The findings below identify the main concerns which arose among Black communities during the pandemic. In particular, community leaders discussed the importance of mobile testing and the role of working conditions in spreading the virus among marginalized groups. They also identified the role of anti-black racism in pandemic response and the importance of equitable health policies. Future lessons/approaches the government should take to implement equitable public health measures that are tailored to the lived experiences of Black communities, were also highlighted.
Common concerns of the community
A common concern emerging from the interviews was a reluctance among individuals from Black communities to get tested for the virus due to misunderstandings of how painful the test would be. Also, there was a fear of increased contact with individuals who have tested positive at the testing centre. This made individuals from these communities less likely to get tested for the virus. In addition, individuals were hesitant to get tested due to the possibility of a positive test, leading them to worry about taking time off work. This would mean they would need to find other sources of income to support their families (i.e. to pay rent, buy groceries).
Many members of these communities also lost jobs and were not eligible for the Canadian Emergency Response Benefit (CERB). This led to other concerns such as the affordability of food and personal protective equipment (PPE). As many members from these communities have a lower socio-economic status, the loss of employment further exacerbated income inequality.
These concerns provide clarity on the negative effects of COVID-19 on Black communities, and the impact of this on the communities’ physical and mental health.
Mobile testing became available in non-racialized GTA neighborhoods (which were socially less burdened) weeks before regions that were most affected by COVID-19. In particular, those communities with inadequate housing and poor access to healthcare were delayed in receiving such resources. Communities with greater populations of racialized individuals suffered the most during the pandemic because there was no prior knowledge of the needs of these communities or what health concerns were already present. Community leaders suggested that differences in resource allocation between certain communities points to systemic discrimination, neglect, and a lack of prioritization of racialized communities which are in need the most.
A disproportionate number of Black female personal support workers (PSW) were employed in nursing homes which were most affected during the pandemic. This increased their chances of contracting the virus themselves, as well as becoming carriers for their family members.
Also, community leaders indicated a correlation between low-income jobs and the risk of contracting COVID-19, in these communities specifically. As one leader highlighted, “a lot of racialized and marginalized communities live in low-income conditions, where their employment situation is precarious to an extent where they aren’t able to access financial assistance” (Executive Director, Community Health Centre in Scarborough, Toronto). Thus, to make ends meet, some Black individuals have to work multiple jobs to receive adequate income.
The psychological effects of COVID-19 are expected to have a significant impact on populations across the country, especially those of marginalized communities who face a greater burden. For example, many individuals from these regions must work throughout the pandemic as they do not have the option of staying home. Often times, these individuals are living with vulnerable family members (i.e. seniors; those with chronic conditions), and therefore, have to send them to other member’s houses to reduce the spread of COVID-19. This adds to the isolation, loneliness, and depression these communities face. The psychological effects are cumulating; therefore, resources need to be tailored and made accessible in these communities. One community leader noted that, “there are accessibility issues to mental health support in these communities already” (Executive Director, Community Health Centre in Scarborough, Toronto). Thus, efforts need to be made to increase access to mental health services in Black communities.
Community leaders highlighted that earlier measures should have been implemented to avoid the high percentage of COVID-19 cases among Black people and other people of colour. Racial inequities faced by communities in the healthcare system continues to be a long-standing concern even prior to the current pandemic. Health officials, therefore, need to prioritize the health of minority populations through the implementation of tangible policies that will produce meaningful change.
It was also noted that health officials need to review policies and create new ways to response to COVID-19, which target anti-black racism, specifically. Similar to the importance of collecting race-based data, it is important for policies to reflect the lived experiences of racialized populations in a real, structural, and meaningful way. Community leaders identified that many institutions already have such policies in place; however, these policies do not always translate into practice.
The provincial delay to collect race-based data is an important lesson to keep in mind, according to community leaders. Black and other racialized communities are impacted by COVID-19 and (other chronic conditions) significantly more than other populations. The inequitable disparities that already exist in these communities (in terms of housing, income, food security), perpetuate these problems even further.
As one leader notes, “the common denominator is anti-black racism and a system that is generating all of these problems. With the COVID-19 pandemic and what has transpired after the Black Lives Matter movement, we as a society have been given a good opportunity to think differently about race and health, and to bring about change” (Executive Director, Community Health Centre in Scarborough, Toronto). Public health officials, governments, and the overall population, can, and should shift the needle towards equity and fairness in health, and overall quality of life.
An important point raised by those in the study was the importance of considering how different communities will access health services when the virus vaccine is ready to distribute, in order to ensure effective usage. Making vaccinations available where community members are most comfortable visiting will be important to consider. Public health officials also need to raise awareness within these communities and promote community engagement to overcome misinformation and myths about vaccinations. In addition, Black communities particularly have a difficult time trusting the health system, since health services, including clinical trials and vaccines, have previously been used to further racialize, marginalize, and kill members of the Black community. Therefore, community leaders encourage and support an equitable deployment plan for vaccination.
Also, community leaders mentioned that they would like to see relationship and community building within Black communities to encourage the use of testing and mobile testing units. This will ensure trust is built and members of the community feel comfortable taking the vaccination. Normally, vaccinations are given through institutions and hospitals; however, this may not be accessible to all Black community members. Therefore, there needs to be a shift in planning to ensure a more equitable approach to intervention and prevention.