Among Canadian cities, Montreal has suffered worst from the novel coronavirus.
And within the city, a grim geography has emerged: Montreal’s poorest neighbourhoods have the highest coronavirus rates. Montreal North, one of the city’s poorest areas, has more than double the average infection rate.
Data released by the city of Montreal shows that many of the hardest-hit boroughs house lower-income people, immigrants and refugees.
The pattern repeats itself in cities around the world.
Why? Experts Global News talked to blame a cluster of factors, from crowded housing to jobs that carry more danger of infection to lack of paid sick leave.
“It’s an unfortunate reality that people who are most marginalized in the society face the greatest consequences of further marginalization, like what comes from a pandemic,” explains Steven Hoffman of York University.
In New York, low-income zip codes have the city’s highest coronavirus death rates. The worst-hit area is the Starrett City public housing complex in Brooklyn, where about two-thirds of residents are African-American.
Many people in well-off areas of the city fled entirely, postal data shows.
In Britain, the Office of National Statistics found that people in low-income areas had coronavirus death rates more than twice as high as those living in better-off areas. The poorest neighbourhoods in London fared worst.
A similar pattern has played out in Paris, where the city’s grim suburbs have seen much higher coronavirus rates than the rest of the capital, to match their much higher unemployment rates.
Some jobs can’t be done from home
“Many people who are higher-income have the resources and stability to work from home, which enables them to create layers of protection for themselves and ensure that they don’t come into contact with the virus,” Hoffman says.
“Others who are in the service industry or working in places that require manual labour are going to be less able to work from home.”
In general, higher-paid, higher-status work comes with the flexibility to do things like work from home.
“The higher you are on the occupational pecking order, the more control you have of how you do your work and where you do your work.”
Many lower-paid jobs come with a higher risk of infection
As well, many jobs involving cleaning, health care, child care and retail necessarily involve contact with other people, increasing the chance of getting sick.
“If you think of who is at risk from an occupational standpoint, it is typically going to be people who have contact with others, doing that in working conditions that are poor,” says Colin Furness of the University of Toronto. “In other words, low-status, low-pay caring occupations – your classic personal support worker.”
Many ways of easing the pandemic cost money
More space, the ability to escape to a cottage, good-quality food, good-quality internet access — all are things that people can throw money at if they have the money to throw.
“Those who can afford grocery delivery can make use of that service, but it is a premium service — it costs more money,” Hoffman says.
“Wealth buys you choices. It buys you wiggle room. Look at New York: people who could go to the Hamptons did. They just left.”
Crowded housing doesn’t help
“When we think of the chronic underhousing that we see in cities across Canada, we shouldn’t be surprised if those populations face greater risk in a pandemic,” Hoffman says.
The more people share a housing situation — a crowded apartment building, for example — the more chances there are for the virus to spread, Furness explains.
“You’re going to have a concentration of people who are all vulnerable, and they’re all in the same apartment, in the same building, in the same neighbourhood. You’ve got handrails and elevator buttons and the local corner store — you’ve got more virus around to catch, period.”
“The more virus is around, the less exposure time it takes to get sick. It’s sort of a self-reinforcing thing: you put a bunch of vulnerable people together, they start to get sick, then they start to get more sick. There’s sort of a runaway train effect.”
People who feel too cooped-up won’t follow lockdown rules
Staying home is a very different experience in a house with a backyard than in a small apartment. People who feel too confined in too small a space for too long are less likely to tolerate orders to stay home, Hoffman says.
“People do need to live, and get fresh air,” he says. “If we don’t provide people with space and amenities in which to live their lives, they’re going to congregate and do other things.”
Using public transit for lack of other options
“Those who have cars are able to drive places, whereas those who don’t might have to use public transit,” Hoffman says.
“I’m not saying that public transit is bad, just that those who have fewer resources have less ability to apply layers of protection around themselves during a pandemic.”
In Toronto on March 31, transit officials identified nine routes where buses are worryingly crowded on weekday mornings before 7 a.m. All serve low-income areas of the city’s inner suburbs.
Lack of paid sick leave
“It’s very easy for political leaders and public health officers to ask people to stay at home if they’re sick, but it’s just not feasible for many people if they’re depending on their salary to put food on the table,” Hoffman says.
People without a formal employment structure — “they’re moonlighting, or they’re doing piece work, or their work is just structured that way” — certainly don’t get paid if they’re sick, Furness says.
“If you are the only breadwinner, you go to work when you’re sick because you can’t afford not to.”
If sick people feel forced to go to work regardless, because they won’t be paid if they don’t, that quickly endangers everybody, Hoffman points out.
“(Paid sick leave) actually protects everybody else, in ensuring that sick people don’t go to work and spread their pathogens to others.”
Language and education
Responding to the crisis depends in part on understanding a lot of information being communicated by government, and applying it to your life.
“The lower your education, the less equipped you are to take steps, to make sense of what is going on,” Furness says.”Language, too.”
“The more disconnected you are from the mainstream of what is going on, the less plugged-in you are, the less you are able to react the way everybody else is reacting.”
Poor diets don’t help fight off disease as well as good-quality ones do, Furness points out.
“If you’re trying to feed a very large family on a minimum-wage budget, people aren’t eating that well, and if they’re not eating that well they’re going to be more susceptible to getting sick, and seriously sick.”
With files from the Canadian Press