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Why COVID-19 killed more in some Canadian neighbourhoods than others

A Statistics Canada study found that in 2020, Canadian neighbourhoods with higher concentrations of seniors died at a rate nearly six times higher than the Canadian average; in immigrant dominated communities, the mortality rate was 2.6 times higher.
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An employee at a poultry plant in Coquitlam, B.C., patrols the gate after an outbreak in April 2020 led to the infection of dozens of low-income workers and their families around Metro Vancouver. - Stefan Labbé/Glacier Media

The first wave of COVID-19 to hit Canada led to higher death rates in neighbourhoods with more immigrants, low-income families and seniors, a new Statistics Canada study has found.

Across Canada, neighbourhoods with a high proportion of elderly people living in seniors’ homes, hospitals or long-term care homes saw the highest mortality rate.

“These neighbourhoods collectively reported 148.4 deaths per 100,000 population in Canada,” noted StatsCan analysts Raj Subedi and Nicole Aitken, “which is almost six times higher than the neighbourhood type reporting the lowest mortality rates.”

The lowest mortality rates, meanwhile, were found in higher-income suburban communities, where residents tended to have higher education, lower unemployment rates, smaller family sizes, and higher rates of people owning their own homes.

But in densely populated urban neighbourhoods, high concentrations of immigrants, single-parent families and relatively low incomes led to COVID-19 death rates surging 2.6 times higher than in Canada’s suburban neighbourhoods.

In cities like Vancouver, Calgary, Montreal and Toronto, neighbourhoods with large South and East Asian populations also tended to have higher COVID-19 death rates.

The researchers said the high COVID-19 death rates in poorer urban neighbourhoods could be because of higher infection and transmission rates driven by dense living and “relatively less open space and greenery.”

Risk of dying from COVID-19 was also likely due to some combination of compliance with public health restrictions and the fact that low-income households tend to work in occupations that require more contact with the public. 

Men were found to have higher death rates due to COVID-19 no matter what neighbourhood they lived in in 2020. In senior or institutionalized populations, the mortality rate for men was 1.7 times higher than for women.

What’s driving that gap is less clear, but the researchers speculate it’s some combination of differences in immune responses or the fact men are more likely to engage in risky habits such as smoking or drinking.

Among Canadian cities, the 2020 waves of the virus hit Montreal hardest, leading to death rates 2.7 times higher than the national average.

Toronto’s COVID-19 mortality rates were 1.2 times higher than the national average, the study found. 

The researchers did not analyze other Canadian cities and how COVID-19 death rates hit neighbourhoods differently. However, multiple outbreaks in long-term care homes led to scores of deaths in 2020 as staff and management struggled to contain the virus. And reporting from Glacier Media has documented how the virus can disproportionately impact low-income immigrant workers and their families when an outbreak hit a poultry plant early in the pandemic.

Statistics Canada did not analyze national mortality data since 2020 as it often takes a year to get finalized, Subedi said.