The post-pandemic future: Race-based data collection can make our city more equitable
Arjumand Siddiqi is Canada Research Chair in population health equity
Each day since stay-at-home orders were first put in place in March, we eagerly and anxiously awaited Eileen de Villa’s report of the Covid-19 numbers for Toronto—the case counts, hospitalization and deaths—to help us gauge the local risk. Then, at the end of May, the city released a stunning, if entirely predictable, report, suggesting the overall numbers were hiding large differences in Covid-19 risk across Toronto neighbourhoods.
As of late July, the case rate was highest in the Jane and Finch area, which reported 509 cases. The next highest rate belonged to Rexdale, at 490 cases. By contrast, Yonge and Eglinton reported 15 cases and the Beaches 16 cases. It turns out Toronto’s Black, working-class neighbourhoods were at much higher risk for Covid than its White, wealthy neighbourhoods. The Covid-related inequalities between Toronto’s racialized and White areas shows once and for all how unequal our city is. The data helps shine a spotlight on how far we have to go before all our people have opportunities to live healthy lives.
The data on neighbourhood differences relating to Covid-19 reflect a starkly segregated city. Our essential workers are largely Black and other non-White people. They are our long-term care and personal support workers. They clean our hospitals and shuttle patients around. They stock our grocery stores, drive our delivery trucks, harvest our produce. Conversely, jobs that afford the opportunity to stay at home are largely occupied by White people. They are our bankers and financiers, our lawyers, our professors. Black, working-class Torontonians often live far from their jobs in transit deserts, which forces them to take multiple buses, streetcars and subways, where proximity to infected people is higher. Their neighbourhoods are often more densely populated, with more people in each home and apartment building. Physical distancing in this context is so much more difficult.
Data establishes a systematic account of the facts of our society. It allows us to distinguish the narratives rooted in anecdote, innuendo and ideology from those rooted in empirical truth. Going forward, the government must routinely collect data on race in all systems where racial inequities can occur.
We should be collecting this information in the health care system so we can understand how racial inequities in health outcomes—from Covid-19 to cardiovascular disease—are manifesting. We should collect this information when people apply for jobs, and when they are employed, so we can understand how discrimination in the labour market is transpiring. We should collect this information in the education system, so we can document when children are being treated differently by race. We should be able to understand when policies and programs are helping to reduce racial inequities, and when they aren’t.
This is not difficult to do. Essentially, institutions must add questions related to race every time they ask people for their names, addresses, ages and genders—we should be providing this information to hospitals, to schools, to employers, to financial institutions. And we must also make the data readily accessible to the public. When we have that data, we can use it to measure how equitable our systems are and then challenge our government and our people to change them. For example, many organizations have put out statements of solidarity with the Black Lives Matter movement, implementing new diversity policies. With comprehensive data, we can measure how effective these policies are in improving the economic power of Black people. We can measure how many Black people are being hired, whether they have decent jobs and decent wages, and whether they hold more senior roles. In health care, we can use the data to create policies that directly address racism perpetrated by health care workers and hospital systems.
All of this requires strong public support. It also requires us to be ready to contend with what the data shows, and to do what is necessary to provide Black and other non-White Torontonians with economic and social security. This data will play a big part in holding Toronto accountable.