Collect race, Indigenous identity on health card renewal to address health inequities, study suggests

To address health inequities that Indigenous and racialized patients can experience, collect data on racial and Indigenous identity at health card application and renewal, suggests a group of authors in Canadian Medical Association Journal.

"Although race is a social construct that uses perceived physical differences to create and maintain power differentials and the existence of discrete racial groups has not been shown to have any biological basis, perceived race influences how people are treated by individuals and institutions," wrote Dr. Andrew Pinto, founder of Upstream Lab based at MAP Centre for Urban Health Solutions, part of Unity Health Toronto hospital network, along with coauthors.

Indigenous and Black patients have less access to health care, receive poorer care and have worse outcomes.

"Having data on race available for analysis can facilitate the measurement of racial inequities in health care, help to hold organizations and governments accountable for addressing these inequities and monitor progress," the authors wrote.

Collecting self-reported identity data on health card applications and renewals could be an efficient way to obtain this information, with the caveat to plan for and prevent potential harms of collection. The authors suggest the following:

• Asking about race and Indigenous identity in a safe and transparent manner
• Guarding against potential bias or race corrections by providing antiracism training
• Ensuring that race or Indigenous identity is not visible on health cards
• Ensuring that data are not interpreted or presented in a way that reinforces racism and discrimination
• Legislating laws that protect communities so that health data are not used to draw broad conclusions about communities
• Supporting Indigenous, Black and racialized communities to lead data collection and analysis with data sovereignty and governance frameworks

"Racism in Canada's health care systems continues to lead to injustice, but data that would assist in tracking progress and ensuring accountability are lacking or inadequate. Near-universal race and Indigenous identity data could be collected efficiently at health card application and renewal across Canadian jurisdictions," the authors conclude.