We are in the midst of a global pandemic, one that will fundamentally transform our province. Early losses and rapid escalation have already shown us glimpses of the devastation COVID-19 will leave in its wake. This is an unprecedented moment. To change this pandemic’s trajectory we must be willing to ask difficult questions, including asking who is left behind in current responses and which communities are at increased risk of harm. We will not contain COVID-19 without bringing critical analysis and differential population health actions to our pandemic response. We are a coalition of Black leaders who work in the community health sector. We have always understood that a plethora of factors affect health outcomes for Black populations in the province. “Good health” is a product of access, social, cultural and economic factors. Similarly, structural and systemic inequalities are contributors to poor health outcomes. Ontario is home to the largest proportion of Black people in Canada. Here too, as in the rest of Canada, race is a determinant of health.
COVID-19 does not flatten these disparities; it amplifies them.
Research continues to validate what our communities know from lived experience; the continuing legacy of anti-Black racism means that Black people experience disproportionately higher rates of poverty, poorer health outcomes and we are overrepresented in the criminal justice system. In health care too, Black communities must contend with anti-Black racism. Studies have shown differential access to care based on race. We cannot escape these conversations as COVID-19 unfolds. Increasing pressure on health infrastructure means service providers will be required to make life and death decisions about who can access care. Without pandemic response strategies firmly grounded in ethical frameworks that account for racial bias, Black people will be exposed to greater harm.
Across Ontario Black people are counted amongst the working poor, many of whom have lost employment as a result of the pandemic. Ontario’s Anti-Racism Directorate’s 2017 community consultations found that Black people face more barriers in gaining employment in the formal sector. As such, high proportions of Black people work in the informal sector or belong to the “gig economy.” For many, income streams have been deeply disrupted by COVID-19. Similarly, workers in the formal economy have been raising alarms about difficulties in accessing social and financial relief for low-income households who do not meet prescribed thresholds, and yet, are deeply impacted by COVID-19. Black workers, (particularly Black women), are over-represented in front facing service provider roles, including among PSW and RPN’s. Many are providing essential services, yet unable to access support for their families. These factors will exacerbate precarity, food insecurity, isolation and mental health concerns.
Much like other low-income populations, significant numbers of Black communities need interventions to ensure housing security. Many Black families live in multigenerational houses where overcrowding is an issue; these families will struggle to practice physical distancing and self-isolation. In addition to making affordable housing options accessible, Black communities urgently need implementation of rent-relief measures across the province.
We can’t talk about families without talking about Black children and youth in government care. As the province works to contain COVID-19, face to face visits with children and youth in care have been suspended. Black children and youth are over-represented in government care. These restrictions will deeply impact our families. Equity in this moment means access to alternative forms of communication must be prioritized across the board. Black families must be able to retain contact with their children throughout the duration of this crisis.
Advocates are also raising concerns about the difficult conditions in prisons and detention centres. These conditions impact infectious disease outbreak and pose specific risks in the context of the COVID-19 crisis. Black and Indigenous communities are over-represented in Ontario’s prisons; outbreaks will disproportionately impact our communities. More recently, the province has announced advanced measures under the Emergency Management and Civil Protections Act, which will allow law enforcement officials to collect identifying information in street checks linked to pandemic containment and control. As Black communities, we will continue to raise concerns about risks linked to racial profiling and COVID-19 policy creating pathways that will enable and maintain disproportionate representation of Black people in the criminal justice system. These outcomes are unacceptable.
COVID-19 is an unprecedented crisis. The policies enacted as the province and communities respond to the pandemic will have lasting impacts. Avenues for minimizing harm are available to the province, including comprehensive consultations with experts and strategists identified by our communities. We urge policy makers and emergency response planning bodies to adopt a critical lens in implementing policies. COVID-19 responses should not further disenfranchise and harm already marginalized communities.
There will be a time after COVID 19 and it would be devastating if not all can recover equally.
- 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 Office, 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