Ontarians who test positive for COVID-19 are more likely to live in neighborhoods with poor housing, lower income status and a higher concentration of immigrants and visible minorities.
The results, which are the first of their kind since the start of the new coronavirus outbreak, come from a study by non-profit ICES scientists in Toronto (formerly the Institute for Clinical Evaluative Sciences) that linked the COVID-19 laboratory test results to socio-demographic data. and health data to paint a picture of who is tested in Ontario, who gets the virus and where they live.
Jeff Kwong, senior scientist at ICES and one of the study’s authors, said that ethnicity and immigration were probably not the main reasons why the most marginalized neighborhoods are where people tested positive are more likely to live. Rather, he said the results could point to other factors: the crowded living and working conditions that many immigrants and low-income people experience.
“Many immigrants to Canada are starting a new life here, and may not be able to afford a single family home yet. So what do they do first? They are going to rent an apartment and there can be several generations of the same family living in the same household, ”he said.
“And then they will get jobs where it is not possible to go physical distance. And at home, it is difficult for them to physically distance themselves from the rest of their family so that household members are more likely to be infected. “
The study also found that those living in neighborhoods with higher ethnic concentrations were less likely to be tested for the virus, but more likely to be among those who were positive. Kwong said this could be due to the way people in these areas access health care and also the criteria for the COVID-19 test used by the provincial government.
The marginalized neighborhoods identified by the researchers were those with the highest ethnic concentrations, residential instability, material deprivation, those with no employment income, and the lowest incomes.
To reach their conclusions, the researchers analyzed the results of the COVID-19 tests in the Ontario Laboratory Information System database obtained through a data sharing agreement with Ontario Health. They then linked this lab test data to another database containing information about anyone who has ever had a health card in Ontario. Using this information, researchers were able to link individuals to postal codes and determine whether the regions were low income or had high ethnic concentrations using census data. The study results are current as of April 30.
Arjumand Siddiqi, Canada Research Chair in Population Health Equity and Associate Professor at the Dalla Lana School of Public Health at the University of Toronto, said that the ratio of HIV-positive people living in communities with high ethnic minorities were “alarming”.
“To me, the fact that ethnic concentration seems to be such an important predictor (of COVID-19) is at least one signal that deserves to be emphasized,” said Siddiqi, who was not the author of the report.
“The most disadvantaged tend to be those at greatest risk of illness,” said Siddiqi. “In cardiovascular disease, for example, the risks relate to diet and stress,” problems that generally affect marginalized groups. With COVID-19, this model repeats, said Siddiqi.
She agreed with Kwong that marginalization is not just about income.
“One problem is that black and brown people tend to be more precarious economically because they face more discrimination in the labor market. They tend to be more likely to work in low-wage service jobs, “and are likely to be front-line workers who are unable to stay indoors and away from society.
Siddiqi agreed with Kwong that living in denser homes may offer fewer opportunities to follow the distance recommendations correctly.
Ethnic minorities who test positive for the virus may be at higher risk of worsening COVID-19 results due to an increased risk of underlying health conditions such as diabetes, said Siddiqi. The discrimination and risks that marginalized groups face in everyday life mean that they are susceptible to “a whole range of health problems at higher rates. And so you’re entering the COVID era with, essentially, bodies that have been beaten by racism. ”
The ICES report found that those who tested positive for the virus were more likely to have chronic health conditions, such as hypertension, diabetes and dementia, which could increase the severity of COVID-19.
The report also found that the majority of people tested for COVID-19 are women, especially those aged 20 to 59. Kwong says that he and his co-authors believe that it is because of those tested, many are health workers and the majority of health workers are women.
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For every 100,000 people tested, the data show that men were more likely to test positive than women in Ontario, although women 90 years and older were more likely to test positive.
“What that means is that men are more likely to have COVID than women, except among the very old. It’s not really new. Other countries have seen this, but we have somehow confirmed that this seems to be the case in Ontario as well, “said Kwong.
“I would say that we have reacted head-on to this pandemic with our public health measures and I think we have made good progress,” he added. “But there is still a long way to go. “