Diabetes: Where You Live Matters! What You Need to Know About Diabetes in Toronto Neighbourhoods

Transcription

1 Diabetes: Where You Live Matters! What You Need to Know About Diabetes in Toronto Neighbourhoods 1

2 Tonight s Presenters Rick Glazier, MD Centre for Research on Inner City Health, St. Michael s Hospital & Institute for Clinical Evaluative Sciences Peter Gozdyra, MA Centre for Research on Inner City Health, St. Michael s Hospital & Institute for Clinical Evaluative Sciences 2

3 Team Rick Glazier and Gillian Booth, Editors Peter Gozdyra, Geographer Marisa Creatore, Epidemiologist Anne-Marie Tynan, Coordinator Students: Kelly Ross, Jonathan Weyman, Amanda Maze 3

4 Support St. Michael s Hospital BMO Financial Institute for Clinical Evaluative Sciences 4

5 Tonight s Talk Provide highlights of a large body of work Stimulate discussion: Your neighbourhoods Your health What role does community play? 5

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7 Why Diabetes? 246 million people with diabetes worldwide in 2007 Over 2 million Canadians living with diabetes In Ontario the proportion of people with diabetes rose 69% (from 5.2% to 8.8%) between 1994 and 2005 Major cause of heart attack, kidney failure, blindness, amputation Huge impact on quality of life and health care costs 7

8 What Puts You at Risk? Age Family history (genes) Ethnicity/race (Aboriginal, Hispanic, South Asian, Asian, African) Income & Education Obesity* (*the most important risk factor for type 2) 8

9 21 st Century Trends Unhealthy diets Sedentary & inactive lifestyles 9

10 DM Risk factors: How do Wards 7, 8 & 9 compare with Toronto? 10

11 Toronto Neighbourhoods and Black Creek Community Health Centre Catchment Area 11

12 Black Creek Community Health Centre Catchment Area and Neighbourhoods 12

13 Total Population: 150,321 Ward 7, 8 & 9 Selected Low Income Individuals: 22.7% Median Household Income = $45,779 Immigrants: 89,520 (60%) Recent Immigrants: 18,075 (12%) Visible Minorities: 92,615 (62%) People not speaking English or French: 11,525 (7.7%) Information Source: 2006 Canada Census, Statistics Canada. 13

14 Income by neighbourhood Data Source: 2006 Census 14 Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

15 Visible minorities Data Source: 2006 Census 15 Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

16 How do You Define a Healthy Neighbourhood? 16

17 Some Trends Diabetes higher in neighbourhoods with: Income Immigration levels 17

18 Defying the odds In Toronto, some low-income, high immigration neighbourhoods defy this trend e.g. Moss Park, South Parkdale, Regent Park, North St. Jamestown 18

19 Neighbourhood Resources Neighbourhood Structure 19

20 Neighbourhood Resources 20

21 Grocery stores, fruit & vegetable stands 21 Data source: City of Toronto 2004 Employment Survey, Ontario Food Terminal data (Canadian Urban Institute)

22 Health Services Primary Care Data source: MD Select,

23 Travel Time to Diabetes Education Programs

24 Parks and Schools 24

25 Public Recreation Spaces 25

26 Neighbourhood Structure 26

27 How Old is Your Neighbourhood? 27

28 Average Number of Cars per Household Data Source: 2001 Transportation Tomorrow Survey (University of Toronto, 2001) 28 Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

29 Average Wait Times for TTC Vehicles 29

30 Daily Transit (TTC) Trips per Person Data Source: 2001 Transportation Tomorrow Survey (University of Toronto, 2001) 30 Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

31 Putting It All Together Do more neighbourhood resources that encourage physical activity = more physical activity? Let s Find Out 31

32 How Activity-Friendly is Your Neighbourhood? Neighbourhood Features: more people more stores stores closer to your home fewer cars less crime 32

33 Activity-Friendly Index Components of Healthy Resources Index: 1. Car ownership (reversed) 2. Population /km2 of residential area 3. Retail services per 10K population 4. Crime per 100K of MaxPop (reversed) 5. Ave distance from residential points to the nearest 5 services (reversed) 33

34 Daily Walking/Biking Trips per Person Data Source: 2001 Transportation Tomorrow Survey (University of Toronto, 2001) 34 Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

35 Putting It All Together II Is Neighbourhood Activity Friendliness Related to Diabetes? 35

36 Diabetes Rates Data Source: Ontario Diabetes Database 36 Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

37 Diabetes Rates 4 1 2, 3 1 North St. Jamestown 2 Moss Park 3 Regent Park 4 South Parkdale Data Source: Ontario Diabetes Database 37 Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

38 Defying the Odds WHAT S GOING ON IN THESE NEIGHBOURHOODS??? 38

39 A Tale of 4 Neighbourhoods Black Creek Regent Park South Parkdale North St. Jamestown Median Household Income $39,755 $24,775 $28,560 $30,237 Population living below the Low income cut-offs (%) 31.0% 58.7% 38.2% 38.3% Recent Immigration (%) 12.8% 15.0% 18.8% 21.8% Visible Minority (%) 78.1% 78.8% 55.5% 68.2% Seniors (%) 10.6% 4.4% 10.7% 8.2% AFI Low High High High Diabetes Rate 7.3% 5.0% 4.9% 4.4% 39

40 Spatial Relationship: Diabetes and AFI Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto 40

41 Key Finding # 1 Toronto Diabetes rates are highest in areas of Toronto that have: lower income levels a higher proportion of visible minorities high immigration rates 41

42 Key Finding # 2 Toronto High diabetes areas tend to be outside of downtown and have generally worse: access to resources activity friendliness 42

43 Key Finding # 3 Toronto Neighbourhoods are affected differently: Downtown high risk areas have lower diabetes rates than expected Wealthy areas have low diabetes rates, no matter their access to resources or activity friendliness 43

44 Implications Make communities more activity friendly Reduce our dependence on cars Promotion of healthy lifestyles must go hand-in-hand with neighbourhood resources and opportunities Improve public transit in under-served areas Prioritize high risk neighbourhoods 44

45 Resources Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto Also available at: And 45