Community Update: Risk inequities and COVID-19

8 MIN READ

Over the past three months, the social challenges people face on a regular basis have not gone away because of COVID-19. In many cases, challenges that existed prior to COVID-19 have gotten worse, and have required innovation to make sure the most vulnerable don’t fall through the cracks. 

While COVID-19 has had an unprecedented impact on our communities and the most vulnerable, the pandemic has not been a universal experience. Those marginalized prior to COVID-19—like Black, Indigenous, and other people of colour (BIPOC), women, LGBTQ+ communities, and others— now face heightened pressures. 

As communities across our region begin to stabilize, and as businesses reopen and adapt, the social services sector is also planning for what comes next, with a lens to supporting the people who are most marginalized. 

For months now, United Way East Ontario has been bringing together a table of public health authorities, municipalities, frontline social service agencies, corporate partners, and many others, to support the most vulnerable through the effects of COVID-19 on our communities.

Michael Allen

By Michael Allen
President and CEO,
United Way East Ontario

This week, our COVID-19 Community Response table met to hear from community sector leaders. Dr. Vera Etches and Marino Francispillai of Ottawa Public Health, Sawsan Al-Refaei, the City of Ottawa’s Women and Gender Equity Specialist, Suzanne Obiorah of Somerset West Community Health Centre, Karen Green of the Ottawa Aboriginal Coalition, Dianne Urquhart of the Social Planning Council of Ottawa, and Faduma Yusuf of Britannia Woods Community House all shared insights on how COVID-19 has had an even greater impact on gendered and racialized communities, and offered guidance on how we can better support these communities in the coming months.  

We again had support from municipal, provincial and federal elected officials, including Rawlson King, Ottawa City Councillor for Rideau-Rockcliffe Ward 13; Jeremy Roberts, Member of Provincial Parliament for Ottawa West—Nepean; and Laura Dudas, Ottawa City Councillor for Innes Ward 2 and Deputy Mayor. These officials are avid listeners at the table, and will play a key role in bringing our sector’s challenges, successes and concerns to higher levels for policy consideration and change.

Understanding the risk inequities

In the early days of the pandemic, the sector responded immediately to growing urgent needs—moving quickly to address things like food security, and safe shelter. But perhaps no surprise to those who work with marginalized communities every day, it became clear that physical distancing measures would not affect everyone in the same way.  

There are multiple factors that influence how people experience inequity. 

For example, by taking into account a person’s gender, race, sexuality, geography or socio-economic status, we have a clearer picture of the risks they face, and in turn, what support they may need.

The impacts of COVID-19 are particularly challenging for women

Sawsan Al-Refaei, the Women and Gender Equity Specialist with the City of Ottawa, spoke to the table about how the gender gap has worsened since the onset of COVID-19. 

She shared that women, particularly women of colour, disproportionately work in the “Five Cs:” caterers, cashiers, cleaners, clerks, and caregivers—all roles that have a greater risk of exposure to COVID-19.

"Women are disproportionately represented within the caregiver sector, whether they are mothers, or taking care of persons with disabilities, or senior adults in the house—this is what we call a double or triple burden."

— Sawsan Al-Refaei

We know that immigrant and newcomer women are also more susceptible to social isolation, food insecurity, and financial hardship. Language barriers and past trauma can also make it harder for newcomers to seek help when they need it, which may result in poor health and mental health outcomes.

Racism as a social determinant of health

Quoting the 2017 report released by the United Nations’ Human Rights Council, Suzanne Obiorah of Somerset West Community Health Centre read:

“History informs anti-Black racism and racial stereotypes that are so deeply entrenched in institutions policies and practices that its institutional and systemic forms are either functionally normalized or rendered invisible.”

— United Nations’ Human Rights Council Report of the Working Group of Experts on People of African Descent on its mission to Canada

Suzanne then brought forward to the table how systemic racism adds an additional layer of inequity during the pandemic in our local communities.

"Ethno-cultural diverse neighbourhoods are experiencing COVID-19 related deaths at a rate that's three times higher than less diverse neighbourhoods. People who are living in these neighbourhoods are also four times more likely to need hospitalization and ICU admission, and death rates are twice as high.”

— Suzanne Obiorah

Black Canadians frequently face systemic racism in the healthcare system, meaning the mental and physical health needs for many in African, Caribbean, and Black communities go unmet. This puts a heavy burden on Black people, leading to further mental distress, social isolation, and silent struggles.

Race-based data is so vital during this time. With what we have, we know that early data paints a picture that the inequities faced every day by Black, Indigenous, and other people of colour, are only amplified during a pandemic. 

Issues that must be addressed now during COVID-19, are just the tip of the iceberg when it comes to the vital work our sector, and entire country, has to do in ending systemic racism. 

Supporting Indigenous communities through COVID-19

Based on their unique history with Canada and the ongoing, intergenerational impacts of colonization and its resulting individual and collective trauma, Indigenous people require culturally unique services and supports that are different from other vulnerable, racialized or equity-seeking groups. 

Within our region, homelessness is one of the greatest issues facing Indigenous people.

“Although Indigenous people account for only 2.5% of the total population of Ottawa, 24% of the population experiencing homelessness identify as Indigenous, with most of the over-representation occurring among single adults and youth.”

— City of Ottawa, 2018 Point-in-Time Count Report on Homelessness in Ottawa

While the 2018 Point-in-Time Count reports that 24% of Ottawa’s population experiencing homelessness identify as Indigenous, Karen Green of the Ottawa Aboriginal Coalition (OAC) notes that data on Indigenous people is often undercounted.

The OAC has always stated that the Point-in-Time count underestimates the number of Indigenous people who are homeless, and asserts that Indigenous people constitute at least 30% of the homeless population in Ottawa—with the actual percentage likely being much higher than that.

Providing basic services like access to washrooms and showers to people experiencing homelessness during COVID-19 has proven to be a difficult task. Karen adds that without access to addiction centres, support services and housing, relapses and overdoses have become even more prominent, and the need for mental health services continues to rise. 

Many Indigenous people experiencing homelessness avoid shelters because they often do not account for their unique cultural needs. As a result, Indigenous people experiencing homelessness tend to seek shelter and encampments in even more isolated and precarious areas—making it more difficult to reach them to deliver food and other basic needs.

Since the start of the pandemic, Indigenous-led organizations have received limited funding and resources to continue their services in a crisis landscape. Consequently, organizations like Minwaashin Lodge and Wabano Centre for Aboriginal Health have had to find creative ways to keep urban Indigenous people healthy, safe and fed to the best of their ability, despite having minimal financial resources to do so.  

Indigenous people in Canada have experienced systemic racism, colonialism and racial violence for centuries. We must work together to provide culturally appropriate services—during COVID-19 and beyond—to ensure we address the whole health of our community: from basic needs, to physical security and safety, to mental health and more.

The geography of inequity

Tools like the Neighbourhood Equity Index, prepared by the Social Planning Council of Ottawa, allow for even more understanding of the challenges people face. 

Using place-based analysis, the NEI assesses the Neighbourhood Effect—a study of the inequitable access to amenities and opportunities for health and healthy development. The Index measures how each neighbourhood is doing in five domains of wellbeing (economic situations, health, social development, physical environment and community/belonging) supported by 28 indicators. 

The tool will enable our table, as well as community groups, organizations, and policy makers to target efforts and resources to address the greatest need, and have the greatest impact. 

During COVID-19, good data is more important than ever 

For every aspect of how our communities grapple with this pandemic, it is clear that having access to comprehensive and up-to-date data is more important than ever. Part of that necessity is having research that closely examines the effects of COVID-19 measures on marginalized communities. 

Currently, Ottawa Public Health collects information on the health status of the city through population health assessments, like the Canadian Community Health Survey. However, without a particular attention to and collection of race-based data, agencies and community groups that serve BIPOC and other marginalized groups cannot use that data to advocate for the services they need. 

We also must continue to listen closely to the experiences of our community members.

“The numbers don't tell the whole picture. You need to have the experience coming through and you need the qualitative data as well to understand what the numbers mean.”

— Dr. Vera Etches

The recent establishment of an anti-racism secretariat at the City of Ottawa, led by City Councillor Rawlson King, will also serve as a vital resource to better serve racialized groups in Ottawa.

“Since 2015, diversity and inclusion policies at the city have been in place, but we don't have mechanisms to actively measure them well. And if we don't measure, we can't monitor and we can't determine the effectiveness of these policies.”

— Ottawa City Councillor Rawlson King

By collecting race-based data carefully and respectfully, we can better assess inequities in our communities, and then go on to inform change at all levels of government. 

The road to resilience

While there is still a lot of work to be done, the road to resilience is paved with and by grassroots organizations that center and uplift the voices, stories, and lived experiences of the diverse communities they serve. 

As such, it is a priority of the COVID-19 Community Response Table to include and collaborate with community organizations who every day are working hard to address the inequities in our community. This helps us together unearth challenges, and find innovative solutions that will hopefully live on, improving our communities long past this pandemic. 

This unprecedented sector collaboration and innovation is already delivering results. 

Just one example is of Britannia Woods Community House, who launched a rapid-response support line for Black and racialized individuals, with funding from Ottawa Community Foundation, that is culturally adapted to respond to the emotional and social needs of Black and racialized individuals. This response was developed to serve community members who couldn’t access typical community house resources due to COVID-19, who reported facing increased isolation, decreased hope, and increased caregiver burden.

Culturally sensitive supports include awareness of the lived experiences, pre-pandemic inequities, and unique pressures that people of colour are currently navigating. With these approaches, racialized communities can access care from professionals who share, understand, and address their lived experience and cultural nuances. The support line employs a linguistically and culturally diverse staff—who offer support in English, French, Arabic, Swahili, Somali, and Lingala—allowing for better connection and outreach to Ottawa’s Black communities. 

“It is very easy to be resilient, when you have the right supports, when you have the structural support in place.”

— Faduma Yusuf, Executive Director of Britannia Woods Community House

The path ahead

As we address the challenges of this “post-peak” phase, we must continue to evaluate our efforts, and commit to the same quality of response, knowing these issues will persist for many months to come. 

Our work at the COVID-19 Community Response Table aims to construct a profile of how the pandemic is affecting our communities’ most vulnerable, supported by real-time data and stories of lived experiences. As a group, we can pinpoint the areas that need our attention, and recommend programs, partnerships and policy changes to ensure a stronger future for everyone. 

Racialized and marginalized communities need our focus and support throughout the pandemic and beyond. Our mission is to work together, using our resources creatively and effectively to address the most pressing needs—now, and over the long term.

In early March, in partnership with Ottawa Public Health and dozens of organizations across the community sector, United Way launched an initiative to help support the most vulnerable in response to the Novel Coronavirus (COVID-19) affecting our region. This collaboration has enabled local problem solving, prioritization of needs, and collaboration. To learn more about supporting the initiative, or if you require community service assistance, please visit unitedwayeo.ca/covid19.

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Help the most vulnerable as we respond to COVID-19.