Diabetes: Where You Live Matters! What You Need to Know About Diabetes in Toronto Neighbourhoods. Peter Gozdyra, Marisa Creatore, CRICH
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1 Diabetes: Where You Live Matters! What You Need to Know About Diabetes in Toronto Neighbourhoods Peter Gozdyra, Marisa Creatore, CRICH 1
2 Tonight s Talk Provide highlights of a large body of work Stimulate discussion: Your neighbourhoods Your health What role does community play? 2
3 3
4 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
5 Diabetes: complications Stroke Heart disease and hypertension Diabetic eye disease (retinopathy and cataracts) Kidney disease Peripheral vascular disease Foot problems 5
6 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) 6
7 Obesity Trends Among Canadian and U.S. Adults, 1990 No Data <10% 10%-14% 15-19% 20% 25% Mokdad AH. Unpubliahed Data. Katzmarzyk PT. Can Med Assoc J 2002;166:
8 Obesity Trends Among Canadian and U.S. Adults, 1994 No Data <10% 10%-14% 15-19% 20% 25% Mokdad AH, et al. J Am Med Assoc 1999;282:16. Katzmarzyk PT. Can Med Assoc J 2002;166:
9 Obesity Trends Among Canadian and U.S. Adults, 1996 No Data <10% 10%-14% 15-19% 20% 25% Mokdad AH, et al. J Am Med Assoc 1999;282:16. Katzmarzyk PT. Can Med Assoc J 2002;166:
10 Obesity Trends Among Canadian and U.S. Adults, 1998 No Data <10% 10%-14% 15-19% 20% Mokdad AH, et al. J Am Med Assoc 1999;282:16. Katzmarzyk PT. Can Med Assoc J 2002;166:
11 Obesity Trends Among Canadian and U.S. Adults, 2000 No Data <10% 10%-14% 15-19% 20% 25% Mokdad AH, et al. J Am Med Assoc 2000;284:13. Statistics Canada. Health Indicators, May, 2002.
12 Obesity Trends Among Canadian and U.S. Adults, 2004/05 No Data <10% 10%-14% 15-19% 20% 25% 30% Provinces (measured) CCHS, 2004 Territories (self-report) CCHS, 2002
13 Why are people getting heavier? 13
14 Unhealthy diets 14
15 Sedentary & inactive lifestyles 15
16 How do You Define a Healthy Neighbourhood? 16
17 Neighbourhood Resources 17
18 Toronto Neighbourhoods and New Heights Community Health Centre Catchment Area 18
19 New Heights Community Health Centre Catchment Area and Neighbourhoods 19
20 Grocery stores, fruit & vegetable stands 20 Data source: City of Toronto 2004 Employment Survey, Ontario Food Terminal data (Canadian Urban Institute)
21 Parks and Schools 21
22 Public Recreation Spaces 22
23 Health Services Primary Care Data source: MD Select,
24 Travel Time to Diabetes Education Program,
25 Neighbourhood Structure 25
26 How Old is Your Neighbourhood? 26
27 Average Number of Cars per Household Data Source: 2001 Transportation Tomorrow Survey (University of Toronto, 2001) 27 Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto
28 Average Wait Times for TTC Vehicles 28
29 Daily Transit (TTC) Trips per Person Data Source: 2001 Transportation Tomorrow Survey (University of Toronto, 2001) 29 Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto
30 Putting It All Together Do more neighbourhood resources that encourage physical activity = more physical activity? Let s Find Out 30
31 Neighbourhood features positively related to activity levels Sidewalks Street connectivity Walkable destinations (stores, services) Parkland Bike paths Play spaces for children Safety issues (lighting, lower crime rates) 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 Some Trends Diabetes higher in neighbourhoods with: Income Immigration levels 37
38 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 38
39 Diabetes Rates 4 1 2, 3 1 North St. Jamestown 2 Moss Park 3 Regent Park 4 South Parkdale Data Source: Ontario Diabetes Database 39 Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto
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 High diabetes areas tend to be outside of downtown and have generally worse: access to resources activity friendliness 41
42 Key Finding # 2 Toronto Diabetes rates are highest in areas of Toronto that have: lower income levels a higher proportion of visible minorities high immigration rates 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 Team Rick Glazier and Gillian Booth, Editors Peter Gozdyra, Geographer Marisa Creatore, Epidemiologist Anne-Marie Tynan, Coordinator Students: Kelly Ross, Jonathan Weyman, Amanda Maze 45
46 Support St. Michael s Hospital BMO Financial Institute for Clinical Evaluative Sciences 46
47 Resources Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto Also available at: And 47
48 Income by neighbourhood Data Source: 2006 Census 48 Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto
49 Visible minorities Data Source: 2006 Census 49 Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto
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