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Social inequalities in COVID-19 deaths in Canada

Highlights from the first wave

An analysis of death rates between January and August of 2020, to find out if social and economic factors were linked to higher rates of death from COVID-19. Highlights from the “Social inequalities in COVID-19 mortality by area- and individual-level characteristics in Canada, January to July/August 2020” technical report.

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Overview

The burden of COVID-19 isn't shared equally among Canadians. Some people are more likely to get sick or die because of their social and economic conditions.

This isn't unique to COVID-19. Long before the pandemic, we knew that social and economic disadvantages can affect a person's:

Social inequality contributes to the differences seen in COVID-19 cases, hospitalizations and deaths. However, there hasn't been a lot of national analysis of COVID-19 using this kind of lens.

This report helps fill the gap in evidence and data. It explores the inequalities in COVID-19 deaths between January and August 2020, using several key social determinants of health, such as sex, income and neighbourhood characteristics.

You can view visualizations of the data in the COVID-19 Mortality Data Tool tab.

Method

We looked at national COVID-19 death rates between January and August 2020, with a focus on factors that are important to health equity. These factors include:

We also looked at national COVID-19 death rates using a variable to identify neighbourhoods that may be more vulnerable to systemic racism and economic inequality. This variable combines 4 other variables. These were measures of the concentration of people in a neighbourhood who:

Data for this report came from:

The data we used had some limitations. For example:

Despite these limitations, the data we used are useful for understanding general patterns of social inequalities in mortality.

To learn more about how we used these data, please refer to the full Technical Report.

Key findings

We found significant inequalities in COVID-19 death rates for people living in large cities, as well as those living in:

We also found that men had higher rates of COVID-19 deaths than women, especially in these neighbourhoods.

This is consistent with what we know about gender and sexism, systemic racism, economic inequality and other social determinants of health. These conditions affect a person's:

For example, Canada's Health Inequalities Data Tool reveals that men and people living in lower income neighbourhoods report:

These underlying differences may explain why these socially and economically disadvantaged groups are more likely to die from COVID-19. We need more research to better understand these patterns.

We also need more research to explore the precise ways that inequalities in COVID-19 deaths occur. This report looks at deaths using one variable at a time. We didn't look at death rates across multiple variables at once. For example, we didn't look at death rates by household size for low-income and higher-income areas separately. Patterns may be different across groups, and can help us understand how inequalities occur. A more complex analysis that considers many factors together would help us understand how different factors interact.

Conclusion

We've provided national evidence of health inequality in COVID-19 deaths during the first part of the pandemic.

Canadians living in vulnerable situations have higher COVID-19 death rates. This is a health equity issue.

Health inequities are avoidable health differences between groups. They are unfair and unjust. They should be addressed through a health equity approach, which promotes healthy living and working conditions for all.

This report is a key step for advancing a fairer pandemic response. It builds on a 2018 report from the Pan-Canadian Health Inequalities Reporting Initiative, which outlined actions to promote health equity.

For more information, please refer to Key Health Inequalities in Canada: A National Portrait.

About this report

This report is a product of the Pan-Canadian Health Inequalities Reporting (HIR) Initiative, which is a collaboration between:

Based on a framework developed by the World Health Organization, the HIR Initiative aims to strengthen the measurement, monitoring and reporting of health inequalities in Canada. It does this through:

You can access data from the HIR Initiative by using the online interactive Health Inequalities Data Tool. It contains over 100 indicators of inequalities in health status, health behaviours, and health determinants.

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