Black Canadians are more likely to die from HIV/AIDS and certain types of cancer than their white counterparts, a new Statistics Canada report has found.
The report published Wednesday analyzed data from Canadian citizens or permanent residents who were aged 19 and older at the time of the 2001, 2006 and 2011 census, followed by a follow-up period until the end of 2019.
According to the report, apart from HIV/AIDS, Black males were at an increased risk of dying from prostate cancer, diabetes mellitus and cerebrovascular diseases.
Black females, meanwhile, were at an increased risk of six causes of death compared to their white counterparts, including HIV/AIDS, stomach cancer, corpus uteri cancer, lymphomas and multiple myeloma, diabetes mellitus and endocrine disorders.
For Black males, the risk of dying from HIV/AIDS was found to be 2.37 times higher than white males, while Black females had a 6.05 times higher risk of dying from HIV/AIDS than white women.
According to the report, the “notable mortality difference” when it comes to HIV/AIDS-related deaths in Black people could be caused by “health inequities, differential antiretroviral therapy (ART) adherence and treatment delays.”
Josephine Etowa, a full professor at the School of Nursing at the University of Ottawa, said structural racism and the social determinants of health contribute to the disproportionate impact of HIV on African, Caribbean and Black (ACB) people in Canada.
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Etowa added that such health inequalities were also seen during the height of the COVID-19 pandemic.
She said another issue that contributes to the mortality difference related to HIV/AIDS is limited knowledge of the disease in ACB communities.
“The knowledge surrounding HIV is limited in our community,” said Etowa, who is Black. “Part of this knowledge includes knowing what new resources are available today and about the prophylaxis treatment that is now available for people to prevent HIV.
“We need to have meaningful engagement with ACB people, including giving them the resources to be able to advocate for themselves,” she added.
The report also pointed out that the respondents’ experience with discrimination was “an important health determinant” that was not available and is difficult to measure.
“Other research has shown that Black people are the most likely to experience discrimination, compared with other groups, and that this discrimination is associated with chronic conditions and chronic condition risk factors, such as smoking, binge drinking and infrequent physical activity,” the report said.
However, the report found that overall Black males have a 25 per cent lower risk of dying from all causes combined when compared to white males, while for Black females, the risk was 22 per cent lower than white females.
Dr. Doreen Ezeife, a medical oncologist based in Calgary, said the data shows that there are health-care system inequalities in Canada “that need to be addressed.”
“These inequalities impact Black patients differently,” said Ezeife. “We see less engagement with the health-care system likely due to medical system distrust. Black patients may not be as willing to see health-care providers, partly because of that distrust and also because of lack of representation from health-care providers that look like them.”
She added that Black patients may also face issues when trying to access specialist physicians, medications and other health care resources.
Ezeife said the lack of race and ethnicity data in Canadian provinces has made it challenging to identify the gaps.
She said although she’s ready to “applaud” Statistics Canada’s report as it shed light on systemic inequalities in health care, the outdated data doesn’t represent the current situation.
“When we collect more timely and detailed race and ethnicity data at the provincial levels, it allows that data to be more up to date and more detailed and more granular,” said Ezeife. “It allows us to learn more about how our Black versus white versus other races of patients using the health-care system, how are they going to the hospital, going to the emergency departments, how often are they seeing specialists and getting surgeries performed.”
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