CREATING HEALTHY INNER CITIES

CREATING HEALTHY INNER CITIES

For men, women and children living in inner cities, life can be isolating. As Toronto s Urban Angel, St. Michael s Hospital reaches out and helps those most in need. As the gap between the rich and poor widens, more Ontario families are living below the poverty line. In Toronto, shelters are used about 28,000 times per year. Substandard housing, limited access to healthy food, and social isolation caused by poverty are all extremely damaging to health. Lower income people get sicker, have more complex health problems, and benefi t less from health care, compared to those who are better off. That is why research in this area is critical. It calls attention to the health issues of the inner city and helps generate solutions. In the pages ahead, you will read about some of the important research and community partnerships involving scientists at St. Michael s Hospital s Centre for Research on Inner City Health. With your support, much more is possible. principal photography by JOSEPH + JAIME cover and back cover photo by Malcolm Taylor design by DUO Strategy and Design Inc.

Look at what St. Michael s Hospital is doing to improve inner city health: Measuring Neighbourhood Health. With Toronto Community Housing Corporation, Regent Park Community Health Centre, and other key community groups, St. Michael s is measuring the health effects of the massive Regent Park Revitalization Initiative. This is the fi rst Canadian assessment of health outcomes related to neighbourhood redevelopment and will have nation-wide implications. There may be as many as 100 other public housing sites in need of redevelopment across Canada. The results of the Regent Park study can help ensure that these initiatives will have maximal health benefi ts for residents. POWER for Women. Dr. Arlene Bierman, the Ontario Women s Health Council Chair, has generated a women s health report card for Ontario. It documents the infl uence of gender, income, education, age, and geography on health outcomes and access to health care. Produced in consultation with women s health groups, health care experts and community agencies across the province, this groundbreaking project, called the POWER study, is a tool the province can use to measure its efforts to improve the health of Ontarians. Zeroing In. The Centre for Research on Inner City Health is using geography to understand gaps in the delivery of health care. For example, we mapped the areas in Toronto where women receive fewest mammography and cervical cancer screenings. These are lower-income neighbourhoods with high proportions of immigrant and non-english speaking families. With this evidence, health planners can better target culturally appropriate services to areas of highest need and make preventative care more accessible. Engaging Doctors around Domestic Violence. In a project that evolved as a part of her doctoral thesis, Dr. Farah Ahmad, a senior CIHR fellow at the Centre for Research on Inner City Health, has tested an innovative and non-threatening computer-assisted tool for family doctors to assess female patients exposure to domestic violence and recommend solutions. Screening for HIV/AIDS. Leading HIV researcher Dr. Ahmed Bayoumi has shown that making HIV screening part of routine medical care for everyone is a cost-effective use of health care resources. Dr. Bayoumi s research, conducted with colleagues from Stanford and Duke Universities, prompted the US Centers for Disease Control to recommend HIV screening for all patients aged 13-64. This recommendation has been adopted by New York State and is under review in other states. Not One Size Fits All. In the fi rst national study to compare body mass index (BMI) among Canadian men and women in relation to their neighbourhood, our scientists showed that men living in affl uent neighbourhoods have a higher BMI (a measure of obesity), compared to men in disadvantaged neighbourhoods. The trend was opposite for women. This research provides clear evidence that there is no one size fi ts all approach to promoting healthy body weight. The Centre for Research on Inner City Health at St. Michael s Hospital is funded by the Ministry of Health and Long-Term Care to generate evidence about what works to ensure Ontarians have equitable access to health care, regardless of who they are, where they live, or what they own. The Centre for Research on Inner City Health also receives support from other generous donors who want to help make a difference.

My work is dedicated to improving the health of new immigrants and refugees in Canada. In the clinic, I see one person at a time. Through research, I hope to make a difference in the lives of thousands of people.

Dr. Kamran Khan Global Cities, Migration, and 21st Century Health Care Dr. Khan is an infectious disease physician and scientist. He studies the best ways to control diseases like tuberculosis that are prevalent among lower income, immigrant groups in Canada s inner cities. His research provides guidance to government and health care providers about better ways to care for patients with tuberculosis for example, by connecting patients to tuberculosis specialists, and by ensuring physicians and patients speak the same language. Dr. Khan also recognizes that Canada s cities are not islands unto themselves, but rather are global villages interconnected with the rest of the world. His research on the global airline transportation network sheds light on how infectious disease outbreaks can spread across the world via commercial aviation. This work is designed to help Canada strategically prepare for pandemics before they occur and rapidly respond to them as they unfold.

A multi-faceted approach is needed to address the diabetes epidemic. Our research suggests that we can make people healthier by planning and redeveloping neighbourhoods, especially for people who are disadvantaged. We know now that some of the answers lie in urban planning, while public transit can also play a major role. The Diabetes Atlas is a wake-up call for all of us.

Dr. Rick Glazier How Activity Friendly is Your Neighbourhood? Dr. Rick Glazier is both a family physician and a researcher whose aim is to identify innovative ways to improve health outcomes for low income and isolated communities. His latest research on neighbourhoods and diabetes shows that where you live affects your likelihood of getting sick from this disease. Diabetes rates in Toronto are close to three times higher in some neighbourhoods than others. Activity friendly downtown areas have lower rates of diabetes, while inner suburbs with fewer healthy resources (such as transit routes, bike paths, and fruits and vegetable stores) have higher rates. The widely-reported Diabetes Atlas has important implications for how we build cities and how we manage chronic disease. It has already been recognized by the City of Toronto and the provincial government as an important guide for policymakers. Local groups are using the Diabetes Atlas to promote healthier communities.

I ve been studying poverty and its health effects since my undergraduate days, but it wasn t until I came to St. Michael s Hospital that I found a like-minded research community.

Dr. Pat O Campo Finding Social Solutions to Inner City Problems An internationally-renowned social epidemiologist, Dr. Pat O Campo has been working in communities for over 20 years and has a strong understanding of the realities facing deprived populations. Recruited from Johns Hopkins University, Dr. O Campo could not resist the opportunity to join St. Michael s as the Director of the Centre for Research on Inner City Health. Her research on violence has translated into practical advice about what works to create healthier communities, especially for women and children suffering abuse. Dr. O Campo s recent work shows that protected green space in city parks not just women s shelters are safe places for abused women to talk about lifesaving resources.

Some of the best ideas for research projects arise from one s day-to-day experience working with patients in my case, with homeless men and women. My job is to do research on the problems I see every day in my clinical practice, to ensure that our health-care system is responsive to the needs of poor and disadvantaged urban populations.

Dr. Stephen Hwang Quantifying the Link Between Housing, Homelessness and Health Dr. Stephen Hwang is a physician and one of the world s most infl uential researchers on the severe health risks faced by homeless people. He wrote the fi rst medical studies on the causes of homeless deaths and on health care use among homeless people. In a landmark report he showed that homeless women in Toronto are 10 times likelier to die than women in the general population. His research and his active partnerships with community agencies helped convince the provincial government to fi nd another way to issue health cards for people living on the streets, and to fund more homeless initiatives in community health centres. Now Dr. Hwang leads Canada s fi rst national collaboration of researchers and community agencies to measure the effects of housing and shelter programs on health.

TORONTO S URBAN ANGEL St. Michael s Hospital is Toronto s Urban Angel. We are proud of our history that began when the Sisters of St. Joseph stepped forward to help with a diphtheria epidemic in 1892. Since then, the Hospital has grown to meet the changing needs of the city. We are widely known as a leading teaching and research hospital with more than 500 beds and extensive outpatient programs. Yet, we never forget our mission to reach out to those in need in our surrounding community. We are the only hospital in Canada with a research centre focused on inner city health. St. Michael s Hospital works with over 80 community partners to provide integrated, sensitive care to patients across the city and to conduct research relevant to community needs. At the Centre for Research on Inner City Health, our team of leading scientists is dedicated to reducing health inequities through innovative research affecting social change. Your support can make a difference. Help us by making a gift to St. Michael s Hospital Foundation today. St. Michael s Hospital Foundation 30 Bond Street Toronto, Ontario M5B 1W8 416-864-5000 To help, please call us at 416-864-5000, visit us at the Hospital on the first floor of the Queen wing, or make an online donation at www.stmichaelshospital.com.