The coronavirus has disproportionately affected racialized Torontonians to a significant extent, new data from the City of Toronto reveal.
A whopping 83 per cent of coronavirus of the city's infections have come from people of colour, with a large proportion of that coming from Black and South Asian Torontonians. Racialized Torontontonians account for 52 per cent of the city's population.
People living in lower-income households are also overrepresented. Lower-income households account for 31 per cent of the population but represented 51 per cent of positive cases. With each increasing income bracket, a lower percentage of Torontonians tested positive for the coronavirus, according to the data. The highest income bracket, which represents 21 per cent of the population, saw 6 per cent of the positive cases.
People who live in households of five or more, who represent 20 per cent of the population, accounted for 27 per cent of the cases.
East Asian and white Torontonians were under-represented in the coronavirus cases, according to the data.
Experts say that the segmented data, the first of its kind from the city, highlights the social determinants of health and how the coronavirus requires a co-ordinated policy response designed to address that reality.
"We need to address these health inequities, and get to the root cause of what underpins our overall health," said Toronto Chief Medical Officer of Health Dr. Eileen de Villa, framing a call to action.
"We need to focus on the social determinants of health, like affordable housing opportunities, access to employment and income supports and educational opportunities," she added. "And yes, we need to address systemic racism."
In an effort to better understand how the pandemic was affecting communities, and who in particular has been most impacted, Toronto Public Health started collecting data on May 20 during COVID-19 tests based on racial group, income, household size and Indigenous identity. The data reflects 73 per cent of the people tested from May 20 until July 1. People who did not provide demographic information were more likely to be hospitalized and not in a position to respond, or were people who had trouble communicating.
Toronto Mayor John Tory acknowledged the significance of the challenge to respond to the coronavirus in a way that addresses communities most at risk from the pandemic. "This data shows us the magnitude of the task before us," he said during an afternoon press conference, adding that he was grateful to have the information at hand in order to better guide policy decisions.
The mayor used the moment to appeal for additional support from other orders of government, particularly on policy files like transit, housing and employment supports that can be disproportionately important to racialized and low-income residents. "If people are living in more appropriate housing better housing ... that will have a positive impact on their health," he commented, adding a call for the federal government to accelerate rent supplement assistance.
Minister of Health spokesperson Alexandra Hilkene stated that the provincial government is doing its best to collect comprehensive data to understand the impacts on Ontario. "We want to understand how the coronavirus pandemic and outbreak response may impact subgroups of the population differently," she wrote in an email. "That’s why we have made a regulatory change to mandate the reporting of data on race, income, language and household size for individuals who have tested positive for COVID-19. This change will allow for the collection of data in a consistent way across the province, while ensuring the privacy of Ontarians is protected."
She added that the provincial government is finalizing a working group to interpret the data accurately, and that it will include policy experts from racialized communities.
The data from Toronto is the most stark, significant and direct analysis of the relationship between race, income and coronavirus outcomes yet.
An earlier analysis from QP Briefing found a strong correlation between community spread and racialized communities, which disproportionately have lower incomes and more people living in each household. In mid-June half of Toronto's new sporadic spread cases, as opposed to outbreaks, came in just 13 of the city's 140 neighbourhoods. These neighbourhoods were largely low-income and racialized.
Dr. Kwame McKenzie, the CEO of the urban health policy organization the Wellesley Insititute, characterized the findings as a landmark report that should act as the start of a journey to address health inequities. "The data has to be linked to action," he urged. "We need an equity-based COVID-19 pandemic plan. We need social policy and recovery plans focused on decreasing current inequities that put people at risk."
University of Toronto epidemiologist Colin Furness called the size of the numbers "shocking" although he wasn't surprised that there was a disproportionate impact based on race, income and household size. He added that those factors are interrelated, based on geography and communities, and they should be addressed in unison. "COVID-19 has exposed cracks and weaknesses in our society," he told QP Briefing by phone. And that means that the most vulnerable bear the brunt of the pandemic, he added.
Furness also praised Toronto Public Health for taking the initiative to collect the information, which he called "enormously useful." At the same time he slammed the provincial government, and Ontario Chief Medical Officer of Health David Williams in particular, for not doing the same, saying that a disinclination to act on this type of initiative contributes to an increasingly negative impression of the province's top doctor.
His sentiments about the importance of this data was echoed by fellow epidemiologist David Fisman on Twitter.
This is what structured health and risk disparities look like. https://t.co/B2B2ykHhIm
— David Fisman (@DFisman) July 30, 2020
The NDP also jumped on the data to say that the government should do more to support communities and services.
TPH data confirms what we already feared - racialized and low-income residents are bearing the brunt of COVID-19. This is what structural inequities look like. We need a prov gov't that will invest in and protect our communities, not cut the services we rely on. https://t.co/MLrRD9p7UC
— Laura Mae Lindo (@LauraMaeLindo) July 30, 2020