West Sub-Region Profile

September 19, 2016 This report was prepared by the following individuals: Ranjeeta Jhaveri, Cynthia Damba, Mohamedraza Khaki, Thivya Sornalingam, Myuri Elango Pandian, Kinga Byczko (Toronto Central LHIN Health Analytics and Innovation Team); Daniel Laidsky (Reconnect MHA Services).

If you have any questions about this, please contact: Ranjeeta Jhaveri ([email protected]) and Cynthia Damba ([email protected])

2 Table of Contents

• Section 1 - Introduction to the Report and West Toronto Sub-Region…...…… 4

• Section 2 - Population Characteristics…………………………………………….11

• Section 3 – Health Status………………………..………………………………….29

• Section 4 – Health Service Use…………………….………………………………37

• Section 5 – Primary Care and Prevention………………………..……………….72

• Appendix A –Additional Information on Population Demographics………… ….84

• Appendix B – Methodology for Identifying Primary Care Physicians…….……..90

3 Section 1. Introduction to the Report and West Toronto Sub-Region

4 Planning at the Sub-Region Level

• One of the key Strategic Priorities that underpins the goals of the Toronto Central LHIN strategic plan is Taking a Population Health Approach, which will direct how we plan, prioritize, fund, and partner with other organizations to target the needs of the population and the sub-populations within.

• This begins with a strong understanding of what our current and future patients’ needs and wants are in order to improve their health status and experience with health care. This information will help to identify neighbourhoods and population segments that may need targeted interventions to achieve the desired and equitable outcomes reflected in our goals.

• A population based approach integrates the full spectrum of health care delivery – from preventing disease (e.g. health promotion) to treatment (e.g. tertiary care). Health is greatly influenced by the social determinants of health – including our environment, our social status, education, employment, gender and culture. The profiles illustrate the diversity of the population of the Toronto Central LHIN, and form a basis of understanding of the variations in populations that can impact our health outcomes.

5 Data Sources, Considerations and Report Structure • Data was obtained from multiple sources for the report and years of data may vary as they are based on the most recent year available for the particular database. There may be minor differences in rates and numbers reported for different indicators due to rounding, use of different data sources and/or timing of data extraction.

• As we get more information, we will update indicators or add new indicators.

• Sub-regions are built from Statistics Census Tracts.

• The report is divided out into 5 sections and some are further sub-divided into sub-sections. Each section starts with a summary of the highlights and then information for individual selected indicators.

• For each indicator, information is presented at LHIN, sub-region and wherever possible at neighbourhood level. The top 2 or 3 rates for neighbourhoods which indicate greater health risk in the summary slides are highlighted in pink.

• Similar slide decks are being prepared for each of the sub-regions and will be posted on the Toronto Central LHIN website. Additional informational information on sub-regions is available on Toronto Central LHIN website: http://www.torontocentrallhin.on.ca/forhsps/crosssectortables.aspx 6 About the West Toronto Sub-Region

St. Joseph’s Health Centre West Park Rehab

Mount Dennis Roncesvalles Stonegate CHC • Bounded by Eglinton Ave. West to the north, the Canadian National Railway to the East, Lake to the south, Islington Ave. (North) and Kipling Ave (South) to the West. • The region contains 14 neighbourhoods and a very small proportion of one neighbourhood (Islington City Centre West). There are 3 designated neighbourhood Improvement Areas (, South Parkdale, and Rockcliffe Smythe) along with higher-income neighbourhoods such as Kingsway South and Runnymede . • Please note: Islington City Centre West has not been included in this profile as the majority is located in 7 Mississauga Halton LHIN. Also, Edenbridge-Humber Valley has a small portion that lies in Central LHIN. West Toronto Neighborhoods (2016)

Population (2011) 232,570 (20.4% of TC LHIN) Males: 48.2% Females: 51.8% % Children and Youth (ages 0-19): 20% % Seniors (ages 65+): 13.7%

8

Source: Toronto Community Health Profiles Partnership, Extracted: 2016; Census of Canada, Statistics Canada, 2011 Health Service Providers(HSP’s) in Toronto Central LHIN (As of July 2016)

HSP mappings are based on primary office locations.

HSPs may have multiple sites. In addition, HSPs in one sub- region may provide services for people in other sub-regions or LHINs.

Sub-Regions

**Primary Care Physicians are defined by a basket of service methodology developed by MOHLTC. General practice Private Primary Care Total HSPs (ex physicians are considered primary Sub-Region CCAC CHC CMHA CSS Hospital LTC Hospital Physicians** FP/GP) care providers if they either 1) belong to a Physician Enrollment West Toronto 4 8 5 3 0 9 155 29 Model (PEM) or 2) satisfied specific Mid-West Toronto 5 20 13 5 0 12 534 55 billing requirements (Appendix A) These numbers are estimates and 1 2 3 10 3 0 3 217 21 do not include PCPs in CHCs. Mid- 4 24 15 3 0 4 199 50 Numbers will be updated East Toronto 2 5 10 2 1 8 236 28 Toronto Central 9 1 17 60 53 16 1 36 1341 184 LHIN West Toronto Sub-LHIN

West Toronto Health Service Providers

Hospital LTC CMH&A CSS CHC 1. Runnymede Healthcare 1. Copernicus Lodge 1. Breakaway Addiction 1. Services for 1. Four Villages Centre 2. Elm Grove Living Services Seniors Community Health 2. St. Joseph's Health Centre Inc. 2. Family Association for 2. Humber Community Centre Centre 3. Garden Court, Mental Health Seniors' Service Inc. 2. Lakeshore Area 3. West Park Healthcare Shaparrall Limited Everywhere 3. Parkdale Golden Age Multi-Services Centre 4. Ivan Franko Home 3. Habitat Services, Mental Foundation Project (Etobicoke) Health Program 4. Storefront Humber Inc. 3. Parkdale Community 5. Lakeshore Lodge Services of Metropolitan 5. Blinds Adults Health Centre 6. Lakeside Long Term Toronto, Inc. 4. Stonegate Care Centre 4. Jean Tweed Treatment Community 7. Norwood Nursing Home Centre Association Limited 5. Parkdale Activity - 8. West Park Long Term Recreation Centre Care Centre 6. Reconnect Community 9. White Eagle Residence Health Services 7. Regeneration House Inc. 8. Working for Change Total: 3 Total: 9 Total: 8 Total: 5 Total: 4

HSP mappings are based on primary office locations. HSPs may have multiple sites. In addition, HSPs in one sub-region may provide services for people in other sub-regions or LHINs. 10 Section 2. Population Characteristics

A) Population Demographics

B) Cultural and Socioeconomic Diversity

Additional detailed information is available in Appendix A

11 Key Highlights – Population Demographics and Diversity

• West Toronto has a slightly higher proportion of children and youth (ages 0-19) in 2011 (20%) compared to Toronto Central LHIN (18.8%). Lambton and Mount Dennis has the highest proportion of children and youth in West Toronto at 26.5% and 25.7% respectively.

• The percentage of the West Toronto population that is over 65 years (2011) at 13.7% is similar to the Toronto Central LHIN average (13.1%). Half of the neighbourhoods of West Toronto have a higher percentage than the Toronto Central LHIN average of seniors living alone.

• West Toronto has the highest proportion of residents who speak English only (85.3%) among the sub-regions. This is also higher than the Toronto Central LHIN average of 83.2%. The top 3 most common languages spoken at home other than English are Spanish, Polish and Portuguese.

• West Toronto has a lower proportion of visible minorities (28.6%) relative to Toronto Central LHIN (33.6%). The most heavily represented visible minorities relative to Toronto Central LHIN are of people with a Latin American Descent.

• Neighbourhoods with the highest levels of marginalization include Rockcliffe-Smythe and South Parkdale.

• Roncesvalles, Rockcliffe-Smythe, Mount Dennis, , and South Parkdale neighbourhoods have median private household income below that of the City of Toronto.

12 2a) Population Demographics

13 Data Limitations

• The 2011 Census and National Household Survey (NHS), and Tax filer data were the main sources for this Population Demographic section.

• Information on visible minorities, immigration, education, labour, and Aboriginal identity were collected as part of the 2011 National Household Survey by Statistics Canada. The National Household Survey was a voluntary survey and subject to non-response bias especially in areas where non-response rates exceeded 25%, the threshold for suppression for the 2011 Census. Non-response bias is a common issue with voluntary surveys and a reflection of the tendency that people who are inclined to respond to a survey have different characteristics from people who do not respond. Consequently, marginalized or underrepresented subpopulations are likely undercounted in the National Household Survey and comparisons between the National Household Survey and previous Censuses should be considered to be unreliable.

• Population estimates provided in the following profile should be considered as an approximate estimate of the population, rather than a true, full count of the population. There may be differences in total population counts due to rounding and use of different data sources. 14 West Toronto: Population Summary by Neighbourhood (2011)

Total Population Children/Youth Seniors % of families % of Total % change in % change in % change in with children % of Total population in % of Total Total the 65+ Total population the 0-19 that are headed population Age 65+ living private Population Population population Population population Population count 2006- population by a lone that are age alone, Both households Male Female that are age Age 65+, (count), 2006- (Both Sexes) 2011, Both (count), 2006- parent in 65+, Both sexes that are 65+, 0-19 Both sexes 2011, Both sexes 2011 private sexes living alone, sexes households Both sexes Edenbridge-Humber Valley 7,075 7,865 14,945 3.40% 20.6% -3.6% 26.2% 2,815 18.8% 10.6% 695 25.9% 10,100 11,190 21,300 1.6% 16.2% 2.8% 29.5% 2,550 12.0% -3.0% 970 41.4%

High Park-Swansea 10,030 11,720 21,750 8.8% 19.0% 11.3% 27.0% 3,385 15.6% 3.7% 1,080 36.3% Junction Area 6,820 7,210 14,015 6.4% 20.1% -2.8% 31.8% 1,320 9.4% 14.8% 280 22.9% Kingsway South 4,330 4,845 9,175 4.6% 24.5% 1.6% 17.5% 1,720 18.7% 9.6% 420 25.9% Lambton Baby Point 3,695 4,220 7,920 1.7% 26.5% 4.5% 32.7% 905 11.4% -3.7% 275 30.6% 12,925 13,625 26,550 6.3% 14.9% -1.9% 37.0% 3,920 14.8% 16.5% 1,465 37.9% Mount Dennis 6,210 6,935 13,150 2.4% 25.7% -7.4% 47.1% 1,490 11.3% 14.2% 325 26.0% New Toronto 5,300 5,600 10,905 2.4% 19.3% -7.5% 43.3% 1,490 13.7% 5.3% 600 44.8%

Rockcliffe-Smythe 10,750 11,520 22,270 -0.5% 23.6% -5.9% 38.9% 3,410 15.3% 0.9% 1,255 36.8% Roncesvalles 7,430 7,620 15,050 2.7% 20.1% 6.1% 30.1% 1,620 10.8% -3.9% 580 35.9% Runnymede-Bloor West Village 4,565 5,065 9,635 0.8% 24.0% 1.5% 22.3% 1,080 11.2% -5.3% 255 23.5% South Parkdale 10,810 10,435 21,245 1.1% 16.3% -11.0% 42.8% 2,225 10.5% 0.7% 895 48.9% Stonegate- Queensway 11,935 12,745 24,690 3.7% 21.0% 5.3% 26.8% 3,975 16.1% -3.3% 1,110 28.5% Toronto Central 557,565 592,995 1,150,555 5.6% 18.7% -0.8% 31.7% 150,965 13.1% 7.1% 47,850 34.1% LHIN

15

Source: Toronto Community Health Profiles Partnership, Extracted: 2016; Census of Canada, Statistics Canada, 2011 West Toronto: Population Demographics (2011)

Population by Age and Sex Distribution in West Toronto and Toronto Central LHIN 5% 5% Total Population in 2011

3% 3%

1% 1% 1% 1% 232,570 3% 3% (Toronto Central LHIN: 1.2 million)

5% 5%

85+

0 to 0 4 to 5 9

10 to 10 14 to 15 19 to 20 24 to 25 29 to 30 34 to 35 39 to 40 44 to 45 49 to 50 54 to 55 59 to 60 64 to 65 69 to 70 74 to 75 79 to 80 84

WestTorontoWomen WestTorontoMen TC LHIN - Men TC LHIN - Women

Projected growth between 2011 and 2026 Most heavily represented age groups relative to +10% +9% +34.6% the Toronto Central LHIN: 85+ years 5-14 years (Toronto Central LHIN: +35%)

16 Source: Census of Canada, Statistics Canada, 2011 West Toronto: Population of Children and Youth (2011)

West Toronto had a higher proportion of children and youth (ages 0-19 years) in 2011 (20% ) relative to Toronto Central LHIN (18.8%).

% of Total Population Ages 0-19, Both Sexes (2011) Toronto Central LHIN: 18.7% Lambton Baby Point 26.5 Mount Dennis 25.7 Kingsway South 24.5 Runnymede-Bloor West Village 24.0 Rockcliffe-Smythe 23.6 Stonegate-Queensway 21.0 Edenbridge-Humber Valley 20.6 Roncesvalles 20.1 Junction Area 20.1 New Toronto 19.3 High Park-Swansea 19.0 Most neighbourhoods have a higher than average % of South Parkdale 16.3 High Park North 16.2 children than the Toronto Central LHIN population. Mimico 14.9 0.0 10.0 20.0 30.0 Lambton Baby Point and Mount Dennis neighbourhoods have the highest proportion of children in West sub-region. 17

Source: Toronto Community Health Profiles Partnership, Extracted: 2016; Census of Canada, Statistics Canada, 2011 West Toronto: Population of Seniors Age 65+ (2011)

Overall, 13.7% of the West Toronto population is over 65 years (2011). This is slightly above the Toronto Central LHIN average population, currently at 13.1%.

% of Total Population, Ages 65+, Both Sexes, (2011) Toronto Central LHIN: 13.1% Edenbridge-Humber Valley 18.8% Kingsway South 18.7% Stonegate-Queensway 16.1% High Park-Swansea 15.6% Rockcliffe-Smythe 15.3% Mimico 14.8% New Toronto 13.7% High Park North 12.0% Lambton Baby Point 11.4% The proportion of seniors among West Toronto neighbourhoods ranges Mount Dennis 11.3% from 9.4% to 18.8%. Runnymede-Bloor West Village 11.2% Half of the neighbourhoods have a higher than average proportion of Roncesvalles 10.8% South Parkdale 10.5% seniors in their neighbourhoods. Junction Area 9.4% Kingsway South and Edenbridge-Humber Valley have the highest 0.0% 5.0% 10.0% 15.0% 20.0% proportion of seniors in West Toronto Sub-region. 18 West Toronto: Seniors Living Alone by Neighbourhood (2011)

Percent (%) of seniors living alone by Neighbourhood 60.0 48.9 50.0 44.8 41.4 40.0 35.9 36.3 36.8 37.9 Toronto Central LHIN 34.1% 28.5 30.6 30.0 25.9 25.9 26.0 22.9 23.5

20.0 Percentage (%) Percentage

10.0

0.0

The proportion of seniors living alone in West Toronto neighbourhoods ranges from 22.9% to 48.9%.

Half of the neighbourhoods have a higher proportion of seniors living alone compared to the Toronto Central LHIN average, with High Park North, New Toronto, South Parkdale having over 40% of seniors living alone. Source: Toronto Community Health Profiles Partnership, Extracted: 2016 19 West Toronto: Homeless Population

Number of Shelters in West Toronto by Neighbourhood (2016)

Junction Area West Toronto has 2 homeless shelters in (Mimico and Junction Area) in Toronto Central LHIN

Mimico

0 1 2 3 4

• In 2013, the proportion of seniors doubled to 10% from 5% in 2009 When planning • High representation of the Indigenous population (16%) services for the • Almost half (46%) used the emergency department homeless population, • Almost one third (26%) used ambulance services key considerations • Higher prevalence of mental health and addictions include: • Higher need for transportation services • Poor data quality in existing databases 20 Source: City of Toronto, 2016, 2013 Street Needs Assessment Results 2b) Cultural and Socioeconomic Diversity

Languages Spoken, Francophone, Visible Minorities, Aboriginals, Immigration, Newcomers, Education, Income, Social Assistance, Marginalization

21 West Toronto: Cultural and Socioeconomic Diversity Summary

% Visible % No % Recent % of % Unemployment: % Population Minority % of persons age Persons living knowled Immigrants of Population (# of unemployed of Aboriginal (by Total 25-65 with post below low Ontario ge of Total Receiving persons age Identity Population in secondary income Marginalization English/ Immigrants Social 15+/100 Persons (Private Private certificate, measure (after- Index (2006) French (from 2006 to Assistance age 15+ in the Households) Households) diploma or degree tax) (2010) (2011) 2011) (2011) Labour Force) (2011) (2011)

2.4% 12.9% 17.5% 74.3% 11.7% 5.0% 8.0% 2.0 0.1% Edenbridge-Humber Valley Stonegate-Queensway 2.1% 16.0% 15.9% 75.9% 11.8% 6.5% 8.0% 1.8 0.4% High Park North 2.1% 18.3% 22.9% 81.2% 16.5% 4.9% 7.8% 1.8 0.5% High Park-Swansea 1.4% 9.9% 16.1% 82.8% 11.9% 7.7% 6.7% 2 0.4% Junction Area 3.7% 13.6% 31.2% 69.7% 18.6% 8.2% 7.9% 2.2 1.5% Kingsway South 0.4% 6.5% 11.0% 88.8% 5.8% 0.8% 5.9% 1.6 0.2% Lambton Baby Point 1.8% 9.4% 22.0% 76.1% 16.4% 13.3% 5.1% 1.8 0.5% Mimico 3.2% 14.2% 25.4% 73.0% 16.5% 9.9% 7.3% 2.4 0.6% Mount Dennis 4.6% 16.2% 64.3% 50.1% 28.0% 22.3% 13.6% 2.6 0.9% New Toronto 3.2% 12.0% 30.6% 66.3% 24.1% 14.7% 8.8% 2.6 1.3% Rockcliffe-Smythe 6.3% 9.5% 46.2% 48.3% 23.1% 15.4% 11.5% 3 1.0% Roncesvalles 7.0% 20.8% 26.0% 71.1% 21.1% 15.1% 6.4% 2.2 1.4% Runnymede-Bloor West 0.9% 7.9% 18.6% 83.2% 8.6% 2.6% 6.9% 1.2 1.0% Village

South Parkdale 6.0% 32.1% 48.4% 64.1% 34.1% 21.0% 13.0% 3.2 2.1% Toronto Central LHIN 4.2% 17.6% 33.6% 74.1% 20% 10.0% 8.3% N/A 0.9%

22

Source: Toronto Community Health Profiles Partnership, Extracted: 2016; Census of Canada, Statistics Canada, 2011; National Household Survey, Statistics Canada, 2011 West Toronto: Diversity Languages Spoken (2011)

% No knowledge of Top 3 Languages other than English Spoken at Home (2011) Neighbourhood Name Percent (%) of Total English/French population in private #1 #2 #3 households that are Roncesvalles 7.0% Hungarian Polish Portuguese recent immigrants: Rockcliffe-Smythe 6.3% Portuguese Spanish Vietnamese South Parkdale 6.0% Tibetan languages Hungarian Polish 6.1% Mount Dennis 4.6% Spanish Portuguese Vietnamese Toronto Central LHIN Junction Area 3.7% Portuguese Vietnamese Spanish New Toronto 3.2% Polish Russian Spanish 6.8% Mimico 3.2% Polish Tagalog (Pilipino, Filipino) Spanish Edenbridge-Humber Valley 2.4% Spanish Ukrainian Italian High Park North 2.1% Polish Ukrainian Russian Visible Minority Stonegate-Queensway 2.1% Russian Polish Spanish Lambton Baby Point 1.8% Ukrainian Polish Hungarian High Park-Swansea 1.4% Polish Serbian Ukrainian 28.6% Runnymede-Bloor West Village 0.9% Ukrainian Polish French Toronto Central LHIN Kingsway South 0.4% Ukrainian Polish French 33.6% Overall West Toronto has the highest proportion of residents who speak English only (85.3%) among the 5 sub-regions and higher compared to Toronto Central LHIN (83.2%).

Aboriginal Identity The most common languages spoken at home other than English include Spanish, Polish and Portuguese. 1,900 Neighbourhoods with higher than Toronto Central LHIN rate of non-English/French speaking individuals Toronto Central LHIN include Roncesvalles, Rockcliffe-Smythe, South Parkdale and 10,665 Mount Dennis. Note: Persons of aboriginal identity are most likely undercounted due to limitations of the Among the Visible Minorities, West Toronto has the highest proportion of people of Latin American Descent NHS 23

Source: Toronto Community Health Profiles Partnership, Extracted: 2016; Census of Canada, Statistics Canada, 2011 West Toronto: Language (2011)

Mother Tongue* Persons who speak Persons with no knowledge French at home: English of either official language:

37% French 61% 6,210 7,855 2% Non-official languages 2.7% (Toronto Central LHIN: 2.9%) 3.4% (Toronto Central LHIN: 4.2%)

Top home languages other than English Most heavily represented languages relative to spoken at home Toronto Central LHIN

Spanish Tibetan Ukrainian Polish Polish Portuguese Croatian Hungarian Ukrainian Somali Russian Serbian Vietnamese Italian Chinese, n.o.s. Vietnamese Russian Albanian Tagalog German Tibetan Spanish Other languages Serbian 0.0% 50.0% 100.0% 150.0% 200.0% 250.0% 300.0% 350.0% - 2,000 4,000 6,000 8,000 10,000 Percent Increase over Toronto Central LHIN Population

Note*: English and French includes non-official languages as well Source: Census of Canada, Statistics Canada, 2011 24 West Toronto: Immigration, Visible Minorities and Aboriginal Population (2011)

Visible minorities by immigration period Visible Minority 16000 14000 12000 10000 28.6% 8000 6000 4000

2000 Population (in thousands) 0 South Black Filipino Latin Arab West Korean Visible Multiple Asian Chinese American Southeast Asian Japanese minority, visible Toronto Central LHIN: 34% Asian n.i.e. minorities

Non-permanent residents Immigrated between 2006 to 2011 Immigrated between 2001 to 2005 Immigrated before 2001 Canadian born Aboriginal identity Most heavily represented visible +83.1% 1,900 minorities relative to +41.4% Latin American Other racialized 0.8% (Toronto Central LHIN: 0.9%) the Toronto Central groups LHIN: 25 Source: National Household Survey, Statistics Canada, 2011 West Toronto: Immigration (2011)

Total immigrant population in private households by Total recent immigrant population in private top selected places of birth households by top selected places of birth (2006 to 2011)

Population % of Total Population Population % of Total Recent from Country in Private Households from Country Immigrants Poland 7,630 3.4% India 1,415 10.2% United Kingdom 5,445 2.4% Philippines 1,145 8.2% Philippines 4,660 2.1% China 615 4.4% Portugal 4,495 2.0% Ukraine 440 3.2% India 3,885 1.7% Brazil 400 2.9% Ukraine 3,880 1.7% Nepal 370 2.7% Viet Nam 3,100 1.4% United States 350 2.5% China 2,955 1.3% Russian Federation 275 2.0% Italy 2,535 1.1% Mexico 185 1.3% Jamaica 2,265 1.0% Colombia 185 1.3% United States 2,240 1.0% Viet Nam 155 1.1% Germany 1,680 0.7% Cuba 135 1.0% Total Population within private households = 226,280 Total recent immigrant population in private households = 13,900

26 Source: National Household Survey, Statistics Canada, 2011 West Toronto: Education and Income (2011)

Educational Attainment Persons living below low income measure 20.0% 19% 17% (after tax) (2013) Unemployment rate 30.0% 15.0% 24.6% (2011) 25.0% 21.7% 9.8% 20.0% 10.0% 8.9% 20.0% 17.5% 15.0% 5.0% Children 10.0% 7.1% 7.6% under 18 5.0% 0.0% 8.5% West TC LHIN 0.0% Toronto Central LHIN: 8.3% % persons below LIM- % Children under 18 % Seniors 65 years AT below LIM-AT and over below LIM-AT Less than High School Diploma High School Diploma West Toronto TC LHIN

Median Private Household Income by Neighbourhood (2011)

$120,000 $106,386 $100,000 $74,729 $80,000 $67,549 $62,463 $62,128 $58,158 $55,300 $53,804 $52,827 $60,000 $46,883 City of Toronto: $52,149 $46,154 $43,790 $40,859 Income $40,000 $32,539 $20,000 $0

27 Source: National Household Survey, Statistics Canada, 2011; Toronto Well-Being, Tax Filer, 2013 West Toronto: Low income and Marginalization At the neighbourhood level, there is Ontario Marginalization Index - per Neighbourhood (2006) variation in levels of 3 3.2 3.5 2.6 2.6 City of marginalization and other socio- 3 2.2 2.2 2.4 2.5 1.8 1.8 1.8 2 2 Toronto: 2.4 economic indicators. 2 1.6 1.5 1.2 1 0.5 Neighbourhoods with high levels of 0 marginalization include: South Parkdale, Rockcliffe -Smythe, Mount Dennis, New Toronto and Mimico

Indicator definition: A combined measure of 18 variables representing residential instability, ethnic concentration, dependency and material deprivation, 2006 Census, Ontario Marginalization Index

% of Population - Low Income (After-Tax) (2010) % of Population Receiving Social Assistance (2012) City of Toronto Rate: 22.2% City of Toronto Rate: 10% South Parkdale Mount Dennis 22.3 Indicator definition: Percentage of the 34.1 population living with incomes below the Mount Dennis 28.0 South Parkdale 21.0 after-tax low income measures (LIM-AT) New Toronto 24.1 Rockcliffe-Smythe 15.4 established in 2010 for the City of Toronto. The after tax-low income Rockcliffe-Smythe 23.1 Roncesvalles 15.1 measure (LIM-AT) is the poverty measure Roncesvalles 21.1 New Toronto 14.7 used by the Ontario Poverty Reduction Strategy. Source: Urban Heart Toronto, Lambton Baby Point Junction Area 18.6 13.3 2014 [2010 TI-Family File, Statistics Mimico 16.5 Mimico 9.9 Canada Income Division] High Park North 16.5 Junction Area 8.2 Lambton Baby Point 16.4 High Park-Swansea 7.7 Indicator definition: Social Assistance: % of the population that are recipients of High Park-Swansea 11.9 Stonegate-Queensway 6.5 Ontario Works, persons on ODSP Stonegate-Queensway 11.8 Edenbridge-Humber Valley 5.0 participating in OW employment High Park North programs and non-OW persons receiving Edenbridge-Humber Valley 11.7 4.9 assistance with medical items, 2012, Runnymede-Bloor West Village 8.6 Runnymede-Bloor West Village 2.6 Toronto Employment & Social Services. Kingsway South 5.8 Kingsway South 0.8 0.0 5.0 10.0 15.0 20.0 25.0 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 28

Source: Urban Heart, 2014 [2006 Census, Ontario Marginalization Index] Section 3: Health Status Prevalence of Disease Conditions

29 Key Highlights – Health Status

• Overall in FY 2014/15, West Toronto sub-region had higher prevalence rates for Diabetes, Asthma, High Blood Pressure, Mental Health Visits & COPD compared to Toronto Central LHIN. Prevalence varied considerably among the neighbourhoods. New Toronto had remarkably higher rates across all conditions apart from diabetes, however there was wide variation across neighbourhoods. Four neighbourhoods have among the highest rates of chronic diseases in the West Toronto sub-region: Mount Dennis, Rockcliffe Smythe, South Parkdale and New Toronto.

• Rates of diabetes (Adults 20+), are particularly high in Mount Dennis (13.1%), Rockcliffe-Smythe (12.4%) and South Parkdale (11.4%).

• Rates of asthma (Adults 20+), are particularly high in Rockcliffe-Smythe (16.9%), New Toronto (15.1%), and Mount Dennis (14.9%).

• Rates of high blood pressure (Adults 20+), are particularly high in Mount Dennis (23.6%), Rockcliffe- Smythe (22.8%) and New Toronto (21.2%).

• Rates of mental health visits (Adults 20+), are particularly high in Mimico and New Toronto, but also high in multiple neighbourhoods as well.

• Rates of COPD (Adults 35+), are particularly high in New Toronto (13.7%) and South Parkdale (10.8%). 30 West Toronto: Disease Prevalence Rates by Neighbourhoods (2014/15)

Age standardized Rates High Blood Pressure Mental Health Diabetes (Ages 20+) Asthma (Ages 20+) COPD (Ages 35+) Neighbourhood (Ages 20+) Visits (Ages 20+)

Edenbridge-Humber Valley 8.10% 13.70% 20.20% 9.40% 7.50% High Park North 6.00% 11.00% 16.40% 9.50% 7.00% High Park-Swansea 5.90% 12.60% 16.90% 10.00% 6.90% Junction Area 9.40% 13.90% 18.60% 10.30% 7.60% Kingsway South 5.40% 13.90% 16.50% 8.70% 6.20% Lambton Baby Point 7.50% 13.90% 18.60% 9.80% 7.10% Mimico 8.30% 13.20% 19.80% 10.70% 10.20% Mount Dennis 13.10% 14.90% 23.60% 9.70% 10.10% New Toronto 9.70% 15.10% 21.20% 10.90% 13.70% Rockcliffe-Smythe 12.40% 16.90% 22.80% 10.30% 10.20% Roncesvalles 8.20% 13.20% 17.10% 10.00% 8.90% Runnymede-Bloor West Village 7.20% 13.40% 17.60% 9.50% 6.60% South Parkdale 11.40% 12.70% 19.40% 9.70% 10.80% Stonegate-Queensway 7.30% 13.00% 19.90% 9.30% 8.40% WEST TORONTO 8.5% 13.4% 19.3 9.9% 8.8% Toronto Central LHIN 8.4% 12.7% 18.3% 9.4% 8.6%

31 Source: Ontario Community Health Profiles Partnership, Extracted: 2016 West Toronto: Diabetes Prevalence Rates by Neighbourhood (2014/15)

Age-Standardized Rate of Diabetes for Population 20+, (2014/15) West Toronto Sub-Region

14.0 13.1 Prevalence Rate 12.4 12.0 11.4 8.5% 9.7 10.0 9.4 8.1 8.2 8.3 Toronto Central LHIN Rate: 8.4% Toronto Central LHIN Prevalence Rate : 8.0 7.2 7.3 7.5 8.4% 5.9 6

6.0 5.4

StandardizedRate -

Age 4.0 West Sub-Region has a similar 2.0 prevalence rate of diabetes as 0.0 compared to Toronto Central LHIN.

Rates of diabetes are particularly high in Mount Dennis, Rockcliffe-Smythe and South Parkdale.

32 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Asthma Prevalence Rates by Neighbourhood (2014/15)

Age-Standardized Rate of Asthma for Population 20+, (2014/15) West Toronto Sub-Region Prevalence Rate 18.0 16.9

16.0 14.9 15.1 13.7 13.9 13.9 13.9 13.4% 14.0 13.2 13.2 13.4 12.6 12.7 13 Toronto Central LHIN Rate: 12.7% 12.0 11 Toronto Central LHIN Prevalence Rate : 12.7% 10.0

8.0 StandardizedRate

- 6.0 Age 4.0 West Toronto Sub-Region has a higher 2.0 prevalence rate of asthma as 0.0 compared to Toronto Central LHIN.

Rates of asthma are particularly high in Rockcliffe-Smythe, New Toronto, and Mount Dennis.

33 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: High Blood Pressure (HBP) Prevalence Rates by Neighbourhood (2014/15)

Age-Standardized Rate of HBP for Population 20+, (2014/15) West Toronto Sub-Region Prevalence Rate 25.0 23.6 22.8 21.2 19.3% 20.2 19.4 19.8 19.9 20.0 18.6 18.6 Toronto Central LHIN Rate: 18.3% 17.1 17.6 Toronto Central LHIN Prevalence Rate: 16.4 16.5 16.9 18.3% 15.0

10.0

StandardizedRate

- Age 5.0 West Toronto Sub-Region has a higher prevalence rate of high blood pressure 0.0 than Toronto Central LHIN.

Rates of HBP are particularly high in Mount Dennis, Rockcliffe-Smythe and New Toronto

34 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto Mental Health Visit Prevalence Rates by Neighbourhood (2014/15)

Age-Standardized Rate of Mental Health Visits for Population 20+, (2014/15) West Toronto Sub-Region

12.0 Prevalence Rate 10.7 10.9 10.3 10.3 9.7 9.7 9.8 10 10 10.0 9.3 9.4 9.5 9.5 Toronto Central LHIN Rate: 9.4% 9.9% 8.7

8.0 Toronto Central LHIN Prevalence Rate: 9.4% 6.0

StandardizedRate 4.0 -

Age West Toronto Sub-Region has the 2.0 second highest prevalence rate of mental health visits of all 5 regions. 0.0 Rates of Mental Health Visits are particularly high in New Toronto and Mimico but also high in multiple neighbourhoods as well.

35 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto Chronic Obstructive Pulmonary Disease (COPD) Prevalence Rates by Neighbourhood (2014/15)

Age-Standardized Rate of COPD for population aged 35+, (2014/15) West Sub-Region Prevalence Rate 16.0 13.7 14.0 8.8%

12.0 10.8 10.1 10.2 10.2 Toronto Central LHIN Prevalence Rate: 10.0 8.9 8.6% 8.4 Toronto Central LHIN Rate: 8.6% 7.5 7.6 8.0 6.9 7 7.1

6.2 6.6 StandardizedRate

- 6.0

Age 4.0 Overall, West Sub-Region has a 2.0 prevalence rate of COPD similar to 0.0 Toronto Central LHIN.

Rates of COPD are particularly high in New Toronto and South Parkdale

36 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 Section 4: Health Service Use A. Emergency Department Care B. Inpatient Services C. Community Services Use

37 4a) Emergency Department (ED) Care Overall Age standardized rates of ED Visits (By Neighbourhood, Sub- Region and LHIN), ED Visits by Disposition Status, High Urgency and Low Urgency ED visits by Age group, ED Visits by Hospital and LHIN of Visit, Growth in ED visits, Reason for ED Visits

38 Key Highlights – Health Service Use – Emergency Department Utilization • In FY 2014/15, there were approximately of 97,275 ED visits by West Toronto residents. The majority (82.7%) of visits were discharged home after they presented to the ED, and 11% were admitted to an inpatient unit. Majority of visits by West Toronto residents were to St Josephs Health Centre (51%) followed by Trillium Queensway(10%). Residents who visited hospitals outside of Toronto Central LHIN went to Mississauga Halton LHIN (13.8%); Central LHIN (9.5%) and Central West LHIN (1.4%).

• Overall, age standardized rate of ED visits per 1,000 population (All Ages 0+, Both Sexes) for West Toronto (409.8/1,000) was above the Toronto Central LHIN rate (353/1,000). Only Runnymede-Bloor West Village and Kingsway South neighbourhoods are below the Toronto Central LHIN rate for ED visits. For high urgency visits, Mount Dennis and South Parkdale had high rates. For low urgency visits, New Toronto, Mimico and Stonegate Queensway had the highest rates.

• All of the neighbourhoods except Mount Dennis in West Toronto are above the Toronto Central LHIN rate of 92.4 for age standardized low urgency visits. High rates of urgent ED visits are noted in South Parkdale, Mount Dennis, Roncesvalles among the following age groups : 45-64, 65-74 age groups. For 75+, South Parkdale, Junction Area and Roncesvalles have notably high rates of urgent ED visits.

• The majority of the neighbourhoods in West Toronto are above the Toronto Central LHIN rate of 260.7/1,000 for age standardized high urgency visits. High rates of urgent ED visits are noted in South Parkdale, Mount Dennis, Roncesvalles among the following age groups : 45-64, 65-74 age groups. For 75+, South Parkdale, Junction Area and Roncesvalles have notably high rates of urgent ED visits.

• ED visit volumes from FY 2010/11 to FY 2014/15 for Toronto Central LHIN rose by 9.8%. Neighbourhoods that have experienced high increases in ED visit volumes during this period include Mount Dennis (21.7%), Mimico (14.6%) and Edenbridge Humber Valley (11.6%) and Stonegate-Queensway (11.2%)

• Nearly half of the visits (43.8%) were for injuries/poisonings or abnormal signs and symptoms. 39 • Women (417/1,000) had a higher rate of ED visits than men (401/1,000) West Toronto: Emergency Visits by Neighbourhood (FY 2014/15)

Age-Standardized Rate of ED Visits for Populations Ages 0+ in West Toronto Sub-Region Neighbourhoods (2014/15) West Toronto age- 600 standardized rate of ED

500 visits per 1,000 population

Toronto Central LHIN Rate: 353.1 400 409.8/1,000 (Toronto Central LHIN ED Visit

300 rate: 353.1) 1,000 1,000 Population

Per Per 200

Rate 100 Only Runnymede-Bloor West 0 Village and Kingsway South neighbourhoods are below the Toronto Central LHIN rate for ED visits.

40 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Overall ED Visit Rates Per 1,000 Population, by Age group (2014/15)

All Ages Neighbourhood Name (Age Age 0-4 Age 5-19 Age 20-44 Age 45-64 Age 65-74 Age 75+ standardized) Edenbridge-Humber Valley 362.6 559.6 289.6 347.5 313.8 355.4 803.3 High Park North 380 566.4 333.9 302 357.8 551 903.8 High Park-Swansea 395.3 531.2 392.4 353.7 336.2 460.8 771.3 Junction Area 414.6 539.4 313 367.2 435.7 478.9 959 Kingsway South 300.1 369.9 309.7 278.8 216.3 326.6 678.7 Lambton Baby Point 367.3 564.1 318.3 357.1 280.1 546.8 542.5 Mimico 448.4 697.3 416.5 384.2 409 560.5 868.7 Mount Dennis 476 766.5 302.9 469 491.6 555.4 778.9 New Toronto 431.5 686.7 322 404.2 418.1 562.3 721.1 Rockcliffe-Smythe 431.5 607 302.3 445.3 408.5 488.2 684 Roncesvalles 428.2 460.8 345.8 354.8 461.4 657.8 935.5 Runnymede-Bloor West Village 346.6 507.5 339.9 299.4 264.1 464.2 780.2 South Parkdale 490.4 617.3 302 387.4 671.6 713.1 1012.3 Stonegate-Queensway 399.2 653.8 382.5 366.3 322.4 458.8 698.4 West Toronto 409.8 590.5 336.4 369.5 394.2 513.6 794.2 Toronto Central LHIN 353.1 517.7 276.8 305.3 350.1 480.2 749.4

41 Source: Ontario Community Health Profiles Partnership, Extracted: 2016 West Toronto: Percent of ED Visits by Disposition Status (FY 2014/15)

Proportion of ED Visits by Disposition Status for West Toronto Residents (FY 2014/15) 1.30% 0.90% 0.30%

3% Discharged Home

11.90% Client Admitted

Client Left without being seen

Discharged to place of Residence

Transferred to another Hospital

Intrafacility transfer to 82.70% clinic

42 Source: National Ambulatory Care Reporting System (NACRS), FY2014/15, MOHLTC, IntelliHealth (Extracted: 2016) West Toronto: All Emergency Department (ED) Visits That Are High Urgency (2014/15)

Age Standardized Rate of High Urgency ED Visits for Ages Rate of ED Visits That Are High Urgency for Ages 0-4 in 0+ in West Toronto Sub-Region Neighbourhoods (2014/15) West Toronto Sub-Region Neighbourhoods (2014/15)

1000 1000 900 900 800 800 700 700 559 600 600 474.3 469.8 500 500 430.8 426.4 401 400.9 388.1 371 372.6 371.7 361.9 361.3 338.4 318.8 346.4 333.3 400 304.3 303 281.7 279.6 276.5 400

260.2 256.3 250.6 245.7 232.3 1,000 Population 1,000 1,000 Population 1,000 300 188.5 300 200 200 Toronto Central LHIN Rate: 344.3

Toronto Central LHIN Rate: 260.7 Per Per Per Per 100 100

0 0

Rate Rate Rate Rate

Rate of ED Visits That Are High Urgency for Ages 5-19 in Rate of ED Visits That Are High Urgency for Ages 20-44 in West Toronto Sub-Region Neighbourhoods (2014/15) West Toronto Sub-Region Neighbourhoods (2014/15)

1000 1000 900 900 800 800 700 700 600 600 500 500 383 400 400 347.2 282.9 257.6 253.4 251.1 248.5 246.1 235.6 227.2 220.8 218.4 217.3 212.4 246.7 244 243.6 228.4 212.9 207.8 1,000 Population 1,000 300 207.2 300 202.9 202.4 197.2 Population 1,000 176.4 154.6 177.8 200 148.2 200

Per Per Toronto Central LHIN Rate: 221.4 100 Toronto Central LHIN Rate: 170.8 Per 100

0 0

Rate Rate Rate Rate

43 Source: Ontario Community Health Profiles Partnership, Extracted: 2016 West Toronto: All Emergency Department (ED) Visits That Are High Urgency (2014/15)

Rate of ED Visits That Are High Urgency for Ages 45-64 in Rate of ED Visits That Are High Urgency for Ages 65-74 in West Toronto Sub-Region Neighbourhoods (2014/15) West Toronto Sub-Region Neighbourhoods (2014/15)

1000 1000 900 900 800 800 700 700 607.2 600 522.2 600 546.8 475.9 446.6 443.4 500 412.2 500 436.4 434 421.3 404.1 356.1 328.4 328 356.6 353.1 349.1 400 287.5 282.7 264.8 400 289.2 246.9 223.6 214.8 Toronto Central LHIN Rate: 399.0 236.7 300 199.6 183.1 Population 1,000 300 137.8 200 Toronto Central LHIN Rate: 270.1 200 100 Per 100

0 0

Rate Rate Rate Per 1,000 Population 1,000 Per Rate

Seniors 75+ have the highest rate of high urgency ED visits followed by Rate of ED Visits That Are High Urgency for Ages 75+ in children aged 0-4. There is considerable variation by age among the West Toronto Sub-Region Neighbourhoods (2014/15)

neighbourhoods. 1000 914.9 858.1 900 814.5 804.6 800 727.7 714.3 697 679.3 662.3 613.5 Mimico, Mount Dennis, High Park Swansea have high rates of high 700 584.5 569.6 600 553 urgency ED visits for 0-19 age group. 500 Toronto Central LHIN Rate: 669.6 455.2 For 20-44, high rates of urgent ED visits are noted in Mount Dennis and 400

1,000 Population 1,000 300 Rockcliffe Smythe. 200

Per Per 100 0

For 45-74, South Parkdale, Mount Dennis and Roncesvalles have high Rate rates of ED visits.

For 75+, South Parkdale, Junction Area and Roncesvalles have high rates of ED visits .

Source: Ontario Community Health Profiles Partnership, Extracted: 2016 44 West Toronto: All Emergency Department (ED) Visits That Are Low Urgency (2014/15)

Age-Standardized Rate of ED Visits That Are Low Rate of ED Visits That Are Low Urgency for Ages 0-4 in Urgency in West Toronto Sub-Region Neighbourhoods West Toronto Sub-Region Neighbourhoods (2014/15) (2014/15) 250 227.5 226.3 222.9 216.3 212.4 207.5 250 191.5 200 180.6 178.1 Toronto Central LHIN Rate: 173.3 165.5 200 159.5 145.6 137.6 149.8 145.3 142.9 150 114.4 150 119.4 115.7 112 111.6 110.3 109.4 107.2 103.5 100.9 93.1 87.9

100 Toronto Central LHIN Rate: 92.4 100 1,000 Population 1,000

50 50

1,000 Population 1,000 Per Per 0

Per Per 0

Rate Rate Rate Rate

Rate of ED Visits That Are Low Urgency for Ages 5-19 in Rate of ED Visits That Are Low Urgency for Ages 20-44 in West Toronto Sub-Region Neighbourhoods (2014/15) West Toronto Sub-Region Neighbourhoods (2014/15)

250 250

200 180.9 180.2 200 161.6 155.7 146.3 145.6 138 133 135.1 126.7 150 150 124.9 121.5 110.3 109.7 109.7 Toronto Central LHIN Rate: 106.1 110 105.9 104.8 104.4 103.9 101.4 101 98.1 Toronto Central LHIN Rate: 83.9 91.6 89.1 85.9

100 84.9 75.7 100 1,000 Population 1,000

1,000 Population 1,000 50 50

Per Per Per Per

0 0

Rate Rate Rate Rate

45 Source: Ontario Community Health Profiles Partnership, Extracted: 2016 West Toronto: All Emergency Department (ED) Visits That Are Low Urgency (2014/15)

Rate of ED Visits That Are Low Urgency for Ages 45-64 in Rate of ED Visits That Are Low Urgency for Ages 65-74 in West Toronto Sub-Region Neighbourhoods (2014/15) West Toronto Sub-Region Neighbourhoods (2014/15)

250 250

200 200 149.4 150 135.4 150 126 121.5 117.1 115.1 107.5 107.3 105.2 112.8 111 106 105.6 104.4 104.2 93 90.2 89.3 89.9 81.1 80.6 80.5 79.4 78.4 79.5

100 100 74.8 66.9 66.2 1,000 Population 1,000

50 Toronto Central LHIN Rate: 80.0 Population 1,000 50 Toronto Central LHIN Rate: 81.2

Per Per Per

0 0

Rate Rate Rate

Children aged 0-4 have the highest rates of low urgency ED visits followed Rate of ED Visits That Are Low Urgency for Ages 75+ in by 5-19 age group. West Toronto Sub-Region Neighbourhoods (2014/15)

250 Mimico, Stonegate Queensway, Edenbridge Humber Valley have high rates of low urgency ED visits for 0-19 age group. 200 141 136.6 150 128.8 125.7 121.1 For 20-44, New Toronto, Stonegate Queensway and Mimico have high rates 108.9 106.3 100.9 100.9 99.2 97.4 100 87.4 of ED visits 70.6 64.7

1,000 Population 1,000 50 Toronto Central LHIN Rate: 79.8 Per Per High rates of low urgency ED visits are noted in South Parkdale, New 0

Toronto and Mimico among the 45-74 age category. Rate

For the 75+ age category, Mimico, New Toronto and Stonegate Queensway have high rates of ED visits.

Source: Ontario Community Health Profiles Partnership, Extracted: 2016 46 West Toronto: Emergency Department Visits by Hospital and LHIN of Visit (FY 2014/15)

Trillium - UHN - TGH Humber - Mississauga 3% York/Finch 3% 1% # of ED % of Total Hospital for LHIN of Hospital Visit Visits ED Visits Sick Children All Others TORONTO CENTRAL 70,366 72.3% 3% 8% MISSISSAUGA HALTON 13,285 13.7% St. CENTRAL 9,254 9.5% Michael's Hospital CENTRAL WEST 1,400 1.4% 3% NORTH SIMCOE MUSKOKA 727 0.7% St. Joseph’s CENTRAL EAST 697 0.7% Health Mount SOUTH WEST 395 0.4% Centre Sinai 51% HAMILTON NIAGARA HALDIMAND BRANT (HNHB) 332 0.3% Hospita CHAMPLAIN 221 0.2% l 4% NORTH-EAST 191 0.2% Humber - SOUTH EAST 170 0.2% UHN - Memorial WATERLOO WELLINGTON 148 0.2% Western 8% Trillium - 6% Queensway ERIE ST. CLAIR 57 0.1% 10% NORTH-WEST 32 0.0% Grand Total 97,275 100.0%

47 Source: National Ambulatory Care Reporting System (NACRS), MOHLTC, IntelliHealth (Extracted: 2016) West Toronto: Emergency Department Visit Rates (FY 2014/15)

Age-Standardized rate of ED visits per 1,000 population, All Ages 500

450 417.0 401.5 409.8 400 354.6 351.7 353.1 350 300 250

200

150 Rate per 1,000 Populationper 1,000Rate 100 50 0 Male Female Both sexes West Toronto Toronto Central LHIN

Age standardized rates of ED visits for all ages in West Toronto is above the Toronto Central LHIN average for both Males and Females Women have a higher rate of ED visits than Men 48 Source: Ontario Community Health Profiles Partnership, Extracted: 2016 West Toronto: Percent Change in ED Visit Volumes from FY 2010/11 to FY 2014/15

25.0% Toronto Central LHIN % 21.7% Change in ED Visit Volumes 20.0% since FY 2010/11

14.6% 15.0% Toronto Central LHIN Rate: 9.6% 11.2% 11.6% 10.1% 10.0% 8.5% 9.6% 5.7% 5.9% 4.5% 5.0% 1.9% 0.0% Neighbourhoods that have 0.0% experienced significantly high -1.1% -0.8% -2.1% increases in ED visit volumes -5.0% since FY 2010/11: • Mount Dennis • Mimico • Edenbridge-Humber Valley • Stonegate-Queensway

49 Source: National Ambulatory Care Reporting System (NACRS), MOHLTC, IntelliHealth (Extracted: 2016) West Toronto Reason for Emergency Department Visits (FY 2014/15)

Percent of ED visits by Reason of Visit (FY 2014/15) Number of ED Visits in 25.0% 23.4% 2014/15 in West Toronto 20.4% 20.0%

15.0% 97,275

10.0% 8.8% (23.5% of total for Toronto

% of Total ED ED Visits Total % of 6.3% 5.2%5.3%5.3%5.3% Central LHIN residents) 4.2% 5.0% 3.6%3.7% 1.4%1.6%1.6%1.8% 0.1%0.4%0.5%1.0% 0.0%

Nearly half (43.8%) of ED Visits in West Toronto sub-region are for injuries/poisonings or abnormal signs and symptoms

50 Source: National Ambulatory Care Reporting System (NACRS), MOHLTC, IntelliHealth (Extracted: 2016) 4b) Use of Inpatient Services All hospitalizations, medical, surgical, prenatal, mental health, ambulatory care sensitive conditions (ACSC), alternate level of care (ALC)

51 Key Highlights – Health Service Use: Inpatient Utilization

. In 2011/12, there were a total of 37,525 hospitalizations by West Toronto residents.

. Overall there was wide variation in all hospitalizations among the West Toronto neighbourhoods ranging from 64.3/1,000 to 91.6/1,000. A significant number of neighbourhoods were above the Toronto Central LHIN rate for all hospitalizations. The neighbourhoods with the highest rate of hospitalizations include: New Toronto (91.6), South Parkdale (90.2), Mount Dennis (87.8).

. For Medical Conditions: . Most neighbourhoods were above the Toronto Central LHIN rate (14/1,000) for medical conditions. The neighbourhoods with the highest rate of hospitalizations include: South Parkdale (23.8), Roncesvalles (18.4), Junction Area (18.4), New Toronto (18.3), Mount Dennis (18).

. For Surgical Conditions: . Most neighbourhoods were above the Toronto Central LHIN rate (7.9/1,000) for surgical conditions. The neighbourhoods with the highest rate of hospitalizations include: Lambton Baby Point (9.4), Kingsway South (9.2) and High Park North (9.1). . For Pre-natal Conditions: . All neighbourhoods apart from Edenbridge-Humber Valley were above the Toronto Central LHIN rate (17.1/1,000) for pre-natal conditions. The neighbourhoods with the highest rate of hospitalizations include: Runnymede-Bloor West Village (29.6), Lambton Baby Point (28.6), and Mount Dennis (28.2). . For Mental Health Conditions: . Most neighbourhoods are below the Toronto Central LHIN rate (722/100,000)for mental health conditions. South Parkdale’s rate (2,237.3) is extremely high as compared to the other neighbourhoods as well as the Toronto Central LHIN rate. . For Ambulatory Care Sensitive Conditions: . Majority of the neighbourhoods in West Toronto sub-region are above the Toronto Central LHIN rate of 284.4/100,000 The neighbourhoods with the highest rate of hospitalizations for ambulatory care sensitive conditions are: South Parkdale (608.1), Roncesvalles (498.7), New Toronto (492.3). . For % ALC Days: . Neighbourhoods with highest % ALC Days: High Park Swansea (19.6), High Park North (18.7), South Parkdale (18.5), Mimico (18.3).For all neighbourhoods, Seniors have the highest rates of % ALC Days. 52 West Toronto: Inpatient Service Use Summary by Neighbourhood

Percent of Hospital Days that Neighbourhood Age-adjusted average annual rate of hospitalizations are ALC Ambulatory All Medical Surgical Pre-Natal Mental Health % ALC Days % ALC Neighbourhood Care Sensitive Hospitalizations Conditions Conditions Conditions Conditions (All Ages) Days(65+) Conditions Edenbridge-Humber Valley 65.7 13.2 7.6 16.2 442.1 238 15.1 19.2 High Park North 71.4 16.2 9.1 18.1 758.4 319.7 18.7 25.8 High Park-Swansea 73.8 15.1 8.5 17.8 586.5 141 19.6 26.1 Junction Area 69 18.4 8.5 24.7 826.5 305.6 12.9 19.6 Kingsway South 64.3 9.3 9.2 19.1 419.1 106.8 15.7 20.2 Lambton Baby Point 69 15.6 9.4 28.6 556.7 223 14.3 19.9 Mimico 67.8 16.4 8.6 23.5 596.9 337.3 18.3 25.8 Mount Dennis 87.8 18 8.1 28.2 837.8 337.8 14.2 20.4 New Toronto 91.6 18.3 8.3 22.3 660.7 492.3 14.2 18.6 Rockcliffe-Smythe 83.4 15.3 8.5 26.9 685.6 338.1 15 22.5 Roncesvalles 79.8 18.4 8.3 22.7 867.6 498.7 14.2 19.7 Runnymede-Bloor West Village 84 13.2 8 29.6 637.6 146.4 12.7 21.5 South Parkdale 90.2 23.8 7.6 19.2 2,237.3 608.1 18.5 24.9 Stonegate-Queensway 76.4 13.4 8.4 25.5 373.2 211.2 17 22.8 Toronto Central LHIN 72.1 14 7.9 17.1 722 284.4 14.0 19.7

53 Source: Ontario Community Health Profiles Partnership, Extracted: 2016 West Toronto: Hospital Admissions: All Hospitalizations by Neighbourhood (2011-12)

Age-adjusted average annual rate of all hospitalizations per 1,000 Rate of Hospitalizations in population, All Ages (2011-12) Toronto Central LHIN (per 1,000): 100.0 90.2 91.6 87.8 90.0 83.4 84.0 79.8 76.4 80.0 73.8 71.4 Toronto Central LHIN Rate: 72.1 69.0 69.0 72.1 67.8 70.0 64.3 65.7 60.0 50.0 A significant number of 40.0 neighbourhoods are above the Toronto Central LHIN rate. 30.0

Rate per 1,000 Populationper 1,000Rate 20.0 The neighbourhoods with the 10.0 highest rate of hospitalizations 0.0 include: • New Toronto (91.6) • South Parkdale (90.2) • Mount Dennis (87.8)

54 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Hospital Admissions: Hospitalizations for Medical Conditions by Neighbourhood (2011-12) Rate of Hospitalizations for Age-adjusted average annual rate of hospitalizations for medical Medical Conditions in Toronto conditions per 1,000 population, All Ages (2011-12) Central LHIN (per 1,000): 25.0 23.8

20.0 18 18.3 18.4 18.4 14.0 16.2 16.4 15.1 15.3 15.6 15.0 Toronto Central LHIN Rate: 14.0 13.2 13.2 13.4 Most neighbourhoods are above

10.0 9.3 the Toronto Central LHIN rate.

The neighbourhoods with the Rate per 1,000 Populationper 1,000Rate 5.0 highest rate of hospitalizations include: • South Parkdale (23.8) 0.0 • Roncesvalles (18.4) • Junction Area (18.4) • New Toronto (18.3) • Mount Dennis (18)

55 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Hospitalizations for Surgical Conditions (2011-12)

Rate of Hospitalizations for Age-adjusted average annual rate of hospitalizations for surgical Surgical Conditions for conditions per 1,000 population, All Ages (2011-12) Toronto Central LHIN (per 10.0 9.4 9.1 9.2 1,000): 9.0 8.4 8.5 8.5 8.5 8.6 8.1 8.3 8.3 8 Toronto Central LHIN Rate: 7.9 8.0 7.6 7.6 7.0 6.0 7.9 5.0 4.0 3.0 Most neighbourhoods are above 2.0 the Toronto Central LHIN rate.

Rate per 1,000 Populationper 1,000Rate 1.0 0.0 The neighbourhoods with the highest rate of hospitalizations include: Lambton Baby Point (9.4) • Kingsway South (9.2) • High Park North (9.1)

56 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Hospitalizations for Prenatal Conditions, Women, Ages 15-49 (2011-2012)

Age-adjusted average annual rate of hospitalizations for prenatal conditions per 1,000 population (2011-2012) Rate of Hospitalizations for Prenatal Conditions for Toronto 35.0 Central LHIN (per 1,000): 29.6 30.0 28.2 28.6 26.9 24.7 25.5 23.5 25.0 22.3 22.7 19.1 19.2 17.1 20.0 17.8 18.1 16.2 Toronto Central LHIN Rate: 17.1 15.0

10.0 All neighbourhoods apart from

5.0 Edenbridge-Humber Valley are above

Rate per 1,000 Population 1,000 per Rate the Toronto Central LHIN rate. 0.0 The neighbourhoods with the highest rate of hospitalizations include: • Runnymede-Bloor West Village (29.6) • Lambton Baby Point (28.6), and • Mount Dennis (28.2).

Prenatal Condition: Prenatal hospitalizations refer to pregnancy related hospitalizations before childbirth 57 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Hospitalizations for Mental Health Conditions, Ages 20+ (2012/13– 2013/14)

Age-standardized average annual rate of hospitalizations for Rate of Hospitalizations for mental health conditions per 100,000 population (2012/13 and Mental Health Conditions in 2013/14) 2,500.0 Toronto Central LHIN (per 2237.3 100,000): 2,000.0 722.0

1,500.0 Population

1,000.0 826.5 837.8 867.6 Toronto Central LHIN Rate: 722..0 758.4 100,000 637.6 660.7 685.6 556.7 586.5 596.9 Most neighbourhoods are below 442.1

500.0 373.2 419.1 the Toronto Central LHIN rate. Rate per Rate South Parkdale’s rate (2,237.3) 0.0 is extremely high as compared to the other neighbourhoods as well as the Toronto Central LHIN rate.

58 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Hospitalizations for Ambulatory Care Sensitive Conditions, Ages 20-74 (2012/13 and 2013/14)

Age-standardized average annual rate of hospitalizations for Total Rate of Hospitalization ambulatory care sensitive conditions per 100,000 population (2012/13 and 2013/14) for ACSC for Toronto Central 700.0 LHIN (per 100,000): 608.1 600.0

492.3 498.7 500.0 284.4 400.0

Population 337.3 337.8 338.1 305.6 319.7 300.0 Toronto Central LHIN Rate: 284.4 223 238

100,000 211.2 The neighbourhoods with highest 200.0 141 146.4 rate of hospitalizations for 106.8 ambulatory care sensitive Rate per Rate 100.0 conditions are:

0.0 • South Parkdale (608.1) • Roncesvalles (498.7 • New Toronto (492.3)

59 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Percent of Hospital Days that are Alternate Level of Care (ALC), All Ages (2011-12)

Percent of hospital days that are ALC, All Ages (2011-12) 25.0 Percent (%) ALC Days in Toronto Central LHIN

19.6 (2011/12): 20.0 18.3 18.5 18.7 17.0 15.7 15.0 15.1 14.2 14.2 14.2 14.3 15.0 Toronto Central LHIN Rate: 14% 12.7 12.9 14.0%

10.0 % ALC Days in Hospital Days in ALC % 5.0 Neighbourhoods with highest % ALC Days:

0.0 • High Park Swansea (19.6%) • High Park North (18.7%) • South Parkdale (18.5%) • Mimico (18.3%)

60 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Percent of Hospital Days that are Alternate Level of Care (ALC), Age 65+ (2011-12)

Percent of hospital days that are ALC, Age 65+ (2011-12) Percent (%) ALC Days in 30.0 Toronto Central LHIN 25.8 25.8 26.1 24.9 (2011/12) for residents above 25.0 22.5 22.8 age 65: 21.5 20.4 19.6 19.7 19.9 20.2 Toronto Central LHIN Rate: 19.7% 20.0 19.2 18.6

15.0 19.7%

10.0 % ALC Days in Hospital in Days ALC % Neighbourhoods with highest 5.0 % ALC Days for Seniors :

0.0 • High Park Swansea (26.1%) • High Park North (25.8%) • Mimico (25.8%) • South Parkdale (24.9%)

61 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 4c) Community Health Service Use from Community Business Intelligence (CBI) Data i. Community-based Addictions Treatment-Substance Abuse ii. Community-based Case Management-Mental Health Service use iii. Community-based Meals Delivery

62 Considerations about Community Business Intelligence (CBI) Data

• Community Business Intelligence (CBI) database captures client demographics, admissions, and discharges at the functional centre level from community-based health service providers (HSPs) in the Toronto Central LHIN.

• Currently, implementation is still in progress across the Toronto Central LHIN; therefore, data for some functional centres are incomplete due to pending upgrades to HSP client management systems.

• HSPs that were not uploading to CBI in FY2015-16 have been noted where applicable. These missing data should be considered when interpreting the maps and tables.

• Some client records are missing postal code information and Toronto Central LHIN residents who access services from providers based in other LHINs are not recorded; therefore, overall service utilization, especially in neighbourhoods along the Toronto Central LHIN boundaries, is inherently undercounted and should be regarded as a minimum value.

• Finally, a small number of health service providers with funding from multiple LHINs may combine data from service locations outside of the Toronto Central LHIN when programs from multiple funders share the same functional centre.

63 Key Highlights: Community Health Service Use in West Toronto

Addiction Treatment – Substance Abuse • The West and Mid-West Toronto Sub-Regions have the highest volume and utilization rates for Addictions Treatment-SA services. • Roncesvalles has the highest volume in the West Toronto Sub-Region and the Toronto Central LHIN. This may be driven by postal codes recorded at Breakaway Addictions Services which is based in this neighbourhood.

Case Management – Mental Health • Overall, the number of clients is significantly correlated with the number of service providers (r = 0.97, p < 0.01) which suggests a strong relationship between proximity and service utilization. • Most sub-regions except for West Toronto have higher utilization in neighbourhoods along subway lines. Volumes in the West Toronto Sub-Region appears to be highest in and around the sub-region’s three neighbourhood improvement areas (Mount Dennis, South Parkdale and Rockcliffe Smythe). • South Parkdale has the highest volume and rates in the West Toronto Sub-Region.

Meals on Wheels • Most Meals on Wheels catchment areas span multiple sub-regions. • Service utilization is more uniform across neighbourhoods compared to other functional centres. • Due to missing data in three out of the five sub-regions, service patterns cannot be assessed with confidence. 64 West Toronto: Addictions Treatment-Substance Abuse Utilization in 2015-16 Clients Served by Sub-Region of Residence West Toronto 326 28% Mid-West Toronto 423 36% North Toronto 87 7% Mid-East Toronto 154 13% East Toronto 177 15% Toronto Central LHIN 1,167 100%

Outside of Toronto Central 1,239 LHIN No Postal Code 284 Total Clients 2,690

How to read the map:

The size of the circles represents the count of active clients per neighbourhood within the Toronto Central LHIN.

The colour gradation represents the rate of addictions treatment-substance abuse utilization per 10,000 adults (over 16 years old) in each neighbourhood for the West Toronto sub region .

The neighbourhoods with the largest circles have the highest number of people Roncesvalles has the highest volume in the West Toronto Sub-Region for Addictions Treatment- using the service and the neighbourhoods with the darkest shading have the Substance Abuse services. highest proportion of people utilizing the service relative to the overall population Breakaway Addictions Services and Jean Tweed Centre are the providers based in West Toronto delivering Addictions Treatment-Substance Abuse services 65 West Toronto: Addictions Treatment-Substance Abuse Health Service Providers that serve West Toronto residents in 2015-16

HSPs based in HSPs based in West Toronto Sub-Region other Sub-Regions • Breakaway Addiction Services* • University Health Network (Mid-West) • Jean Tweed Treatment Centre* • Hospital for Sick Children (Mid-West) • Centre for Addiction and Mental Health (Mid- West) • 416 Community Support for Women (Mid-East) • Pine River Institute (Mid-East) • St. Stephen's Community House (Mid-West) • Salvation Army Homestead- Harbour Light Centre (Mid-East) *denotes highest volume HSPs that serve >50% of all clients in Sub-Region

66 West Toronto: Case Management-Mental Health in 2015-16 Clients Served by Sub-Region of Residence West Toronto 415 22%

Mid-West Toronto 529 28%

North Toronto 104 5%

Mid-East Toronto 536 28%

East Toronto 318 17%

Toronto Central LHIN 1,902 100%

Outside of Toronto 956 Central LHIN No Postal Code 2,126

Total Clients 4,984

How to read the map:

The size of the circles represents the count of active clients per neighbourhood within the Toronto Central LHIN.

The colour gradation represents the rate of case management-mental health utilization per 10,000 adults (over 16 years old) in each neighbourhood for the West Toronto sub region.

The neighbourhoods with the largest circles have the highest number of people Volume in the West Toronto Sub-Region appears to be highest in and around the sub-region’s three neighbourhood using the service and the neighbourhoods with the darkest shading have the improvement areas (Mount Dennis, South Parkdale and Rockcliffe Smythe). highest proportion of people utilizing the service relative to the overall population South Parkdale has the highest volume and rates in the West Toronto Sub-Region. 67 West Toronto: Case Management-Mental Health Service Providers that serve West Toronto residents in 2015-16

HSPs based in HSPs based in West Toronto Sub-Region other Sub-Regions • Reconnect Community Health Services* • Fred Victor Centre (Mid-East) • Regeneration House Inc.* • LOFT Community Services (Mid-East) • Parkdale Activity - Recreation Centre • Cota Health (Mid-East) • Jean Tweed Treatment Centre • Central Toronto Youth Services - New Outlook (Mid-East) • Native Canadian Centre of Toronto (Mid-West) • Sistering - A Woman's Place (Mid-West) • 416 Community Support for Women (Mid-East) • Street Health Community Nursing Foundation (Mid-East) • Alternatives (East) • West Neighbourhood House (Mid-West)

*denotes highest volume HSPs that serve >50% of all clients in Sub-Region

HSPs not uploading to CBI (Sub-Region name, clients budgeted for FY2015-16): Centre for Addiction and Mental Health (Mid-West, 233 clients) Michael Garron Hospital (East, 160 clients) St. Joseph’s Health Centre (West, 75 clients) St. Michael’s Hospital (Mid-East, 275 clients)

68 Meals on Wheels Methodological Notes

• Meals on Wheels service is delivered based on specific catchment areas • For the purposes of comparing service rates with the population of seniors, individuals under 65 years old, or 15% of the sample size, have been excluded from this analysis. In addition, a small number of HSPs delivering meals were not uploading data to CBI as of the extraction date. These were: • Canadian Red Cross Society, Ontario Zone • Meals on Wheels (East) • Yorkminster Park Meals on Wheels

• Meals Delivery services are largely structured on a non-overlapping catchment basis. Areas covered by HSPs that were not uploading to CBI are indicated as “No Primary HSP Data" on the maps. Because of these geographical gaps in the data, service volume totals have not been calculated for each sub-region (see next slide).

69 West Toronto: Meals on Wheels Catchment Areas in 2015-16

70 West Toronto: Meals on Wheels Utilization in 2015-16

Because non-Toronto Central LHIN providers are not currently uploading to CBI, utilization patterns for this sub-region could not be assessed.

How to read the map:

The size of the circles represents the count of active clients per neighbourhood within the Toronto Central LHIN.

The colour gradation represents the rate of Meals on Wheels utilization per 10,000 adults (over 16 years old) in each neighbourhood for the West Toronto sub region.

The neighbourhoods with the largest circles have the highest number of people using the service and the neighbourhoods with the darkest shading have the highest proportion of people utilizing the service relative to the overall population 71 Section 5: Primary Care and Prevention

A. Primary Care Enrollment and Continuity of Care

B. Cancer prevention - Mammograms, Pap Smears, Colorectal Cancer screening rates

72 5a) Primary Care Access, Enrollment and Continuity of Care

73 Key Highlights - Primary Care Enrollment, Continuity and Prevention Primary Care Enrollment and Continuity of Care

• % of Enrolled Population with Low Continuity in West Toronto sub-region (25.9%) is lower compared to Toronto Central LHIN (26.1%).

• Neighbourhoods with the lowest levels of continuity include; Rockcliffe-Smythe (24.8%), Mount Dennis (24.6%), New Toronto (24.3%) and Mimico (22.9%).

Prevention

• Overall, there is considerable variation in cancer screening rates across West Toronto neighbourhoods. South Parkdale, New Toronto and Rockcliffe-Smythe residents have particularly low levels of cancer. screenings.

• More than half of neighbourhoods in West Toronto sub-region are below the Toronto Central LHIN average rate of mammograms (59%). Screening levels are particularly low in New Toronto, Roncesvalles, and South Parkdale

• Most neighbourhoods are above the Toronto Central LHIN rate of Pap-Smears (53.8%). Neighbourhoods with particularly low screening rates include South Parkdale, Rockcliffe-Smythe and Mount Dennis.

• Most neighbourhoods are below the Toronto Central LHIN rate of colorectal cancer screenings (60.8%). Neighbourhoods with particularly low screening rates include South Parkdale and New Toronto.

• Most neighbourhoods are below the Toronto Central LHIN rate of colonoscopies (41.9%). Neighbourhoods with particularly low screening rates (<30%) include South Parkdale, Mount Dennis and Rockliffe-Smythe.

• Most neighbourhoods are below the Toronto Central LHIN rate of FOBT screenings (31.3%). Lowest performing neighbourhoods include New Toronto, Mimico, and Lambton Baby Point. 74 West Toronto: Low Continuity Amongst Population Enrolled to a PEM/CHC (Both Sexes, Ages 19+) (2011-2013) • Population Enrolled: rostered with a Patient Enrolment Model (PEM) or registered with a Community Health Centre (CHC). • Measurement of Continuity is limited to those with at least 3 primary visits in the previous 2 years. % Low Continuity Amongst Population 19+ Enrolled with at Least 3 Visits in the Previous 2 Years (Both sexes) 35.0 29.3 30.0 25.9 26.8 26.1 24.5 25.0 23.4

20.0

15.0

10.0

5.0 % Enrolled Population with Low Continuity with Low Population % Enrolled 0.0 West Toronto Mid-West North Toronto Mid-East East Toronto Toronto Toronto Toronto Central LHIN

75 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Low Continuity Among Total Population (Enrolled and Not Enrolled) Ages 19+ (2011-2013)

% Low Continuity Amongst Enrolled & Non-Enrolled, Both sexes, Ages 19+ 30.0 % Low Continuity amongst total population in Toronto 24.6 24.8 25.0 24.3 Toronto Central LHIN Rate: 21.3% 22.9 Central LHIN (Both Sexes, 22.1 20.3 20.5 20.5 20.7 21.0 Age 19+) 19.6 19.9 19.9 20.0 17.6 15.0 21.3%

10.0 % with Low Continuity Low% with 5.0 Neighbourhoods with the lowest levels of continuity include: 0.0 • Rockcliffe-Smythe • Mount Dennis • New Toronto • Mimico

76 5b) Prevention Mammograms, Pap Smears, Colorectal Cancer Screening

77 West Toronto: Cancer Screening Summary by Neighbourhood

% Screened Age standardized Any Colorectal Cancer Colonoscopy FOBT (Men and Women, Mammograms Pap Smears Screening (Men and Women, Aged 50-74) (FY 2013/14- Neighbourhood (Women Aged 50-69) (Women Aged 21-69) (Men and Women Aged 50-74) 14/15) (FY 2013/14-14/15) (FY 2012/13 to 14/15) Aged 50-74)Screening (FY 2005/06-14/15) (2015) Edenbridge-Humber Valley 62.9 57.9 65.3 50.0 29.2 Kingsway South 68.6 60.0 72.7 57.6 34.9 Stonegate-Queensway 61.2 60.3 62.2 44.1 31.2 Mimico 57.1 55.3 56.4 38.6 27.7 New Toronto 52.7 53.9 51.2 32.4 26.5 South Parkdale 49.5 50.0 48.9 24.2 30.3 Roncesvalles 52.4 54.8 53.7 32.6 30.0 High Park-Swansea 58.8 58.4 62.6 45.2 30.5 High Park North 54.4 55.4 59.6 40.5 30.6 Runnymede-Bloor West Village 63.9 62.4 64.2 45.0 33.7 Junction Area 54.0 54.5 55.1 33.7 30.8 Rockcliffe-Smythe 59.9 52.2 53.8 31.6 31.3 Lambton Baby Point 60.8 57.6 62.3 46.7 28.2 Mount Dennis 58.1 52.9 55.5 30.6 35.0 WEST TORONTO 58.0 55.8 58.4 39.0 30.5 Toronto Central LHIN 59.0 53.8 60.8 41.9 31.3

78

Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Mammogram Screening Within Past 2 Years (2013-2015)

Age-adjusted % of total eligible population aged 50-69 having mammograms within the last 2 years (2013-2015) % of Total Eligible Population

80.0 (Age 50-69) in West Toronto 68.6 having a Mammogram within 70.0 63.9 60.8 61.2 62.9 58.1 58.8 59.9 last 2 years 60.0 57.1 52.4 52.7 54 54.4 49.5 Toronto Central LHIN Rate: 59.0% 50.0 58.0% 40.0 Toronto Central LHIN Rate: 59.0%

30.0

Percentage(%) Screened 20.0 Most neighbourhoods are below the 10.0 Toronto Central LHIN average rate 0.0 of mammograms.

Screening levels are particularly low in South Parkdale, Roncesvalles and New Toronto.

79 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Pap Smear Screening Within the Past 3 Years (2012-2015)

Age-adjusted % of total eligible population aged 21-69 having pap smear within the last 3 years (2012-2015) % of Total Eligible Population (Age 21-69) in Toronto Central 70.0 62.4 LHIN having a Pap Smear within 60 60.3 57.6 57.9 58.4 60.0 54.5 54.8 55.3 55.4 last 3 years 52.2 52.9 53.9 Toronto Central LHIN Rate: 53.8% 50 50.0 55.8% 40.0 Toronto Central LHIN Rate: 53.8%

30.0

20.0

Percentage(%) Screened West Toronto rate is higher than the

10.0 Toronto Central LHIN rate.

0.0 The lowest performing neighbourhoods are South Parkdale, Rockcliffe-Smythe and Mount Dennis.

80 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Colorectal Cancer Screening – Any Type (2013-2015)

Age-adjusted % of total eligible population (men and women) aged 50-74 having any colorectal cancer screening (2013-2015) % of Total Eligible Population

80.0 (Age 50-74) in Toronto Central 72.7 LHIN having colorectal 70.0 65.3 62.2 62.3 62.6 64.2 screening in past 3 years 59.6 Toronto Central LHIN Rate: 60.8% 60.0 56.4 53.7 53.8 55.1 55.5 51.2 48.9 50.0 58.4% Toronto Central LHIN: 60.8% 40.0

30.0

PercentageScreened (%) 20.0 West Toronto is below the Toronto 10.0 Central LHIN rate. 0.0 Lowest performance rates are in the South Parkdale and New Toronto neighbourhoods.

81 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Colorectal Cancer Screening – Colonoscopy (2005-2015)

Age-adjusted % of total eligible population (men and women) aged 50-74 having a colonoscopy in the last 10 years % of Total Eligible Population (Age 50-74) in Toronto Central 70.0 LHIN having colonoscopy 60.0 57.6 within past 10 years 50 50.0 46.7 44.1 45 45.2 Toronto Central LHIN Rate: 41.9% 38.6 40.5 39.0% 40.0 32.6 33.7 30.6 31.6 32.4 Toronto Central LHIN: 41.9% 30.0 24.2

PercentageScreened (%) 20.0 West Toronto is below than the 10.0 Toronto Central LHIN rate. 0.0 The lowest performing neighbourhoods include South Parkdale, Mount Dennis and Rockliffe-Smythe.

82 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 West Toronto: Colorectal Cancer Screening – FOBT (2013-2015)

Age-adjusted % of total eligible population (men and women) aged 50-74 having Fecal Occult Blood Testing in the last 2 years (2013-2015) % of Total Eligible Population 40.0 (Age 50-74) in Toronto Central 34.9 35 LHIN having colonoscopy in 35.0 33.7 31.3 30.3 30.5 30.6 30.8 31.2 past 2 years 29.2 30 30.0 27.7 28.2 Toronto Central LHIN Rate: 31.3% 26.5 25.0 30.5% Toronto Central LHIN Rate: 31.3% 20.0

15.0 West Toronto is below than the

PercentageScreened (%) 10.0 Toronto Central LHIN rate. Most neighbourhoods are also below the 5.0 Toronto Central LHIN rate.

0.0 Lowest performing neighbourhoods include New Toronto, Mimico, and Lambton Baby Point.

83 Source: Toronto Community Health Profiles Partnership, Extracted: 2016 APPENDIX A – Additional Information on Population Demographics

84 West Toronto Population Demographics (2011)

Population by Age Group Male Female Total Population

Age 0-4 Ages 75+ Age 10-14 Age 0-4 6,525 6,180 12,705 5.5% Age 5-9 6.8% 4.7% Age 65-74 4.8% 6.9% Age 5-9 5,780 5,475 11,255

Age 15-19 5.0% Age 10-14 5,610 5,370 10,980

Age 15-19 5,835 5,760 11,595 Age 45-64 28.4% Age 20-44 42,675 45,500 88,175 Age 20-44 37.9% Age 45-64 32,205 33,705 65,910

Age 65-74 7,390 8,725 16,115

Ages 75+ 5,965 9,785 15,750

Total Population 111,985 120,500 232,485 85 Source: Census of Canada, Statistics Canada, 2011 West Sub-Region: % of Population that are Children and Youth (Ages 0-19)

% of Total Both Toronto Central LHIN % of Neighbourhood Name Male Female Population sexes Ages 0-19 Population Ages 0-19 Lambton Baby Point 1,090 1,025 2,115 26.7% 18.7% Mount Dennis 1,720 1,670 3,380 25.7% Kingsway South 1,165 1,105 2,260 24.6% Total Toronto Central LHIN Runnymede-Bloor West 1,150 1,170 2,315 24.0% Population Ages 0-19: Village Rockcliffe-Smythe 2,745 2,545 5,270 23.7% 214,800 Stonegate-Queensway 2,685 2,525 5,175 21.0% Edenbridge-Humber Valley 1,600 1,485 3,080 20.6% Roncesvalles 1,550 1,480 3,035 20.1% Most neighbourhoods have a higher than average % of children than the Toronto Junction Area 1,415 1,400 2,820 20.1% Central LHIN population. New Toronto 1,110 1,000 2,090 19.2% High Park-Swansea 2,020 2,090 4,120 19.0% Lambton Baby Point and Mount Dennis have the highest proportion of children of South Parkdale 1,750 1,720 3,480 16.4% neighbourhoods in West Sub-Region. High Park North 1,750 1,710 3,460 16.2% Mimico 2,050 1,895 3,945 14.9% 86 West Sub-Region: % of Population that are Seniors (Ages 65+)

% of Total Toronto Central LHIN % of Neighbourhood Name Male Female Both sexes Population Ages 65+ Population Ages 65+ Edenbridge-Humber Valley 1,185 1,610 2,805 18.8% Kingsway South 710 980 1,705 18.6% 13.1% Stonegate-Queensway 1,690 2,300 3,975 16.1% Total Toronto Central LHIN High Park-Swansea 1,275 2,115 3,390 15.6% Population Ages 65+ Rockcliffe-Smythe 1,375 2,030 3,410 15.3% Mimico 1,760 2,170 3,940 14.8% 151,000 New Toronto 615 860 1,480 13.6% High Park North 1,025 1,525 2,555 12.0% Half of neighbourhoods have a higher Lambton Baby Point 385 525 905 11.4% than average proportion of seniors in their neighbourhoods. Mount Dennis 615 890 1,495 11.4% Runnymede-Bloor West 470 615 1,085 11.3% Edenbridge-Humber Valley and Village Kingsway South have the highest Roncesvalles 760 880 1,625 10.8% proportion of seniors in West Sub- South Parkdale 950 1,280 2,230 10.5% Region. Junction Area 565 740 1,320 9.4% 87 Population Composition by Sub-Region (2011) Red = Highest Value Blue = Lowest Value

Count of Toronto Central West Toronto Mid-West Toronto North Toronto Mid-East Toronto East Toronto Population LHIN Total 0 to 4 years 12,745 12,445 10,955 5,570 17,890 59,605 5 to 14 years 22,220 19,235 21,475 8,695 29,415 101,040 15 to 24 years 25,215 39,655 23,340 17,390 29,850 135,450 25 to 44 years 74,625 124,510 61,015 56,295 83,765 400,210 45 to 64 years 65,900 70,305 53,020 38,700 75,275 303,200 65+ years 31,920 39,535 29,230 16,740 33,575 151,000 TOTAL 232,625 305,685 199,035 143,390 269,770 1,150,505

Toronto Central % of Population West Toronto Mid-West Toronto North Toronto Mid-East Toronto East Toronto LHIN Average 0 to 4 years 5.5% 4.1% 5.5% 3.9% 6.6% 5.2% 5 to 14 years 9.6% 6.3% 10.8% 6.1% 10.9% 8.8% 15 to 24 years 10.8% 13.0% 11.7% 12.1% 11.1% 11.8% 25 to 44 years 32.1% 40.7% 30.7% 39.3% 31.1% 34.8% 45 to 64 years 28.3% 23.0% 26.6% 27.0% 27.9% 26.3% 65+ years 13.7% 12.9% 14.7% 11.7% 12.4% 13.1%

Note: Comparison of data highlighting the highest and lowest rates are between sub-regions 88 Source: Census of Canada & National Household Survey, Statistics Canada, 2011 West Toronto Unemployment Rate (%) by Neighbourhood (2011) Unemployment rate is defined as the number of unemployed persons who are seeking work. This is expressed as a percentage of the labour force and includes individuals who are 15 years of age or older. City of Toronto 9.3% Mount Dennis 13.6 South Parkdale 13 % Unemployment Rate in Rockcliffe-Smythe 11.5 City of Toronto New Toronto 8.8 Stonegate-Queensway 8 9.3% Edenbridge-Humber Valley 8 Range of Unemployment Junction Area 7.9 High Park North 7.8 for all City of Toronto Mimico 7.3 5.0 - 17.1% Runnymede-Bloor West Village 6.9 High Park-Swansea 6.7 Unemployment rates are highest Roncesvalles 6.4 in Mount Dennis, South Kingsway South 5.9 Parkdale, and Rockcliffe- Lambton Baby Point 5.1 Smythe. All other 0 2 4 6 8 10 12 14 16 neighbourhoods have better than % Unemployment Rate average unemployment rates.

89 Source: Urban Heart Toronto, 2014 [2011 National Household Survey] APPENDIX B – Methodology for Identifying Primary Care Physicians

90 MOHLTC Method for Identifying Primary Care Physicians

• Primary care physicians were identified as general practitioners (i.e., the majority of their claims had a specialty of 00) who submitted an approved claim in fiscal year 2015/16 and:

• 1. Belonged to a primary care patient enrolment model (PEM), as of March 31, 2016 OR

• 2. During fiscal year 2015/16, had at least 100 claims with a fee schedule code that is included in one of the family health group, family health network, or family health organization basket of services AND the total amount billed for the following fee codes accounted for at least 19% (i.e., the 5th percentile) of their total claims: A001, A003, A007, A888, K132 (these fee schedule codes are the most frequently used assessment codes among PEM physicians).

• Note that physicians paid by salary (e.g., those working in Community Health Centres) and not submitting claims were not captured by this methodology and were therefore not identified as providing primary care.

91