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systemic racism, barriers explain higher rates of covid-19 among immigrant, non-white communities in ottawa

ottawa's medical officer of health, dr. vera etches, says 66 per cent of local covid-19 patients identified as being from a racialized community, while 54 per cent were immigrants.

by ottawa citizen

jun 29 2020
read time 5 minute read
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covid-19 rates higher among immigrant, non-white communities in ottawa
suzanne obiorah, director of primary care and regional programs at the somerset west community health centre, says health inequities "are deep-rooted, and they're a direct consequence of systemic barriers, of systemic racism." jean levac / postmedia news
by taylor blewett
exposure to covid-19 is a non-negotiable fact of life for many immigrant and visible minority residents in ottawa. take a look at the pandemic-era essential workforce: those supporting the food supply chain, providing taxi or ride-share services, or caring for residents in long-term care homes.
every day, abiola tijani goes into work knowing that his next covid-19 test — he’s already taken three — could come back positive.
“i’m underemployed, but that’s the only way for me not to rely on the system … to earn my living.”
an immigrant from nigeria with a university degree in industrial and labour relations, tijani works as a personal-support worker at the grace manor long-term care home in hintonburg.
even before the pandemic, many of his colleagues were non-white, often newcomers. job opportunities are restricted when you have an accent or degree from a non-western university, tijani explained.
“we did not come here to sit home, or rely on the government.
“you want to work and feed your family … that’s the easiest job to get now. that’s why we are finding more immigrants working (in long-term care).”
according to experts, it’s also part of the reason why covid-19 appears to pose a disproportionate threat to immigrants and visible minorities, as preliminary data from ottawa public health recently confirmed.
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with the virus ripping through congregate care homes, agri-food workplaces and other sites of precarious and low-paying work disproportionately held by newcomers and people of colour, it was inevitable that infection rates would be higher among these groups.

in may, public health ontario reported that the rate of covid-19 infection in the province’s most ethnically diverse neighbourhoods was three times higher than it was in the least-diverse neighbourhoods. hospitalization and icu admission rates were four times higher, and death rates were twice as high.

in ottawa, medical officer of health dr. vera etches announced last wednesday that 66 per cent of local covid-19 patients — who provided this information since collection began in early may — identified as being from a racialized community; 54 per cent were immigrants, or more than double the percentage of ottawans identified as immigrants or racialized in the 2016 census.
etches said workplace exposure to the virus could explain some of this disparity.
“what we’re seeing is a health inequity,” said suzanne obiorah, director of primary care and regional programs at the somerset west community health centre.
“health inequities are deep-rooted, and they’re a direct consequence of systemic barriers, of systemic racism.”
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obiorah was among a group of black health leaders from across ontario who penned an open letter in early april, warning authorities about the potential for covid-19 to disproportionately impact the black community because of a variety of systemic factors: overcrowded living conditions due to housing insecurity, over-representation in ontario’s prisons, and higher levels of employment in public-facing service jobs, to name a few.
after months of pressure from advocates and public health experts, the ontario government announced june 15 it was proposing to mandate the collection of data about race, income, language and household size from those who tested positive for covid-19 across the province.
“the beauty of having … this type of data is that it forces you to really face the issues,” obiorah said. “health inequities are not new, but, without the data, what often happens is that these concerns are easily dismissed as anecdotal and then your interventions are not prioritized.”
she raised the example of long-term care homes. because ontario was tracking the staggering number of cases among ltc residents and staff, it was able to create a policy response to try to contain deadly outbreaks and to prevent new ones from occurring.

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when it comes to race, “we have not been very good at capturing this data, and that’s led us, a little bit, to a reactive situation,” obiorah said.
meanwhile, the particular vulnerability of immigrants and people of colour to covid-19 has already become a matter of life or death.
labour union cupe ontario has lost six of its members to covid-19. the majority of them were racialized people working jobs with little pay and security, president fred hahn said.
“we’re in the midst of a global health pandemic, but there’s also a pandemic of systemic racism. there’s also a pandemic of precarious work,” hahn said. “when we look across our province, it’s important to ask ourselves: who are in the jobs that have the luxury of self-isolation and working from home?”
it’s a long-standing reality in canada that immigrants and people of colour are often under-employed.
that’s according to hindia mohamoud, director of the ottawa local immigration partnership.
“there’s formidable, formidable barriers for immigrants to access jobs that are commensurate to their experience and credentials,” mohamoud said. then there’s discrimination in the hiring process, lack of employer capacity to assess foreign qualifications, policy gaps … the list goes on, she said.

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the result for many? precarious work and income insecurity. the latter, according to registered nurse and university of alberta professor bukola salami, is the single-greatest social determinant of health.
“people with lower incomes, for example, are more likely to live in poorer neighbourhoods, they’re more likely to live in cramped housing where being able to physically distance yourself is a greater challenge, where access to green space is much more of a challenge.”
understanding the nexus between income and visible minority or immigrant identity is critical, salami said, when it comes to rooting out health inequities. for instance, you can’t assume every covid-19 patient has the same capacity to self-isolate.
“a lot of health-care professionals tend to think, sometimes, that … ‘i’m colour-blind,’” salami said. “being colour-blind also means not addressing the inequities that we face within the system.”
there’s no simple answer when it comes to resolving the disproportionate vulnerability of newcomers and racialized people to covid-19.
however, a good place to start, somerset west’s obiorah suggested, is understanding and engaging with communities about their health needs. maybe that involves improved access to ppe or availability of health information in a diversity of languages.

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“we really need to be accountable as health service providers in asking, constantly asking, the question about … who is at increased risk and who is being left behind?”
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