A new study published in the Canadian Medical Association Journal reveals a troubling pattern in Canada's healthcare system: Black Canadians are significantly more likely to skip or delay filling their prescriptions because they simply cannot afford them. The research shows they are 75% more likely to face this situation compared to white Canadians, a gap that points to deep structural inequalities well beyond individual financial decisions.
The Numbers Behind the Gap
In 2022, only 72.5% of Black adults in Canada had prescription drug coverage, compared to 80% of white adults. That difference in insurance access translates directly into people going without medications they need. Even though rates of non-adherence dropped among Black Canadians, from 15.3% in 2015 to 9.5% in 2022, they remain nearly double those recorded for white adults.
More Than Just Money
Researcher Dr. Oluwabukola Salami, a Canada Research Chair in Black and racialized peoples' health, points out that financial barriers do not exist in isolation. Systemic racism affects employment opportunities, wages, and therefore access to workplace health benefits, creating a cycle where economic disadvantage and healthcare exclusion reinforce each other.
What Could Change Things
The Pharmacare Act, passed in October 2024, offers a window of opportunity, but current agreements still leave roughly 80% of Canadians without coverage. Dr. Salami argues that drug coverage must be assigned based on need, not financial capacity, if the system is ever to serve everyone equitably.
Questions - Answers
Quest: Why are Black Canadians more likely to skip prescriptions? Ans: Primarily due to lower rates of insurance coverage and higher out-of-pocket costs, compounded by systemic barriers linked to employment and racial inequality.
Quest: Has the situation improved over time? Ans: Yes, rates among Black adults dropped from 15.3% in 2015 to 9.5% in 2022, but the gap with white Canadians remains significant.
Quest: What does the Pharmacare Act change? Ans: It introduces publicly funded drug coverage, but current agreements still exclude the vast majority of Canadians, limiting its reach for the most vulnerable groups.