The numbers indicate this trend since the first wave of the pandemic: Exposure to COVID-19 follows clear social fault lines. Low wage earners, people who live in densely populated, isolated neighborhoods where housing is cramped and green spaces are scarce, contract the disease more.
In the disadvantaged sectors of the city, the Direction de santé publique de Montréal already noted in 2020 that there were 2.5 times more cases than in the most privileged sectors.
For almost two years, therefore, not only the inequalities in the face of the virus, and the causes of these inequalities, have been well known, but they have been abundantly quantified, here as elsewhere. So much so that this notion is now part of common sense. Health inequalities exacerbated by the pandemic have been incorporated into our political grammar. However, they have not been corrected.
Recent data published by the Direction de santé publique de Montréal indicate that these inequalities have persisted over time, and that they widen with each upsurge in transmission. Thus, since the spring of 2020, deaths caused by COVID have been twice as numerous in the most disadvantaged sectors of the Quebec metropolis: Saint-Michel, Saint-Léonard, Rivière-des-Prairies, Pointe-aux-Trembles and Montreal. -North.
Building to building survey
In Montréal-Nord, in fact, a report unveiled on Friday intends to draw a more precise portrait of how these inequalities have manifested themselves in the lives of citizens of the borough since the start of the pandemic. The data analyzed come from the Building to Building survey, a research project launched by the Parole d’ExcluEs and Hoodstock organizations.
Between October and March 2021, a team of young people from Montreal-North – who therefore had an intimate knowledge of the context – received training on data collection and questionnaire completion. They then knocked on 2,700 doors in the neighborhood, or about 13% of homes, to get feedback from residents. We wanted to document the experience of people who have suffered the ravages and constraints imposed by COVID more than anyone else, but whose voices are too few to be heard.
Unsurprisingly, the results indicate that the majority of respondents encountered additional difficulties related to containment, without having access to adequate assistance and resources. Antoine Mazot-Oudin, the researcher who was responsible for analyzing the data collected by the survey, explains to me that, even when needs could have been met by the available services, the distance that has grown between institutions and citizens prevent them from resorting to the assistance offered.
This distance cannot be understood only from statistics on the transmission of the virus, and it deserves attention. This stems from various barriers, emphasizes Antoine Mazot-Oudin: linguistic, social. Or the “digital divide” experienced by some residents, ie insecure or restricted access to the Internet connection or digital devices. Like an obstacle course that stands between citizens and institutions.
Mistrust of public health
However, the results of the building-to-building survey indicate that this distance tends to fuel mistrust of public health discourse – whether it be vaccination or adherence to physical distancing measures. Mistrust, notes Antoine Mazot-Oudin, which cannot be read, as it is now agreed to do, through the simple prism of “conspiracy”.
“The framing of conspiracy refers to incompetence or deviance,” says the researcher. However, this mistrust must be included in the social conditions of existence. It refers to social needs. Having access to a family doctor, for example. Montreal-North is one of the boroughs where the rate of residents with a family doctor is one of the lowest on the island of Montreal. There is a lack of contact with someone you trust. “
It is also necessary to see, and this is what the data collected reflect, that the inhabitants of Montreal-North suffered more severely from the containment measures at the start of the pandemic. “The social cost of confinement was greater, especially for people who could not telework or who lived in inadequate housing, with several other people,” explains Antoine Mazot-Oudin. This is true in Montreal-North, but also, we can guess, in other underprivileged sectors of the metropolis where residents have been hit harder by the pandemic.
The distance that has grown between these populations and the institutions, as well as our inability to stretch the social net under those who, in a crisis situation, need it most, testifies to the abandonment of the primary mission of public services.
There is also a democratic issue: the bond of trust of certain citizens towards institutions has been allowed to crumble because the political cost of this neglect is low. After all, it’s easy to ignore people’s needs when not given the opportunity to express them. Except that this balance of power could well be changing.