Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Can J Public Health. 2021 Jun;112(3):352-362. doi: 10.17269/s41997-021-00496-6. Epub 2021 Mar 19.
To assess health equity-oriented COVID-19 reporting across Canadian provinces and territories, using a scorecard approach.
A scan was performed of provincial and territorial reporting of five data elements (cumulative totals of tests, cases, hospitalizations, deaths, and population size) across three units of aggregation (province or territory level, health regions, and local areas) (15 "overall" indicators), and for four vulnerable settings (long-term care and detention facilities, schools, and homeless shelters) and eight social markers (age, sex, immigration status, race/ethnicity, healthcare worker status, occupational sector, income, and education) (180 "equity-related" indicators) as of December 31, 2020. Per indicator, one point was awarded if case-delimited data were released, 0.7 points if only summary statistics were reported, and 0 if neither was provided. Results were presented using a scorecard approach.
Overall, information was more complete for cases and deaths than for tests, hospitalizations, and population size denominators needed for rate estimation. Information provided on jurisdictions and their regions, overall, tended to be more available (average score of 58%, "D") than that for equity-related indicators (average score of 17%, "F"). Only British Columbia, Alberta, and Ontario provided case-delimited data, with Ontario and Alberta providing case information for local areas. No jurisdiction reported on outcomes according to patients' immigration status, race/ethnicity, income, or education. Though several provinces reported on cases in long-term care facilities, only Ontario and Quebec provided detailed information for detention facilities and schools, and only Ontario reported on cases within homeless shelters and across occupational sectors.
One year into the pandemic, socially stratified reporting for COVID-19 outcomes remains sparse in Canada. However, several "best practices" in health equity-oriented reporting were observed and set a relevant precedent for all jurisdictions to follow for this pandemic and future ones.
使用记分卡方法评估加拿大各省和地区以健康公平为导向的 COVID-19 报告情况。
对五个数据要素(测试、病例、住院、死亡和人口规模的累计总数)在三个聚合单位(省或地区一级、卫生区域和地方)(15 个“总体”指标)和四个弱势群体环境(长期护理和拘留设施、学校和无家可归者收容所)和八个社会指标(年龄、性别、移民身份、种族/族裔、医护人员身份、职业部门、收入和教育)(180 个“与公平相关”的指标)在 2020 年 12 月 31 日的报告情况进行了扫描。对于每个指标,如果发布了病例限定数据,则得 1 分,如果仅报告了汇总统计数据,则得 0.7 分,如果两者都未提供,则得 0 分。结果采用记分卡方法呈现。
总体而言,病例和死亡的信息比测试、住院和人口规模的分母更完整,这些分母是用于估计率的必要信息。提供给各管辖区及其地区的信息总体上更易获得(平均得分为 58%,为“D”),而与公平相关的指标则更难获得(平均得分为 17%,为“F”)。只有不列颠哥伦比亚省、艾伯塔省和安大略省提供了病例限定数据,安大略省和艾伯塔省提供了地方地区的病例信息。没有任何司法管辖区根据患者的移民身份、种族/族裔、收入或教育报告结果。尽管几个省份报告了长期护理设施中的病例,但只有安大略省和魁北克省提供了拘留设施和学校的详细信息,只有安大略省报告了无家可归者收容所和整个职业部门的病例。
在大流行一年后,加拿大对 COVID-19 结果的社会分层报告仍然很少。然而,在以健康公平为导向的报告方面,观察到了一些“最佳实践”,为所有司法管辖区在本次大流行和未来的大流行中提供了相关的先例。