opinion: year of covid-19 revealed racial inequities in health
the more deprived or marginalized you are, the less care you get – and the more likely you are to become sick with covid-19. the statistics in ottawa this year were startling.
mar 12 2021
3 minute read
dr. kwadwo kyeremanteng: 'what i see clinically on the front line is heartbreaking.'
james park
/
postmedia
by: mohammed adam
this week marks the anniversary of the first diagnosed covid-19 case in ottawa – and of the world health organization declaring the virus a pandemic. our continuing series analyses the year that was, and what lies ahead.
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there’s not much doubt anymore that race and socio-economic status are significant determinants of health care. who you are, where you live, what work you do, and how much you make often dictate the quality of your health services.
the more deprived or marginalized you are, the less care you get – and in the age of the pandemic – the more likely you are to get covid-19.
inequities that have long existed in health care have left many in racialized communities vulnerable on many levels, and when covid-19 struck ottawa, it hit them the hardest.
“analysis of sociodemographic data has shown that, similar to elsewhere, covid-19 has disproportionately impacted people who are racialized. in ottawa, particularly black communities,” says an ottawa public health report released last year. “racialized populations, (particularly those who identify as black), are over-represented among people diagnosed with covid-19.”
using the 2016 census, the report finds that racialized groups make up 29 per cent of the ottawa population, but 63 per cent covid-19 cases. in contrast, whites, with 71 per cent of the population, make up 33 per cent of the cases. it’s much worse for blacks, who make up seven per cent of the city’s population but 37 per cent of those infected with covid-19.
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close contact is the biggest source of infection among all groups, but is “more pronounced among people who are racialized,” because “racialized communities may have difficulty limiting exposure to covid-19 due to factors such as higher density housing that makes physical distancing difficult, and/or employment in essential work that is often ‘precarious’ – low wage, temporary, unstable and without pensions or benefits,” says the report.
the pain and agony are all too familiar to ottawa hospital critical and palliative care physician dr. kwadwo kyeremanteng. “what i see clinically on the front line is heartbreaking and it disproportionately affects black communities,” says kyeremanteng, who also works at montfort hospital.
an unfortunate part of a physician’s life is to sometimes see patients die, and every life lost is always hard to take. but kyeremanteng says it’s harder still when he sees the toll on black communities. “it’s hard when you see somebody that looks like you dying of covid-19 – somebody that’s working hard but struggling to make ends meet – and because of circumstances succumbs to covid. it breaks your heart.”
kyeremanteng says there are historical factors at play, but poor housing is clearly a big part of the problem. many of the people live in packed high-rises or cramped multi-generational homes where it’s hard to physically distance or isolate. worse still, many of these marginalized people work in high-risk jobs, as personal support workers and in other areas that expose them to sources of infections. many of these jobs, usually part-time, don’t offer benefits such as paid sick leave to allow workers to take a break when sick. consequently, kyeremanteng says, there’s a reluctance to get tested because it could mean staying home without income. “that’s a huge barrier, and it’s why i am a big advocate for sick leave so people can safely isolate,” he says.
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ottawa’s medical officer of health, dr. vera etches, has certainly taken the issue to heart. oph has recognized the adverse health impact of racial prejudice and economic deprivation. and etches has acknowledged the disproportionate impact of covid-19 on racialized and marginalized communities, and made them a priority in the vaccination campaign.
the city’s immunization plan for people in high-risk neighbourhoods has drawn praise from kyeremanteng. he sees it as a significant step to stop the spread of covid-19 and ease the suffering he often sees. “they talking about vaccinating our most vulnerable. they are going in areas where the most positive tests are occurring and that’s good.”
michelle james, coordinator of african caribbean black mental health program at the somerset west community health centre, says oph is doing a good job. “when i look at the work being done since covid started, i’m hopeful,” says james. “people have recognized the inequities that covid has brought to light, and i hope that this will be a catalyst for continued change.”
mohammed adam is an ottawa journalist and commentator.
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