‘We are not all in this together’: Hamilton Community Foundation report
They were called Potemkin villages, named after Grigory Potemkin, a Russian statesman in the late 1700s.
Legend has it Potemkin erected fake villages with beautiful facades along the banks of the Dnieper River to impress Catherine the Great as she made her way to Crimea. The artificial villages would then be taken down and reassembled further along the route to keep up the pretense that all was well with the Russian empire.
In a way, COVID turned Hamilton into a Potemkin village in 2020.
From the outside, the city's facade seems strong as ever. Cars fill the roads, cranes still poke into the sky, sidewalks are busy.
Behind the facade, though, there's another Hamilton, one where people are struggling to hang on 15 months into a global pandemic that has scrambled daily life.
The tale of these two solitudes," as Hamilton Community Foundation CEO Terry Cooke describes it, is the story that emerges from this year's Vital Signs report.
Vital Signs is the foundation's annual report card on a variety of health, social and economic factors across Hamilton and, not surprisingly, this year's findings are heavily skewed by COVID's impact.
COVID in real time has exposed in very, very practical ways that we are not all in this together and that it isn't the great equalizer," Cooke said. In fact, what it's doing is compounding the inequality by wealth, by neighbourhood, by race."
Whether it's employment, mental health, vulnerability to COVID infection, or more recently, vaccination rates, there's a city of haves and another of have-nots.
Some of us who have secure employment and own our own homes ironically will emerge from this in a stronger financial position," Cooke said. But that will be a very different experience for people who are precariously housed, who have precarious employment, who don't have food security.
The tragic trajectory of COVID is that it is compounding these inequities and it's going to be a very long and difficult recovery for folks who are on the wrong side of that fault line," he added.
Racial and socioeconomic inequality
COVID certainly hasn't been colour-blind in Hamilton, hitting the city's racialized population at a rate two-and-a-half times higher than the white population.
About 19 per cent of the city's residents identify as visible minorities yet they accounted for slightly more than 50 per cent of all COVID infections, according to data from Hamilton's public health unit.
The Vital Signs findings are similar to the results of a recent report by Hamilton's Social Planning and Research Council (SPRC) released in May.
Another way to show the unequal impact of COVID is through a neighbourhood measure called ethnic concentration," meaning the proportion of people who are either recent immigrants or visible minorities or both.
When Hamilton's 142 census tracts, or neighbourhoods, are gathered into five groups from the lowest proportion of ethnic concentration to highest, there's a sharp, steady increase in the rate of COVID infections.
According to the SPRC data, the group of neighbourhoods with the highest proportion of ethnic concentration had 75 per cent more COVID infections than the group with the lowest ethnic concentration - 3,571 infections per 100,000 people compared to 2,020 per 100,000.
More recent data around the city's COVID vaccination rates shows the impact of income inequality.
Comparing the city through forward sortation areas (FSA) - the first three digits of postal codes - a Spectator analysis in late April showed some of the wealthiest areas of Hamilton, with the lowest rates of COVID infections, had the highest rates of vaccinations.
Meanwhile, five of the six least-vaccinated FSAs are in the lower city, where the proportion of racialized residents is highest and where median household incomes range from $37,200 to $53,100 - significantly below the city average of $69,000.
The notion of socioeconomic inequality and impact of poverty by postal code on health, educational and social outcomes shouldn't be a revelation to this community because of the amount of focus we've put on it over the past decade," Cooke said.
The city's COVID data mimics the results found in the Spectator's decade-long Code Red project, which repeatedly showed the strong connections that exist in Hamilton between health, social and economic factors.
Whether it's lifespan, cancer mortality, emergency room visits, birth outcomes or psychiatric emergencies, the results from Code Red have been consistent - poor outcomes are tied to low income, poverty and low educational attainment.
These are the so-called social determinants of health, the concept that much of a person's physical health is tied to social and economic factors, such as income, education, poverty, housing and community supports.
The first thing to acknowledge is that these things have been going on for years, even long before the Code Red reports came out," said Kojo Damptey, executive director of the Hamilton Centre for Civic Inclusion.
To address these issues we really have to take action," Damptey said. We can't just talk about it, we can't just continue doing research and analysis.
The analysis has been done. It's time to put those recommendations into action."
Yet even when efforts have been made to address COVID's unequal burden on Hamilton's racialized population, Damptey noted, the results have been discouraging.
When the city announced in April it would prioritize vaccinations for Black people and other racialized populations living in hot spots, a torrent of racist venom was unleashed on social media.
That's the type of systemic racism that Black, Indigenous and racialized communities face in society, whether it's the health-care system, policing, even in the education system," Damptey said. Even when interventions are made, you still get this pushback from community members."
It's not just people's physical health that's been put at risk during the pandemic.
Skyrocketing mental-health problems
The percentage of Canadians reporting their mental health as excellent or very good dropped to 55 per cent from 68 per cent prior to the start of the pandemic.
Opioid-related overdose deaths in Ontario jumped by nearly 80 per cent last year. Hamilton public health reported 113 opioid-related deaths through November 2020 compared to 105 in all of 2019.
For children and adolescents, mental-health problems are skyrocketing.
In March, McMaster Children's Hospital reported that youth admissions for suicide attempts had tripled from the previous year while youth admissions for substance abuse doubled.
Youth referrals to the eating disorder program increased by 90 per cent from a year earlier.
Dr. Khrista Boylan, a child and adolescent psychiatrist at McMaster Children's Hospital, said she's now seeing children as young as 11 being admitted after a suicide attempt.
It's striking, really," Boylan said.
Two things have collided since the onset of the pandemic, according to Boylan.
Families are spending more time together and if family life was a source of mental health stress for children, that's only been compounded over the past year. On top of that, children have also lost their external supports, such as teachers, social workers, a family doctor or extended family.
They get too much in their head and too isolated and that's when we see them," Boylan said. They're not reaching out to anyone any more.
They just kind of shut down and they're sitting with these suicidal thoughts and not knowing what to do with them," she added.
Boylan said eating behaviours can be affected by a loss of normal daily routines, along with conflicts that can develop with peers over the internet now that students can't socialize face-to-face in their usual small groups.
Their lives have become really constricted to a virtual world which has its problems - for self-esteem and feeling part of the group," Boylan said.
Restricting food intake is something they can control and they have less supervised time so people aren't really aware what they're up to," she added.
Boylan fears the impact of the pandemic on the mental health of young people will last for another two years. She's also worried about the strain it's putting on mental-health providers.
The numbers are going to continue to climb and it's not going to settle down after the lockdown is done," Boylan said. I think mental health is kind of screwed, really."
Job gains and losses
On the jobs front, there are signs that a healthy recovery has begun.
The Hamilton metropolitan area's unemployment rate peaked at 12.4 per cent in July 2020, up from 4.3 per cent before the pandemic. By February, it had dropped back to seven per cent.
Some sectors, though, have been decimated.
A survey by Hamilton's economic development department found that nearly half of all jobs in the arts, entertainment and recreation sectors were lost between January and December 2020.
A national survey of arts organizations found that 70 per cent don't expect to survive the summer without additional supports or financing changes.
Carl Jennings sings and plays bass for Freedom Train, a popular Hamilton band. He said the group lost 120 bookings last year.
This year, the band started with 150 bookings including rollovers from last year. All of them except 10 have been cancelled," Jennings said.
Everyone's probably going to say the same thing, so it's not new for me to say it sucks," he said.
I'm among only a handful of musicians that I know of who actually rely on live performances as their main source of income. This is all we do.
The one guarantee I thought we would always have is if you were good at playing live, there would always be work," he added. The last thing I expected ever was that would be taken away from us for over a year."
Jennings has tried to fill the void by giving private music lessons and making music for clients in his recording studio, along with the government's Canada Emergency Response Benefit (CERB) payments.
But nothing makes up for the rush from live performances, he noted.
We're totally looking forward to playing again and feeling the energy with the actual audience," Jennings said.
Even the bits of good news come with dark clouds.
Housing crisis
Take construction, for example. Last year, Hamilton reached $1.38 billion in building permit value, the third-highest annual amount ever recorded. Nearly $1 billion of that was residential construction, which would seem to be a positive development.
Yet housing insecurity is rising across the city as the price of homes and rents skyrockets.
A new study shows that Hamilton is now third on the North American list of least affordable cities for housing, worse than Los Angeles and New York City.
Between March 2020 and March 2021, the average price of a detached home in Hamilton rose by 32 per cent and the average rent for an available two-bedroom apartment jumped 25 per cent to more than $2,000 a month. The wait-list for subsidized housing in Hamilton is around 5,200 households.
It's turned a crisis into a five-alarm fire," Cooke said. It trickles all the way down through the housing stream - from affordable home ownership to people paying market rents in private buildings to folks who are on affordable housing waiting lists.
We are going to have a generational crisis on our hands," Cooke added.
For many people, the lasting impression from a year-long pandemic will be a sense of aloneness. Elderly people deprived of their families. Children separated from their friends. Workers cut off from their workplaces and colleagues.
Nearly half of Ontarians reported they wished they had someone to talk to, according to a poll by the Canadian Mental Health Association.
More than a third reported being often, very often or almost always lonely.
How soon life will return to normal is anyone's guess.
COVID has had a much broader and more damaging reach on the lives of people than has been fully appreciated," Cooke said. On their mental health, their physical health, and their economic well-being."
Steve Buist is a Hamilton-based investigative reporter at The Spectator. Reach him via email: sbuist@thespec.com