Ethnicity, race and health equity: 3 lessons from the COVID-19 pandemic
The COVID-19 pandemic has underscored the critical need for robust and equitable public health systems in Canada that address the population’s diverse needs. One of the most glaring issues during the pandemic was the lack of standardized definitions and consistent data collection methods regarding ethnicity and race within the health system. This gap was particularly evident in the discrepancies between federal and provincial systems.
The importance of data collection
During the pandemic, timely and accurate data on COVID-19 infectivity rates among different ethnic and racialized groups were insufficient. This hindered efforts to identify hotspots and effectively prioritize increased opportunities for testing and vaccinations.
The absence of such data reflects a broader issue: the need for structured and formalized data collection practices for public health purposes that do not depend on provincial priorities.
Currently, data collection varies across regions. Public health systems often do not collect self-reported ethnicity and race in a standardized and safe manner. They may not have digitized vaccine records, and often lack access to comprehensive health-care system data.
To be prepared for future epidemics, these gaps in the public health system must be addressed. As physicians and research experts we suggest the following “prescription,” which includes a three-pronged strategy.
1. Collect key demographic characteristics
First, provincial governments and public health organizations should begin routine collection of key demographic characteristics, including ethnicity and race, to identify hotspots — communities that have a higher caseload — of preventable infectious diseases. These data are essential for guiding evidence-based decision-making and improving public health responses.
At the federal level, the Disaggregated Data Action Plan (DDAP) aims to improve data collection from diverse populations and enable intersectional assessments considering sex/gender, ethnicity and race, and socioeconomic status. Collaboration between Statistics Canada, provincial and territorial governments is crucial to address data gaps, uncover health inequity, and inform policy and research priorities.
The federal government set an example with DDAP, and during the pandemic, the Public Health Agency of Canada (PHAC) worked closely with provincial and territorial colleagues, academics and research funders. During the COVID-19 pandemic PHAC strengthened its connection with communities, including facilitating by regular meetings with faith-based leaders, which exemplified the importance of ongoing community alliances.
Provincial and municipal data collection is necessary because public health responses are administered provincially. Localized data helps to address specific community needs. This was seen in Toronto’s neighborhood-specific studies during the pandemic, which informed the deployment of mobile vaccine clinics.
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