficult in this regard given the health jurisdiction arguments and jurisdictional issues cannot be tossed aside). And of course, more desegregated data, including ethnic and racial backgrounds, is needed:

A clear picture of the fight against COVID-19 is being hampered by lack of consistent data about the virus across the country, Canada’s Chief Public Health Officer Theresa Tam said Wednesday.

But the problem of sharing such data among provinces was flagged four years ago in a report commissioned by the nation’s top public health officers.

Failure to put in place a mechanism for data surveillance across the country would have negative consequences for people’s health, said the 2016 report.

Despite that report inadequate data sharing information has been a problem during the COVID-19 crisis, Tam admitted Wednesday.

“Data is extremely important obviously to any outbreak,” she said. “There’s obviously some gaps particularly in reporting to the national level that we do have to address.”

The 2016 report was commissioned by the Pan Canadian Public Health Care Network, a group designed to coordinate the work of the nation’s top public health officers. It flagged that Canada’s public health surveillance system was inadequate, with inconsistent data sharing between provinces, a lack of common standards and gaps that could hamper a response to a virus like COVID-19.

The network’s report was a blueprint for how to create a more unified system for public health, one where all provinces looked for similar problems and collected data in a similar way. It found provinces collected data differently and didn’t have consistent standards when it came to monitoring for disease outbreaks.

“The lack of a mechanism to align surveillance standards across Canada is a missing pillar of surveillance infrastructure that holds the potential to delay the early detection of outbreaks and is a barrier to better understanding chronic diseases and injuries, resulting in negative consequences for the health of Canadians,” reads the report.

Since the outbreak began, not only have Canadian provinces counted their COVID-19 data in different ways, they have also switched their methodologies during the outbreak.

While some provinces use fully electronic systems to report new cases and trace the contacts of people who are infected, it has been revealed that others still use fax machines to report the information.

The network’s report found data sharing was done on an ad hoc basis with informal agreements, but no consistent rules. Tam said that has been a barrier during this crisis and policy makers at all levels are trying to address it.

Before the pandemic, the network aimed to bring together public health agencies across the country into a common set of standards by 2022. Health care is a provincial jurisdiction and provinces have consistently resisted any efforts for the federal government to regulate any part of their systems.

Tam said some of the issues around information sharing have been addressed, food-borne illnesses as an example are well tracked with good information sharing between provinces. In the case of COVID-19, a respiratory illness, she said there are still barriers.

“It is absolutely recognized also at the first ministers level that this is another chance for us to improve on what we are doing,” she said. “Capitalizing on the crisis that we have, we need to give it another good go for the next piece.”

She said the data on COVID-19 now comes from a wide-array of sources.

“It’s the complexity of the Canadian landscape of data, some data has to come from hospitals, some comes from labs, some comes from local public health units.”

The network’s report noted that the European Union had managed to pull together a more uniform surveillance system over a five year span, creating the European Centre for Disease Control, despite having to merge 27 countries and 23 official languages into one system.

A report into the SARS crisis in 2003 made similar recommendations about sharing information, arguing that a disease outbreak required a federal response and it should have all the necessary data to make decisions.

It called for a stand-alone public health agency with the authority to gather data from the provinces, which led to the creation of the Public Health Agency of Canada.

Testifying at the House of Commons health committee on Wednesday, Amir Attaran, a law professor at the University of Ottawa, said this jurisdictional issue should be tossed aside.

“It is good for the federal government to let provinces run their show, and that’s normally how it should work,” he said. “ But I’ll suggest that a pandemic is not normal times, and there comes a point where the federal government must step in — the point where provincial actions are killing Canadians.”

Attaran said the federal government has the power to step in and demand sharing of data and it could also use that authority to demand better testing from the provinces. He said both these steps should be taken despite the jurisdictional challenges because lives are at risk.

“If our country cannot show that once-in-a-century flexibility, then, yes, we are turning the Canadian Constitution into a suicide pact.”

Tam said where good data is most needed, the local level, it is available and accessible to decision makers. Local public health officials are able to track the virus in their communities and use it to do contact tracing and make other decisions.

She said what is missing is the bigger picture on how the virus is spreading across the country.

“It is important to get the national picture and to be able to provide that to policymakers as well.”

She said they need a deeper level of data than what is currently available to get a better picture of how vulnerable groups are being hit by the disease.

“We have the basic information, but I think what people need, and are asking for now is for what we call this aggregation, more in depth analysis,” she said. “Those are the kinds of things that we need to work on.”

Source: 2016 report warned about public health data reporting problems Canada is facing with COVID-19

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Canada’s COVID-19 blind spots on race, immigration and labour

2020/05/21 Leave a comment

Yet another article on racial and economic disparities and COVID-19. Nothing new here and perhaps a sign that governments just need to get on with collecting the data. Should be a role for CIHI in this:

The low-paid and precarious positions in industries that are considered essential during the COVID-19 pandemic (sanitation, health care, and those in the food supply chain) are filled with women, recent immigrants, and racialized Canadians. Many of these workplaces are notoriously plagued with exploitative labour practices that, in many ways, contributed to the spread of the virus in the first place. Recent immigrants and racialized Canadians, notably Filipinos and Sudanese Dinka, who work in these industries, for example, meat-packing plants in Brooks, High River and Balzac, Alberta, are at great risk of negative health outcomes during this pandemic.

And, yet, we do not collect the necessary data in Canada on the social determinants of health for racialized minorities. Stories from across the country paint a bleak picture. In April, a 40-year-old Haitian asylum seeker contracted COVID-19 while working as a personal support worker. He died in his home after having been denied refugee status. In Toronto, researchers have recently connected positive COVID tests to neighbourhoods characterized by a higher proportion of visible minorities and recent immigrants, poor housing and low income.

There have been numerous calls to gather disaggregated data on COVID-19, health and race. After initial reluctance, the federal government and some provincial jurisdictions are now considering collecting more demographic data. We join our voices to the call and argue that Canadian governments need data not only on race and health, but also on immigration status during this COVID-19 crisis and beyond.

While collecting data on race will show that people of colour are disproportionately affected by COVID-19, we know that not all racialized Canadians are equally vulnerable to being exposed to this disease. From our work in community health, and gender and politics, we know that despite the best intentions of epidemiological approaches to the pandemic, marginalized groups face barriers to accessing and benefiting from public services. In fact, recent research by the University of Lethbridge’s Eunice Anteh shows that in places like Brooks, newcomers’ health profiles will vary based on numerous factors, including gender, race, language barriers, and the health and social infrastructures in their settlement locations.

We need longitudinal data that intersects the usual factors – gender, age, education, income, for example – with race and immigration profiles to enable policymakers to better understand the pathways and structures that create hierarchies of vulnerabilities within racialized and newcomer communities. This will enable public health officials to work with other stakeholders in eliminating the institutional barriers to health equity for all within our borders.

Intersecting reasons why some are more vulnerable to COVID-19

In Quebec, disparities in COVID-19 infection rates are shaped by the intersection of race, gender, immigration, labour, and public health. Health care workers account for 20 percent of infections, and in the hard-hit Greater Montreal area, up to 80 percent of the aides in long term care facilities are racialized women, mostly Black and Maghrebi. Industries of care are feminized and undervalued despite being critical to preserving the health and safety of the population.

For years workers have complained about these institutions’ chronic understaffing, high patient-to-aide ratios, and unsafe working conditions. As occurred in other provinces, the government subcontracted public services to private entities, with limited public oversight, enabling these institutions to avoid paying employment benefits by privileging part-time over full-time work. This left many health care aides with no other choice but to work at multiple sites to make ends meet. These are the conditions that upended Quebec’s response to COVID-19.

In Alberta, the links between race, immigration, labour, and public health manifested themselves in the food supply chain. Over 1200 COVID-19 cases were linked to the Cargill meat plant. Seventy percent of employees are of Filipino descent, most of whom work as general labourers amongst the lowest-paid employees, and some who have spouses working as health-care aides in Calgary. Public health officials named carpooling and crowded living arrangements as contributing factors to the rapid spread of the virus but overlooked labour practices and socioeconomic conditions that lead to shared living and transportation arrangements in the first place.

The second-largest meat packaging plant in Canada, JBS, is also facing an outbreak. It is the main employer in the city of Brooks, Alberta. A third of the population there are visible minorities, mostly from East Africa, South Asia, and Latin America. Today, JBS employees account for approximately 26 percent of Alberta’s active cases, and over 6 percent of Brooks’ population, one of the highest rates across Canadian municipalities. These outbreaks revealed mistakes and oversight linked to concerns around the food supply chain and showed the price that racialized and marginalized workers pay due to neglect and prioritization of profit over safety.

Temporary foreign workers are also at risk

As the agricultural season enters in full swing and concerns grow about Canada’s food supply chain, we must take stock of employment inequities in how we treat temporary foreign workers (TFWs) and the implications for overall community health and wellbeing. For decades TFWs from the Caribbean and Latin America have taken on work that Canadian often refuse to do, generally because of long working hours, unsanitary bunkhouses, and low wages. Many of these workers are reluctant to speak out about their work conditions given the precariousness of their employment and residency status, which are both tied to their employers.

These conditions, like those of personal service workers or meat plant employees, are not new or even unique to Canada. Across the world, industrialized countries depend on temporary migrant workers to sustain their basic infrastructures. Around the world and in Canada, it is clear that the temporary migration of racialized individuals serves as the backbone of essential services in Canada. From the West Indian Domestic Scheme (1955) and the Caribbean Seasonal Agricultural Workers Program (1966) to our modern TFW program, the utilitarian approach to immigration and the neglect of these populations have resulted in systematic and deep-rooted inequities that weaken health and safety institutions.

A lack of political will to address neglect

Why do Canadians tolerate these types of working conditions that can become public health issues during a crisis like COVID-19? Is it because of who is overrepresented in these fields: female, racialized, and immigrant workers who struggle to get substantive political representation? Some in the broader society rationalize these challenges by saying that newcomers are better off here than where they came from. Others turn a blind eye altogether to these conditions.

In reality, we ignored the working conditions of racialized and immigrant workers who help sustain our health and food supply infrastructures, and way of life.

Yes, we need to gather COVID-19 related data on race and immigration to better address the needs of vulnerable communities that also tend to work in essential sectors. But going forward, we also need long-term changes to what we consider to be health-relevant demographic data.

Provincial healthcare professionals need to pay as much attention to collecting data on race and immigration profiles as they do in collecting data on gender, education, and income. This data needs to feed into national environmental population surveys that will allow public health officers to tie specific demographic markers to health status over time. It will paint a clearer picture of social, economic, and health disparities between various communities and point to needed improvements and progress. This will also enable provincial health officials to identify variations and gaps between federal and provincial jurisdictions. For example, while refugees are resettled and supported by the federal government, their access to health services is the responsibility of the provinces.

Finally, this data should then be the starting point for engagement between public health officers, immigration and labour policy-makers, and relevant stakeholders from relevant industries. Together, they can help develop more robust social and labour protection for racial minorities, newcomers and migrants. We need to be invested in the health and work conditions of racialized and immigrant populations in Canada, not only because, as COVID-19 has demonstrated, safety for them means safety for all, but most importantly because this is what this country says it stands for.

Source: Canada’s COVID-19 blind spots on race, immigration and labour

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Suburban families. Young renters. Frail seniors. Data reveals who is most at risk financially and socially across Canada amidst the pandemic

2020/05/20 Leave a comment

Some impressive integration of diverse data sources that highlights the range of vulnerable groups from a variety of angles:

New data from Environics Analytics highlights communities made vulnerable by coronavirus lockdowns across the country and profiles people at risk — such as young suburban families — that might get overlooked.

The data suggests where governments, businesses and social agencies need to focus supports and services as the economy takes baby steps toward reopening, Environics says.

“Governments are going to have to get more focused and pinpoint who they need to help and how,” says Rupen Seoni, senior vice president at Environics Analytics. “We have to get the right help to the right people.”

The data, which Environics Analytics made available to the Star, scores Canada’s more than 850,000 postal code communities on how likely they are to be vulnerable financially, socially, and by how old and frail their residents might be. The data company also developed profiles of people most at risk in those categories.

The company used thousands of data points from a long list of sources, including its own demographic research, Statistics Canada, the Bank of Canada, Canada Post, aggregated credit scores, Canada Mortgage and Housing Corporation, the census and surveys.

Environics found that the most financially vulnerable census metropolitan area in the country is Cold Lake, Alta., largely because of its reliance on the oilsands industry, which has seen the price of its product plummet during the pandemic’s economic fallout.

The least financially vulnerable is Canmore, also in Alberta, and the Greater Toronto Area fares only slightly worse. But the affluence indicated at Toronto’s metropolitan census level masks dense vulnerable pockets of people at the neighbourhood level, Environics notes.

Environics defines financially vulnerable people as those who will struggle to meet financial obligations like mortgages or utility bills if coronavirus lockdowns caused a sudden drop in their income. It’s sadly no surprise that Indigenous people, after generations of colonialism and trauma, appear in this category as highly vulnerable.

More surprising, perhaps, is the high financial vulnerability of young suburban families.

According to Environics, the 700,000 households in this group are affluent when all is well. But they have relatively low savings — $57,000 on average — and a total debt that is double their household income of $105,000.

“They don’t have the liquid assets in savings to fall back on,” Seoni says. “They may be running into trouble in terms of having a sudden loss of income, based on their lifestyles.” Much depends on whether they’re able to continue working at home or in essential services during the lockdown.

Also highly vulnerable financially are “young urban renters,” Environics found.

“The younger renters in cities are not that highly indebted, they just don’t have that much income in the first place,” Seoni says. “When they lose their jobs, there’s just nothing left.”

Young single people in urban areas also face high levels of social vulnerability due to pandemic restrictions on movement.

Environics Analytics defines social vulnerability as people likely to experience isolation and mental health troubles, while having limited social networks and supports. It’s a challenge more prevalent in urban areas rather than rural ones.

Environics found that 36 per cent of young singles surveyed in cities reported feeling a weak sense of community belonging.

“Often, they are transplants into the big city, so their social networks tend to be weaker,” Seoni says. “A good number of them would be students … They’re alone in the city, almost.”

Newcomers to Canada also face high levels of social vulnerability, Environics found.

“What’s really driving it for these newcomers is a lack of social networks,” Seoni says. Something as simple as finding a trusted person to rely on for groceries, for example, can be a challenge, Seoni adds.

Older people, particularly those on low incomes, and people with poor health, make up a group that, according to Environics, is vulnerable due to a high level of “frailty.”

The coronavirus has made only too clear the vulnerability of people in nursing homes. But the people Environics highlights are those not living in nursing homes, but whose frailty makes daily activities difficult.

The District of Guysborough, anchored by a port town in Nova Scotia, has the highest frailty level of vulnerability in Canada, Environics found. Peel Region, west of Toronto, has one of the lowest, but Seoni again warns about the regionwide picture masking vulnerable pockets.

“In the big picture, you don’t have many frail citizens,” he says. “But they’re there and they need help.”

Source: https://www.thestar.com/news/canada/2020/05/08/suburban-families-young-renters-frail-seniors-data-reveals-who-is-most-at-risk-financially-and-socially-across-canada-amidst-the-pandemic.html

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