A technician counts pills in a pharmacy laboratory, Wednesday February 5, 2025. The Canadian Press
A new study has uncovered a troubling gap in Canada’s healthcare system: Black Canadians are significantly more likely to skip or avoid filling prescriptions due to cost compared to white Canadians.
Published in the Canadian Medical Association Journal, the research highlights how financial strain and systemic challenges continue to shape health outcomes—even in a country known for universal healthcare.
A Costly Trade-Off
Analyzing data from the Canadian Community Health Survey, researchers found that between 10% and 15% of Black adults reported not filling prescriptions or skipping doses. Among white adults, that figure was closer to six percent.
At the heart of the issue is affordability. According to the study, Black Canadians are less likely to have access to drug insurance coverage, making medications harder to afford. Around 72% reported having coverage, compared to roughly 80% of white adults.
For many, the choice becomes stark and deeply personal.
“When people have to choose between medication and feeding their families, they choose food,” said Mojola Omole, president of the Black Physicians Association of Ontario. She notes that this dilemma is a frequent reality among patients she treats.
Beyond Income and Insurance
Even when researchers accounted for income levels and insurance coverage, the disparity remained. That suggests deeper, less visible barriers at play.
Bukola Salami, senior author of the study and Canada Research Chair in Black and racialized people’s health at the University of Calgary, points to systemic issues—including distrust in the healthcare system.
Decades of unequal treatment and experiences of racism may influence how individuals engage with medical care, including whether they feel comfortable following through on prescriptions.
Gaps in “Universal” Healthcare
The findings also spotlight a key limitation in Canada’s healthcare model: while doctor visits and hospital care are publicly funded, prescription medications are not universally covered.
This gap has long been debated. The study’s data was collected before the introduction of the Pharmacare Act in 2024, which aims to expand access to essential medications. So far, agreements have been reached in select regions, but nationwide coverage remains incomplete.
Researchers say it’s too early to determine whether pharmacare will close the gap for Black Canadians—but the need is clear.
Trust, Access, and Ongoing Challenges
Another layer of the issue is access to consistent care. A shortage of primary care providers means many patients rely on walk-in or episodic services, making it harder to build trust with doctors.
Without that relationship, patients may feel less confident about medications or less inclined to prioritize them—especially when costs are high.
For experts, the study is more than just data—it’s a call to action.
Improving access to affordable medications, addressing systemic inequities, and rebuilding trust within healthcare systems are all essential steps. Without them, disparities like these are likely to persist.
