Indigenous Health Counts in Urban Homelands: Estimating COVID-19 Incidence and Mortality among Indigenous Populations Living in Ontario Cities

First Nations, Inuit, and Metis peoples face many challenges as a result of the COVID-19 pandemic. Due to existing social factors such as poor quality, overcrowded housing, homelessness, and lack of clean running water, infections like COVID-19 can spread quickly. There are also big gaps in data about how COVID-19 is spreading among Indigenous peoples, especially in cities. To address this, we will use information from existing studies about the health of Indigenous peoples living in cities to learn more about COVID-19 spread and it's impacts. The Our Health Counts Toronto, London and Thunder Bay studies used social networks to find Indigenous community members living in these cities. These studies were done by the Indigenous community for the Indigenous community. Our methods allowed us to gather information about the needs of the entire Indigenous populations in these cities, even those who don't use services regularly. By linking the Our Health Counts studies to the provincial COVID-19 database at the Institute for Clinical Evaluative Sciences (ICES), our team will use new statistical methods to accurately estimate the rate of COVID-19 transmission for Indigenous peoples in these cities. We will also check for increases in mortality rates, due both to COVID-19 itself and gaps in access to health care for acute (e.g. heart attack) and chronic (e.g. diabetes) health conditions. In partnership with Indigenous community health services, our research team will improve statistical methods and produce currently unavailable information regarding the burden of COVID-19 and its rate of spreading through the urban Indigenous communities living in Toronto, London and Thunder Bay, Ontario. This information is important as Indigenous Peoples are highly mobile between urban areas and First Nations reserves, and rural and remote Metis and Inuit communities. Improving our understanding of COVID-19 in urban centres can reduce its risk of spreading within and from these cities.