Mobilizing African, Caribbean, and Black (ACB) communities for effective COVID-19 response

Posted on Thursday, February 11, 2021

Author: Prof. Josephine Etowa

Faculty Affiliate, ISSP
Full Professor, School of Nursing, Faculty of Health Sciences, uOttawa

As we mark Black History Month, we are reminded of the increased burden of COVID-19 on African, Caribbean, and Black (ACB) communities and the urgent need for evidence-based, racially responsive healthcare. In both the ACB and healthcare provider communities, pandemic-related challenges are real and mounting. ACB people are confronted with different realities, including closeness to hotspots due to poor employment situations, use of public transportation, and denser housing, all of which make social distancing far more difficult. Healthcare providers are also pointing to the limited resources available for culturally safe COVID-19 care for ACB people.

These intersectional problems are the basis for the COVID-19 ACB Providers Project (CAPP), a new collaborative initiative spearheaded by uOttawa’s CO-CREATH lab, a hub for community-based researchers, students, and professors conducting critical research to advance health equity and transformative community engagement. We are collaborating with the HIFI lab at St. Michael’s Hospital and the Canadians of African Descent Health Organization (CADHO). Together, we are engaging ACB communities and healthcare providers to examine the challenges they are facing and identifying strategies to build capacity to address COVID-19 related-health outcomes.

To date, we have surveyed 249 primary, secondary and tertiary healthcare providers in Toronto and Ottawa. Respondents cut across various healthcare providers, including doctors (17%), nurses (54%), and others, including pharmacists, respiratory therapists, community health providers, and public health experts (29%). Most (72%) respondents reported that almost half of their patients are African Caribbean and Canadian Black. We have also conducted about 80 individual interviews with ACB community members, health care providers and policymakers in Ottawa and Toronto. All three groups acknowledged the disproportionate impact of COVID-19 on the ACB community and have pointed to systematic racism, comorbidities, and social conditions as key causes.

Discrimination is a barrier affecting access to healthcare services, and it is vital that healthcare providers better understand the needs of ACB patients. ACB interview participants pointed to the importance of more meaningful engagement with healthcare providers in developing strategies, policies, and programs to better address these needs, including COVID-19 testing, treatment, and vaccination rollouts. As my collaborator Dr. Ruby Edet, Vice President of CADHO, has noted, ACB professionals must be at the forefront of creating solutions for their communities and tailoring interventions.

Our preliminary findings underline how factors such as socioeconomic vulnerability, comorbidities, critical health literacy, and discrimination affect healthcare access and outcomes in ACB communities. They also highlight the need for anti-racist healthcare knowledge, training, and service provision to ACB communities in both Ottawa and Toronto. 

Data collection for the COVID-19 ACB Providers Project is ongoing. We are targeting 600 surveys of healthcare providers and 100 in-depth individual interviews with ACB community members, health care providers, and policymakers. Our hope is to develop a rich dataset that covers topics such as COVID-19 knowledge and practices, provider preparedness, cultural safety, discrimination, and access to COVID-19 related services for ACB people. Properly mobilized, this research can help create more just and more equitable health outcomes for some of Canada’s most vulnerable populations. 

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