Bill Blair orders prison data to be turned over, but does the data even exist?

Good question in the header (follow-up article to Paul Wells’ Another farce on Bill Blair’s watch:

Public Safety Minister Bill Blair says he has ordered Correctional Service Canada to hand over data to an independent panel reviewing its practises, nearly a year after the panel first requested the information. But new documents from the corrections agency reveal it may be failing to accurately collect the data altogether.

In an interview with Maclean’s, Blair vows that “we are working very hard to make sure that we are able to provide that information and access to what the panel needs before they would consider continuing their job.”

Anthony Doob, the former head of the panel, says he still hasn’t heard from Correctional Services and has not been convinced to continue his work. “I need to know that we can actually do our work,” he told Maclean’s.

Last month, the panel tapped by the Trudeau government to review the implementation of its Structured Intervention Units (SIUs) was disbanded. Its scathing final report pointed to a lack of cooperation from Blair and Correctional Services, which rendered the panel “powerless to accomplish the job that it was set up to do.”

The new SIUs were supposed to replace an existing solitary confinement regime, which courts in Ontario and British Columbia called unconstitutional and, possibly, torture. Yet when Doob and his panel tried to analyze whether the new units were complying with the court orders and a new legal regime, they were stonewalled.

Doob says the information is crucial to the implementation of these units and that “the bulk, or all of the data, that we’re asking for is stuff they should want for their own purposes.”

But Correctional Services was unable to turn over the necessary data before the panel’s appointment ended in August. It has yet to offer a timeline on when it might supply the statistics.

On Wednesday, Correctional Services posted a request for information to the Canadian government’s procurement platform, seeking companies capable of updating its offender management system. The system, which tracks every inmate in custody, was implemented in the early 1990s and last updated in 2002.

The system governs just about every part of Canadian prisons, and is responsible for tracking the accommodations and mental health status of inmates. It is also the system that monitors inmates placed in the Structured Intervention Units.

Correctional Services first identified the need to update the system in 2015. Today, the database is strained, the document reveals. The systems to input and check crucial information on inmates, including their risk of suicide, “are manual, cumbersome, redundant and open to potential human error in data entry.” Other indicators, such as social history, are “not well integrated into the overall process.”

Correctional Services also notes that, on several fronts including inmate discipline, the process is “cumbersome and relies on paper and humans to ensure that information is gathered.”

Doob says that while their computer systems may be “not ideal,” that technology is no excuse. “They do lots of research themselves using their old system to get data. And, as I’ve said many times, if they truly cannot get the data for the panel, that means that they don’t know what is happening, in a systematic way, in their institutions.”

Often, the only recourse for inmates to contest the conditions of their confinement is to file a grievance. As Correctional Services notes in the procurement documents, the “offender grievance process is approximately 90 per cent paper based. This process has resulted in delays in processing offender grievances from the 60-80 day policy prescribed timeframes to up to three years.”

The service did provide a batch of files to the panel in May but, Doob says, the tables were unusable, inaccurate and essentially worthless for his study. For example, he says, the data noted when an inmate had a mental health issue—but not whether it was noted before, during or after their stay in the Structured Intervention Unit. The service employee responsible for data analysis admitted the information was essentially worthless, Doob says.

Maclean’s asked Correctional Services about deficiencies in their inmate tracking system, but has yet to receive a response.

Blair acknowledges that “Correction Services Canada struggled to collect and then make available the information in a timely way.” The panel first alerted Blair to its issues obtaining data in mid-March, then filed an interim report, noting “this panel has not been allowed to do its work” on July 23, and filed its final report on Aug. 11.

It wasn’t until the details of the report were released by Vice on Aug. 26 that Blair’s office responded. The day after, Blair called Doob to discuss next steps.

Asked why he didn’t intervene sooner, Blair didn’t answer. “When it was brought to my attention, I immediately gave direction that the information was to be collected and made available to the panel,” he says.

Doob says that, even if Correctional Services produces the data, he’s not sure he’ll rejoin the panel. He wants assurances that he’ll be able to properly review the service’s practises, including on-the-ground access to the new cells. “I’ve heard zero from CSC,” he reports.

Zilla Jones, a Winnipeg-based lawyer and a fellow member of the panel, has clients who have been placed in the Structured Intervention Units at the Stony Mountain penitentiary in Manitoba. She says the upgrades to some of the cells have been limited to “cosmetic” changes, such as a new coat of paint and some posters.

In a series of court rulings declaring the old system unconstitutional, the courts of appeal in Ontario and British Columbia ruled that inmates must be given more than two hours outside their cell per day. As part of the new Structured Intervention Units, the Trudeau government vowed that 20 hours per day would be the maximum amount of time per day that inmates would be locked up.

Through the COVID-19 pandemic, Correctional Service Canada has locked some inmates—especially those who are awaiting tests for the virus, or who exhibit symptoms—in the Structured Intervention Units for upwards of 23 hours a day.

Blair disagrees that doing so has run afoul of the courts’ rulings. “That was not for the purposes of either administrative or disciplinary segregation,” he says. “It was medical isolation for those who were ill.”

Given that Correctional Services has not been collecting data on those put in these units, Doob and the panel have questioned if Ottawa even knows whether the new law is being followed.

Nevertheless, Blair is confident. “The law is explicit, in that it eliminates the administrative and disciplinary segregation in those institutions,” Blair says. “We have eliminated [solitary confinement].”

Source: Bill Blair orders prison data to be turned over, but does the data even exist?

Wells: Another farce on Bill Blair’s watch

Hard not to read this column by Paul Wells and not be discouraged. Why launch a process, led by a well-known expert, and then not provide the needed data and cooperate.

And even more shocking that Correctional Services Canada does not have any of the requested data on hand.

Fortunate that with immigration, IRCC has an abundance of data, and with diversity and representation, as does TBS, even if I sometimes complain and want more.

The GiC appointments index, on the other hand, bears some similarity to the issues raised in the case of Correctional Services Canada, in that there is no integrated spreadsheet of all appointments, only separate tables by organization, as I discovered when doing my baseline analysis in 2016 (Governor in Council Appointments – 2016 Baseline):

I’ve got my journalistic obsessions, Lord knows. But the notion that Bill Blair, the minister of public safety and emergency preparedness, is in way over his head was not something I brought to this game. It’s a learned response. Lately it’s kind of getting locked in.

First there was the federal government’s response to April’s mass murder in Nova Scotia, which amounted to three months of silence and stonewalling, a botched announcement of an “independent review” that would have no power in law to compel testimony, and a hasty retreat after three days because basically everyone in Nova Scotia was saying in the newspapers what hundreds of them had been trying to tell Blair in private for months.

The hallmarks of this farce were unfamiliar but, in hindsight, look characteristic.  A long period of bland assurance that all is well in hand. (“We’ll put the processes in place to make sure that those answers not only are obtained for Canadians, but done in a way which is trustworthy,” Blair told Maclean’s in June. “It’s not an easy thing to do, but that’s my job.” Nice touch, that last bit.) The belated realization that actually, freaking nothing is happening. And finally, the headline-driven climb-down, accompanied by assurances that the minister was on top of things all along.

Fast forward to the strange case of Anthony Doob, Emeritus Professor of criminology at the University of Toronto. He’s 77, he’s in the Order of Canada, he’s one of the most-cited criminologists in the field. Last summer Blair’s predecessor Ralph Goodale put Doob in charge of a distinguished panel to monitor changes to solitary confinement in Canada’s federal prisons.

The change was part of Bill C-83, and it amounted to replacing “segregation units,” where inmates could be holed up alone for up to 22 hours a day if they were deemed dangerous to other prisoners or if they were under investigation for disciplinary infraction, with “structured intervention units (SIUs),” where they could be kept for up to 20 hours a day. Under the new law, summarized with its limitations in this article, inmates would also be given regular “meaningful human contact” with a counsellor, elder or other helpful person.

It’s a very modest improvement to treatment that’s been found systematically damaging to inmates’ prospects of rehabilitation—and, in some cases, to their lives. A succession of courts have found disciplinary segregation violated inmates’ Charter rights. Finally a B.C. Supreme Court justice gave the feds a year to fix the system.

The stakes were high. Section B of the court’s decision begins with a long discussion of whether extended solitary confinement constitutes torture. The judge sounds inclined to conclude it does.

So Bill C-83 was the Trudeau government’s coerced response to a legal obligation, not a spontaneous decision for reform. But Goodale appointed Doob and seven colleagues because he wanted to make sure the reform was working. The SIU review panel “will play an essential role in ensuring that the new SIU system achieves our goal of humane and effective corrections,” Goodale said then. He told the panel to “give ongoing feedback” to Correctional Services Canada during its one-year mandate—and to “alert the Minister directly” about any “problems or concerns” with the new system.

On Tuesday of this week, Professor Doob announced the panel no longer exists and that it had achieved nothing because Correctional Services Canada gave it no usable information and Bill Blair did nothing to help when Doob tried to tell him what was happening.

Justin Ling has reported on this over at Vice, and it’s been reported elsewhere, but I want to emphasize the Kafkaesque absurdity of the situation.

Usually when this government screws up, its defenders look around for somebody they can designate an outsider, spoiler, saboteur or wrecker, somebody who doesn’t understand the Trudeau government’s beautiful mission and who seeks to discredit it. A Jody Wilson-Raybould, a Jesse Brown, a Postmedia. That’s hard in this case because every player in this drama was appointed by this government: Blair, CSC Commissioner Anne Kelly, Doob and his fellow panelists.

From Doob’s final report (“We have essentially not been able to examine any aspect of the SIUs during their first 7-8 months of operation”) and a telephone conversation I had with Doob on Friday, the short version of what happened is as follows.

In mid-November, the panel told CSC it would need a set of information on every inmate transferred to an SIU: the inmate’s case history, the reasons for transfer, the maximum number of hours in the SIU in a 24-hour period, the average number of hours of confinement per day over the length of the stay, and so on. It was a long list of indicators, but that’s why Doob sent the list to CSC before the SIUs even opened in late November, and it’s why he asked for the first batch of data to be sent in February. This would take time. Updates would follow every two months.

The information the panel requested was “all things that were administrative in nature,” Doob said. “It’s stuff that is almost certainly in their files somewhere.” If anything he asked for wasn’t available, he’d adjust. “I’ve been working with quantitative data for 50 years. This is the sort of thing that happens all the time. And you don’t worry about it.”

Correctional Services gave no hint that any of this would be a problem.

In mid-February Doob contacted the agency to begin figuring out how the data would be transmitted to the panel, how inmate confidentiality could be respected, and so on. This is three months after he told them what he wanted and five months after the responsible cabinet minister called his work “essential.” Doob’s contact at CSC said the agency hadn’t yet decided whether it would give the panel any of the information it had requested.

This turn of events “came to the panel as a complete surprise,” Doob wrote mildly in his final report. After some back-and-forth to insist on the importance of the panel’s request and gauge the agency’s willingness to block, he wrote to CSC Commissioner Anne Kelly in mid-March—and to Bill Blair at the end of March. From Kelly, he received no reply. Not until she saw her name cc’d on the complaint to Blair. That got a request from her for a meeting. But it took most of April for the meeting to happen. Finally in late May, CSC delivered data to Doob.

That data was unusable. Instead of a single spreadsheet with comparable indicators for every inmate, there were more than 900 spreadsheets. And Doob quickly discovered that depending on the criterion, the number of cases varied. Which meant that there was no way to compare among cases or between criteria. “It was a pile of crap,” he told me. Remember, this is a guy who’s spent decades in the field.

Doob’s dismayed response led to CSC, an organization with 18,000 employees, coughing up one (1) data analyst to work with him on cleaning up the data. His report is very complimentary about this data analyst, but after she’d worked for six weeks, he sent CSC a report advising the agency that he had no systematic analysis because he’d been given no useful data for most of his panel’s time on this earth.

CSC received that report on July 21. By an agreement Doob had reached with the agency when his panel was formed, it had three weeks to respond. After three weeks it hadn’t responded. After three weeks and six days, Doob received a letter from a senior deputy commissioner saying, in effect, sorry for the crummy data, we’re in the process of transferring our data collection from a platform that no longer works to one that doesn’t work yet. On the bright side, CSC promised monthly updates. On the downside, members of Doob’s panel were reaching the end of their one-year mandates, a couple at a time because they hadn’t even been appointed at the same time.

On Tuesday, Doob sent Ottawa reporters his final report with a cover-letter broadside, via the office of Kim Pate, a (Trudeau-appointed!) Ontario Senator with a long career in criminal-justice reform. “Our panel no longer exists,” he wrote. And it wasn’t just a problem that it wasn’t given the information it needed. It’s a problem because the agency that jails a huge prison population seems uninterested in how they’re doing. “CSC is telling us that it does not have systematic information on the operation of its Structured Intervention Units and apparently never made the gathering of this information a priority.”

Remember Bill Blair? Remember how he had nothing to say when Doob warned him through official channels in March? He did now, once Doob made his concerns public. “There have been news reports on the Correctional Services of Canada’s work with an Implementation Advisory Panel,” a statement from Blair’s office read.

“It is amusing to me that they don’t even acknowledge that these ‘news reports’ come from a report (from our panel) that CSC had for weeks,” Doob writes in an annotated version of Blair’s statement that Doob has been sending reporters.

The statement rehashes some of the background of the panel and adds: “We have dedicated extra resources to expedite this request.” Doob’s response: “CSC itself, for its own purposes, should want to know how the SIUs are operating. They shouldn’t have to be pushed into getting these data by an independent panel. They should want to know. Hence the implication that we are requiring them to dedicate ‘extra resources’ is, quite frankly, offensive.”

At midweek, Doob received a telephone call from Blair. “He said to me, ‘I’d like you to do this job,’” said Doob, who had written to Blair five months earlier warning that he was not being permitted to do his job.

Doob still thinks it’s worth knowing whether a court-mandated and hastily-developed reform is achieving its ends. He still thinks somebody should do the work he tried to do. Will he, now? “I told [Blair] that a necessary condition would be that I actually have the data in front of me,” he says. Promises of data later aren’t enough.

But that’s what Doob needs before he’ll even consider doing for Blair the work Goodale assigned him, the work he’s spent all of 2020 trying to do. “That’s the necessary condition. I don’t know what the sufficient conditions would be. If they even exist.”

A few concluding thoughts.

Once at a public event, I met a staffer from the Prime Minister’s Office I didn’t know yet. This person worked on files related to science and research policy, a longstanding preoccupation of mine. “When you tweet about science policy, I wind up working all weekend,” this person said. Sure, it was flattering, and I’m sure it wasn’t meant as a rigorously truthful or complete statement. But it also struck me as a little odd. I’m not smart enough to write anything on science policy that I haven’t heard from researchers. Why would my tweet be the thing that provokes overtime shifts? Why not the scientists?

I thought about this conversation when I learned that a report from a duly-constituted government-appointed panel isn’t enough to get the responsible minister involved in the file—but a headline in Vice is. Blair’s call was “a response to what’s in the media,” Doob told me, “not to what I’ve sent the government.”

This is what many people who work with this government tells me. Public servants, consultants, NGOs. Official channels are useless. Process is window dressing. This government consults but doesn’t listen, and whatever the plan is, it’s never as useful to know the plan as it is to have the personal phone numbers of a half-dozen senior staffers so you can text one of them and urge an improvised change of plans.

A couple of weeks ago Rob Silver, a supremely well-connected Liberal working for a mortgage firm, was in the news for his attempts to secure a legislative change that would benefit his company. Silver’s overtures were fruitless and I offer no opinion on their propriety, but he plainly knew what you need to do if you want to get something done in this town: Call Mike McNair, call Elder Marques, call Justin To. Write a letter to the minister? Don’t be old-fashioned.

When Anne Kelly became the Commissioner of Correctional Services Canada, Ralph Goodale wrote her a public mandate letter. “I encourage you to instil within CSC a culture of ongoing self-reflection,” he wrote, amusingly in hindsight. “This includes: regularly reviewing policies and operations to identify what works and change what does not… and welcoming constructive, good-faith critiques as indispensable drivers of progress.”

But in a government in which only a handful of staffers can actually make a decision, very few people in any department have the kind of autonomy Goodale was hoping Kelly would exercise. When the decision-making pipeline is no thicker than the PMO, and every particle of communication is the product of a chain involving dozens of staffers and bureaucrats reaching across government, nobody has the right to decide. So nobody is accountable for their decisions.

I don’t just mean that in the negative sense that nobody is sanctioned for a bad decision. I mean nobody has the authority to make a good decision. Things just happen. Or they just don’t. In a real sense, we’re not governed. We’re just given a constant runaround by people who, in many cases, would prefer not to be part of the immense machine delivering the runaround. Which is how a panel appointed to answer a basic question — has Canada stopped torturing people yet? — could work for a year and find no answers. And somehow it’s nobody’s fault. Not even Bill Blair’s, I guess.

Source: Another farce on Bill Blair’s watch

Ottawa must put data first and tie to health funding

Agree in principle but politically hard to achieve (Quebec doesn’t even automatically share its data with CIHI):

The federal government looks yet again about to transfer billions of dollars to the provinces with essentially no strings attached.

We’ve seen this before with $40 billion in the 2004 First Ministers’ Health Accord and then $11 billion in the 2017 Health Accord, both highlighting home care, without evidence of significant progress.

And the prime minister just announced $19 billion for the Safe Restart Program, though without any details, especially as to what the federal government receives in return.

One major quid pro quo could address Canada’s profound lack of high-quality data, especially highlighted by the COVID-19 pandemic. While U.S. analysts are able in near real time to estimate and project COVID cases, hospitalizations and deaths down to the county level, Canada is barely able to produce comparable data by province.

Some of this $19 billion is meant for COVID testing and tracing, and improvements in long-term care.

A major failing in the tragic and disproportionate COVID-19 mortality rates in nursing homes was due to poor staffing levels, an issue that has been known for decades and pointed out in myriad reports and studies. But there are essentially no comparable and complete national data in this area.

As strongly recommended in the recent Royal Society of Canada report, high quality data on current staffing levels, connected at the individual level to health outcomes, are essential, especially for the federal government to develop the evidence-based national standards for long-term care so many have been calling for.

The provinces have typically argued that health care is a provincial jurisdiction, so the federal government cannot compel them to provide sorely needed data. However, in another example, we have had almost two decades of cajoling the provinces with federally funded Canada Health Infoway paying at least half the cost to develop and implement standardized and interoperable software systems for electronic health records.

Most relevant for the current pandemic, Infoway was specifically tasked with producing a system for anticipating and dealing with infectious disease outbreaks. This system, had it been working even 15 years after its initial funding in 2004, would have enabled a very different outcome this year, likely with far fewer cases and deaths from COVID-19.

Paper agreements and cajoling the provinces with optional subsidies have clearly failed. It’s time for a much tougher stance.

The federal government has the necessary constitutional powers, including explicit jurisdiction for statistics, criminal law, spending powers, and the general peace, order and good government (POGG) power, to compel the collection and flows of 21st century kinds of data.

Monique Bégin, as federal minister of health, successfully ended the practice of physicians’ extra-billing by amending the Canada Health Act to deduct any extra billing from an offending province’s fiscal transfer. The Supreme Court has just upheld the federal government’s genetic privacy legislation as constitutional despite objections from Quebec.

In the current pandemic emergency, high-quality, standardized, real-time data on “excess deaths,” COVID cases and hospitalizations, and details on the operations of the thousands of nursing homes and retirement residences across Canada are essential.

For nursing homes, we need these data to learn why some were completely successful in avoiding any novel coronavirus cases amongst residents and staff, while others suffered tragically. In turn, such statistical information will provide the federal government the strong evidence base needed to take the lead in establishing national standards for nursing home staffing levels, though action on staffing must not wait for perfect data.

And once we have standardized individual-level data on COVID cases, including factors like age, sex, neighbourhood, other diseases, individuals’ household composition, race, hospitalization rates, disease severity, and deaths, as the U.K. has been able to do for 17 million of its residents in near real time, then Canada will be able to support far more sophisticated analysis and projections to deal with the current top pandemic issues — not least, whether to open bars or schools.

NDP calls for race-based data collection to combat racism, spur change

Valid call. Will see whether the government’s Centre for Gender, Diversity and Inclusion Statistics within Statistics Canada starts to generate results and in which areas:

NDP Leader Jagmeet Singh says the federal government must start collecting race-based data in order to make policy changes that will start to turn the tide on what the United Nations has called the “deplorable” treatment of African Canadians.

Protests against the police-killing of George Floyd in the U.S. spilled into Canada last weekend and Toronto was seized by the death of Regis Korchinski-Paquet, who fell from a 24th-floor Toronto apartment while police were in the home. Her death is under investigation by the province’s police watchdog.

On Monday, Canada’s political leaders tried to address the growing outrage. Mr. Singh proposed firm steps to address anti-black racism in Canada, while Prime Minister Justin Trudeau promised his government would do more but didn’t outline specific steps or a timeline to act. Conservative Leader Andrew Scheer proposed no new policies but said all levels of government have “much more to do.”

In contrast to protests south of the border, violence at Canadian demonstrations was limited to Montreal, where 11 people were arrested after dozens of businesses were damaged at the tail end of the formal march, which took place without incident.

Mr. Trudeau promised to “keep taking meaningful action to fight racism and discrimination in every form.” That progress in Canada has been too slow though, according to a 2017 United Nations Human Rights Council report on anti-black racism.

Across Canada, the report found disproportionately high unemployment rates for African Canadians, leading to more precarious and low-paid work, and worse health outcomes, where people in black communities are less likely to access health care services and more likely to suffer from chronic health conditions. In Nova Scotia, it found “deplorable” socioeconomic conditions and no change in educational inequities, 30 years after schools were integrated.

While federal leaders acknowledged the persistence of racism and systemic discrimination in Canada, Quebec Premier François Legault denied that it stems from structural problems.

“All humans are equal, are all the same, regardless of the colour of their skin,” Mr. Legault said. The UN report found African Canadians in Montreal have the highest poverty rates among visible minorities in the city.

The UN report recommended a mandatory nationwide policy on the collection of data disaggregated by race, colour, ethnic background, national origin and other identities “to determine if and where racial disparities exist for African Canadians so as to address them accordingly.”

That hasn’t yet happened and without it Canada is missing critical information that countries like the United States have readily available, said Arjumand Siddiqi, Canada Research Chair in population health equity. For example, Canada does not have information about how employment statistics break down along racial lines, making it difficult to know if some groups are being excluded from the suite of financial aid the Liberals have rolled out in the wake of the economic shutdown sparked by COVID-19.

While race-based data is collected in the census every five years, there is no routine collection of data, and on top of that, the data that is collected is not readily available, said Prof. Siddiqi, who is also an associate professor at the University of Toronto’s Dalla Lana School of Public Health.

The difference between the data available in the U.S. and Canada is “night and day,” she said. Without that data, evidence-based policy changes are stymied and it’s harder to hold governments to account.

The failure to collect the valuable data comes even as the impact of having the information is clear, Mr. Singh said, noting that changes to police carding were only made when numbers laid bare that the practice disproportionately targeted black and Indigenous people.

He said the data collection would help spur systemic changes in policing, the justice system and to inequities in health care, education, housing and employment, which “perpetuates the undervaluing of black life, of racialized people’s lives.”

The Liberals funded a new Centre for Gender, Diversity and Inclusion Statistics within Statistics Canada in 2018. A spokesperson for Innovation, Science and Industry Minister Navdeep Bains did not explain why a separate centre was created rather than integrating it with all of the work done by the federal agency.

Evidence from other countries and small pockets of information in Canada show that poorer people and people of colour are being hit harder by the novel coronavirus. But the Prime Minister acknowledged that collecting that information widely in Canada is an uphill battle, given that at the moment the government doesn’t even have the age data for a “large portion” of the people diagnosed with COVID-19.

Mr. Singh also said he supported the use of body cameras for police officers to ensure accountability and said police need more training in how to de-escalate incidents.

The UN report released a long list of recommendations to the federal government, which included apologizing for Canada’s history of slavery and other historical injustices, as well as considering paying reparations. The federal government on Monday did not say whether it was going to accept either of those recommendations.

Source:    NDP calls for race-based data collection to combat racism, spur change NDP Leader Jagmeet Singh echoed the call made in a 2017 UN Human Rights Council report on anti-black racism in Canada <img src=”https://www.theglobeandmail.com/resizer/06BMxG3XANkkpiQPUyh4FRZLZTY=/0x0:3600×2400/740×0/filters:quality(80)/cloudfront-us-east-1.images.arcpublishing.com/tgam/OV42UZ73E5JO7BMPP6YND6GQ3I.jpg” alt=””>     

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

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 

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

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

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

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

How Canada’s crucial data gaps are hindering the coronavirus pandemic response

Good long read on data gaps. Have excerpted the intro and the section on the lack of visible and ethnic minority data:

Gaps in key health and economic data are hindering Canada’s response to the COVID-19 pandemic, leaving Canadians in the dark about who is being infected or struggling with the devastated economy, say researchers, politicians and scientists.

These blind spots could blunt the federal economic rescue effort, hide inequities in deaths from the disease and slow our emergence from self-isolation in the months ahead. Experts are urging provincial and federal leaders to open up more streams of data immediately, as doing so might save lives and livelihoods.

Canada has a long-standing problem of information gaps, The Globe and Mail found in a year-long series, and that has left us vulnerable during public health crises before. A government audit found that during the 2009 swine flu pandemic, data deficiencies left the Public Health Agency of Canada “unable to answer basic questions such as the rate of spread” of the virus.

….

Nationally, the ethnicity of those who have been infected or have died is unknown. Because of data gaps, the death toll likely is being underestimated.

On the economic front, Canadians don’t know how many in each province are applying for employment insurance every week (as the United States does by state). They don’t have up-to-date numbers on bankruptcies, mortgages in arrears, how workers in the gig economy are faring, the extent of layoffs or the degree to which the federal government’s plan for an enhanced wage-subsidy program has spurred rehiring.

Arjumand Siddiqi, the division head of epidemiology at the University of Toronto’s Dalla Lana School of Public Health, said she and her colleagues are eager to help analyze the fast-moving crisis to a greater extent, but have been stalled by a lack of detailed figures on the demographics and locations of confirmed cases, among other things.

“We have the will, we have the expertise, but we don’t have the data,” she said. “It would be good to know what is actually happening.”

One of the most pressing gaps, Dr. Siddiqi said, is information about the ethnicity of those who have tested positive for COVID-19 or died of the disease. No Canadian province makes this data available, in keeping with a long-standing national aversion to publishing statistics about racial disparities in health. (Toronto’s Medical Officer of Health, Eileen de Villa, has announced that the city is exploring ways to collect race-based coronavirus data on its own.)

But there is reason to suspect race may be a factor in determining who is being infected and dying from the virus, Dr. Siddiqi said, both because of the prevalence of various underlying health conditions in some racialized communities, and their over-representation in low-wage jobs such as nursing, delivery and retail, which make them highly prone to exposure to the virus. Early U.S. data indicate that black Americans are being admitted to hospital and dying from COVID-19 at a disproportionate rate.

“We are very clear that we want to know who is at risk,” Dr. Siddiqi said. “But we’re just very hesitant – and that’s kind of putting it mildly – to add race to the set of dividing factors that we’re willing to entertain.”

This blind spot extends to Indigenous people, whose health care is largely provided by the federal government. NDP MP Charlie Angus would like to change that. In a letter to Health Minister Patty Hajdu last week, he urged the government to start keeping data on COVID-19 cases among Indigenous people, saying, “It would be irresponsible at this time to turn a blind eye to the movement of COVID through vulnerable populations.”

“It seems bloody obvious that you would want to track this and make policy based on this information,” he said in an interview. “I think there’s a naive arrogance in the principle of saying: ‘We’re not the United States, we don’t have their problems, we don’t discriminate like that.’ ”

Even government-funded groups such as the Canadian Institute for Health Information (CIHI) have begun calling for race-based data around coronavirus cases. The organization now supports the idea of health care providers asking a common question about the race of COVID-19 patients and says it would be willing to compile the data.

“The COVID pandemic is certainly exposing gaps in important data flows within and between health care systems in Canada,” CIHI spokeswoman Alex Maheux said.

Source: How Canada’s crucial data gaps are hindering the coronavirus pandemic response ‘We have the will, we have the expertise, but we don’t have the data’: Nationally, the lack of coronavirus-related health and economic data is stalling efforts to analyze the fast-moving COVID-19 crisis

Being Counted in Canada’s Coronavirus Data, Ontario’s lack of diversity data for COVID-19 is an embarrassment

Two good commentaries on the lack of diversity data, starting with Howard Ramos of Dalhousie:

The lack of COVID-19 data on immigrants and racialized minorities collected and shared by Canada’s many layers of government could lead to health inequities.

Canada is not alone in having a data gap on immigrant and racialized groups. In the United States civil rights groups and doctors have called on its federal government to release demographic data on coronavirus infections.

Analysis that looks at the number of COVID-19 cases based on publicly available American data and census information shows that counties that are majority African-American have three times the rate of infection and almost six times the rate of deaths as counties where white residents are in the majority. It is a trend that has raised alarm across American cities.

Understanding Canada-U.S. differences

Past research suggests, however, that Canadians should be cautious in reaching conclusions and not automatically assume that what takes place in the U.S. naturally holds true north of the border.

The ‘healthy immigrant effect’ debate, for instance, which shows that many newcomers to the country self-report better health than native-born Canadians may mean that immigrants, who are also largely racialized, may not follow the same patterns as seen in the U.S.

What is needed to answer that question, and many others, is access to quality data. And just like personal protective equipment – it is currently in short supply.

Part of the problem in capturing immigrants and racialized groups in health data rests with how they are captured. Health data is largely the domain of provinces and territories, leading to uneven data collection and reporting across them.

When asked if Ontario could offer insights on the pandemic’s impact on racialized communities, Dr. David Williams, the province’s chief medical officer of health, noted that “statistics based on race aren’t collected in Canada unless certain groups are found to have risk factors.”

Ironically, if data are not collected, one cannot tell if a group has risk factors to begin with. This could lead to health inequities for African-Canadian, Indigenous, racialized, and other new Canadians.

That scenario is a big reason why the African, Caribbean and Black Network of Waterloo Region recently launched a petition demanding that data on race, ethnicity, sexual orientation, and socio-economic status be collected and reported on.

Data gap flows all the way to Ottawa

The data-gap is also seen at the federal level too. For instance, the new and innovative crowd sourced survey on the social and economic impacts of COVID-19 run by Statistics Canada measures age and gender but not other demographic features. The same absence is also seen in the Public Health Agency of Canada’s ‘detailed confirmed cases of coronavirus disease’ data, which is hosted by Statistics Canada.

The detailed data does not provide geo-coding or additional information on the location of the cases which means that researchers cannot link it to census tracts or other geographic units to do the kinds of analysis that was done for American communities.

As a result, the maps offered through the interactive Canada’s COVID-19 Situational Awareness Dashboard are fairly coarse. In many cases, more detailed information can be found through non-governmental sites such as ViriHealth. But, once again, sociodemographic characteristics are not provided and the location data is where people are treated over where they live.

Lastly, once Canada begins to move towards recovery, Statistics Canada’s data on job loses and employment can report on immigrants and racialized groups. Much of this data is collected through the Labour Force survey, which is good news. It’s only logical that measures of health and wellbeing be captured with the same level of detail.

If there’s one thing silver lining to Canada’s experience during the COVID-19 pandemic, it’s reinforcing the point that collecting data matters. It’s essential to insure that everyone, regardless of race or ethnicity, is treated equally as citizens.

Source: newcanadianmedia.ca/being-counted-…

Secondly, the Ontario situation by Adam Kassam a Toronto-based physician:

The United States recently earned the unfortunate distinction of having the highest number of COVID-19 cases in the world, at more than 575,000. The true number of infected individuals, of course, is likely much higher given the lack of widespread and available testing.

But in that U.S. data, an alarming trend emerged: The coronavirus appeared to be disproportionately killing African-Americans. Last week, the Centers for Disease Control and Prevention (CDC) released a preliminary report suggesting that there were higher rates of hospital admissions and death among black Americans compared with other communities.

These revelations have intensified a nationwide conversation on the social determinants of health and the necessity to collect better data. The CDC report is far from comprehensive, which has led to presumptive Democratic nominee Joe Biden calling on the organization to be more transparent by releasing more information. Even U.S. President Donald Trump has expressed concern, and instructed his African-American Surgeon-General, Dr. Jerome Adams, to formulate a federal response to address the problem.

This discourse about diversity data and its impact on racialized communities in the U.S. stands in sharp relief against the Canadian experience. Last week, Dr. David Williams, Ontario’s Chief Medical Officer of Health, summarily dismissed calls for the collection of racial data. He asserts that statistics on race aren’t collected unless certain groups are found to have risk factors, and that “regardless of race, ethnic or other backgrounds, they’re all equally important to us.”

We have a problem in this country when Donald Trump sounds more progressive about racial disparities than our own public health officials. Imagine if our Chief Medical Officer of Health claimed that it wasn’t important to collect gender-based data? This would be a fireable offence. It is, therefore, inconceivable that this same official, in the country’s most diverse province, would willfully choose to effectively ignore the unique needs of the nearly four million visible minorities who call Ontario home.

This is the manifestation of structural and systemic biases that have been omnipresent within our medical community for generations. Canada’s poverty of diversity data has been an indefensible blind spot, both in terms of health care and in our educational institutions. It is the symptom of an insidious disease, whose current hallmark is a leadership that looks increasingly less like the communities which it serves.

How else could you explain the dearth of visible minorities in some of the top leadership roles in health care across Ontario? Public Health Ontario’s executive does not appear to include a single visible minority. A visible minority has never served as Ontario’s health minister. And because diversity data of this nature is not collected or made public, we don’t know how many deputy ministers of health, deans of medicine or chiefs of medical departments have represented diverse backgrounds.

In many ways, you only measure what you really care about. Ontario’s Chief Medical Officer has unfortunately made that very clear. Never mind that collecting race-based data wouldn’t be an onerous task; crucially, it is part of good science. Only by intentionally studying diverse populations have we learned that women experience certain health challenges, such as heart attacks, differently from men. In the same vein, disease has been shown to manifest differently for patients from different ethnic backgrounds. It is my belief that all people deserve to know the details of their lives and to know that their lives are worthy of study.

While we don’t know whether racial differences influence COVID-19′s effect on individuals, Canada should be invested in determining this definitively, instead of taking its cues from the World Health Organization.

Early reports from the U.S. have pointed to disadvantaged and marginalized groups – the poor, immigrant, black and brown communities – being more significantly affected, and this has prompted crucial scrutiny of the deep and enduring fault lines between the haves and have-nots. Yet we cannot have those conversations here, as we cannot know whether the U.S. data reflect Canada’s, even though just a border separates us.

In Canada, where we are quick to declare that diversity is our strength, we must now dispense with the empty platitudes and put our money where our mouth is. Our governments should openly commit to funding the collection and publication of diverse health data during and after this pandemic. Their explicit goal should be to create policy that improves the health care of all its citizens. What’s clear is that this ethos will only become a priority when our medical leadership more closely reflects the Canada of today.

Source: Ontario’s lack of diversity data for COVID-19 is an embarrassment: Adam Kassam

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.”