South-East Asian residents make up the majority. Why is this important to point out? Well, health
experts in Toronto, especially those associated to the Community Health Centre movement, say
that race is often one of the most telling facts about a person that determines their health outcomes. These ‘facts’ that determine someone’s health are called social determinants of health.
It is no surprise then that community health centres have been collecting Ethno-racial data on clients for quite some time, and are urging the province, and even the country, to follow suit. This is because community health centres were established on the principles of the social determinants of health which includes factors like safe and secure housing, social inclusion, income and education, and increasingly race. These factors matter when assessing the health needs of their clients because they are the real drivers in determining how healthy somebody is.
Community health centres are not alone, as the movement to collect ethno-racial stats is growing. This has been, in part, due to numerous studies of data collection in the United States indicating significant disparities among different racial and ethnic groups and the kinds of barriers they encounter. These studies have also been used to show which racial and ethnic population groups are most a risk for certain diseases, the knowledge of which can lead to more effectively targeted public health efforts. In the midst of COVID-19, indicating that racial and ethnic minority groups are being disproportionately affected and are at increased risk of getting sick and dying, ethno-racial data in United States is increasingly being linked to evidence of widespread systemic racism.
In Canada, there is no systematic collection of ethno-racial data at the federal or provincial level but community health experts in Toronto say that this information is crucial to their work as health care providers and that they’ve been pushing for this for years.
Experts like Paulos Gebreyesus, who is the Executive Director of the Regent Park Community Health Centre, located in Regent Park, Toronto. Paulos Gebreyesus argues, “if we did not have information that is collected on any range of health outcomes, we would not understand what it is that we should be improving, what it is we should be prioritizing or even if there's a problem. So the collection of relevant information in order to better understand the impact of the work that we do is long-standing. It’s part of the whole scientific logical sort of approach to organizing work and services. We do so very diligently with some notable exceptions. This is where it's helpful to gather that information in order to compare, and better understand, patterns that may not be as visible to an individual anecdotally. Or perhaps they are visible anecdotally but there's no proof as it were that this is a larger systemic issue. So the whole idea of collecting all of the information is to be able to actually study that information to discern those patterns.”
When anti-racist activist say that anti-black and anti-indigenous racism is a health crisis in this county, its important to show how these realities are “reflected in a statistical or in a data form [reinforcing] the narrative that communities have been asserting,” says Gebreyesus. He argues that without verifiable information, our institutions are resistant to change, often because those who operate and manage resources don’t understand what is actually happening.
Paulos Gebreyesus illustrates how ethno-racial data and looking at the social determinants of health, can tell us who is at increased risk for getting Covid-19. “If you happen to live in a dwelling where there is sufficient living space and amenities for everybody in that household to remain distant from each other, then you have a far higher likelihood of not getting Covid or surviving Covid. If you have sufficient income to where, you don't need to take public transit or, you don't need to be in your job, then again, you have these protective factors. So in the same way we have learned over generations that there are systemic patterns to how we have organized ourselves as Torontonians, as Ontarions.” Paulos suggests that when you look at all these factors, people of colour are at far higher risk for getting Covid -19.
On the issue of incarceration, Gebreyesus states, “if we see that the rates of incarceration among indigenous peoples, or people who identify as black, or who are racialized, and compare that to the size of that subpopulation within our community, we would expect (if things were all equal) that a population that is only 3% of the general community would only have somewhere very close to 3% within the population that's currently incarcerated. So when we see that there's data that says 20% of all incarcerated people are indigenous, then we know that we have a systemic issue, and that we need to work at dismantling that, and addressing that, and responding to that. So I think the data really points us to where things are not equitable. This is the rationale to why we want to go out and collect as much information about the various facets of who we are as individuals.”, says Gebreyesus.
Considering how controversial Black Lives Matter protests are, it seems that the correlation between race and health is lost on many people. Some do not understand how anti-black and anti-indigenous racism as it is reflected in our institutions (ex. government, housing, workplaces, education, health care and policing) is a health crisis which threatens the well-being, mental/physical health, and the very lives of black and indigenous people. Ethno-racial data collection then is a way to collect undeniable data and convince individuals, and more importantly institutions, to use this data to make change. Just as importantly, ethno-racial data collection is a tool for community health centres and other health data stewards to better cater their services to their particular communities.
Our conversation with Paulos Gebreyesus is the first of a three- part series on ethno-racial data collection and race as a social determinant of health.
To watch Paulos Gebreyesus full interview on race and data collection, please visit our youtube channel @ Regent Park tv.
By Fabio Herediac
(Fabio Heredia is a media journalist with Radio Regent and the Focus Media Arts Centre)