Dear Minister Elliott and Dr. Williams,
We are a coalition of Black Health Leaders. The organizations we lead serve populations that face obstacles in accessing healthcare across the province. Recently, we issued a statement on COVID-19’s impact on Black communities in Ontario. The issues identified in the statement remain salient and pressing. These contextual realities make recent comments by CMOH Dr. David Williams regarding disaggregated data collection to measure health disparities all the more disappointing. Evidence suggests increased risk of COVID-19 harms to marginalized communities, including Black and Indigenous communities, people living on low incomes, people living with disabilities and people experiencing homelessness.
We were especially concerned to hear the CMOH say all people in Ontario are “equally important” despite race, ethnicity or other background. Studies show differential access to healthcare due to race, ability and socio-economic status. These studies stand in stark contrast to the CMOH’s statement. According to the 2017 Ontario Anti-Black Racism Strategy, “the impact and consequences of our history have created systemic barriers that prevent people from fully participating in all parts of society.” These inequalities extend to healthcare and health systems. A 2016 report issued by the UN Working Group of Experts on People of African Descent on its mission to Canada found “a lack of race-based data and research that could inform prevention, intervention and strategies to protect the human rights of African Canadians.” The 2017 Black Experiences in Healthcare Symposium exploring health inequities faced by Black Ontarians identified the need for systemic change and named race-based data collection as an important lever in moving this work forward. The gaps in healthcare created by the lack of systemic disaggregated data collection in Ontario are well documented.
Advocates have long called for the collection of race and socio-demographic data in Ontario, alongside transparency and accountability in its use for health planning. Collecting these data is a crucial step in designing equitable and effective health systems. We cannot understand who the pandemic disproportionately impacts without these data. Without an evidence base, the inequitable experiences of marginalized populations are dismissed as anecdotal and interventions are not prioritized.
We urge the province to immediately:
- Mandate the collection and use of socio-demographic and race-based data in health and social services now as relates to COVID-19, and more expansively to inform overall health system planning and resource allocation.
- Operationalize the 2018 Ontario Health Equity Standards by mandating the collection of race and socio-demographic data to “assess and report on the health of local populations describing the existence and impact of health inequities and identifying effective local strategies that decrease health inequities.”
- Include sociodemographic and race-based indicators in the Pandemic Threat Response (PANTHR) health data platform.
- Expand data collection and reporting requirements within the integrated Public Health Information System (iPHIS) to include race.
COVID-19 is unprecedented. We urge the province and Public Health leadership to act now to limit harm to disproportionately impacted communities.
Sincerely,
- Angela Roberston, Executive Director, Parkdale Queen West Community Health Centre
- Cheryl Prescod, Executive Director, Black Creek Community Health Centre
- Denise Brooks, Executive Director, Hamilton Urban Core
- Florence Ngenzebuhoro, Executive Director, Centre Francophone du Grand Toronto
- Francis Garwe, Chief Executive Officer, Carea Community Health Centre
- Keddone Dias, Executive Director, LAMP Community Health Centres
- Liben Gebremikael, Executive Director, TAIBU Community Health Centre
- Lori-Ann Green Walker, Executive Director, Women’s Health In Women’s Hands Community Health Centre
- Paulos Gebreyesus, Executive Director, Regent Park Community Health Centre
- Safia Ahmed, Executive Director, Rexdale Community Health Centre
- Simone Atungo, Chief Executive Officer, Vibrant Healthcare Alliance
- Suzanne Obiorah, Director, Primary Health Care, Somerset West Community Health Centre
- Sané Dube, Policy & Government Relations (Black Health), Alliance for Healthier Communities