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Letter to Premier Ford, Deputy Premier Elliott and Dr. Williams regarding the need to collect and use socio-demographic and race-based data

Dear Premier Ford, Deputy Premier Elliott and Dr Williams,

We are alarmed to hear the CMOH of Canada's most populous and diverse province say there is no need to collect data that tracks race and socio-demographic information.

During this turbulent COVID-19 pandemic, we rely on our leaders to boldly take action and put interventions in place that will limit the harms posed by the crisis. This makes the comments made by CMOH Dr. David Williams, during the April 10 COVID briefing all the more troubling.

The experiences of people and communities across the province demonstrate how unjust and untrue is the CMOH’s assertion that all people are considered “equally important”. In Ontario, key priority populations including Indigenous people, Black people, Francophone populations, 2S&LGBTQ+ communities, people living with disabilities and people who live in poverty do not have the same access as their counterparts to healthcare and resources that promote good health. Structural and systemic discrimination profoundly impact access to care. Ontario, like other provinces and territories in Canada, continues to deal with ongoing legacies of colonization, structural inequality and systemic racism. Responding to COVID-19 with the expectation that all people will experience the pandemic in the same way hurts already marginalized people and communities.

Collecting race and socio-demographic data is an essential component of the work of eliminating inequalities in healthcare. The World Health Organization says to “develop effective prevention strategies, countries need to improve their information.” We cannot address what we cannot measure. Collecting and analyzing data allows systems to measure differential experiences, account for disparities and develop evidence-based interventions. Ontario recognized the importance of data collection in 2017 when all Ministries except health were required to collect and use these data. The health sector has long called for the responsible collection and use of these data and COVID-19 highlights the urgency of this call. All sectors must be mandated to immediately collect data that will allow us to understand who this pandemic impacts and which pathways must be interrupted to stop its escalation. We will not address population health inequities and effectively contain COVID-19 without data that illuminates gaps to care in our system.

Community led primary health care organizations have long collected and used these data, safely and responsibly, to reduce disparities and improve health for people and communities facing discrimination. In the same vein, as early as 2010, organizations and institutions within the Toronto Central LHIN began collecting patient race and socio-demographic data to inform health planning. This crisis is dire. We cannot wait for our leaders and policy makers to catch up to what experts and front facing providers are already telling us. Communities across Ontario are concerned about the absence of strategic and proactive leadership in response to this crisis.

If indeed this province’s leaders say that all people are equally important they must act now to ensure that COVID-19 care is equally accessible to all groups that have so far been left behind in this response, including Indigenous and Black populations, people experiencing homelessness, people living on low incomes, people living with disabilities, those facing the double crisis of COVID-19 and a poisoned drug supply, and people facing the intersections of more than one of these at once.

Ontario’s response to COVID-19 to date has failed the test of health equity. Too many people in marginalized social locations that cause “pre-existing” medical conditions and vulnerabilities have been ignored by a one-size-fits all approach to the province’s public health. Bioethics frameworks mention equity- but do not incorporate Black or Indigenous expertise. Overdose prevention sites close their services due to staff exposures to the coronavirus. Seniors die days after Ontario’s Chief Medical Officer of Health recommends against the use of masks by long term care workers. From front-facing workers in healthcare and essential services working without masks or test kits, to people living without safe shelter or access to digital devices, Ontario’s most marginalized have been forgotten. If indeed everyone is equally important the province must act now to ensure that enhanced care is available for populations who have been so far left behind.

Systemic and structural inequalities govern everyday life for people across Ontario. We cannot effectively contain COVID-19 and mitigate its long term harms without addressing underlying inequalities that facilitate this pandemic’s escalation. We urge our province’s leaders to act boldly now to address this crisis with the urgency and gravity it deserves.

We call on Ontario to implement a health equity approach immediately by:

  • Mandating the collection and use of socio-demographic and race-based data in health and social services now as it relates to COVID-19;
  • Ensuring diverse and racialized voices on provincial and regional decision-making tables, including bioethics and critical care tables;
  • Prioritizing PPE, testing and funding for health services that take an anti-oppressive approach and provide trusted, evidence-driven healthcare to populations facing discrimination; and
  • Including regular updates on health equity data and progress in daily COVID-19 press conferences and situation reports

*This letter is endorsed by 192 organizations and 1612 individuals.

Organizational endorsements (total= 192):

  • 613/819 Black Hub
  • Aboriginal Legal Services
  • Access Alliance Multicultural Health and Community Services
  • Across Boundaries: an Ethnoracial Mental Health Centre
  • Action positive VIH/Sida
  • Addictions & Mental Health Ontario
  • Advantage Ontario
  • African Canadian Association
  • Afri-Can FoodBasket
  • AgentsC Inc.
  • AIDS ACTION NOW!
  • AIDS Committee of Ottawa
  • Alliance For Healthier Communities
  • Alliance pour des communautes en sante
  • Alpha Alpha Delta Omega Chapter of Alpha Kappa Alpha Sorority, Incorporated
  • Alzheimer Society of Hastings-Prince Edward.
  • ARCH Disability Law Centre
  • Association of Family Health Teams of Ontario
  • Atonaa Media Group
  • Battick Consulting
  • BC Community Alliance
  • Belleville and Quinte West Community Health Centre
  • Better Creative
  • Black Coalition for AIDS Prevention
  • Black Creek Community Health Centre
  • Black Gay Men’s Network of Ontario
  • Black Health Alliance
  • Black Legal Action Centre
  • Black Medical Students Association
  • Black Ottawa Business Network
  • Bloom Clinic
  • BluePath Synergies.com
  • Bridges Community Health Centre
  • Campaign 2000
  • Canadian Alliance to End Homelessness
  • Canadian Antisemitism Education Foundation
  • Canadian Association of Muslim Women in Law
  • Canadian Centre for Accreditation
  • Canadian Public Health Association
  • Canadians of African Descent Health Organizations (CADHO)
  • Carea Community Health Centre
  • CaterToronto
  • CEE Center for Young Black Professionals
  • Centre de santé communautaire de Kapuskasing et région
  • Centre de santé communautaire de Timmins
  • Centre for Sustainable Access to Health In Africa
  • Centre Jubilee Centre
  • Centre on Drug Policy Evaluation
  • Centretown Community Health Centre
  • Chatham-Kent Community Health Centres
  • Cheshire Homes Inc.
  • Chigamik Community Health Center
  • Children’s Mental Health Service
  • Children's Aid Society of Toronto
  • Children's Mental Health Ontario
  • Choice In Health Clinic
  • CMHA Toronto
  • Coalition of Black Trade Unionists, Ontario Canada
  • Community Advocacy & Legal Centre
  • Craving Change Inc
  • Creating Healthy and Sustainable Environments (CHASE)
  • DEEN Support Services
  • Democratic Socialists of Canada - London Chapter
  • Devon MacFarlane Consulting
  • Digital Foundations
  • Durham Community Legal Clinic
  • Elevate NWO
  • Elizabeth Fry Toronto
  • Elspeth Heyworth Centre for Women (North York)
  • Enrichment Centre for Mental Health
  • Extinction Rebellion Hamilton
  • Flemingdon Health Centre
  • FoodShare Toronto
  • Four Corners Health Centre
  • Front de Libération de L'ontario
  • Full Bellies Breastfeeding Support
  • Geoffrey Forbes Medicine Professional Corporation
  • Gerstein Crisis Centre
  • Girls Empowerment Movement
  • Greenest City Environmental Organization
  • Guelph Community Health Centre
  • Hamilton Centre for Civic Inclusion
  • Hamilton Community Legal Clinic
  • HAMSMaRT (Hamilton Social Medicine Response Team)
  • Harriet Tubman Community Org
  • Health Providers Against Poverty Ontario
  • HF Connecting Health Nurse Practitioner-Led Clinic
  • HIV & AIDS Legal Clinic Ontario
  • Hoffmann La-Roche Ltd.
  • Hong Fook Mental Health Association
  • Humewood House Association
  • IAVGO Community Legal Clinic
  • Ifa - International Federation On Ageing
  • Injured Workers Action for Justice
  • International Federation on Ageing
  • Jamaican Canadian Association
  • Kaleidoscope Consulting
  • Kensington-Bellwoods Community Legal Services
  • Kidney Health Education and Research Group
  • Kingston Community Health Centres
  • Kinna-aweya Legal Clinic
  • K-laba Hair and Beauty Supplies
  • LAEN - Latinx, Afro-Latin-America, Abya Yala Education Network
  • LAMP Community Health Centre
  • Law Office of Caryma Sa’d
  • Law Union of Ontario
  • Lindsay Advocate
  • London InterCommunity Health Centre
  • M9Medias
  • Maple Peak Group Inc
  • Mending the Chasm
  • Midland Midwives by the Bay
  • Midwives Collective of Toronto
  • Millennial Womxn in Policy
  • Mississauga Community Legal Services
  • MK Productions
  • Muscular Dystrophy Canada
  • Neighbourhood Legal Services (London & MIddlesex) Inc.
  • NFAMC
  • Niagara Falls Community Health Centre
  • Nigerian Canadian Association  Ottawa
  • Noojmowin Teg Health Centre
  • Nyanda Consulting
  • OCASI-Ontario Council of Agencies Serving Immigrants
  • OHIP for All
  • One of 1 Consulting
  • Ontario AIDS Network
  • Ottawa Neighbourhood Study
  • Oya Media Group
  • PARC
  • Parents of Black Children
  • Parkdale Community Legal Services, Inc.
  • Parkdale Queen West Community  Health Centre
  • Peterborough 360 Nurse Practitioner-Led Clinic
  • Peterborough AIDS Resource Network
  • Phi Beta Sigma Fraternity, Inc.
  • Pinecrest-Queensway Community Health Centre
  • PN Research
  • Positive Pregnancy Practice (P3)
  • Progress Toronto
  • Qhawe Communications
  • Quantum
  • Quest Community Health Centre
  • Regent Park CHC
  • Renfrew County Legal Clinic
  • Rexdale Community Legal Clinic
  • Roots to Harvest
  • Scarborough North Provincial Liberal Association
  • Seaway Valley Community Health Centre
  • Shelter Health Network
  • Shift Health
  • SisterTalk Group
  • South Asian Legal Clinic of Ontario
  • South Riverdale Community Health Centre
  • Speqtrum Hamilton
  • Stonegate Community Health Centre
  • Street Health
  • Sudbury Community Legal Clinic
  • TAIBU Community Health Centre
  • Tech Reset Canada
  • The AIDS Committee of Durham Region
  • The Backpack Project Int'l Program
  • The Center for Patient Protection
  • The Griot In Me
  • The Obstetric Justice Project
  • The Womxn of Colour Durham Collective
  • ThinkData Works
  • Tomlinson Lifestyle Medicine Consulting
  • Toronto Birth Centre
  • Toronto Community Benefits Network
  • Toronto Overdose Prevention Society
  • UBC Black Student Union
  • Unifor Chair in Social Justice & Democracy
  • Unison Health & Community Services
  • University of Windsor Students’ Alliance
  • Vibrant Healthcare Alliance
  • Waasegiizhig Nanaandawe'iyewigamig
  • WellFort Community Health Services
  • West Elgin Community Health Centre
  • West End Midwives
  • West Nipissing Community Health Centre
  • Western Ottawa Community Resource Centre
  • WombCare Inc.
  • Women of Inspiration
  • Women's Health in Women's Hands
  • Woolwich community Health Centre
  • Working for Change
  • Young Urbanists League
  • Youth Research & Evaluation eXchange (YouthREX)
  • YWCA Canada
  • YWCA Hamilton
  • ZIMMR Consultancy
Friday, April 10, 2020
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