Black patients see higher hospital admissions as primary care gaps persist across Canada

Black Canadians had the highest rates of avoidable hospitalizations in the country, according to a June 18 report from Statistics Canada, with experts linking the trend to inequitable access to primary care and systemic barriers in the health-care system. 

As per the 2023/2024 data, 272 out of every 100,000 Black men and boys were hospitalized for treatable conditions such as asthma, diabetes, and hypertension. Among Black women and girls, the rate was 253 per 100,000.  

The Canadian Press reports that these figures outpaced those for all other racialized and non-racialized groups. 

According to the same StatCan report, Chinese Canadians had the lowest rates, with 65 hospitalizations per 100,000 among men and boys and 52 per 100,000 among women and girls.  

Non-racialized Canadians recorded the second-highest rates: 257 per 100,000 among men and 226 per 100,000 among women. 

Cynthia Maxwell, a member of the senior leadership team at Women’s College Hospital in Toronto and former president of the Black Physicians Association of Ontario, said chronic illnesses are more common in Black communities and often linked to barriers navigating the system.  

According to The Canadian Press, she added that limited access to nutritious food and greater exposure to environmental toxins also contribute to respiratory issues and other health concerns. 

Maxwell connected low access to primary care with higher mortality from serious illnesses.  

She said, “We know Black women have less access to screening for conditions such as breast cancer and cervical cancer, which are major issues and have high morbidity and mortality in Black communities.”  

Most conditions, she added, are typically identified in a primary care setting where patients are referred to specialists. 

According to StatCan, 72 percent of Black Canadians had access to a primary care provider in 2023, compared to 84 percent of non-racialized individuals.  

The Canadian Medical Association does not track the number of Black physicians, but the Academic Medicine Journal estimated that in 2018, just 2.3 percent of practising physicians in Ontario were Black. 

Notisha Massaquoi, assistant professor of health education and promotion at the University of Toronto, said the data reflects a long-standing equity gap.  

She noted that the Black population “has experienced an enormous amount of racism in the health-care system,” which has led many to delay seeking care until it becomes urgent.  

“There’s a lack of trust in terms of going to a primary health-care setting,” she said. She added that when people routinely avoid care, their conditions tend to worsen. 

Massaquoi also cited the low number of Black providers as a factor in patient hesitancy.  

She pointed to studies showing improved health outcomes and survival rates when Black patients are treated by Black caregivers. 

Both Maxwell and Massaquoi called for the development of more Black-led clinics and increased training on cultural competency within the broader health-care system.  

According to The Canadian Press, Maxwell said it is unlikely there will ever be enough Black health-care providers to serve all members of the Black community.  

Because of this, she stressed the importance of having “all allies in the health system engage in and learn about cultural safety and competencies that will help drive better health-care outcomes.” 

Maxwell also underscored the need for better race-based patient data to identify patterns in access, diagnosis, and treatment.  

“Without the … race-specific data,” she said, “you can't really get to the nuances of what the particular issues are within a community and what it means for a community to be disproportionately affected, either by a health condition or by the outcome of treatment for a health condition.” 

Massaquoi said Black health advocates have “constantly” called for race-based data to support targeted interventions. She added that members of the Black community want to see solutions designed specifically for them, rather than repeated reports highlighting disparities.  

“We're no longer just getting this trauma type of data that keeps telling us over and over in every manner how badly we're doing,” she said.