Posts tagged ‘Health’

May 19, 2011

Breast cancer least common in poor neighbourhoods

If you live in a higher-income neighbourhood, you are 15% more likely to be diagnosed with breast cancer than if you live in a poor neighbourhood. Statistics Canada’s Health Reports has just published this report from University of British Columbia researchers, Borugian, Spinelli, Abanto and Wilkins,  using data from the Canadian Cancer Registry and past censuses. Rates of breast cancer were studied in neighbourhoods across Canada.

The findings are counter to the trend found in most research on the social determinants of health.

Researchers found that, even when they controlled for mammography rates, age and childbirth rates, women in the lowest income quintile (fifth) of neighbourhoods had the lowest risk of breast cancer. Researchers were not able to determine why this was so but speculate that the effects occur at more than the individual level.

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December 1, 2010

How scared should we be about bed bugs?

Adult bed bug, Cimex lectularius

Image via Wikipedia

Knowing I work at WoodGreen Community Services, which has been on the forefront of the bedbug issue for a while, a friend asked me how nervous she should be about going to a movie theatre that night.

Her fear sprang from the furor causes when a tweet wrongly accused Scotiabank Theatre of harbouring bed bugs and the widespread media coverage how the bugs are sweeping Manhattan’s toniest locations.

“Or how about subways and street cars?” she asked.

“Go,” I said. “If you’re nervous, strip off when you get home, bag your clothes and then launder and dry them.”

We are not (yet) at the point you have to stop going out into public spaces.

Some activities are riskier, such as

  • moving residences (especially if it’s into an apartment building — so make sure to ask),
  • travelling (check those head boards and mattress seams), or
  • picking up second-hand furniture off the street (no more boulevard shopping).

I still trust the Toronto Transit Commission – especially safe in the winter when most of its vehicles sit outside overnight, freezing. And I think movie theatres – and other entertainment venues – were so shaken by the Twitter furor, that I expect discreet inspections are done regularly.

The good news, this week, was the attention that bed bugs generated at the municipal and provincial levels. If we manage our own surroundings cautiously and if coordinated and proactive actions are taken, bed bugs will be well-managed.

A community bed bug committee, composed of residents, tenant associations, non-profits, government reps and broader networks recently adopted a “Bedbug Mani-pest-o” outlining five key points:

  1. Build a public education campaign to raise awareness on the rising incidence of bed bug infestations, the methods of dealing with them and to de-stigmatize bed bugs
  2. Establish standard protocols for treatment of bed bugs
  3. Develop and promote a consistent community response that includes funds to support vulnerable populations to reduce financial barriers to eradicate bed bugs
  4. Conduct widespread monitoring of bed bug incidences across the Province
  5. Draft and enact legislative policies that support quick and effective responses to bed bugs

Liberal M.P.P. Mike Colle has taken almost all of these and built them into his recommendations to the province, only shying away from the legislative piece.

N.D.P. Cheri DiNovo has introduced a bill to license landlords.

The Toronto Board of Health and the City of Toronto are both lobbying for more resources, arguing that early interventions will ensure bed bugs don’t spread further.

Solutions are emerging.

For the moment, we can sleep tight. Just don’t let the bed bugs bite.

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December 29, 2009

Neighbourhood vitality in Toronto's towers

Toronto’s residential towers are flung far across the city’s inner suburbs, tossed over subway lines or sprinkled along ravines and major roadways, further from transit. E R A Architects made the strong case for the renewal of these urban structures, and the City’s (now being re-branded) “Mayor’s Tower Renewal Project” has focused resources on these vertical neighbourhoods.

Wading into the issue soon will be a new United Way Toronto report on housing and neighbourhood vitality, tentatively titled (until the marketers get a hold of it),The Role of Housing in Neighbourhood Vitality: An investigation into the impact of high-rise living on personal well-being and neighbourhood vitality. It will examine the quality of housing in these mainly private marker towers located within the poor neighbourhoods in Toronto’s inner suburbs; it will also measure residents’ satisfaction levels, the impact on health and well-being for themselves and their families, their attachment to the neighbourhood and the experience of various populations groups within this housing stock.

United Way laid the groundwork for this study as part of its Building Strong Neighbourhoods focus. Part of this earlier work was laid out in an exploration of the elements of neighbourhood vitality. That report went so far as to recommend useful data variables which could be drawn from primary and secondary sources.

Scheduled for release sometime in the first half of 2010, the donor-funded report is a rigourous and sweeping undertaking with a total survey interview sample of 2800 tenants and additional focus groups. York University researchers (led by Robert Murdie) are already undertaking to replicate the survey in the Parkdale neighbourhood.

The data collection was completed through the fall with a team of interviewers and 3 field coordinators. Data cleaning and analysis are now underway.

The research is being done in partnership with the

  • Social Housing Services Corporation, looking at the potential of a provincial roll-out
  • Toronto Community Housing, to compare social housing tenants and private market renters
  • Toronto Public Health, to understand the impact of housing on health
  • Ministry of Municipal Affairs and Housing, to inform the new provincial housing strategy
  • City of Toronto, to create a a baseline of knowledge and also test the limitations of the complaints process, and
  • Apartment Association of Greater Toronto, who has provided access to private market rental stock.
May 3, 2009

Urban neighbourhoods: The long view

Urban neighbourhoods characterized by poverty, rapid residential turnover, and dilapidated housing suffer disproportionately high rates of infant mortality, crime, mental illness, LBW, TB, physical abuse, and other factors detrimental to children’s well-being (Shaw & Mackay, 1942).

April 28, 2009

Disease and the regenerative power of cities

An appropriate quote, in these pandemic times, from Jane Jacobs’ The Death and Life of Great American Cites:

Vital cities have marvoulous innate abilities for understanding, communicating, contriving and inventing what is required to combat their difficulties. Perhaps the most striking example of this ability is the effect that big cities have had on disease. Cities were once the most helpless and devastated victims of disease, but they became great disease conquerors. All the apparatus of surgery, hygiene, microbiology, chemistry, telecommuications, public health measures, teaching and research hospitals, ambulances and the like, which people not only in cities but also outside them depend upon for the unending war against premature mortality, are fundamentally products of big cities and would be inconceivable without big cities. The surplus wealth, the productivity, the close-grained juxtaposition of talents that permit society to support advances such as these are themselves products of our organization into cities, and especially into big and dense cities.

April 2, 2009

Urban or Suburban: Physical activities differ by kind, not amount

I have the daily pleasure of walking, to work, to shop, to visit my neighbours. In fact, at least once a week one of my neighbours and I will head out for an evening march, just to avoid too many evenings in front of a screen. I fit the profile of a central urban resident, as released in a Stats Can study looking at the physical activity levels of urban and suburban residents, Life in Metropolitan Areas.

My extended family live in less dense neighbourhoods, further out from the city core, with big lawns, wide streets, and impossibly long walks to a hardware store or a restaurant. The study shows however that their physical activity levels are still likely on par with mine because they do more outdoor yard work (much more!) and they are also more likely to engage in an active leisure activity.

So, the study’s analysis of daily activitity shows, however we do it, urban and suburban dwellers tend to spend about the same amount of time engaged in daily physical activities. (If you’re interested in some of the other demographic characteristics of active people, see a previous Statistics Canada study, Who participates in active leisure?)

There were, however, two exceptions to the comparable physical activity levels amongst urban and suburban residents.

Suburban dwellers who were less physically active were those who:

  • work or go to school more than 9 hours a day, and/or
  • live in the tall residential apartments and condominiums that sprinkle most of Toronto’s suburbs, those that live in the tall towers, far from easy transit or commercial activities. 

While New Urbanism (see also CBC’s video clips on the topic) addresses some of the issues of built form and more compact and walkable communities, targeted intitiatives, such as the Mayor’s Tower Renewal project, are more likely to make a difference to those who are not physically active. Introducing such things as commmunity gardens and mixed commercial activity, the Tower Renewal Project changes the landscape surrounding tall buildings, thereby providing further opportunties for local residents to be physically active, whether through walking to do their errands or yard work.

Today’s Stats Can study simply underscores how landscape offers different opportunities to be physically active.

 

 

March 22, 2009

Advocacy in a time of change

To commemorate the International Day for the Elimination of Discrimination, 130 community activists gathered at the  School of Public Health at the University of Toronto. The auditorium was filled with familiar faces, with familiar messages in this old, familiar place (the old Toronto School Board office). However, this time, there was change in the air.

“We can’t sit around and watch our children die anymore,” said one presenter. “The Ontario government will use the economic downturn as a reason not to act on its commitments to poverty reduction and to the Roots of Violence recommendations,if we don’t act.”

Akua Benjamin, Ryerson Social Work professor, underlined the point, that young Black men are the ones who are dying most often, and that we need to address this specifically. Too often the broader terms of racism or people of colour occlude the particular issue of anti-Black racism.

The keynote speaker was the honourable Alvin Curling, co-chair of the recent Roots of Violence report. He has been making the rounds to numerous community meetings since its release because “writing that report was just one part” of what needs to be done.

If the recommendations are to be implemented, he explained, citizens need to push the government to carry out its commitment and to develop an implementation plan with hard goals and timelines.

Curling sounded pessimistic as some of the deadlines from the fall report loom.  However, he had people laughing out loud as he described the structural problems which lay in the way of successful implementation of the Roots of Violence report.

Siloed government ministries are like the kids in a family who each have to have their own iPod. Now, he explained, they can’t use their iPod 24 hours a day, but they also cannot share, so they each go out and get one. In fact, he explained, they won’t even tell each other what they have on their playlists.

The problem is so deep, he said, that there is no way we should throw money at it “unless the government gets its act together.”

In response to a question, Curling highlighted the recommendation on mental health supports, though, noting that this was the one recommendation which had money attached to it because of the seriousness of the issue.

Curling also touched on the topic of race-based collection of statistics, recounting a story from the consultations.

“We can’t do that,” the review was told by law enforcement officials. “The Blacks [sic] don’t like us to collect that.”

“Oh no,” snapped back one of the staff. “We just don’t like what you do with them.”

Other presenters at the day:

The City of Toronto public health report,  The Unequal City (2008), which demonstrates how different health outcomes are tied to income.

Sarah Blackstock, from the Income Security Advocacy Centre, exemplified how the 25 in 5 Network has ably kept poverty reduction on the agenda. [Conflict of interest, 1st alert, I sat onthe Steering Committee for a number of months.] The Network has had to balance maintaining an authentic link to community and labour while balancing Blackberries and meetings with the Premiers’ Office and the cabinet-level Results table, now charged with implementing the poverty reduction strategy. It’s a long way from the barricaded doors of old.

Lance McCready, from OISE/UT described his work in inner city and high need schools and his participation with the People for education report on Urban and Suburban schools. [Conflict of interest, 2nd alert, I was involved in this report and P4E before that.]

Margaret Parson of the African Canadian Legal Clinic described the upcoming World Conference on Racism and her participation, with many others in the room that day, at the conference ten years ago. Parsons urged Canadian NGOs and activists to participate even if the Canadian government was choosing not to participate in anticipation of a descent into”regrettable anti-Semitism.” She concluded by reading the final version of the controversial paragraph which had sparked the furor at the 2001 World Conference, and urged participants not to allow the broader issues of racism to be so easily set aside by a government seemingly unwilling to act.

Colin Hughes gave participants the long view, describing how the unanimous (and now notorious) 1989 parliamentary motion to abolish child poverty is  nine years overdue. Yet the momentum to keep the promise has not waned through the efforts of groups like Campaign 2000. Far from defeated, Hughes kept his sense of humour, laughing about his “useless Powerpoint slides” which had lost all his labels on the graphs.

Uzma Shakir, filled out the panel, and finished with a candid and rousing summary:

  • Racism might not be healthy for us,but anti-racism is.
  • It’s not good enough to hope that by ameliorating poverty, you are ameliorating the effectsof race. Because if good jobs are created, they run the risk of becoming generic jobs, ones that reenfoce the same old power structures. And then people of colour will be right back where we started.
  • Race and marginalization are not a newcomer phenomenon. There is a long history to racism in Canada. Immigrationis being blurred with it because most newcomers are people of colour.
  • The issue of race has to be disaggregated. If you use averages, then you could put my head in the freezer and feet in the oven, and say my body temperature was average. But that wouldn’t mean that I was healthy.

The Colour of Poverty campaign convened the one day forum with anti-racist and poverty activists, entitled Social Determinants, Growing Colour-coded Inequality in Ontario , and Racial Justice – the Pathway Forward.

A few short hours the provincial government announced it was increasing the Ontario Child Tax benefit and funding for housing. “A classic case of Liberals under-promising and over-delivering,” said one participant as his Blackberry buzzed with the leak of the announcement. “They undercut us again.”

Not that many minded. (But we’ll see what the provincial budget holds.)

March 5, 2009

Are hospital visitors targeted for parking violations, or are we just negligent roadhogs?

My parents go to the hospital so frequently that the last time I escorted them, they carefully coached me in how to avoid getting a parking ticket. It’s energy well-spent, given the frequency with which parking tickets are handed out around hospitals from York region, to Ottawa, from Newfoundland to Australia.

Whether you are visiting, attending a doctor’s appointment, or rushing there for an emergency, parking tickets are a common part of the hospital experience, along with high parking fees, shortages of spots, and meters which expire in short intervals.

A recent piece in the Toronto Star highlighted how frequently hospitals visitors are stung by the green hornets here in Toronto. The streets around hospital made up half of the top ten sites for parking tickets in 2007. The Ottawa Citizen found similar patterns in their examination of the issue in 2007. The Vancouver Sun also found the same, to a lesser degree.

It’s the sort of thing that drives people crazy, filling Bulletin Boards and other blogs (see here for a hilarious list of the ten worst parking tickets ever issued).

Some places in the world are trying to find a solution. Scotland now offers free parking at most of its hospitals, and Wales is considering the same, while recognizing the complexity of such an endeavor, and wondering how to discourage “freeloaders” without setting up another expensive bureaucratic layer.

Some argue, perhaps fairly, that if you own a car, you need to take responsibility for it. Residents who live near hospitals have to put up with slackers on a daily basis. It must grow tiresome.

However, hospitals are one of the likeliest places in the city where some administrative discretion should be used. People attending hospitals are often ill, or escorting those who are, and they have little control over the sorts of delays they may face once inside.

I have my bias in answer to the question: I remember a sweet and random act of parking kindness  I received at my local hospital once, when I raced, daughter in my arms, son at my side, into the emergency room. When we left, all safe a few hours later, I realized that I had parked by the entrance and not even noticed the meter by my car. But there sat my car ticket-less.

Someone had put some money into the meter.

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February 13, 2009

February 17 Event: Neighbourhoods & Mental Health

Urban Moods and Urban Myths: Do Neighbourhoods Matter for Mental Health? Café Scientifique. Presented by The Canadian Institutes of Health Research (CIHR) and the Centre for Research on Inner City Health (CRICH). Tuesday, February 17, 7-9 pm: Gladstone Hotel, 1214 Queen St. West, Toronto. Free, all welcome.
To RSVP, e-mail Tynama at smh dot toronto dot on dot ca

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