why covid may come calling at your door but not your neighbour's
a study’s data suggests a strong correlation between social factors and covid incidence.
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while it’s true that covid-19 is, in many regards, an equal opportunity virus that infects without prejudice, not all of ottawa’s neighbourhoods are identical when it comes to the illness’s spread and severity.
why, for example, do ledbury-heron gate-ridgemont and emerald woods-sawmill creek shoulder infection rates of 5,981 and 5,879 cases per 100,000 residents, respectively (as of april 30, 2021), while carp’s rate of confirmed cases, at 672 per 100,000 residents, is a small fraction — about one-ninth — of those?
(neighbourhood-based infection rates and totals do not include long-term care or retirement homes.)
according to massive troves of data collected by university of ottawa’s ottawa neighbourhood study (ons), there are a number of interwoven factors that contribute to the varying prevalence and outcomes of covid throughout ottawa.
for the past 15 years, ons researchers have collected and analyzed data from more than 100 ottawa neighbourhoods, looking at such factors as health, income, housing, population, age and race demographics, crime statistics, and residents’ access to services and amenities in each, all with a mind to helping inform and drive public policy.
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according to ons program manager katie carr, factors such as education, income, employment, housing — even the built and natural environments of the neighbourhoods in which we live — conspire to play outsized roles in determining our health as individuals.
“the social determinants of health include such conditions as where we work, live and grow,” she says, “and we know that these social and economic conditions are a better predictor of our health than our genetics are.”
indeed, the neighbourhood study’s data suggests the strong correlations between social factors and covid incidence. these are the 10 neighbourhoods with the highest incidence of covid-19 infection per 100,000 residents, as of april 30, 2021:
- ledbury-heron gate-ridgemont: 5,981
- emerald woods-sawmill creek: 5,879
- bayshore-belltown: 4,084
- findlay creek: 3,613
- sandy hill: 3,556
- byward market: 3,550
- hunt club park: 3,507
- overbrook–mcarthur: 3,404
- hawthorne meadows-sheffield glen: 3,375
- greenboro east: 3,253
- (ottawa’s overall rate: 2,084)
of these, five rank among the 10 areas with the lowest median after-tax income, while all but two — byward market, which has a median after-tax income roughly $1,800 higher than the city average of $37,149, and findlay creek, at $40,230 — are among the lowest quintile, or fifth, of neighbourhoods.
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meanwhile, nine of the 10 neighbourhoods with the highest median incomes have covid infection rates below the city average.
these are the 10 neighbourhoods with the lowest incidence of covid-19 infection per 100,000 residents, as of april 30, 2021:
- carp: 672
- corkery: 712
- kanata lakes-arcardia: 787
- constance bay: 802
- laurentian: 848
- fitzroy: 884
- dunrobin: 975
- osgoode-vernon: 993
- beaverbrook: 1,050
- crystal bay-lakeview park: 1,072
other figures point to a strong relationship between the disadvantages many neighbourhoods face and the covid infection rates each has experienced.
six of the 10 neighbourhoods with the highest infection rates, for example, are also among the 10 with the highest unemployment rates, according to the most recent statistics canada figures. four are among those with the lowest rates of high-school graduation. half are among the 10 neighbourhoods with highest percentage of newcomers to canada during the six years ending in 2016. four of the neighbourhoods are among the 10 with the highest percentage of residents who speak neither english nor french — all of them at least double the city’s average of 1.5 per cent.
meanwhile, of the 21 neighbourhoods with the lowest ranking in terms of their “health and wellness socioeconomic index,” which scores neighbourhoods on a scale of 1 to 5 based on eight factors including income, housing, education and employment, 15 fell into a similar size group in terms of neighbourhoods with the highest covid infection rates. four of the remaining six were in the next highest quintile.
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by contrast, 13 of the 20 neighbourhoods ranked most favourably by the index are in the two quintiles with the lowest infection rates, while only two — cardinal creek and chapel hill south — had infection rates higher than the city average.
“things like income, education, the neighbourhood that you live in, your access to healthcare, your race and gender, those non-medical factors contribute significantly to our health outcomes,” says carr. “they contribute to some of the health inequities that we see in canada, and ottawa.”
and these factors, she points out, don’t live in vacuums. improvements in one area can positively affect others, while the opposite is also true.
“these determinants of health all fit into each other. it’s like a cycle. so if you have a lower education, you’re less likely to have a good employment opportunities and more likely to be living in low income. and living in low income is attributed to both a higher risk of exposure to covid-19 and also a higher risk of getting sicker from covid-19.
“lower income families are more likely to report two or more chronic conditions, they’re more likely to smoke. so it’s those types of outcomes that create inequities in ottawa. that’s especially relevant in a covid-19 context, where we know that pre-existing medical conditions can make the outcome of covid-19 illness much more severe for people.
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“so what we see is that many of the neighbourhoods that have been hit hardest by covid-19 are lower income neighbourhoods,” she adds. “there are more risk factors related to living in low income. you’re more likely to be living in a more crowded household setting, perhaps having multiple families living in a single household, or having a large family live in a household that doesn’t have many bedrooms to accommodate all of the family members. so you can imagine all these people living in close quarters, each having their own lives and jobs that they’re having to go out into the community to do. so that alone can put people at a higher risk of contacting covid-19.”
factors such as language skills and access to internet and transportation, as well as simply a sheer lack of time for those who are perhaps working multiple jobs that can’t be done from home and which often put them at the front lines with the public, such as in retail or hospitality, can make it difficult to be informed about ongoing developments regarding the pandemic, and officials’ changing responses to it. additionally, while these considerations add to many residents’ risk of exposure, they may also decrease the likelihood of the same residents getting vaccinated.
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“i think that people living in these neighbourhoods that have been most impacted by covid-19 are going to be the same people who face the most barriers to getting vaccinated,” says carr.
ottawa public health, which has not yet released any neighbourhood-based vaccination data, has taken steps to try to address some of the problems created by these socioeconomic inequities. it has held information sessions in numerous languages other than english and french, and has identified 21 high-risk neighbourhoods where it is targeting extra vaccination efforts, including mobile pop-up clinics. the plan overlaps and adds to the province’s “hot spot” identification by postal code.
“the province, through the hotspot strategy, is opening up postal codes in the provincial booking system now down to age 45,” ottawa’s medical officer of health, dr. vera etches, said recently, “and that’s useful for people to access. but we also know, locally, that won’t be sufficient to reach people who cannot work from home and to support neighbourhoods where they have had the greater burden of covid-19, where they face more barriers to being immunized.”
etches added that the plan, as it has in similarly hard-hit neighbourhoods in toronto and peel, allows health units to vaccinate residents as young as 18.
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“we are not having a barrier based on age,” she said. “we are trying to be most efficient and reach people who cannot work from home, across all the age ranges.”
it may be too early to assess the success of oph’s interventions in those hardest hit neighbourhoods. of the 10 neighbourhoods with the highest overall rates of infection over the past 14 months, eight were among the 10 with the highest test positivity last month alone, all with rates of 11 per cent or higher. hunt club park’s was the highest in april, at 15.6 per cent, slightly more than double ottawa’s overall test positivity of 7.6 percent that month.
“the limitation here is the amount of vaccine,” said etches. “we still don’t have enough to do everybody 18-plus in those neighbourhoods, but this is our focus. this is what the ottawa program is targeting and seeing as one of our measures of success will be how quickly we can protect people in the areas hardest hit.”
visit neighbourhoodstudy.ca for more information.
ottawa neighbourhoods where more that 10 per cent of covid-19 tests conducted in april 2021 came back positive:
- hunt club park: 15.60 per cent
- ledbury-heron gate-ridgemont: 14.90
- findlay creek: 14.40
- emerald woods-sawmill creek: 13.80
- hunt club-ottawa airport: 13.60
- sandy hill: 13.30
- bayshore-belltown: 12.50
- greenboro east: 11.10
- parkwood hills-stewart farm: 11.00
- byward market: 11.00
- hunt club upper-blossom park-timbermill: 10.60
- centretown: 10.40
- riverview: 10.30
- ottawa average: 7.6 per cent
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