Multilevel Health Issue Assignment
How Social Determinants of Health Inequalities Impact Minority Groups During Covid-19
There are many ways individuals are able to view and understand health in Canada, but the most in-depth and insightful way is through the use of understanding multilevel health issues. The approach I chose to examine in relation to health inequalities of minority groups in Canada during Covid-19 is the model of social determinants of health. To better understand what social determinants of health really is, real life examples will be examined in relation to health of minority groups during the pandemic. In simple terms, social determinants of health involve a multitude of factors that influence health differences in individuals. According to the World Health Organization (WHO), 2021, social determinants of health are non-medical factors that contribute to and influence one’s overall health. Factors such as were individuals are born, work, live, and access their resources such as income and nutrition all contribute to the health of all individuals. Health inequalities in Canada in this paper are more concerned with the unfair systems and policies in place that affect one’s ability to access food, education, healthcare, and transportation. According to the government of Canada, racialized adults, especially women, such as Black, Asian, and Arab adults are less likely to feel that their health is either good or excellent (Canada, 2022).
The Covid-19 pandemic impacted the world significantly with its strict lockdown measures, shortages, and most importantly its effect on individual’s health, more specifically, minorities health. Working in the healthcare field, especially during the pandemic, has shown how minority groups are treated across the world and how health inequalities are still present in Canada today. With the influence of social determinants, minority groups were remarkably disproportioned compared to their counterparts and were unfortunately marginalized. Public Health Ontario gathered information throughout the pandemic and released findings on the number of confirmed cases across different domains. Results found that individuals livening in high ethic populations, lower income areas, and greatest material deprivation had higher cases that were positive for Covid-19 (Toronto Public Health, 2020). Furthermore, higher rates of hospitalization occurred for immigrants to Canada, unemployed individuals, and those in racialized communities (Toronto Public Health, 2020). The findings from this study alone highlight how minorities in ethnic areas as well as immigrants and unemployed individuals were at higher risk and therefore had higher positive cases for Covid-19 in Canada. Minority groups such as poorer populations and individuals of colour have shown higher hospital admission rates requiring intensive care and higher mortality rates (WHO, 2021). Not only were these minority groups experiencing harsher outcomes from the Covid-19 pandemic, many of these individuals were at an even greater disadvantage due to the lack of access to healthcare and resources available to them. To be specific, locations such as those which are highly populated and close together often did not and were not able to practice safe social distancing measures nor were they as accessible to work, healthcare, and housing compared to those who were white or lived in the city (Pecoraro, 2021). Many of these individuals do not have access to resources such as water, food, housing or healthcare which has disadvantaged them greatly when it came to the pandemic and its harsh effects. Lack of access to transportation to receive healthcare is one of the main factors that notably impacted minority populations (Pecoraro, 2021). Additionally, those living in migrant population affected by emergencies were often displaced and at higher risk for Covid-19 due to their living conditions (WHO, 2021).
Countless reports across the healthcare systems in the world have shown the marginalization of these minority groups during the pandemic. Many of the issues steam from the factors of social determinants to their health that have led these individuals to be at a disadvantage. Poverty, deprivation, and the conditions individuals, mostly those of colour, live and work in are one of the main causes of health inequalities (Pecoraro, 2021). The increased need to ensure these individuals have resources they need that are both attainable and affordable is the first step needed to be taken to help get started in the right direction for improved health. Unfortunately, the Centers of Disease Control and Prevention (CDC) conducted a study that examined the rates of mortality and morbidity in minorities during the Covid-19 pandemic and found that minority groups suffered immensely during this time. Employment was one of the main social determinates of health that affected minority communities during the pandemic and that is due to the strict polices they had to face. Many minority individuals work in production, transportation, and material moving industries that often did not provide any sick pay, benefits, or allow for time off (Pecoraro, 2021). This was a major issue as the pandemic created a lockdown with restrictions that allowed many to work from home or be off work, unfortunately, that was not the case for these workers as they were not given that option and risked infection each day they reported to work (Pecoraro, 2021). With that in mind, it is important to note how access to healthcare was an issue as many minorities did not have access due to the lack of transportation, either personal or public, and lack of healthcare benefits (Pecoraro, 2021).
Similarly, researchers from metropolitan areas in Canada found that Covid-19 was easily transmissible among areas that were deemed lower income and those which contained a higher number of immigrants to Canada (Xia et al., 2022). Additionally, those living in high density housing which often meant visible minority groups were seen with higher number of positive cases compared to those living in the city (Xia et al., 2022). Areas in which immigrants lived in were popular hotspots for positive Covid-19 cases with the lowest rate of vaccination (Xia et al., 2022). It is important to keep in mind that many visible minority groups in Canada were either not eligible for the Covid-19 vaccination until later on or did not have access to centers due to the proximity to their housing (Xia et al., 2022). Vaccination rates were the lowest for immigrants and those living in lower income and high-density housing areas which in turn could have impacted the number of individuals getting sick from this virus (Xia et al., 2022).
To conclude, there are many social determinants of health that have created health inequalities that specifically targeted minority groups during the Covid-19 pandemic. The lack of employment benefits leading individuals to go to work sick or risk losing their job is yet another factor contributing to the health of minority groups (Pecoraro, 2021). Access to and the quality of healthcare provided, the conditions people live and work in, the lack of basic necessities and resources such as clean water and food, and the absence of transportation to and from work all are social determinants of health and impact minority groups especially during the worldwide pandemic. It is especially important as a global unit to come together to address these issues to ensure healthcare is accessible and affordable to all, and that individuals are treated with respect and equally. Links on my website have been posted to further discuss implication from Covid-19 such as decreased mental health ability, information from the World Health Organization is provided or, click here to learn more WHO- Covid-19 and Mental Health
Figure 1
The five domains of social determinants of health (SDOH).
Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved March 2nd, 2023, from https://health.gov/healthypeople/objectives-and-data/social-determinants-health
Video 1
CBC News. (2021). Inside some of Canada's hardest-hit hospitals in the 3rd wave of covid-19. CBCnews. Retrieved March 2, 2023, from https://www.cbc.ca/player/play/1884532291896
References:
Canada, P. H. A. of. (2022, August 16). Government of Canada. Racialized adults and inequalities in Canada - Canada.ca. Retrieved February 27, 2023, from https://www.canada.ca/en/public-health/services/publications/science-research-data/inequalities-health-racialized-adults-18-plus-canada.html
CBC News. (2021). Inside some of Canada's hardest-hit hospitals in the 3rd wave of covid-19. CBCnews. Retrieved March 2, 2023, from https://www.cbc.ca/player/play/1884532291896
Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved March 2nd, 2023, from https://health.gov/healthypeople/objectives-and-data/social-determinants-health
Pecoraro, K. A. (2021). How social determinants of health affect covid-19-related morbidity and mortality. Nursing, 51(5), 24–32. https://doi.org/10.1097/01.nurse.0000742408.10859.a7
Toronto Public Health. (2020, June 8). Covid-19 and the Social Determinants of Health: What do we know? . Are some populations disproportionately affected by COVID-19 in Toronto? Retrieved February 27, 2023, from https://www.toronto.ca/wp-content/uploads/2020/06/9872-SDOHandCOVID19_Summary_2020June8.pdf
World Health Organization. (2021). Covid-19 and the social determinants of Health and Health Equity: Evidence Brief. World Health Organization. Retrieved February 21, 2023, from https://www.who.int/publications-detail-redirect/9789240038387
World Health Organization. (2022, June 16). The impact of covid-19 on mental health cannot be made light of. World Health Organization. Retrieved February 18, 2023, from https://www.who.int/news-room/feature-stories/detail/the-impact-of-covid-19-on-mental-health-cannot-be-made-light-of
Xia, Y., Ma, H., Moloney, G., Velásquez García, H. A., Sirski, M., Janjua, N. Z., Vickers, D., Williamson, T., Katz, A., Yiu, K., Kustra, R., Buckeridge, D. L., Brisson, M., Baral, S. D., Mishra, S., & Maheu-Giroux, M. (2022). Geographic concentration of SARS-COV-2 cases by social determinants of health in metropolitan areas in Canada: A cross-sectional study. Canadian Medical Association Journal, 194(6). https://doi.org/10.1503/cmaj.211249
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