Coronavirus pandemic exposing health inequities among Canadians, experts say

The ongoing coronavirus crisis is exposing health inequities that have long existed in Canada.

As well, Canadian charities and agencies are busy trying to meet the increased need brought on by the pandemic.

“We can see that COVID-19 is hitting communities that are socially and economically marginalized or disadvantaged hardest,” McGill University associate professor Nicholas King, who studies public health policy and ethics, told Global News.

King says this impact has to do with a number of “structural disadvantage or cumulative disadvantage” factors, including living in “high-density” environments and working certain jobs now deemed essential during the pandemic.

“They have families to support, and now their occupations have been deemed essential,” King said of people living in such communities. “They have to go to work both to put food on the table and also because they’re in jobs where they still will be going to work.”

While the majority of Canadians have been advised to stay at home to limit the spread of COVID-19, essential workers have little choice.

“I think about people that don’t have access to a car, for example, so they have to take public transit,” Laura Rosella, an epidemiologist and associate professor at the Dalla Lana School of Public Health, told Global News.

“So they might just have to be in settings where they are with mixing with other populations at a greater frequency, and that’s going to increase risk of infection.”

The critical role of social determinants of health

The data Rosella and her colleagues are analyzing during the pandemic shows patterns.

“What we do see is that groups who happen to live in lower socioeconomic areas are disproportionately affected in terms of being positive for COVID-19. Also, we see some higher rates of mortality as well,” she said.

According to King, these groups also “generally have already suffered long-standing health inequalities, so they’re more likely to be sick already.”

This is due to the social determinants of health: social and economic factors like income, discrimination and access to quality food, health care and education, all of which can impact a person’s health and how long they will live.

“It’s really a variety of factors that lead to them being much more vulnerable to both getting COVID-19 and suffering really terrible consequences from COVID-19,” he said.

Those who study public health say the inequities existed before the pandemic hit and in communities around the country.

“These disparities were there before COVID-19,” Rosella said, “COVID reveals them. It doesn’t cause them.”

It’s also interesting, according to Rosella, that when the first cases appeared in Canada, the rates were similar across socioeconomic status, but that started to change when the infection became more community-spread.

The role of data

These realities raise a critical issue related to the social and economic factors of health, she says: the collection of data can help to determine who is being impacted and how best to help. The collection of this information in Canada has been inconsistent at best.

“When we are missing data on segments of the population that are at risk, it really hinders our ability to make sure that our responses are protecting those people and, worst-case scenario, not making the situation more risky for certain groups in the population,” Rosella told Global News.

The homeless and under-housed populations have been suffering as well.

The shelter systems and staff, already under-resourced, have been working to cope with physical distancing and caring for this at-risk group.

Public health experts reiterate that even before COVID-19, those experiencing homlessness had shorter life spans and many lived with complicated chronic illnesses.

“It’s just such a difficult situation, any congregate living situation. This virus has proven to be extremely contagious and spreads very easily,” Rosella told Global News.

With COVID-19 testing and data collection inconsistent across the country, it’s difficult to know what the actual impact has been on different populations.

Rosella is also concerned that a second wave of infection could reinforce disparities and be more concentrated in certain groups.

“The one thing about infectious diseases is that we neglect groups of the population,” Rosella said. “That means that the outbreak will continue.”

Helping those in need 

It’s hard to quantify the need created by COVID-19’s economic impact. Lori Nikkel, CEO of Second Harvest, told Global News the increased demand for support being provided by charities and not-for-profit organizations it works with has been significant.

“The numbers have increased exponentially.”

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Second Harvest is Canada’s largest food rescue and operates at the intersection of two problems: a food system with too much wasted food and too many people going hungry.

“When COVID-19 hit, it really magnified the existing problem. And then it created an even larger-scale challenge, both with the amount of food that is going into landfill and the amount of people that really need to access this food,” Nikkel told Global News.

Existing programs also had to pivot to provide food in new ways due to physical distancing, isolation and stay-at-home orders.

“Over 60,000 organizations in Canada, 60,000 use food in their program, charities and non-profits. So we need to map those charities with the 58 per cent of surplus in lost food to make sure that it goes through the system. And so we do that with a matchmaking system that I refer to as the eHarmony of food because it’s really simple.”

That’s where Second Harvest and foodrescue.ca come in: if a farmer, grower, restaurant or manufacturer has food to donate anywhere in the country, they are connected with a charity in their local community who needs it.

Since the pandemic started, the website has ramped up, and since March, it has helped to rescue close to seven million pounds of food and assist thousands of charities.

One of those organizations receiving food from Second Harvest is the East Scarborough Boys and Girls Club.

Through its programs, it helps close to 6,000 children and youth every year. Now, the help is coming in a new form: the club is receiving additional food from Second Harvest and packaging hampers.

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“It’s been a huge challenge but opportunity, I think, across the sector, and for us locally, to look at how we can scale up our services to make sure we are not letting anyone fall between the gaps,” Utcha Sawyers, executive director of the Boys and Girls Club of East Scarborough, told Global News.

Twice a week, staff members are personally packing and then driving the food to families who need it, so far delivering more than 5,000 hampers.

One of those families is Damilola and her seven-year-old son. As a single mother, she’s still working from home, but her hours have been cut back.

“Then you start to worry about your finances, what’s going to happen,” she told Global News.

So for the first time, she’s receiving food hampers twice a week.

“It’s a very good initiative, and we’re grateful,” she said.

The balance works for now, but if her rent returns to a full amount and her income is still reduced, she could get into financial difficulty.

“If I was paying my full rent and groceries, there’s no way I can meet it because there are more bills to pay and then the income is not enough at this time,” she told Global News.

Back at the Boys and Girls Club, the organization knows people are anxious and need more help.

“We’re seeing more and more that folks are needing things over and above food,” Sawyers told Global News.

The organization is now offering educational support, mentoring, virtual services and hygiene kits. Staff are also helping isolated seniors and those with mobility issues. The need is great and growing.

“We’ve started to do analysis across the community through our assessments, and the reality is that looking at the metrics, it may take almost a year of these continued emergency-type supports to support families so that they can balance out and resume some type of normalcy,” Sawyers told Global News.