Does COVID-19 discriminate? This is how some Canadians are harder-hit
TORONTO -- There are a few things we know about COVID-19's impact on different groups of Canadians.
We know that women made up 54 per cent of Canada's confirmed COVID-19 patients as of Tuesday, even though they account for only slightly more than 50 per cent of the population.
We also know that older Canadians appear more at risk. Twelve per cent of all cases have been confirmed in patients 80 years of age or older, despite their proportion of the total population being less than half that, and those under the age of 20 make up 22 per cent of the country, but only 5 per cent of all known cases.
Beyond sex and age, though, we're in the dark. There is no data on Canadian COVID-19 patients' income levels, race, gender identity or physical environments. These are four of the many factors known as social determinants of health – circumstances that do not directly measure physical health but are known to affect it.
There might not be data, but there is evidence that Canadians care about these issues. Statistics Canada found that 79 per cent of those it recently surveyed reported being very or extremely concerned about the health of vulnerable people, while only 36 per cent said they had that much concern for their own health.
Canadian governments are increasingly being asked why they are not collecting race-based data on COVID-19 infections. Many have responded similarly to Dr. David Williams, Ontario's chief medical officer, who said on April 10 that Ontario is focusing on known risk factors, including age and medical history.
Dr. Deena Hinshaw, Williams' Alberta counterpart, sounded a different note on the same day. Telling reporters that her province's screening procedure is mainly looking for "risk activities," she added that Alberta "need[s] to look closely at" incorporating race-based data.
"We know that certain groups of people are systematically disadvantaged based on their appearance or their socioeconomic status," she said.
The U.S. has not publicized federal race-based data on COVID-19 cases, but analyses of the publicly available information suggest the pandemic is hitting black communities especially hard. The Associated Press estimated that black Americans make up more than 30 per cent of known COVID-19 deaths, based on examination of data from an area where the total black population is 13 per cent.
Roberta Timothy, an assistant professor at the University of Toronto's Dalla Lana School of Public Health, says her experience with Toronto's black community leads her to believe a similar discrepancy exists in Canada.
"The devastation that is happening in our community is not being measured, it's not being talked about – only in our community," she told CTVNews.ca Wednesday in a telephone interview.
Timothy said the version of the pandemic she hears at government press conferences "doesn't match" what she sees in Toronto, where she says she sees concerns about everything from PPE provided to essential workers to accessing proper medical treatment.
"We say things like 'We're all in this together' … [but] do not address the historical and current-day traumas and health disparities. It's like you're saying that we're not important. You're saying our community doesn't matter," she said.
"My fear is that people in racialized communities are going to … mistrust the system so much, and they're not going to seek the help – and that's a life-and-death situation."
Semir Bulle, co-president of the Black Medical Students Association and the son of Ethiopian refugees, argues minority communities are hit harder than others because they are already vulnerable.
“It’s impossible to socially distance in my community, in the shelter community (and) in the refugee community,” he told CTV News. “What is social distancing when you live on top of each other?”
A group of black health leaders in Ontario recently wrote an open letter to the provincial government, calling for a pandemic response strategy that accounts for racial bias, among other measures.
There are also concerns about how COVID-19 will affect Indigenous communities, which were hit disproportionately hard by the H1N1 influenza pandemic in 2009. Although coronavirus caseloads in Indigenous communities have thus far been low, the government has warned against complacency as the virus spreads.
LOW WAGES; VULNERABLE WORKERS
The COVID-19 pandemic has swelled the ranks of marginalized Canadians, as millions have lost their jobs and applied to the government for financial assistance.
StatCan found several trends in its latest snapshot of Canada's labour force, noting that disappearing employment was most notable in young workers and women in part-time jobs.
Those two demographic groups are generally well represented in the category of vulnerable workers – which, according to StatCan, was hit especially hard in March. The number of temporary workers fell at three times the rate of permanent ones.
This stands to reason. Most higher-paying white-collar jobs can be done from home, while the lists of businesses ordered to close around the country heavily feature service-industry companies, which often pay closer to minimum wage.
"If you're a lawyer or even a doctor these days, you can work remotely. If you're a server in a restaurant, or if you're working in a clothing store, you can't," Sheila Block, a senior economist with the left-leaning Canadian Centre for Policy Alternatives (CCPA), told CTVNews.ca via telephone Wednesday.
As a result, many of those who find themselves out of work are unlikely to have amassed significant savings.
Low-income workers who haven't lost their jobs – think grocery store workers and delivery drivers – may find themselves having to defy physical distancing recommendations simply to perform their assigned duties.
According to the CCPA, they're also less likely to have access to paid sick leave. Combine that with the realities of living a low-income life, and it becomes clear some face a stark choice if they fall ill: stay home, recuperate and risk being unable to afford rent, or go to work, earn a paycheque and risk acquiring or spreading COVID-19.
"We need to take a hard look at how these workers, who we now realize are essential, have been poorly treated and poorly paid," Block said.
A report released Tuesday by CCPA found that payday loan companies are likely to see big increases in business as a result of the pandemic, with many laid-off workers feeling the high-interest loans are their best financial option.
In Block's opinion, the government has generally done a good job of looking out for low-income workers by introducing various benefits and subsidies and then adapting them as it becomes clear some have fallen through the cracks.
She would like to see some of the emergency measures made permanent to better protect workers after the economy returns to some semblance of normalcy – although that may be difficult, given the CCPA and various progressive-minded groups have been calling for similar programs for a long time without success.
"A lot of the government response has been addressing fundamental weaknesses in our social security net that have been pointed out for probably 10 to 20 years," Block said.
With files from CTV News Correspondent Heather Wright and CTVNews.ca Writer Ben Cousins