Researchers work with African Nova Scotian communities in Dartmouth on health registry

A research project working with African Nova Scotian communities in Dartmouth is collecting information for a future health registry, in hopes the province will do something similar to identify racial inequities in health.

OmiSoore Dryden, associate professor at Dalhousie University and the James R. Johnston Chair in Black Canadian Studies, began research for Don’t Count Us Out! in August and September 2020. Dryden is also a board member of Health Association of African Canadians.

Dryden said two events motivated her research proposal.

“First, North Preston was shamed for having a COVID-19 outbreak by the premier and chief medical officer,” Dryden said, and many people including Dryden requested an apology.

“Then in April 2020 a new emergency grant was announced, and the grant supported work focusing on the experiences of African Nova Scotian communities.”

The research project is focused on health care of African Nova Scotian communities in Dartmouth, specifically the Preston Township including East Preston, North Preston, Cherry Brook, and Lake Loon.

Don’t Count Us Out! has two goals, Dryden said: measuring factors of trust in African Nova Scotian communities and developing infrastructure for a population health registry.

“What we learn from the project will help us identify appropriate structures,” Dryden said.

Community health registry

According to the Dalhousie website, an African Nova Scotian Community Health Registry will help address historic inequities and harms in the healthcare system. The health registry is an opportunity for African Nova Scotian communities to have control over their own health data and identify inequalities.

“Systematic racism is a part of all systems in Canada, including health systems,” Dryden said.

“Black and Indigenous people have poorer health outcomes and greater health disparities due to the impacts of systematic racism.”

Black people may not have the same access to primary care physicians, or may have different access to health care, Dryden said.

Don’t Count Us Out! is collecting initial information to push the province towards collecting this disaggregated data, Dryden said.

Participants are being asked to share health card numbers, Dryden said, but the data will be disaggregated so no one is identified individually in interpretation and analysis.

Challenges in the project have included delays getting the project started, doing this work during COVID-19, and concerns with sharing sensitive health information (health card numbers), Dryden said.

Dryden said they are working with community members to alleviate concerns and ensure security measures are in place.

“There are strict protections put into place to ensure that the information does not identify specific people, but instead provides us an overall sense of health concerns in the Preston Township,” Dryden said.

They are planning community and provincial partnership meetings to discuss initial outcomes of the research and next steps, Dryden said.

Voices for African Canadian health

Sharon Davis-Murdoch is the co-president of Health Association of African Canadians (HAAC), an organization that addresses African Canadian health issues and system inequities affecting health.

HAAC is not a part of the research team or project, but supports Dryden in her work.

“There is no question that the HAAC board and membership are extraordinarily in support,” Davis-Murdoch said.

“The Health Association of African Canadians have been asking for data with race, ethnicity, and language identifiers, for quite some time since our establishment in 2000.”

Davis-Murdoch said that HAAC asks for comprehensive data including ethnicity and language identifiers, to address inequities based on ethnicity and language.

“We need evidence in order to inform the system so that we can have better health policy so we can have evidence-based decision making,” Davis-Murdoch said.

“Not only do we want to know rates of chronic disease, rates of disorders, but we also want to know about the utilization of the health system.”

Davis-Murdoch said important information includes what health issues have been disproportionally impacting African Nova Scotian communities, and how the health care system is being used—including accessibility to services, availability of culturally specific services, and many other factors.

The disproportionate impact of COVID-19 on communities of African ancestry has been documented in countries including the United States, the United Kingdom, and western countries where data is collected, Davis-Murdoch said.

“All of this is important information so that decisions can be made, so that funding can be provided appropriately, and so that issues of inequity can be addressed,” Davis-Murdoch said.

“We are in a position to be governors that have that information and work with government, so that we will be able to have an Afrocentric interpretation of that data … We are not interested in having interpretation that is in any way systematically racist.”

Research team and support

Dryden shares a research team and staff with Ingrid Waldron, who she is working collaboratively with. Ingrid Waldron is principal investigator of the project A Culturally Specific COVID-19 Response Strategy for African Nova Scotians in the Prestons.

The Nova Scotia COVID-19 Health Research Coalition has awarded funding for the project. The project has been fully funded for $75,000.

The funding helped them hire within the Preston Township, offer training supports, and respect time of participants in research study, Dryden said.

While there has been lots of support from people in the Preston township, Dryden said she wished they could focus on African Nova Scotian communities across the province.

“I look forward to more opportunities to work collaboratively with African Nova Scotian communities and agencies specifically around addressing health disparities and inequalities,” Dryden said.