Archive for February, 2014

February 26, 2014

A new measurement of health equity: Urban HEART Toronto

The City of Toronto’s official 140 neighbourhoods now have a new measurement tool: an adapted version of the World Health Organization‘s Urban Health Equity Assessment and Response Tool (Urban HEART).

To be released today by the Centre for Research on Inner City Health (CRICH) at St. Michael’s Hospital, Urban HEART Toronto is a neighbourhood-level dashboard to five key health domains:

  • Economic Opportunities
  • Social and Human Development
  • Governance and Civic Engagement
  • Physical Environment and Infrastructure, and
  • Population Health

Key indicators for each of these areas were identified by panels of experts from academia, government and community. Things like diabetes rates, high school graduation rates and income levels were all part of final set of data.

After being collected for every neighbourhood, the data were sorted into Red, Yellow, and Green, like a stop light. The intention was to take complex data understandable. So Red means below a minimum benchmark, Yellow means below an ideal target, and Green means the neighbourhood is at or above target. All the benchmarks and targets were developed by the technical team.

At the recent City of Toronto consultations on the City’s Strong Neighbourhood Strategy, policy staff Sarah Rix described the nuances the Urban HEART tool offers. Under the former Priority Neighbourhood Areas, identified ten years ago, resources were concentrated in 13 identified area of the city. However, Urban HEART takes a wider view, allowing each neighbourhood to be measured, a little like a blood pressure reading or body temperature taken, Rix explained.

The result? Urban HEART allows anyone to get an idea of the strengths and weaknesses both within a specific neighbourhood and to also see how it compares to others across the city.

Under the new Urban HEART tool, no neighbourhood in the City is entirely green, nor is any entirely red. Neighbourhoods like Bridle Path suffer, for instance, for not being very walkable, while places like Scarborough Village, at the edge of the lake, show better mental health rates than the majority of other city neighbourhoods.

Like any collection of health readings, if a neighbourhood indicator pops up yellow or red under Urban HEART, further probing is probably a good idea. High youth ? High premature mortality rates? A simple reading of the numbers won’t tell us what to do, but they will tell us about the neighbourhood’s well-being and where to look to fix any problems.

First stop for Urban HEART will be an update of the City’s Strong Neighbourhood Strategy and discussion of ‘Neighbourhood Investment Areas’ at the Community Development and Recreation Committee on March 10, 2014.

Full disclosure: I was a member of the Steering Committee for the development of Urban HEART and helped with some of the technical aspects of the project.

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February 9, 2014

My neighbour, Jeffrey Baldwin

If I peek through the branches out my son’s bedroom, I can see the room where Jeffrey Baldwin lived, and died, he, the five-year-old who died from neglect, in my backyard.

At that time, when he lived, my children were close to his age, and I knew some of the hardships of this community and of our school. I remember the mother who asked me for $2 so her child could enjoy the school’s hot dog lunch. I remember the girl who carried the last bits of a bag of corn flakes to school for her lunch. I remember the boy who didn’t go to school because he had no winter coat until he got a hand-me-down — how he danced along the block then in that ugly corduroy coat! And I remember the kindergarten child whose mother was always ‘sleeping’ as she wandered our street, joining snack time on our porch.

But I don’t remember Jeffrey Baldwin, who also lived here in my neighbourhood. Instead, I vaguely remember the noisy crowd of adults that sat on his porch (one of them, Jeffrey’s aunt, trained in Early Childhood Education — another shocker).

Later, I learned that Jeffrey’s sisters were at the same grade school my children were, although, in different grades. We would all have gone to the same school concerts or gathered together out in the playground. Each day, Jeffrey’s sisters would have munched on the same daily offering of muffins or yogurt and carrots or apples from the small kitchen on the main floor where volunteers chopped and baked for the snack program.

At the inquest into Jeffrey’s death, a pediatric nutritionist said that this classroom food program probably saved Jeffrey’s sister; she too was targeted, neglected by her grandparents, but, unlike Jeffrey, she was ‘allowed’ to go to school, and so she ate.

I remember the snack program donation envelopes carried home in my son’s backpack each month. And I remember the hunt to fill it with the requested $20 donation each time. Times were lean in our household, but I knew some of my neighbours had it worse than we did so I felt that obligation.

Now, years later, having heard how the snack program had sustained Jeffrey’s sister, I sobbed aloud. I hadn’t understood the role of those scrounged pennies. “One doesn’t know,” I said to myself, “what makes a difference.”

I think Jeffrey’s awful death has stuck with me, not only because of the revulsion we all feel, but also, more personally, as a neighbour who failed him.

I remember a part of the murder trial for Jeffery’s grandparents, the testimony from another neighbour, who described how one day, Jeffrey’s grandmother asked her if she would take Jeffrey, then still a baby. She considered, but refused, having no way to know the atrocity to come.

‘We didn’t know’ seems an awful, sorry excuse. Bitter lessons.

In the closing days of the inquest into Jeffrey long neglect and death, Irwin Elman, the provincial children’s advocate said  “We expect and demand more. More from the child welfare system, more from the educational system, more from the neighbours, and more from the family who stood by and watched Jeffrey starve and die…We can do better.”

Elman’s right.

What neighbourhood-based solutions would have helped?  Better snacks? Better registration and attendance records at school? The parent-child drop-in where I found solace? Neighbourliness (what sociologists describe as stronger social connections and reciprocity)? More ‘eyes on the street’? Even, just more old-fashioned nosiness? Those questions continue to gnaw at me.

Some of the answers lie in the formal and informal networks of a neighbourhood. Perhaps, the inquest’s results will tell us more.

For now, a new family, full of kids, lives in Jeffrey’s house. They know the sad history of it, but, as another neighbour explained to me, they are re-writing it, making it better this time.

We all must.

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