Race-based sampling, measurement and monitoring in health data: promising practices to address racial health inequities and their determinants in Black Canadians.

Abstract

Introduction: Racial health inequities are explained by inequities in access to medicaladvice and treatment, and the physiological effects of inequities in material conditions and everyday life; however, Canadian evidence on racial health inequities is limited. This review describes promising practices in population survey methods and approaches that can strengthen sampling, measurement and monitoring of racial health inequities and determinants of health for population subgroups within Canada-particularly Black Canadians.

Methods: We employed three steps to identify promising practices in Canada's peer countries and their applicability to the Canadian context. First, we conducted a scan of websites based on prior knowledge of population-level health surveys and datasets. Second, we conducted a review of publications from 2010 to 2020 to identify any missed surveys and datasets. Third, we conducted a targeted review of Canadian population-level health surveys and data sources to identify challenges to and opportunities for implementing these promising practices.

Results: We identified 20 relevant surveys and data sources from the US, the UK, Australia and New Zealand. In several of Canada's peer countries, information on arealevel racial or ethnic concentration of residents is used to conduct targeted sampling strategies, increasing the non-White sample. Our search of the available Canadian datasets found that Canadian health surveys and administrative sources do not routinely incorporate these strategies.

Conclusion: Canada could improve the measurement and monitoring of racial health inequities by applying enhanced sampling practices to collect racial data in surveys and improving procedures for administrative and other routinely collected data sources. There are also novel predictive methods being used to improve sampling of non-White groups, though further investigation of these methods is required.