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Who is most likely to die from COVID-19?

Who Is Most Likely to Die From Covid-19

     I have said it many times before but once again I repeat myself. If you are healthy you have nothing to fear from Covid-19 but now that we are deep into this pandemic scientists have identified clear patterns in which people who suffer from Covid-19 are most likely to die. Pre-existing medical conditions are one important factor. As of June 3, roughly nine in 10 residents of Ontario and Quebec who died from Covid-19 suffered from underlying chronic conditions.

     But those underlying conditions don’t affect everyone equally. They are much more prevalent among elder people in nursing homes who account for 82 per cent of all the deaths in Ontario. However, they are also more prevalent among lower-income workers. Rates of obstructive pulmonary disease, kidney disease and diabetes, for example, among the poorest 10 per cent of Ontarians are estimated to be 40 per cent higher than the rate among middle and upper class citizens.

    In fact, across Canada, people with the lowest incomes have the highest rates of diabetes, asthma, high blood pressure and kidney and pulmonary disease—conditions that put Covid19 patients at a higher risk of severe illness.

     Why should this happen in a country with national health care for all regardless of income? Wealthy people enjoy a wide range of advantages. They can afford better diets and quality supplements, better housing and working conditions; they are less exposed to dangerous environments; they experience less stress and engage in more physical activity; and they use our health care system the way it was intended. When I operated my pharmacy most of my clients on welfare or very poor did not even have a family doctor. They would always go to Emergency for all medical conditions and none of them had specialists. Lower income people are not as well educated and are poor at using our medical system. People with more money had a regular family physician, an obstetrician/gynaecologist, a cardiologist, an opthamologist and maybe even a sports doctor. They knew how to get the most out of our health system. This all adds up to to what researchers call a “socioeconomic gradient in health”—wealthier people experience better health than those making less money, at every point on the income scale.

     The wealthy and the poor have become increasingly segregated from one another. In 1970, 15 per cent of the urban population lived in neighbourhoods that were predominantly poor or rich. This number has more than doubled since 2009.

     As a result, the physical environments in which lower-income and affluent Canadians are most likely to live are very different. Poor areas have limited access to healthy food and a higher density of fast-food outlets. They usually have less green space and areas for recreation. Low-income communities are also more likely to be closer to industrial facilities, so people who live there are more exposed to hazardous pollutants. This last item is very significant as a new nationwide study showed a strong association between long-term exposure to pollution and higher Covid-19 death rates.

     Researchers have a term for this: health justice. It’s a measure of the correlation of health outcomes with income/race/ethnicity and sex, and it has become worse over the past few decades according a recent McGill University study.

     The fact is we live in an environment that works best for those with social and economic power and so it is no surprise that favourable outcomes of Covid-19 favour that group.

     There are many things that could be done to remedy this situation; early childhood education especially with regard to knowledge of fruits and vegetables and cooking. As I write this, the United States has the highest death toll in the world from Covid-19 because, in my opinion, their lifestyle is the unhealthiest on this planet. We need to teach our children the value of nutrition as soon as they start school. We also should have health centres at our schools to spot potential disease outbreaks. We need home based nursing care and of course professional nursing care for all of our retirement homes. We need more affordable housing and low-cost transportation infrastructure.

     My hope is that once our politicians start to look back at the people who suffered the most deaths from Covid-19, they will recognize the factors and try and do better so these people are not hit as badly when the next pandemic occurs. [print_link]