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Diabetes in Toronto: Where You Live Makes a Difference

Diabetes in Toronto: Where You Live Makes a Difference. Rick Glazier, CRICH October 2, 2007 2 . Why diabetes?. Obesity 1 in 2 Canadian adults now overweight overweight and obesity in children nearly quadrupled since 1980s

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Diabetes in Toronto: Where You Live Makes a Difference

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  1. Diabetes in Toronto: Where You Live Makes a Difference Rick Glazier, CRICH October 2, 2007 2

  2. Why diabetes? • Obesity • 1 in 2 Canadian adults now overweight • overweight and obesity in children nearly quadrupled since 1980s • related to sedentary living, eating habits • Diabetes • obesity is the most important risk factor (type 2) • major cause of heart attack, kidney failure, blindness, amputation • huge impact on quality of life and health care costs

  3. Today’s talk • Provide highlights of a large body of work • Stimulate discussion: • Your neighbourhoods • Implications for what you do

  4. Methods: data sources • Administrative data • Ontario Diabetes Database • 2001 Canadian census • income, immigration, visible minority • population density • Other data sources • CCHS • City of Toronto • Ontario food terminal • Land use files • Transportation Tomorrow Survey • 2001 Police reports

  5. Who Lives Where?

  6. High & low income households 30 - 50,000 50 - 75,000 75 - 100,000 100- 150,000 150- 375,000 Data Source: 2001 Census Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

  7. Visible minorities 7-15% 16-30% 31-45% 46-65% 66-90% Data Source: 2001 Census Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

  8. People with diabetes* 2.8 - 4.1% 4.2 - 5.1% 5.2 - 5.8% 5.9 - 6.5% 6.6 - 7.6% Data Source: Ontario Diabetes Database (*Age and Sex Adjusted) Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

  9. Neighbourhood Resources

  10. Groceries, fruits & vegetables # outlets per 10,000 population 0.0 - 3.0 3.0 - 6.0 6.1-10.0 10.1-13.0 13.1-26.3 Data source: City of Toronto 2004 Employment Survey, Ontario Food Terminal data (Canadian Urban Institute)

  11. Walk to groceries, fruit & vegetables (red 20-40 minutes)

  12. Access to healthy resources (foods, parks, recreation, doctors)

  13. Spatial relationship between geographic access to healthy resources and diabetes rates

  14. St. Michael’s Hospital neighbourhoods are unusual

  15. Neighbourhoods

  16. Older and newer housing

  17. Daily walking/biking trips per person # trips / person 0.06- 0.10 0.11- 0.20 0.21- 0.30 0.31- 0.50 0.51- 0.76 Data Source: 2001 Transportation Tomorrow Survey (University of Toronto, 2001) Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

  18. Daily transit (TTC) trips per person # trips / person 0.10- 0.30 0.31- 0.40 0.41- 0.50 0.51- 0.60 0.61- 0.84 Data Source: 2001 Transportation Tomorrow Survey (University of Toronto, 2001) Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

  19. Average number of cars per household # per household 0.5- 0.7 0.8- 0.9 1.0- 1.1 1.2- 1.3 1.4- 1.6 Data Source: 2001 Transportation Tomorrow Survey (University of Toronto, 2001) Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

  20. “Activity Friendly” Neighbourhoods Environmental Features: • population density • service density • service proximity • car ownership • drug and violent crime rates

  21. Activity-Friendly Neighbourhoods 2.2 - 3.4 3.5 - 4.1 4.2 - 4.9 5.0 - 5.7 5.8 - 7.2 c AFI Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

  22. Diabetes & Activity Friendly Neighbourhoods High DM rates High DM rates Low DM rates Low DM rates Lower AFI score Higher AFI score Higher AFI score Lower AFI score Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

  23. Key Finding # 1 • Diabetes rates are highest in areas that have: • lower income levels • higher unemployment rates • a higher percentage of population without high school education • a higher proportion of visible minorities • high immigration rates

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

  25. 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

  26. Team • Rick Glazier and Gillian Booth, Editors • Peter Gozdrya, Geographer • Marisa Creatore, Epidemiologist • Anne-Marie Tynan, Coordinator • Kelly Ross, Jonathan Weyman, Students

  27. Support • St. Michael’s Hospital • BMO Financial Group • Institute for Clinical Evaluative Sciences

  28. Resources www.TorontoHealthProfiles.ca November 1, 2007 Neighbourhood Environments and Resources for Healthy Living: A Focus on Diabetes in Toronto

  29. Implications • Make communities more activity friendly • Reduce our dependence on cars • Provide more opportunities physical activity • More opportunities for healthy eating • Enhance access to health services in high need areas • Prioritize high risk neighbourhoods

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