Manitoba to collect racial data in hospitals

WINNIPEG – Manitoba is launching a new system-wide expansion of race-based data collection in hospitals, building on efforts to track how different racial groups were disproportionately impacted by COVID-19. Beginning this spring, the province will ask patients to self-declare their racial or ethnic background as part of the hospital admission process, making Manitoba the first Canadian jurisdiction to do so, according to the University of Manitoba.

“Black, Indigenous and racialized folks actually receive significantly unequal care by race, and that is a reflection of how multi-level racisms operate in our healthcare system,” said Dr. Marcia Anderson (pictured), executive director of the Ongomiizwin Indigenous Institute of Health and Healing at the U of M Rady Faculty of Health Sciences.

“If we are not able to hold up that mirror and use data and evidence, what happens is a failure to act to change.”

Anderson said the data will enable service providers to “disrupt and dismantle systemic racism in healthcare.”

She will lead the program, jointly run by the U of M and Shared Health, the provincial agency that co-ordinates healthcare services. The George and Fay Yee Centre for Healthcare Innovation at the U of M will evaluate the program and help develop training for hospital staff.

Patients will be asked to volunteer information about their identity starting in April, choosing from categories such as First Nations status, Inuit, Métis, Black, Filipino, Southeast Asian, African, Chinese, South Asian, Latin American, Middle Eastern or white.

In a statement, Monika Warren, chief operating officer of Shared Health provincial services, said while the disclosure is entirely voluntary, “it is an important element in our efforts to improve patient care, health reporting and planning, and health system performance and services.”

While race-based hospital data is collected in other countries, such as the U.S., Australia and England, Manitoba’s is the first such program in Canada, according to Anderson.

Other Canadian jurisdictions have gathered, or will start gathering, some race data. For example, last fall, Nova Scotia started asking people applying to renew provincial health cards to declare race and language information.

But none have gone so far as to attempt to collect it from all hospital patients, Anderson said. She suggested the Manitoba approach will provide higher-quality data quickly.

“It’s really important, collecting this race-based data, because it sort of sheds a light on the disparities in terms of health outcomes,” said Souradet Shaw, an assistant professor at the U of M and a Canada Research Chair in global public health.

Shaw said it will be important to ensure data collection doesn’t stigmatize certain populations.

Dr. Alan Katz, a professor in family medicine and community health sciences at the U of M, said a culturally sensitive approach will be needed.

“If people are self-declaring being of First Nations or other racial groups that are at risk for racism, then they are opening themselves up to that kind of discrimination,” said Katz.

“That’s a potential significant harm.”

The initiative follows previous efforts by Shared Health and the Manitoba First Nations COVID-19 Pandemic Response Team, which was also headed by Anderson.

The Cree-Anishinaabe physician helped conduct demographic studies that found disparities in infection rates and more severe COVID-19 outcomes in Black, Indigenous and other communities of colour.

Anderson and others attributed those trends in part to social determinants of health – such as employment and overcrowded housing, particularly on some First Nations – and systemic racism that creates barriers to care.