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Immigrants and refugees have been disproportionately affected by COVID-19 in Ontario



Disadvantaged communities face disproportionate risks of becoming infected with COVID-19, suggesting inequities in the burden of the virus. Recent immigrants and refugees, many of whom have low income and are more likely to live in overcrowded housing or multigenerational households, are at increased risk of infection, this despite research that shows Ontario newcomers are healthier than long-term and Canadian-born residents. Recent immigrants and refugees are also more likely to be employed in settings that put them at greater risk of infection, such as hospitals or nursing homes, or that don’t offer sick leave, such as hotels and restaurants. Lower language proficiency may also make it more difficult for them to follow public health directives that are important in reducing the risk of COVID-19 infection.

Immigrants and refugees have higher case rates, lower rates of COVID-testing and a higher percentage of positive COVID-19 tests than other Ontarians. And while the province’s COVID-19 vaccination strategy has prioritized some high-risk communities, immigrants and refugees still have much lower rates of vaccine coverage. An enhanced effort focused on reducing barriers to vaccination and directing vaccines to the highest-risk communities is needed to ensure vaccine equity for immigrant and refugee communities in Ontario.

ICES Research

In September 2020, a team of ICES investigators led by Dr. Astrid Guttmann released a report comparing patterns of COVID-19 testing and test results among immigrants and refugees in Ontario with those of Canadian-born and long-term residents. The study found that of all Canadian-born and long-term residents tested for COVID-19 between mid-January and mid-June 2020, 2.9% tested positive. Of the people tested who identified as immigrants or refugees, 8.1% received a positive diagnosis. The report highlighted the toll the virus was taking on those living in low-income neighbourhoods and on immigrant, racialized women, particularly those employed as health care and personal support workers. The report was presented widely, including to all Ontario medical officers of health and to Immigration, Refugees and Citizenship Canada.

Individual reports using data through to November 2020 were produced by the ICES team for the three public health units in Ontario serving the largest immigrant populations. The team also co-wrote a briefing note with Toronto Public Health for community partners, including those providing settlement services.

Areas of impact

A follow-up report released by ICES in April 2021 compared vaccine coverage among immigrants, refugees, other newcomers and Canadian-born and long-term residents in Ontario. The study showed that immigrants and refugees, particularly the elderly among them, were less likely to be vaccinated for COVID-19. Detailed reports have been produced regularly for the three public health units in Ontario serving large immigrant populations and have helped to inform their local vaccination strategy.

How this work is having impact

  • These findings have helped to inform targeted public health efforts to minimize COVID-19 infection among immigrants and refugees, including the provision of mobile testing units in at-risk communities.
  • Lorna Jantzen, assistant director for Immigration, Refugees and Citizenship Canada (IRCC) said the partnership with ICES helped the Government of Canada leverage IRCC data to bring out important results that would not otherwise have been possible and to fill key information gaps that benefit all Canadians, by allowing other provinces to learn from the experience of Ontario.
  • In April 2021, the Toronto-based Wellesley Institute released a paper quantifying inequities in vaccination across Ontario, using data downloaded from ICES’ COVID-19 dashboard.
  • ICES data, including more granular information on specific groups of immigrants, has informed local strategies to address low vaccination rates among older immigrants and refugees who are at high risk of severe disease and provided continued surveillance on progress.
  • The vaccine report was presented by Dr. Guttmann to IRCC, and the Privy Council of Canada has been using ICES dashboard data for federal presentations and briefings.

“The findings should be a call to action to address systemic inequities by allowing people to leave work to be tested, protecting people in their workplaces, providing paid sick leave so people who are precariously employed don’t lose income in order to protect themselves and their families while ill, and supporting those who can’t safely quarantine within their own crowded households.”
Dr. Astrid Guttmann, Chief Science Officer, ICES


Posted December 2021

Published in the 2020-21 Annual Report

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