Lightman and Akbary: New data provide insight into pandemic inequalities

2023/04/03 Leave a comment

Insightful analysis, contrasting vaccination rates (relatively similar) and health outcomes (disparities):

Existing analyses of COVID-19 in Canada and internationally suggest infection rates were highly variable across populations, with researchers highlighting the disproportionate burdenexperienced by groups that are intersectionally disadvantaged.

Early in the pandemic, widespread evidence emerged of the unequal rates of infection experienced by residents and care workers in long-term care homes in Canada. Soon after, racialized populations and immigrants were also found to be especially hard-hit. The COVID-19 mortality rate was significantly higher for racialized populations.

Our new research finds that while these individuals had higher rates of COVID-19 infection, they were equally or more likely to get vaccinated than comparison groups. This has important policy implications. Rather than focusing on individual decision-making, the data suggest a need to prioritize protections and pay for workers in essential jobs that are unpredictable, dangerous, physically demanding and/or low wage.

Overwhelming evidence shows that vaccines are an effective protective measure, both in terms of reducing infection ratesand severity of illness. Using the 2022 Statistics Canada dataset “Impacts of COVID-19 on Canadians – Testing and Vaccination,” our analyses found that variable vaccination rates were not the reason behind differing rates of infection.

These data were collected as part of Statistics Canada’s crowdsourcing initiative which aimed to gather timely information on Canadians’ experiences of testing for COVID-19 and access to vaccination during the pandemic. Statistics Canada used open advertising to obtain participants who chose to self-select by completing an online questionnaire from February 21 to March 13, 2022.

For racialized minorities, 20 per cent tested positive, compared to 15 per cent for non-racialized minorities (outcomes were similar when comparing PCR to rapid test results). In particular, those who identified as Black and Filipino (populations that also have high rates of employment in care occupations and in service industries fared worst. Black populations experienced a one-third rate of positivity for rapid tests (see Figure 1).

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Citizenship was also an important factor. Those without Canadian citizenship status (including temporary foreign workers) fared worse for both types of testing (at an average of 22 per cent positivity), compared to those immigrants with citizenship status and the Canadian-born. The latter fared by far the best, at 14 per cent positivity via PCR tests, and 17 per cent positivity via rapid tests (see Figure 2).

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Women and men, interestingly, were found to have had similar rates of infection. However, those who identified as essential workers had higher rates of infection (see Figure 3), with women overrepresented among this population.

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Yet the data on rates of vaccination tell a different story. This suggests that variable infection rates were tied to specific jobs or to systemic inequalities, rather than a function of individual choice.

There was only a marginal difference in vaccination rates between essential workers and non-essential workers. Racialized people and immigrants had higher rates of vaccination than non-racialized people and non-immigrants (see Figure 4).

https://e.infogram.com/lightman-fig4-1h7g6k0gvyrgo2o?live?parent_url=https%3A%2F%2Fpolicyoptions.irpp.org%2Fmagazines%2Fmarch-2023%2Fnew-data-provide-insight-into-pandemic-inequalities%2F%3Futm_source%3DPolicy%2BOptions%2BNewsletter%26utm_campaign%3D18ca25504e-EMAIL_CAMPAIGN_2022_02_14_05_26_COPY_01%26utm_medium%3Demail%26utm_term%3D0_26f66e24ce-18ca25504e-104024581%26mc_cid%3D18ca25504e%26mc_eid%3D86cabdc518&src=embed#async_embed

Finally, the data reject explanations tied to access to health facilities. In the five cities in Canada with the highest rates of infection, residents had higher rates of access to at least one health facility and a pharmacy close to them (see Figure 5).

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Together, this information suggests that COVID-19 infection rates were not related to personal decision-making or access to health services. Instead, it raises concerns about broader social responsibilities. Populations that are racialized and/or non-citizens and those doing essential jobs were infected at disproportionate rates, even as they took steps to get vaccinated.

Notably, the data do not provide information on time order, so it is plausible that those workers on the front lines reported positive cases prior to having access to the vaccine. This raises further questions about which occupations and which areas of each city were prioritized for personal protective equipment and early access to vaccination, while refuting suggestions of a lack of awareness or interest in vaccination by underserved communities.

As well, the data do not indicate the severity of illness. Thus, the analyses may tell a story of lives saved due to vaccination for populations that were at greater risk of infection due to their workplace conditions.

In terms of policy, this suggests that there is an urgent need to focus on improving working conditions for essential workers. This includes providing paid sick leave and job guarantees for those who take time off work to care for themselves or others. Staffing levels and accommodations to work from home for those who are sick (when possible) should be ensured. Accommodations to reduce workplace injuries and increase mental health supports must be made available. Providing safe transportation to and from work facilities as well as paid time to travel to get vaccinated should be a policy initiative. Finally, emergency housing for self-isolation when needed and access to child and elder care, as well as affordable housing for those with lower socioeconomic status, should also be top priority.

Perhaps most critically, wages must be raised for workers who are systematically at higher risk of infection due to the face-to-face nature of their employment (while also structuring workplaces to avoid dangerous work conditions where possible.) This would at least partially compensate for increased rates of infection within certain jobs and recognize the toll it takes on individuals, families and communities.

All this reinforces a structural rather than individual analysis of disease burdens and public health measures. Clearly, getting vaccinated is not the end of the story. Ongoing social responsibility is needed to protect vulnerable groups – whether this takes the form of masking, work-from-home measures, or other workplace accommodations.

The implications of the pandemic are nowhere near over. There must be a move beyond rhetoric of “gratitude” to essential workers; instead, governments and employers must implement better policies and pay. These policies must be evidence-based so Canadians have an accurate understanding about the pandemic and its effects.

Given the emerging information about the potentially long-term implications of COVID-19, these measures take on added urgency for groups such as children, people with disabilities and intersectionally disadvantaged populations.

A note about methodology

Statistics Canada started the crowdsourcing initiative as part of a data collection series to address the informational needs of Canadians and enhance their understanding related to the impact of COVID-19. According to an evaluation report, Statistics Canada’s crowdsourcing products have proven to be useful for briefing purposes, policy research and analysis, program and service planning and decision-making, as well as knowledge-production and modeling. Statistics Canada uses a number of measures to ensure the quality of data collected through the crowdsourcing initiative. First, the questionnaires are designed based on Statistics Canada’s standard practices and wording used in a computer-assisted interviewing environment. During data collection, a computer application is used to automatically control the flow of questions, depending on participant responses, and to check for logical inconsistencies and errors in participant responses. The computer application used for these purposes is tested extensively. After data have been collected, Statistics Canada maximizes the quality of crowdsourced data through error detection of invalid or missing values for age, gender and postal code at micro levels. Furthermore, Statistics Canada compensates for overrepresentation and underrepresentation by calculating a benchmark factor for every participant based on demographic projections of the number of people by province and territory, sex and age group. As recommended by Statistics Canada, therefore, the authors of this article used the benchmark factor to produce their results in the same way that survey weights are used to produce estimates from non-crowdsourced data.

Source: Lightman and Akbary: New data provide insight into pandemic inequalities

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Lightman: Working more and making less: Canada needs to protect immigrant women care workers as they age

2023/02/23 Leave a comment

Of note. Would also be interesting to have some comparisons with males and with a variety of sectors. It would also benefit from analysis of the cost of the proposed measures and the impact of those costs:

The pandemic has heightened Canadians’ awareness of the 3D jobs — dirty, difficult and dangerous — done by many migrant workers in our communities.

When the pandemic first struck, many of these workers were on the front line working in essential services. Engaged in low-wage work in health and child care, immigrant care workers had high rates of COVID-19 infections, while also experiencing widespread job losses and continuing financial struggles to make ends meet. 

Our recent paper in the Journal of Aging and Social Policy reveals troubling realities for immigrant women care workers as they age. We found that immigrant women aged 65 and over who entered Canada through the (Live-in) Caregiver program work more but make less than other comparable immigrant women. The required live-in component was removed in 2014 and the program has since been split into two pilot programs. 

These findings are crucially important given Canada’s rapidly aging population and increasing concern about senior poverty in racialized communities.

Working past retirement age

In Canada, we have long known that it is disproportionately racialized immigrant women (specifically Black and Filipina women) who do challenging and devalued work as carers. We also know that jobs like personal support workers, home health aides and child-care workers are still usually associated with “women’s work” and tend to have low wages.

However, what we have not known is whether these women continue to experience these disadvantages later in life. Specifically, we have very little information about the financial challenges immigrant women care workers in Canada face as they age. 

On the one hand, it is plausible that care workers are more likely than other workers to continue working past the typical retirement age because of their relatively low wages and limited savings. 

On the other hand, due to the physically and emotionally demanding nature of care work, which can be detrimental to their health, care workers may be less likely to continue working past age 65 and have higher rates of eligibility for government low-income supports. 

Our recent research tried to clarify the situation of immigrant care workers as they age. We examined 11 years of Statistics Canada data from 2007-2017 to compare the income sources and trajectories of immigrant women who entered Canada through three migrant entry programs. 

We used Statistics Canada’s Longitudinal Immigration Databaseto unpack how the gendered and racialized devaluation of caring occupations disadvantages immigrant women as they age. The database is a comprehensive source of administrative data that includes information on the socio-economic status of tax-filing immigrants since their arrival in Canada.

The data show that care workers are more likely to be employed after the age of 65 than other immigrant women, but have a lower and declining total income as they age. 

Furthermore, while care workers receive higher rates of government pension benefits, they tend to have lower levels of private pension savings. And the cumulative income they report shows a relative decline over time.

Prioritizing care workers as they age

So what does this all mean? Our study underscores serious concerns about government investment in alleviating senior poverty. The conditions of low-wage care workers, before and after retirement, must be prioritized.

The package of pension supports available in Canada, which includes Old Age Security, the Guaranteed Income Supplement and the Canada Pension Plan, does not offset the decline in earnings immigrant care worker women face as they age. 

That means there is a need to enhance policies that address senior poverty, recognizing that immigrant care worker women are among Canada’s most vulnerable populations. These women experience intersectional disadvantages as immigrants, women and racialized minorities. 

Our findings also reinforce the need for more full-time, permanent and well-paying jobs in the Canadian care sector. As of 2017, the unemployment rate of female immigrants in Canada was nearly double that of their Canadian-born counterparts. Recent research finds that the pandemic increased rates of unemployment and led to shifts to precarious work for many immigrant women in Canada.

The federal government must enhance access to and the amount of money provided through the Guaranteed Income Supplement to address senior poverty within underserved communities. Any government invested in reducing social inequalities and protecting vulnerable senior populations must consider the financial challenges immigrant care worker women face as they age and equalize their income over time with other comparable groups. And we, as the electorate, must do our part to keep governments accountable to this goal. 

Ultimately, immigrant women are doing the essential jobs that most Canadians rely on. They are caring for our elderly, sick or young family members when we are in need. 

It is the very least we can do to ensure that immigrant women care workers are able to age with financial security, dignity and adequate social protections.

Source: Working more and making less: Canada needs to protect immigrant women care workers as they age

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Three times more racialized renters live in overcrowded housing in Toronto than non-racialized renters — and the starkest gap is among those born in Canada, study says

2020/11/18 Leave a comment

Significant study on inequality and minority groups:

If you look at Toronto renters who spend at least 30 per cent of their income on housing — a traditional marker of unaffordability — you might miss the deep racial divides of the city’s housing crisis.

There’s barely a gulf between racialized and non-racialized renter households that spend that much: 41 per cent versus 43, respectively, census data says. Similarities prevail as fortunes get worse: 19 per cent of racialized renter households spend at least half their income on rent, versus 20 per cent of non-racialized households.

But a new study of census micro data, shared exclusively with the Star, reveals stark inequalities in the housing conditions of Toronto renters — especially in unsuitable housing, an indicator of overcrowding that was found to be nearly three times higher for visible minority renters.

For housing to be reported as unsuitable, it has to lack an adequate number of bedrooms for the size and composition of the household that lives there, according to the national occupancy standard.

University of Calgary researcher Naomi Lightman said looking at overcrowding allowed for a broader understanding of the housing crisis — noting that some renters may choose to squeeze more people into a smaller unit, instead of overspending on enough space.

“People are making choices within constrained conditions,” said Lightman, who co-authored the study with York University associate professor Luann Good Gingrich and Social Planning Toronto analyst Beth Wilson.

The data took on new weight during the COVID-19 pandemic, Lightman noted — neighbourhoods in Toronto with high levels of overcrowding have shown infection rates almost four times higher than in other areas, as stated by Toronto’s public health agency in July.

In York Centre in the city’s hard-hit northwest corner, 22 per cent of non-racialized renter households are considered unsuitable. Among racialized renters, that jumps to 51 per cent. In nearby York South-Weston, the unsuitability rate is 25 per cent and 49 per cent, respectively. Racialized renters in every city ward had higher rates of unsuitable, overcrowded conditions.

And though those gaps persisted among both the newcomer and long-term immigrant populations, the starkest racial divide the study found was among those born in Canada. While 14 per cent of non-racialized Toronto renters born in Canada reported unsuitable housing conditions, that number more than tripled for racialized non-immigrants — to 48 per cent.

Toronto councillor Joe Cressy, chair of the city’s board of health, said that finding illustrates how racism can be systemic — noting longstanding inequalities in access to employment and income.

“People often talk about opportunity like, you know, ‘Everybody gets a fighting chance,’” he said. “The fact of the matter is, in our city, non-racialized people are starting at the 50-yard line. And that’s due to decades of disproportional access and intergenerational wealth.”

Lightman said their data overall highlighted that the housing crisis played out in “different ways than we might have expected,” and had geographic implications within Toronto. “The divides between people translate into divides between places — and an increasingly segregated city.”

The findings are part of a multi-year research project on social exclusion in Canada. It examines micro data from the last census — specifically, data on affordability, unsuitability, housing in need of major repair, and what’s known as “core housing need.” The latter refers to housing that falls below any of those standards, where the household would have to spend 30 per cent or more of its pre-tax income to afford the median rent of alternative, adequate housing nearby.

Core housing need, like overcrowding, saw higher rates among racialized tenants — with 39 per cent of them reporting core housing need versus 27 per cent of non-racialized renters.

But Lightman said their work also underscored a need for more granular data, as it showed that certain groups — like Black, Latin American and Southeast Asian tenants — were reporting especially high rates of core housing need. While racialized and non-racialized renters had similar rates of unaffordable housing, the study found more than half of Korean, West Asian, Arab and Chinese renters reported spending at least 30 per cent of their income on shelter.

Avvy Go, director of the Chinese and Southeast Asian Legal Clinic, said the findings about specific racialized communities underscored a need for more disaggregated, race-based data in the housing sphere, to understand which communities are facing the worst outcomes, followed by more targeted efforts from governments to address the housing crisis within those groups.

While Go said she’d expect racialized communities to struggle more in the rental housing market — noting that racialized people were more likely to live in low-income households in general — the difference in the study between racialized and non-racialized renters, born in Canada and living in unsuitable housing, was more significant than she would have expected.

“Even if you take away immigration status as a factor, there is still a racialized gap. You cannot blame it on the fact they are born outside of Canada, to explain away the racial inequality that exists in Canada,” she said.

Cressy backed calls for more disaggregated data, noting the city’s executive committee will consider a strategy on Wednesday that would collect voluntary data on race from those who use city services or participate in public consultations.

“In the face of data, decision makers have one of two choices,” he said. “They can address it, or they can remain complacent.”

Source: Three times more racialized renters live in overcrowded housing in Toronto than non-racialized renters — and the starkest gap is among those born in Canada, study says

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