Hamilton’s COVID cases divide along race, income lines

Poorer, racialized neighbourhoods in Hamilton have been harder hit with COVID cases than the city's richer, whiter neighbourhoods, according to a new analysis prepared by the Social Planning and Research Council.

Hamilton's poorest neighbourhoods had 80 per cent higher rates of coronavirus infections than the richest neighbourhoods - 179 cases per 100,000 in the poorest neighbourhoods versus 99 cases in the richest neighbourhoods.

The average number of cases in Hamilton through July was 136 per 100,000 people.

When the neighbourhoods were grouped by their proportion of visible minorities, the differences were even more dramatic, according to the Social Planning and Research Council (SPRC) report.

Neighbourhoods with the highest rates of visible minorities had more than double the rate of COVID infections than neighbourhoods with the lowest proportions of visible minorities.

In the most racialized neighbourhoods, the infection rate was 196 per 100,000 people. In the least racialized neighbourhoods, the rate was 81 per 100,000.

COVID has highlighted the inequities that have long been a part of our society and which disproportionately affect those who are most marginalized," said Kim Martin, the SPRC's executive director. When we look at the recovery implications for our community, it is clear that this is where we need to prioritize our efforts."

The report's findings mirror the conclusions uncovered repeatedly in The Spectator's decade-long Code Red project, which found strong connections between poor health outcomes, poverty and poor educational outcomes.

We know there's an important social gradient in health," said Sara Mayo, a social planner with SPRC. Lower incomes are associated with worse health outcomes and we see that same trajectory with COVID."

There are several possible reasons for the higher proportion of cases in poorer, racialized neighbourhoods, Mayo noted - more crowded living conditions, more direct interactions with other people, an inability to isolate from others, the need to use public transportation, an inability to take time off for sickness from a job, and precarious employment in general.

COVID exploits that kind of precarity," Mayo said. Those pre-existing inequalities we had in our labour market and in our housing conditions get magnified by COVID."

Dr. Tim O'Shea, an infectious disease specialist who works with the city's vulnerable population, said there are government policy changes that could help reduce the inequalities.

He points to guaranteed sick time, sick benefits and employment protection for workers, along with improved housing conditions. The issue of homelessness and encampments has come to the forefront during the pandemic, he said, and he fears there will be a new wave of homelessness as evictions begin to rise.

Those are obviously bigger discussions but I'm encouraged to see they're happening a little bit more because of COVID," said O'Shea.

Mayo said it's important to note the income and race associations with the rate of cases is taken from neighbourhood characteristics, not from information taken directly from COVID patients. Income and race data was not available at the time of the SPRC analysis.

The rates are also based on the total number of infections, whether they resulted in serious health outcomes or not. The number of COVID-related hospitalizations and deaths in Hamilton was too small to analyze at a neighbourhood level.

But Mayo said a large Public Health Ontario study looking at COVID hospitalizations and deaths at the provincial level also found the same income and racial disparities seen in Hamilton.

The SPRC's analysis also made adjustments to account for neighbourhoods that had high infection counts due to outbreaks at long-term care facilities.

Steve Buist is a Hamilton-based investigative reporter at The Spectator. Reach him via email: sbuist@thespec.com