Women and racialized Canadians worry more about COVID-19 largely because they are more at risk. This may have future mental health implications.

A common thread that connects all Canadians these days is worry. We worry about our senior relatives, children home from school struggling with online lessons, sky-rocketing unemployment, the safety of essential workers and working from home instead of well-equipped offices.

The current pandemic has most Canadians worried as COVID-19 touches every corner of the society and people valiantly try to do their part to slow the spread of the disease. In a recent survey by the Consortium on Electoral Democracy (C-Dem), we found that most Canadians are at least a little worried about how COVID-19 will affect their household.  As Figure 1 indicates, fears that someone in their household could contract the disease posed the biggest worry, with the economic impact also raising concerns. Fewer Canadians  worried about access to basic goods.

Yet, while everyone might be worried, we cannot ignore an important truth: the disease itself, and its vast societal consequences, are not affecting all Canadians equally. The current coronavirus crisis has highlighted the considerable care-taking roles of women in the home and in the labour force – in health care, long-term care, personal support work and essential service sectors. Women are on the front-lines helping to keep Canadians healthy and supplied with necessities.

At the same time, women have also been the hardest hit by pandemic-related job losses, as Statistics Canada’s March jobs report first revealed. Cutting across this gender difference, racialized and immigrant workers are particularly affected given their employment in industries with high COVID-19 infection rates, such as meat-packing plants and long-term care homes. Immigrant women, especially Filipino women, are concentrated in nursing and caregiving professions. Visible minorities make up nearly a majority of people working as personal support workers in Ontario, of whom 96 percent are women.

Beyond the economics, COVID-19 also has differential infection rates in Canada. Early evidence from other countries provided little evidence of sex-differentiated COVID-19 infection rates, but reported higher fatality rates for men.

Canadian data seem to tell a different story. As of mid-May, women account for 55 per cent of confirmed COVID-19 cases and 53 per cent of deaths in Canada, though the trend varies across the country. Some provinces, including the two largest (Quebec and Ontario), report women-skewed infection rates, but some others (for example Alberta and BC) report essentially no difference.

Part of the story could be who is able to get tested – as more women work in health and long-term care settings, they have priority. And we do not yet have good data on racialized gaps in infection rates because provincial and federal authorities in Canada have not collected race-disaggregated data throughout the pandemic.  However, several provincial and municipal health authorities have started or are developing processes for this (for example, Ontario, Manitoba, Quebec, and the City of Toronto’s public health unit).

Preliminary evidence suggests that infection rates are higher in Canada among black and immigrant communities and a recent study suggests that neighborhoods with higher ethnic density had less testing but higher infection rates.

Because we know that people are being affected differently in material ways by the pandemic, does this extend to the mental burden of general worries as well? Are certain subgroups of society more concerned about the illness and the economic upheaval than others?

In our survey, women generally expressed more worry than men about contracting the disease and the economic impact on their families and follow-up analyses determined that this could not be attributed to parental status. Mothers were not distinguishable from fathers, or from women without children, once controls were added to our models. That said, gender-role norms that women are more maternal or caring than men could still drive the gender gap in worry, whether respondents have children or not.

In Figure 2, we explore these gender gaps in more detail by exploring how concerns varied by immigration and visible minority status. It shows the predicted levels of worry after controlling for a host of demographic factors. In other words, after controlling for differences among these groups in socio-economic status, age, etc., do we still see significant differences?

The most dramatic gender gap appears,  as Figure 2 shows, with immigrant women, who show the highest levels of concern Still,  visible minority immigrants that are men are almost equally as concerned across our measures of worry. The heightened level of worry is consistent with the observation that the front line of the pandemic response is gendered and racialized.

Academic studies argue that the workforce in long-term care homes is not well researched or understood. What is clear is that care aides perform the majority of direct care to clients in these facilities, and that this occupational group is predominantly female and in some cases half of them are immigrant workers.

Current figures place long-term care homes at the centre of the pandemic, with reports that they are connected to 79 per cent of COVID-19 deaths in Canada. In this context, it is not surprising that immigrant women are significantly more worried and concerned about their chances or their family’s likelihood of contracting the virus.

The messaging of the COVID-19 crisis so far has been important and effective. Government leaders and public health authorities have emphasized the importance of physical distancing, while maintaining solidarity and connection. The mantra has been that we are “in this together.”

Our data suggest an important corollary. Attention needs to be paid – now and after the pandemic has ended – to how worries and risks differ across social groups. We know that mental health risks are just as real as physical health risk during the pandemic, so paying attention to who is bearing the burden of worry is extremely important. Looking at the data this way not only documents differences and inequalities, but encourages empathy – and perhaps crucial policy responsiveness and accountability as society recovers.

This article is part of the The Coronavirus Pandemic: Canada’s Response special feature.

Photo: A woman wearing a face mask walks past artwork of author and illustrator Roger Hargreaves’ ‘Little Miss Sunshine’ character wearing a face mask, painted on the outside of a boarded up business in downtown Vancouver, on April 19, 2020. THE CANADIAN PRESS/Darryl Dyck