Diabetes: Where You Live Matters! What You Need to Know About - - PowerPoint PPT Presentation

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Diabetes: Where You Live Matters! What You Need to Know About - - PowerPoint PPT Presentation

Mar 12, 2023 343 likes •797 views

Diabetes: Where You Live Matters! What You Need to Know About Diabetes in Toronto Neighbourhoods 1 Tonights Presenters Rick Glazier, MD Centre for Research on Inner City Health, St. Michaels Hospital & Institute for Clinical

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

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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

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Team

  • Rick Glazier and Gillian Booth, Editors
  • Peter Gozdyra, Geographer
  • Marisa Creatore, Epidemiologist
  • Anne-Marie Tynan, Coordinator
  • Students: Kelly Ross, Jonathan

Weyman, Amanda Maze

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Support

  • St. Michael’s

Hospital

  • BMO Financial
  • Institute for Clinical

Evaluative Sciences

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Tonight’s Talk

  • Provide highlights of a large body of

work

  • Stimulate discussion:

– Your neighbourhoods – Your health – What role does community play?

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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
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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)

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21st Century Trends

Unhealthy diets Sedentary & inactive lifestyles

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

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Toronto Neighbourhoods and Black Creek Community Health Centre Catchment Area

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Black Creek Community Health Centre Catchment Area and Neighbourhoods

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Ward 7, 8 & 9 – Selected Information

Total Population: 150,321 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%)

Source: 2006 Canada Census, Statistics Canada.

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Income by neighbourhood

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

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Visible minorities

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

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How do You Define a Healthy Neighbourhood?

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Some Trends

Diabetes higher in neighbourhoods with:

↓

Income

↑

Immigration levels

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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

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Neighbourhood Resources Neighbourhood Structure

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Neighbourhood Resources

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Grocery stores, fruit & vegetable stands

Data source: City of Toronto 2004 Employment Survey, Ontario Food Terminal data (Canadian Urban Institute)

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Health Services – Primary Care

Data source: MD Select, 2002

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Travel Time to Diabetes Education Programs 2004

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Parks and Schools

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Public Recreation Spaces

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Neighbourhood Structure

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How ‘Old’ is Your Neighbourhood?

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Average Number of Cars per Household

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

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Average Wait Times for TTC Vehicles

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Daily Transit (TTC) Trips per Person

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

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

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How ‘Activity-Friendly’ is Your Neighbourhood?

Neighbourhood Features: – more people – more stores – stores closer to your home – fewer cars – less crime

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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)
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Daily Walking/Biking Trips per Person

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

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

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Diabetes Rates

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

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Diabetes Rates

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

1 2, 3 4

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

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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%

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Spatial Relationship: Diabetes and AFI

Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

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Key Finding # 1

  • Diabetes rates are highest in areas of

Toronto that have:

– lower income levels – a higher proportion of visible minorities – high immigration rates

Toronto

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Key Finding # 2

  • High diabetes areas tend to be outside of

downtown and have generally worse:

– access to resources – activity friendliness

Toronto

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Key Finding # 3

  • 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

Toronto

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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
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Resources

Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

Also available at: www.TorontoHealthProfiles.ca And www.ices.on.ca