Hamilton Niagara Haldimand Brant

Regional Measures of Diabetes Burden in Ontario ICES 96

LOCAL HEALTH

INTEGRATION 4 NETWORK

Diabetes Measures by Region Results / Diabetes Measures by Region / Hamilton Niagara Haldimand Brant LHIN ICES 97

EXHIBIT 4.1 Diabetes prevalence per 100 adults in the Hamilton Niagara Haldimand Brant LHIN (4), by subLHIN, on March 31, 2011

KEY FINDINGS 8 5 7 Toronto • For every 100 adults in the Hamilton NiagaraDiabetes Haldimand Prevalence Brant LHIN, thereRate were aboutPer 100nine Ontarianspeople living (2011), with in diabetes.Hamilton This prevalence Niagara (9.15 Haldimand per Guelph Mississauga 100) wasBrant slightly (4) lower LHIN, than by theSubLHIN 6 Ontario average (9.64 per 100). 3 6.18 - 8.00 Kitchener-Waterloo • The highest prevalence8.01 was - 9.00 in the New Credit and Six Nations subLHIN 9.01 - 10.00 (22.76 per 100). Higher levels of prevalence (above 1010.01 per 100)- 12.00 were Burlington also found in Brant and12.01 Brantford - 22.76 and Flamborough Burlington in Hamilton Urban Core.subLHIN boundary Hamilton Urban Core LHIN boundary Hamilton Dundas LHIN 4 Hamilton Outer Core Hamilton Ancaster Outer Core Stoney Creek St Catharines Brant and Brantford Brantford Glanbrook North West Niagara Niagara

New Credit 4 and Six Nations East Niagara

South Niagara PREVALENCE PER 100 ADULTS Haldimand and Norfolk 6.18 - 8.00 8.01 - 9.00 2 Simcoe 9.01 - 10.00 10.01 - 12.00 12.01 - 22.76 subLHIN boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

Data sources: Ontario Diabetes Database; Registered Persons Database. Technical note: Adults were defined as those aged 20 years and older. Rates were age- and sex-standardized using the 2001 Ontario population of the same age as the standard population. Results / Diabetes Measures by Region / Hamilton Niagara Haldimand Brant LHIN ICES 98

EXHIBIT 4.2 Diabetes incidence per 100 adults in the Hamilton Niagara Haldimand Brant LHIN (4), by subLHIN, 2009/10

KEY FINDINGS 8 7 5 Toronto • For every 100 adults living in the 1-YearHamilton Diabetes Niagara Incidence Haldimand Rate Brant Per LHIN100 who Ontarians were free (2009/10), of diabetes inin MarchHamilton 2009, Niagaranearly one Haldimand was Guelph Mississauga diagnosedBrant (4) with LHIN, diabetes by SubLHIN in the 6 subsequent year. This incidence 3 0.61 - 0.80 rate (0.96 per 100) was nearly Kitchener-Waterloo identical to that0.81 for Ontario- 0.95 as a whole (0.97 per 0.96100). - 1.10

• Diabetes incidence1.11 was- 1.40 highest Burlington in the New Credit1.41 and - 2.79 Six Nations Flamborough Burlington subLHIN (2.75 persubLHIN 100). Above-boundary average rates (above 1.10 per 100) Hamilton Urban Core LHIN boundary Hamilton were also seen in Hamilton Urban Dundas Core and in HaldimandLHIN 4 and Norfolk. Hamilton Outer Core Hamilton Ancaster Outer Core Stoney Creek St Catharines Brant and Brantford Brantford Glanbrook North West Niagara Niagara

New Credit 4 and Six Nations East Niagara

South Niagara INCIDENCE PER 100 ADULTS Haldimand and Norfolk 0.61 - 0.80 0.81 - 0.95 2 Simcoe 0.96 - 1.10 1.11 - 1.40 1.41 - 2.79 subLHIN boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

EXHIBIT 4.3 Number, per 10,000 adults with diabetes, who had at least one hospitalization or emergency department visit for hyper- or hypoglycemia in the Hamilton Niagara Haldimand Brant LHIN (4), by subLHIN, 2006/07–2010/11

KEY FINDINGS 8 5 7 Toronto • Overall, for every 100 adults living with diabetes in the Hamilton Niagara 5-YearHaldimand Rate of Brant Hospitalizations LHIN on March and31, Guelph Mississauga Emergency2006, approximately Department six had Visits at least for Hyper-one hospitalizationor Hypoglycemia or emergency per 10,000 6 department visit for hyper- or 3 Ontarians with Diabetes (2006-2011), hypoglycemia in the subsequent five Kitchener-Waterloo inyears. Hamilton This rate Niagara (565 per Haldimand 10,000 adultsBrant with (4) diabetes)LHIN, by was SubLHIN higher 272 - 400 than the provincial average (486 Burlington per 10,000). 401 - 500 Burlington • Rates varied 501by nearly - 600 two-fold Flamborough across subLHINs.601 - 700The highest Hamilton Urban Core rates were found701 - in 1001 New Credit Hamilton Dundas Hamilton Outer Core and Six NationssubLHIN (1,001 boundary per 10,000) and in Hamilton Urban Core (814 Hamilton LHIN boundary Ancaster Outer Core Stoney per 10,000). Creek St Catharines LHIN 4 Brant and Brantford Brantford Glanbrook North West Niagara Niagara

New Credit 4 and Six Nations East Niagara

NUMBER PER 10,000 ADULTS South Niagara WITH DIABETES Haldimand and Norfolk 272 - 400 401 - 500 2 Simcoe 501 - 600 601 - 700 701 - 1001 subLHIN boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

Data sources: National Ambulatory Care Reporting System; Canadian Institute of Health Information Discharge Abstract Database; Ontario Diabetes Database. Technical note: Adults were defined as those aged 20 years and older. Rates were age- and sex-standardized using the same-aged population in the Ontario Diabetes Database on March 31, 2006 as the standard population. Results / Diabetes Measures by Region / Hamilton Niagara Haldimand Brant LHIN ICES 100

EXHIBIT 4.4 Number, per 10,000 adults with diabetes, who had at least one hospitalization or emergency department visit for skin and soft tissue infection or foot ulcer in the Hamilton Niagara Haldimand Brant LHIN (4), by subLHIN, 2006/07–2010/11

KEY FINDINGS 8 7 5 Toronto • For every 100 adults living with 5-Yeardiabetes Rate inof the Hospitalizations Hamilton Niagara and EmergencyHaldimand Department Brant LHIN Visits in March for 2006,Skin Guelph Mississauga and Softmore Tissue than seven Infection had at or least Foot one Ulcer hospitalization or emergency Per 10,000 Ontarians with Diabetes 6 department visit for a skin and soft 3 (2006 – 2011), in Hamilton Niagara tissue infection or foot ulcer during Kitchener-Waterloo Haldimandthe subsequent Brant (4) five LHIN, years. by ThisSubLHIN rate (711 per 10,000277 adults - 450 with diabetes) was higher than451 the- 630 provincial Burlington average (618631 per -10,000). 820 Burlington • Rates varied 821by nearly - 1050 2.5-fold across Flamborough subLHINs, ranging1051 - 1540from 474 per Hamilton Urban Core 10,000 in Ancaster to 1,133 per 10,000 Hamilton subLHIN boundary Dundas in New Credit and Six Nations. Hamilton Outer Core LHIN boundary Hamilton Ancaster Outer Core Stoney LHIN 4 Creek St Catharines Brant and Brantford Brantford Glanbrook North West Niagara Niagara

New Credit 4 and Six Nations East Niagara

NUMBER PER 10,000 ADULTS South Niagara WITH DIABETES Haldimand and Norfolk 277 - 450 451 - 630 2 Simcoe 631 - 820 821 - 1050 1051 - 1540 subLHIN boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

EXHIBIT 4.5 Number, per 10,000 adults with diabetes, who had at least one hospitalization for a cardiovascular condition in Hamilton Niagara Haldimand Brant LHIN (4), by subLHIN, 2006/07–2010/11

KEY FINDINGS 8 5 7 Toronto • Approximately one in 10 adults with 5-Yeardiabetes Rate of living Hospitalizations in the Hamilton for CardiovascularNiagara Haldimand Conditions Brant LHINPer in 10,0002006 Ontarians was hospitalized with Diabetes at least once Guelph Mississauga (2006 for- 2011), a cardiovascular in Hamilton condition Niagara in the 3 6 Haldimandensuing Brant five (4) years. LHIN, This by rateSubLHIN (1,005 per 10,000 adults with diabetes) was Kitchener-Waterloo higher than567 the - 760provincial average (888 per 10,000).761 - 880

• Rates varied881 by - 1020 more than Burlington 1.5-fold across1021 -subLHINs. 1200 The Flamborough Burlington highest rates1201 of - hospitalizations1446 for cardiovascular conditions were in Hamilton Urban Core subLHIN boundary Hamilton Hamilton Urban Core (1,270 per Dundas 10,000) andLHIN New boundary Credit and Six Hamilton Outer Core Nations (1,245LHIN per4 10,000). Hamilton Ancaster Outer Core Stoney Creek St Catharines Brant and Brantford Brantford Glanbrook North West Niagara Niagara

New Credit 4 and Six Nations East Niagara

NUMBER PER 10,000 ADULTS South Niagara WITH DIABETES Haldimand and Norfolk 567 - 760 761 - 880 2 Simcoe 881 - 1020 1021 - 1200 1201 - 1446 subLHIN boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

Data sources: Canadian Institute of Health Information Discharge Abstract Database; Ontario Diabetes Database. Technical notes: Adults were defined as those aged 20 years and older. Rates were age- and sex-standardized using the same-aged population in the Ontario Diabetes Database on March 31, 2006 as the standard population. Cardiovascular conditions included myocardial infarction, stroke, congestive heart failure, unstable angina and transient ischemic attack. Results / Diabetes Measures by Region / Hamilton Niagara Haldimand Brant LHIN ICES 102

EXHIBIT 4.6 Number, per 10,000 adults with diabetes, who had a lower extremity amputation in the Hamilton Niagara Haldimand Brant LHIN (4), by subLHIN, 2006/07–2010/11

KEY FINDINGS 8 7 5 Toronto • In the Hamilton Niagara Haldimand Brant LHIN, nearly nine of every 1,000 adults with diabetes experienced a lower extremity Guelph Mississauga amputation5-Year Rate between of Lower 2006/07 Extremity and 3 6 Amputations2010/11. This ratePer (8910,000 per 10,000 Ontarians adultswith Diabeteswith diabetes) (2006 was - higher2011), thanin Kitchener-Waterloo theHamilton Ontario average Niagara (74 Haldimand per 10,000). • RatesBrant varied (4) byLHIN, more by than SubLHIN eight-fold across subLHINs.Data unavailable Burlington 22 - 50 • The highest rate was in the New Flamborough Burlington Credit and Six51 Nations - 80 subLHIN (187 Hamilton Urban Core per 10,000). High81 - rates110 were also Hamilton Dundas seen in Hamilton111 Urban- 150 Core, East Hamilton Outer Core Niagara, and Haldimand and Norfolk. 151 - 211 Hamilton Ancaster Outer Core Stoney subLHIN boundary Creek St Catharines Brant and Brantford LHIN boundary Brantford Glanbrook North LHIN 4 West Niagara Niagara

New Credit 4 and Six Nations East NUMBER PER 10,000 ADULTS Niagara WITH DIABETES South Niagara Data unavailable Haldimand and Norfolk 22 - 50 51 - 80 2 Simcoe 81 - 110 111 - 150 151 - 211 subLHIN boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

Data sources: Canadian Institute of Health Information Discharge Abstract Database; Ontario Diabetes Database. Technical note: Adults were defined as those aged 20 years and older. Rates were age- and sex-standardized using the same-aged population in the Ontario Diabetes Database on March 31, 2006 as the standard population. Results / Diabetes Measures by Region / Hamilton Niagara Haldimand Brant LHIN ICES 103

EXHIBIT 4.7 Number, per 10,000 adults with diabetes, who received chronic dialysis or kidney transplantation in the Hamilton Niagara Haldimand Brant LHIN (4), by subLHIN, 2006/07–2010/11

KEY5-Year FINDINGS Rate of Chronic Dialysis or 8 Kidney Transplant Per 10,000 5 7 Toronto • OverallOntarians in the with Hamilton Diabetes Niagara (2006 - Haldimand2011), inBrant Hamilton LHIN, the Niagara rate of chronicHaldimand dialysis orBrant kidney (4) LHIN, Guelph Mississauga transplantationby SubLHIN was 135 per 10,000 adults with diabetes, a level that was 3 6 higher than the provincial73 - 100 average (122 per 10,000).101 - 125 Kitchener-Waterloo • Rates varied by as126 much - 150 as three-fold across subLHINs, ranging from 90 151 - 200 per 10,000 in Dundas to 280 per Burlington 201 - 280 10,000 in New Credit and Six Nations. Burlington Higher rates weresubLHIN also found boundary in Flamborough Hamilton Urban LHINCore boundaryand in North Hamilton Urban Core and East Niagara. Hamilton LHIN 4 Dundas Hamilton Outer Core Hamilton Ancaster Outer Core Stoney Creek St Catharines Brant and Brantford Brantford Glanbrook North West Niagara Niagara

New Credit 4 and Six Nations East Niagara

NUMBER PER 10,000 ADULTS South Niagara WITH DIABETES Haldimand and Norfolk 73 - 100 101 - 125 2 Simcoe 126 - 150 151 - 200 201 - 280 subLHIN boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

Data sources: Ontario Health Insurance Plan Database; Canadian Organ Replacement Register Database; Canadian Institute of Health Information Discharge Abstract Database; Trillium Gift of Life Network Database; Ontario Diabetes Database. Technical note: Adults were defined as those aged 20 years and older. Rates were age- and sex-standardized using the same-aged population in the Ontario Diabetes Database on March 31, 2006 as the standard population. Results / Diabetes Measures by Region / Hamilton Niagara Haldimand Brant LHIN ICES 104

EXHIBIT 4.8 Number, per 100 adults with diabetes, who had an additional chronic medical condition in the Hamilton Niagara Haldimand Brant LHIN (4), by subLHIN, 2006/07–2008/09

KEY FINDINGS 8 7 5 Toronto • In the Hamilton Niagara Haldimand Brant LHIN overall, 57 of every 100 Rateadults of One with or diabetes More Non-Diabetes had at least one Relatedchronic Medical medical Conditions condition other Per than100 Guelph Mississauga Ontariansdiabetes betweenwith Diabetes 2006/07 (2006and - 6 2008/09.2009), in This Hamilton rate (57.01 Niagara per 100) was 3 slightlyHaldimand higher Brant than the (4) provincial LHIN, Kitchener-Waterloo average (54.84by SubLHIN per 100). • There was some44.19 variation - 50.00 in rates across subLHINs,50.01 with - 54.00 higher rates Burlington seen in the peripheral subLHINs and Burlington lower rates elsewhere.54.01 - 57.00 Flamborough 57.01 - 61.00 Hamilton Urban Core Hamilton 61.01 - 65.43 Dundas Hamilton Outer Core subLHIN boundary Hamilton LHIN boundary Ancaster Outer Core Stoney Creek St Catharines LHIN 4 Brant and Brantford Brantford Glanbrook North West Niagara Niagara

New Credit 4 and Six Nations East Niagara

NUMBER PER 100 ADULTS South Niagara WITH DIABETES Haldimand and Norfolk 44.19 - 50.00 50.01 - 54.00 2 Simcoe 54.01 - 57.00 57.01 - 61.00 61.01 - 65.43 subLHIN boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

Data sources: Ontario Health Insurance Plan Database; Ontario Diabetes Database. Technical note: Adults were defined as those aged 20 years and older. Rates were age- and sex-standardized using the same-aged population in the Ontario Diabetes Database on March 31, 2006 as the standard population. Results / Diabetes Measures by Region / Hamilton Niagara Haldimand Brant LHIN ICES 105

EXHIBIT 4.9 Number, per 100 adults with diabetes, who made a mental health visit for a psychotic or nonpsychotic illness in the Hamilton Niagara Haldimand Brant LHIN (4), by subLHIN, 2006/07–2008/09

KEY FINDINGS 8 5 7 Toronto • In Hamilton Niagara Haldimand Brant, nearly one in three adults with diabetes had one or more Ratemental of Any health Mental visits betweenHealth Visit For Guelph Mississauga a Psychotic2006/07 and or 2008/09. Nonpsychotic This rate Illness 6 (31.59Per 10 per Ontarians 100) was slightly with Diabetes lower 3 (2006than the- 2009), provincial in Hamilton average (32.89 Niagara Kitchener-Waterloo perHaldimand 100 adults with Brant diabetes). (4) LHIN, • The highestby rates SubLHIN (above 33 per 17.52 - 24.00 100) were seen in Brant and Burlington 24.01 - 29.00 Brantford, Burlington, Dundas Burlington and North Niagara.29.01 - 33.00 Flamborough Hamilton Urban Core 33.01 - 37.00 Hamilton Dundas 37.01 - 41.66 Hamilton Outer Core subLHIN boundary Hamilton Ancaster Outer Core Stoney LHIN boundary St Catharines Brantford Creek LHIN 4 Brant and Brantford Glanbrook North West Niagara Niagara

New Credit 4 and Six Nations East Niagara

NUMBER PER 100 ADULTS South Niagara WITH DIABETES Haldimand and Norfolk 17.52 - 24.00 24.01 - 29.00 2 Simcoe 29.01 - 33.00 33.01 - 37.00 37.01 - 41.66 subLHIN boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

EXHIBIT 4.10 Percentage of economic families with low income in the Hamilton Niagara Haldimand Brant LHIN (4), by subLHIN, 2005

8 KEY FINDINGS 5 7 • In thePrevalence Hamilton Niagara of After-Tax Haldimand Low Toronto BrantIncome LHIN, nearly in Economic eight of every Families, 100 familiesin Hamilton were living Niagara with low Haldimand income Guelph in 2005.Brant This (4)percentage LHIN, by (7.5%) SubLHIN was Mississauga lower than the provincial average of 6 8.6% of families. Data unavailable 3 • Levels of low income2.2 -were 4.0 highest in Kitchener-Waterloo Hamilton Urban Core,4.1 - followed6.0 by Hamilton Outer Core.6.1 - 8.0 8.1 - 14.0 Burlington 14.1 - 25.3 Flamborough Burlington subLHIN boundary Hamilton Urban Core LHIN boundary Hamilton Dundas Hamilton Outer Core LHIN 4 Hamilton Ancaster Outer Core Stoney Creek St Catharines Brant and Brantford Brantford Glanbrook North West Niagara Niagara

New Credit 4 and Six Nations East PERCENTAGE OF LOW-INCOME Niagara ECONOMIC FAMILIES South Niagara Data unavailable Haldimand and Norfolk 2.2 - 4.0 4.1 - 6.0 2 Simcoe 6.1 - 8.0 8.1 - 14.0 14.1 - 25.3 subLHIN boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

Data source: 2006 Census of Canada. Technical note: Economic family refers to a group of two or more persons who live in the same dwelling and are related by blood, marriage, common law or adoption. Economic families with low income are defined as those that devote a larger share of their after-tax income (at least 20% more than average) to necessities of food, shelter and clothing. Performance of this measure is limited in rural and remote communities due to missing data from First Nations reserves. Results / Diabetes Measures by Region / Hamilton Niagara Haldimand Brant LHIN ICES 107

EXHIBIT 4.11 Percentage of visible minorities in the Hamilton Niagara Haldimand Brant LHIN (4), by subLHIN, 2006

8 KEY FINDINGS 5 7 3 • In the Hamilton Niagara Haldimand Toronto Brant LHIN, the overall percentage of residents who self-identified as belonging to a visible minority group Guelph (9.10%) was less than half the Mississauga provincial average (22.82%). 6 • The highest percentages of visible Kitchener-Waterloo minorities were living in Hamilton Urban Core and Hamilton Outer Core. Burlington

Flamborough Burlington Hamilton Urban Core Hamilton Dundas Hamilton Outer Core Hamilton Ancaster Outer Core Stoney Creek St Catharines Brant and Brantford Brantford Glanbrook North West Niagara Niagara

New Credit and Six Nations East PERCENTAGE OF 4 Niagara VISIBLE MINORITIES South Niagara Data unavailable 2 Haldimand and Norfolk 0.00 - 1.00 1.01 - 4.00 Simcoe 4.01 - 12.00 12.01 - 30.00 30.01 - 78.00 subLHIN boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

Data source: 2006 Census of Canada. Technical note: Visible minorities include persons other than Aboriginal peoples who are non-Caucasian in race or non-white in colour. Results / Diabetes Measures by Region / Hamilton Niagara Haldimand Brant LHIN ICES 108

EXHIBIT 4.12 Diabetes prevalence per 100 adults in the Hamilton Niagara Haldimand Brant LHIN (4), by census subdivision, on March 31, 2011

KEY FINDINGS 5 7 Toronto • In theDiabetes majority Prevalence of census subdivisions Rate Per (CSDs),100 Ontarians the prevalence (2011), of diabetesin Hamilton was similar to the LHIN average (9.15 Niagara Haldimand Brant (4) per 100) and the provincial average Guelph Mississauga LHIN, by Census Subdivision (9.64 per 100). 3 6 • Above-average diabetes0.00 - 9.00 prevalence Kitchener-Waterloo was found in the New9.01 Credit - 12.00 and Six Nations of the Grand12.01 River - 16.00 First Nations communities. 16.01 - 24.00 24.01 - 31.27 Burlington CSD boundary LHIN boundary Hamilton LHIN 4

St Catharines Brantford

PREVALENCE PER 100 ADULTS 0.00 - 9.00 9.01 - 12.00 2 Simcoe 12.01 - 16.00 16.01 - 24.00 24.01 - 31.27 CSD boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

EXHIBIT 4.13 Diabetes incidence per 100 adults in the Hamilton Niagara Haldimand Brant LHIN (4), by census subdivision, 2005/06–2009/10

KEY FINDINGS 8 5 7Toronto • In most census subdivisions (CSDs), the incidence of diabetes in adults over the five-year period between April 2005 and March 2010 was Guelph Mississauga 5-Yearsimilar Diabetes to the LHIN Incidence average Rate (4.74 Perper 6 100100) Ontarians and the provincial (2005/06 average - 2009/10), (4.85 3 in Hamiltonper 100). Niagara Haldimand Brant Kitchener-Waterloo (4)• The LHIN, highest by Censusincidence Subdivision rates were found in the SixData Nations unavailable of the Grand River First Nations0.00 - communities.4.00 Higher-than-average4.01 - 5.00 rates were also Burlington seen in Hamilton, Brantford, New 5.01 - 6.00 Credit, Haldimand County (south of Hamilton) and 6.01Welland - 7.00 (south of Hamilton St. Catharines).7.01 - 16.32 CSD boundary St Catharines LHIN boundary Brantford LHIN 4

INCIDENCE PER 100 ADULTS

Data unavailable 0.00 - 4.00 4.01 - 5.00 2 Simcoe 5.01 - 6.00 6.01 - 7.00 7.01 - 16.32 CSD boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

EXHIBIT 4.14 Number, per 10,000 adults with diabetes, who had at least one hospitalization or emergency department visit for hyper- or hypoglycemia in the Hamilton Niagara Haldimand Brant LHIN (4), by census subdivision, 2006/07–2010/11

5-YearKEY FINDINGS Rate of Hospitalizations and Emergency Department Visits for Hyper- 5 7Toronto or Hypoglycemia• In most census Persubdivisions 10,000 Ontarians (CSDs) in the Hamilton Niagara Haldimand with Diabetes (2006 - 2011), in Hamilton Brant LHIN, rates of hospitalization Niagara Haldimand Brant (4) LHIN, or emergency department visits for Guelph Mississauga by Census Subdivision hyper- or hypoglycemia were similar 3 6 to the LHIN averageData (565unavailable per 10,000 adults with diabetes)0 - 480 and the Kitchener-Waterloo provincial average (486 per 10,000). 481 - 650 • Higher rates were found in two 651 - 930 smaller CSDs, one located southeast 931 - 1400 of Brantford (Six Nations of the Grand Burlington River) and the other1401 south - 2168 of St. Catharines (Thorold).CSD boundary Hamilton LHIN boundary LHIN 4 St Catharines Brantford

4 NUMBER PER 10,000 ADULTS WITH DIABETES

Data unavailable 0 - 480 481 - 650 2 Simcoe 651 - 930 931 - 1400 1401 - 2168 CSD boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

EXHIBIT 4.15 Number, per 10,000 adults with diabetes, who had at least one hospitalization or emergency department visit for any acute complication in the Hamilton Niagara Haldimand Brant LHIN (4), by census subdivision, 2006/07–2010/11

KEY FINDINGS 8 5 7Toronto • Between 2006/07 and 2010/11, rates 5-Year Rate of Hospitalizationsof and hospitalizations Emergency or Department emergency department visits for acute Visits For Any Acute Complication (Hyper- or Hypoglycemia, complications of diabetes were Guelph Mississauga Skin and Soft Tissue Infection or Foot Ulcer) Per 10,000 in Hamilton similar in most census subdivisions 6 Niagara Haldimand Brant (4) LHIN,(CSDs) by to theCensus LHIN average Subdivision (1,182 per 3 10,000 adults with diabetes) and the Kitchener-Waterloo Data unavailable provincial average (1,029 per 10,000). 0 - 1200 • Higher rates of acute complications were seen in several1201 - 1500CSDs in the southern part of1501 the - LHIN.2000 Burlington 2001 - 2800 2801 - 4431 Hamilton CSD boundary LHIN boundary LHIN 4 St Catharines Brantford

4 NUMBER PER 10,000 ADULTS WITH DIABETES

Data unavailable 0 - 1200 1201 - 1500 2 Simcoe 1501 - 2000 2001 - 2800 2801 - 4431 CSD boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

Data sources: National Ambulatory Care Reporting System; Canadian Institute of Health Information Discharge Abstract Database; Ontario Diabetes Database. Technical notes: Adults were defined as those aged 20 years and older. Rates were age- and sex-standardized using the same-aged population in the Ontario Diabetes Database on March 31, 2006 as the standard population. Acute complications consisted of hyper- or hypoglycemia, skin and soft tissue infection or foot ulcer. Results / Diabetes Measures by Region / Hamilton Niagara Haldimand Brant LHIN ICES 112

EXHIBIT 4.16 Number, per 10,000 adults with diabetes, who had any chronic complication in the Hamilton Niagara Haldimand Brant LHIN (4), by census subdivision, 2006/07–2010/11

KEY FINDINGS 8 5 7Toronto • Between 2006/07 and 2010/11, rates of chronic complications were similar in most census subdivisions (CSDs) to the LHIN average (1,151 per 10,000 Guelph Mississauga adults with diabetes) and the 3 6 5-Year Rate of Hospitalizationsprovincial average For (1,016 Any Chronicper 10,000). Complication (Cardiovascular• Higher rates Conditions, (above 1,300 Amputations per 10,000) Kitchener-Waterloo and End-Stage Renalwere Disease) seen in Per the Six10,000 Nations Ontarians of the with Diabetes (2006Grand - 2011), River in First Hamilton Nations Niagara Haldimand Brant (4)communities LHIN, by Census southeast Subdivision of Brantford. Data unavailable Burlington 0 - 1000 1001 - 1300 Hamilton 1301 - 1700 1701 - 2300 St Catharines 2301 - 3371 Brantford CSD boundary LHIN boundary LHIN 4 4 NUMBER PER 10,000 ADULTS WITH DIABETES

Data unavailable 0 - 1000 1001 - 1300 2 Simcoe 1301 - 1700 1701 - 2300 2301 - 3371 CSD boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

Data sources: Ontario Health Insurance Plan Database; Canadian Organ Replacement Register Database; Canadian Institute of Health Information Discharge Abstract Database; Trillium Gift of Life Network; Ontario Diabetes Database. Technical note: Adults were defined as those aged 20 years and older. Rates were age- and sex-standardized using the same-aged population in the Ontario Diabetes Database on March 31, 2006 as the standard population. A chronic complication consisted of hospitalization for a cardiovascular condition or having a lower extremity amputation or end-stage renal disease (chronic dialysis or kidney transplantation). Results / Diabetes Measures by Region / Hamilton Niagara Haldimand Brant LHIN ICES 113

EXHIBIT 4.17 Locations of diabetes education programs in the Hamilton Niagara Haldimand Brant LHIN (4), 2011

KEY FINDINGS 8 5 7Toronto • Main diabetes education programs were scattered fairly widely across the LHIN, but most were located in or near major urban centres. In addition, Guelph Mississauga one program was located in the New Locations of Diabetes Education 6 Credit and Six Nations subLHIN. 3 Programs in Hamilton Niagara Kitchener-Waterloo • SatellitesHaldimand of diabetes Brant education (4) LHIN, programs wereby SubLHIN found near Hamilton and in the northwest and southeast areas of theMain LHIN. DM program location Burlington Satellite of DM program • A few outreach programs were Flamborough Burlington located near Hamilton and in the Outreach DM program Hamilton Urban Core southeast end of the LHIN. subLHIN boundary Hamilton Dundas LHIN 4 Hamilton Outer Core Hamilton LHIN boundary Ancaster Outer Core Stoney Creek St Catharines Brant and Brantford Brantford Glanbrook North West Niagara Niagara

4 New Credit and Six Nations East Niagara

South Niagara

Haldimand and Norfolk TYPE OF PROGRAM 2 Simcoe Main program Program satellite Outreach program subLHIN boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

Data source: Diabetes Regional Coordination Centres. Technical note: Locations were designated based on six-digit postal codes using Statistics Canada’s Postal Code Conversion File. Results / Diabetes Measures by Region / Hamilton Niagara Haldimand Brant LHIN ICES 114

EXHIBIT 4.18 Locations of endocrinologists and eye specialists in the Hamilton Niagara Haldimand Brant LHIN (4), 2010/11

KEY FINDINGS 8 5 7Toronto • Endocrinologists were located near LocationsHamilton and of in Endocrinologists the Dundas subLHIN. and Eye Specialists in Hamilton • Eye specialists (optometrists and Guelph Mississauga ophthalmologists)Niagara Haldimand were Brantmuch more (4) numerousLHIN, and bydistributed SubLHIN more 3 6 widely across the LHIN compared with endocrinologists.Endocrinologist However, most Kitchener-Waterloo were concentratedOphthalmologist in or near major urban centres.Optometrist subLHIN boundary Burlington

LHIN boundary Flamborough Burlington LHIN 4 Hamilton Urban Core Hamilton Dundas Hamilton Outer Core Hamilton Ancaster Outer Core Stoney Creek St Catharines Brant and Brantford Brantford Glanbrook North West Niagara Niagara

4 New Credit and Six Nations East Niagara

South Niagara

Haldimand and Norfolk TYPE OF SPECIALIST 2 Simcoe Endocrinologist Ophthalmologist Optometrist subLHIN boundary

LHIN boundary 0 25 50 km LHIN 4 boundary

Data sources: Locations of endocrinologists and ophthalmologists came from the ICES Physician Database, 2010; listings of optometrists came from the Corporate Provider Database, April 1, 2010 to March 31, 2011. Technical note: Locations were designated based on six-digit postal codes using Statistics Canada’s Postal Code Conversion File. Regional Measures of Diabetes Burden in Ontario ICES 115

Central West

LOCAL HEALTH INTEGRATION 5 NETWORK

Diabetes Measures by Region Results / Diabetes Measures by Region / Central West LHIN ICES 116

EXHIBIT 5.1 Diabetes prevalence per 100 adults in the Central West LHIN (5), by subLHIN, on March 31, 2011

KEY FINDINGS

• For every 100 adults in the Central West LHIN, more than 12 people were 12 living with diabetes. This prevalence 2 (12.39 per 100) was substantially higher thanDiabetes the Ontario Prevalence average Rate(9.64 per 100).Per 100 Ontarians (2011), in • DiabetesCentral prevalence West was (5) highest LHIN, by (above 13 per 100)SubLHIN in Brampton, Malton and Rexdale.6.18 - 8.00 8.01 - 9.00 9.01 - 10.00 10.01 - 12.00 12.01 - 22.76 Dufferin County subLHIN boundary LHIN boundary 8 LHIN 5

Orangeville 5

Caledon

PREVALENCE PER 100 ADULTS Woodbridge 6.18 - 8.00 (Vaughan) 8.01 - 9.00

9.01 - 10.00 Rexdale 10.01 - 12.00 3 Brampton (Toronto) 12.01 - 22.76 Malton (Mississauga) subLHIN boundary 7 LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.2 Diabetes incidence per 100 adults in the Central West LHIN (5), by subLHIN, 2009/10

KEY FINDINGS

• For every 100 adults living in the 12 Central West LHIN who were free of 2 1-Yeardiabetes Diabetes in March Incidence 2009, more Rate than Per one100 person Ontarians was diagnosed (2009/10), with in Centraldiabetes West in the(5) subsequentLHIN, by SubLHIN year. This incidence rate (1.21 per 100) was notably higher0.61 than - 0.80 for Ontario as a whole (0.97 per0.81 100). - 0.95 • Diabetes incidence0.96 - 1.10 was highest in Brampton, Malton,1.11 - 1.40 Rexdale and Woodbridge.1.41 - 2.79 subLHIN boundary LHIN boundary Dufferin County LHIN 5 8

Orangeville 5

Caledon

INCIDENCE PER 100 ADULTS Woodbridge 0.61 - 0.80 (Vaughan) 0.81 - 0.95

0.96 - 1.10 Rexdale 1.11 - 1.40 3 Brampton (Toronto) 1.41 - 2.79 Malton (Mississauga) subLHIN boundary 7 LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.3 Number, per 10,000 adults with diabetes, who had at least one hospitalization or emergency department visit for hyper- or hypoglycemia in the Central West LHIN (5), by subLHIN, 2006/07–2010/11

KEY FINDINGS

• Overall, for every 100 adults living 12 with diabetes in the Central West 2 5-YearLHIN Rate on March of Hospitalizations 31, 2006, and Emergencyapproximately Department four had at Visits least onefor Hyper-hospitalization or Hypoglycemia or emergency per 10,000 Ontariansdepartment with Diabetes(ED) visit for (2006-2011), hyper- or in Centralhypoglycemia West (5) in theLHIN, subsequent by SubLHIN five years. This rate (390 per 10,000 272 - 400 adults with diabetes) was notably lower than the401 provincial - 500 average (486 per 10,000).501 - 600 • There was little601 variation - 700 in rates of hospitalizations/ED701 - 1001visits for Dufferin County hyper- or hypoglycemiasubLHIN boundary across subLHINs, except in Dufferin County where the rateLHIN was boundaryabove average at 595 per 10,000.LHIN 5 8

Orangeville 5

Caledon NUMBER PER 10,000 ADULTS WITH DIABETES Woodbridge 272 - 400 (Vaughan) 401 - 500

501 - 600 Rexdale 601 - 700 3 Brampton (Toronto) 701 - 1001 Malton (Mississauga) subLHIN boundary 7 LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.4 Number, per 10,000 adults with diabetes, who had at least one hospitalization or emergency department visit for skin and soft tissue infection or foot ulcer in the Central West LHIN (5), by subLHIN, 2006/07–2010/11

KEY FINDINGS

• For every 100 adults with diabetes in 5-Yearthe Rate Central of Hospitalizations West LHIN in 2006, and more 12 Emergencythan fourDepartment had at least Visits one for Skin 2 and Softhospitalization Tissue Infection or emergency or Foot Ulcer Per 10,000department Ontarians visit for with a skin Diabetes and soft (2006 – tissue2011), infection in Central or foot West ulcer (5) during LHIN, the subsequentby SubLHIN five years. This rate (410 per 10,000277 adults- 450 with diabetes) was notably lower than the provincial 451 - 630 average (618 per 10,000). 631 - 820 • There was relatively little variation in rates across821 subLHINs, - 1050 except in Dufferin County1051 where- 1540 the rate (947 per 10,000) subLHINwas above boundary average. Dufferin County LHIN boundary LHIN 5 8

Orangeville 5

Caledon NUMBER PER 10,000 ADULTS WITH DIABETES Woodbridge 277 - 450 (Vaughan) 451 - 630 631 - 820 Rexdale 821 - 1050 3 Brampton (Toronto) 1051 - 1540 Malton subLHIN boundary (Mississauga) 7 LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.5 Number, per 10,000 adults with diabetes, who had at least one hospitalization for a cardiovascular condition in the Central West LHIN (5), by subLHIN, 2006/07–2010/11

KEY FINDINGS

• More than eight in 100 adults with 12 diabetes in the Central West LHIN in 2 5-Year2006 were Rate hospitalized of Hospitalizations at least once for inCardiovascular the ensuing five years.Conditions This rate Per (811 per 10,000 adults with diabetes) 10,000 Ontarians with Diabetes was lower than the provincial average (888(2006 per - 10,000).2011), in Central West (5) LHIN, by SubLHIN • The highest rate of567 hospitalizations - 760 was in Dufferin County (973 per 761 - 880 10,000), followed by Woodbridge (929 per 10,000). 881 - 1020 1021 - 1200 1201 - 1446 Dufferin County subLHIN boundary LHIN boundary LHIN 5 8

Orangeville 5

Caledon NUMBER PER 10,000 ADULTS WITH DIABETES Woodbridge 567 - 760 (Vaughan) 761 - 880

881 - 1020 Rexdale 1021 - 1200 3 Brampton (Toronto) 1201 - 1446 Malton (Mississauga) subLHIN boundary 7 LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.6 Number, per 10,000 adults with diabetes, who had a lower extremity amputation in the Central West LHIN (5), by subLHIN, 2006/07–2010/11

KEY FINDINGS

• In the Central West LHIN, nearly five of every 1,000 adults with diabetes 12 5-Yearexperienced Rate a of lower Lower extremity Extremity 2 Amputationsamputation between Per 10,000 2006/07 Ontarians and 2010/11.with Diabetes This rate (2006 (48 per - 10,0002011), in adultsCentral with diabetes) West (5) was LHIN, notably by lower than theSubLHIN Ontario average (74 per 10,000). Data unavailable • Rates varied by 22nearly - 50 three-fold across subLHINs:51 the- 80 highest rate was in Dufferin County81 - 110 (99 per 10,000) and the lowest in Woodbridge (36 111 - 150 per 10,000). 151 - 211 Dufferin County subLHIN boundary LHIN boundary 8 LHIN 5

Orangeville 5

Caledon NUMBER PER 10,000 ADULTS WITH DIABETES Woodbridge 22 - 50 (Vaughan) 51 - 80

81 - 110 Rexdale 111 - 150 3 Brampton (Toronto) 151 - 211 Malton (Mississauga) subLHIN boundary 7 LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.7 Number, per 10,000 adults with diabetes, who received chronic dialysis or kidney transplantation in the Central West LHIN (5), by subLHIN, 2006/07–2010/11

KEY FINDINGS 5-Year Rate of Chronic Dialysis or • In Kidneythe Central Transplant West LHIN Per overall, 10,000 the 12 rateOntarians of chronic with dialysis Diabetes or kidney (2006 - 2 transplantation2011), in Central was 119West per (5) 10,000 LHIN, adults with diabetes,by SubLHIN a level that was slightly lower than the provincial 73 - 100 average (122 per 10,000). 101 - 125 • The highest rates were seen in 126 - 150 Malton (158 per 10,000) and Rexdale (139 per 10,000).151 - 200 201 - 280 subLHIN boundary LHIN boundary LHIN 5 Dufferin County

Orangeville 5

Caledon NUMBER PER 10,000 ADULTS WITH DIABETES Woodbridge 73 - 100 (Vaughan) 101 - 125

126 - 150 Rexdale 151 - 200 3 Brampton (Toronto) 201 - 280 Malton (Mississauga) subLHIN boundary 7 LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.8 Number, per 100 adults with diabetes, who had an additional chronic medical condition in the Central West LHIN (5), by subLHIN, 2006/07–2008/09

KEY FINDINGS

• In the Central West LHIN overall, about 52 of every 100 adults with 12 diabetes had at least one chronic 2 medical condition other than diabetes Ratebetween of One 2006/07 or More and Non-Diabetes2008/09. RelatedThis rate Medical (51.56 Conditionsper 100) was slightlyPer 100 Ontarianslower than with the Diabetes provincial (2006 average - 2009), (54.84in Central per 100). West (5) LHIN, by • There was relativelySubLHIN little variation in rates across subLHINs.44.19 - 50.00 The highest rates were seen50.01 in Woodbridge - 54.00 (57.58 per 100) and Caledon (57.04 per 100). 54.01 - 57.00 57.01 - 61.00 Dufferin County 61.01 - 65.43 subLHIN boundary 8 LHIN boundary LHIN 5 Orangeville 5

Caledon NUMBER PER 100 ADULTS WITH DIABETES Woodbridge 44.19 - 50.00 (Vaughan) 50.01 - 54.00

54.01 - 57.00 Rexdale 57.01 - 61.00 3 Brampton (Toronto) 61.01 - 65.43 Malton (Mississauga) subLHIN boundary 7 LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.9 Number, per 100 adults with diabetes, who made a mental health visit for a psychotic or nonpsychotic illness in the Central West LHIN (5), by subLHIN, 2006/07–2008/09

KEY FINDINGS

• In the Central West LHIN, nearly 12 Rate ofone-third Any Mental of adults Health with Visit diabetes For had a 2 Psychoticone oror moreNonpsychotic mental health Illness visits Per 10 Ontariansbetween with 2006/07 Diabetes and 2008/09.(2006 - 2009),This rate (31.89 per 100) was slightly lower in Central West (5) LHIN, by than the provincial average (32.89 per 100). SubLHIN 17.52 - 24.00 • There was some variation in rates 24.01 - 29.00 across subLHINs, ranging from 26.55 per 100 in Malton29.01 to - 36.0333.00 per 100 in Woodbridge. 33.01 - 37.00 37.01 - 41.66

subLHIN boundary Dufferin County LHIN boundary LHIN 5 8

Orangeville 5

Caledon NUMBER PER 100 ADULTS WITH DIABETES Woodbridge 17.52 - 24.00 (Vaughan) 24.01 - 29.00

29.01 - 33.00 Rexdale 33.01 - 37.00 3 Brampton (Toronto) 37.01 - 41.66 Malton (Mississauga) subLHIN boundary 7 LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.10 Percentage of economic families with low income in the Central West LHIN (5), by subLHIN, 2005

KEY FINDINGS

• In the Central West LHIN overall, more than nine of every 100 families 12 were living with low income in 2005. 2 This percentage (9.3%) was higher than the provincial average (8.6%). • Levels of low income were highest in Malton and Rexdale (above 14%), followedPrevalence by Brampton. of After-Tax Low Income in Economic Families, in Central West (5) LHIN, by SubLHIN 2.2 - 4.0

4.1 - 6.0 Dufferin County 6.1 - 8.0 8.1 - 14.0 8 14.1 - 25.3 subLHIN boundary LHIN boundary Orangeville 5 LHIN 5

Caledon PERCENTAGE OF LOW-INCOME ECONOMIC FAMILIES Woodbridge 2.2 - 4.0 (Vaughan) 4.1 - 6.0 6.1 - 8.0 Rexdale 8.1 - 14.0 3 Brampton (Toronto) 7 14.1 - 25.3 Malton (Mississauga) subLHIN boundary LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.11 Percentage of visible minorities in the Central West LHIN (5), by subLHIN, 2006 Percentage of Visible Minorities*, in Central West (5) LHIN, by KEY FINDINGSSubLHIN * Persons, other than Aboriginal peoples, who• In arethe non-Caucasian Central West inLHIN, race ormore than 12 non-whitehalf of allin colour residents self-identified as 2 belonging to0.00 a visible - 1.00 minority group. This percentage1.01 - 4.00(50.19%) was more than double the provincial average 4.01 - 12.00 (22.82%). 12.01 - 30.00 • The Brampton, Malton and Rexdale 30.01 - 78.00 subLHINs had the highest proportion of visible minoritiessubLHIN boundary as a percentage of their totalLHIN population. boundary LHIN 5

Dufferin County

Orangeville 5

Caledon PERCENTAGE OF VISIBLE MINORITIES Woodbridge 0.00 - 1.00 (Vaughan) 1.01 - 4.00 4.01 - 12.00 Rexdale 12.01 - 30.00 3 Brampton (Toronto) 30.01 - 78.00 Malton (Mississauga) subLHIN boundary 7 LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.12 Diabetes prevalence per 100 adults in the Central West LHIN (5), by census subdivision, on March 31, 2011

KEY FINDINGS

• In the majority of census subdivisions (CSDs) in the Central West LHIN, the 12 prevalence of diabetes was in the 2 Diabetessame range Prevalence or lower than Rate the Per 100provincial Ontarians average (2011), (9.64 perin Central 100). • TheWest highest (5) diabetesLHIN, by prevalence Census (above 13 perSubdivision 100) was found in Brampton. However, this prevalence was similar to the0.00 LHIN - 9.00 average (12.39 per 100). 9.01 - 12.00 12.01 - 16.00 16.01 - 24.00 24.01 - 31.27 CSD boundary LHIN boundary 8 LHIN 5

Orangeville

5 PREVALENCE PER 100 ADULTS

0.00 - 9.00 9.01 - 12.00 12.01 - 16.00 16.01 - 24.00 3 24.01 - 31.27 CSD boundary 7 LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.13 Diabetes incidence per 100 adults in the Central West LHIN (5), by census subdivision, 2005/06–2009/10

KEY FINDINGS

• In the central and northern census subdivisions (CSDs), the incidence of 12 diabetes in adults over the five-year 2 period between April 2005 and March 5-Year2010 Diabetes was similar Incidence to the provincial Rate Per 100 averageOntarians (4.85 (2005/06 per 100). - 2009/10), in Central West (5) LHIN, by Census • In the CSDs located in the south, Subdivision diabetes incidence was higher and more similar to the LHIN average (5.98 per 100).0.00 - 4.00 4.01 - 5.00 5.01 - 6.00 6.01 - 7.00 7.01 - 16.32 CSD boundary 8 LHIN boundary LHIN 5 Orangeville 5

INCIDENCE PER 100 ADULTS

0.00 - 4.00 4.01 - 5.00 5.01 - 6.00 6.01 - 7.00 3 7.01 - 16.32 CSD boundary 7

LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.14 Number, per 10,000 adults with diabetes, who had at least one hospitalization or emergency department visit for hyper- or hypoglycemia in the Central West LHIN (5), by census subdivision, 2006/07–2010/11

KEY FINDINGS 5-Year Rate of Hospitalizations and Emergency • In most census subdivisions (CSDs), Department Visitsrates for of hospitalizationHyper- or Hypoglycemia or emergency 12 Per 10,000 Ontariansdepartment with Diabetes(ED) visits for(2006 hyper- - 2011), or 2 in Central West hypoglycemia(5) LHIN, by were Census similar Subdivision to the LHIN averageData unavailable (390 per 10,000 adults with diabetes)0 - 480 and the provincial average (486 per 10,000). 481 - 650 • A higher-than-average651 - 930 rate of hospitalizations/ED visits was found in a largely931 rural- 1400 CSD located in the northwest1401 portion - 2168 of the LHIN. CSD boundary LHIN boundary LHIN 5 8

Orangeville 5

NUMBER PER 10,000 ADULTS WITH DIABETES

Data unavailable 0 - 480 481 - 650 651 - 930 931 - 1400 3 1401 - 2168 CSD boundary 7

LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.15 Number, per 10,000 adults with diabetes, who had at least one hospitalization or emergency department visit for any acute complication in the Central West LHIN (5), by census subdivision, 2006/07–2010/11

KEY FINDINGS

• In census subdivisions (CSDs) located in the south and in one CSD northwest 12 of Orangeville, five-year rates of 2 hospitalizations or emergency 5-Year Rate ofdepartment Hospitalizations visits for and any Emergencyacute Department Visitscomplication For Any of Acutediabetes Complication were similar (Hyper- or Hypoglycemia,to the LHIN average Skin and(750 perSoft 10,000 Tissue Infection or Footadults Ulcer) with diabetes). Per 10,000 in Central West (5)• LHIN,In several by Censusnorthern SubdivisionCSDs, rates were higher andData more unavailable similar to the provincial0 -average 1200 (1,029 per 10,000). 1201 - 1500 1501 - 2000 2001 - 2800 2801 - 4431 8 CSD boundary LHIN boundary LHIN 5 Orangeville 5

NUMBER PER 10,000 ADULTS WITH DIABETES

Data unavailable 0 - 1200 1201 - 1500 1501 - 2000 2001 - 2800 3 2801 - 4431 CSD boundary 7

LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.16 Number, per 10,000 adults with diabetes, who had any chronic complication in the Central West LHIN (5), by census subdivision, 2006/07–2010/11

KEY FINDING 5-Year Rate of Hospitalizations For Any Chronic • Between 2006/07 and 2010/11, rates Complication (Cardiovascular Conditions, 12 Amputations ofand chronic End-Stage complications Renal in Disease) all census 2 Per 10,000 Ontarianssubdivisions with Diabetes (CSDs) were (2006 similar - 2011), to in Central Westthe (5) LHIN LHIN, average by Census (919 per Subdivision 10,000 adults with diabetes) and the provincialData average unavailable (1,016 per 10,000). 0 - 1000 1001 - 1300 1301 - 1700 1701 - 2300 2301 - 3371 CSD boundary LHIN boundary LHIN 5 8

Orangeville 5

NUMBER PER 10,000 ADULTS WITH DIABETES

Data unavailable 0 - 1000 1001 - 1300 1301 - 1700 1701 - 2300 3 2301 - 3371 CSD boundary 7

LHIN boundary 0 10 20 km LHIN 5 boundary 6

Data sources: Ontario Health Insurance Plan Database; Canadian Organ Replacement Register Database; Canadian Institute of Health Information Discharge Abstract Database; Trillium Gift of Life Network; Ontario Diabetes Database. Technical note: Adults were defined as those aged 20 years and older. Rates were age- and sex-standardized using the same-aged population in the Ontario Diabetes Database on March 31, 2006 as the standard population. A chronic complication consisted of hospitalization for a cardiovascular condition or having a lower extremity amputation or end-stage renal disease (chronic dialysis or kidney transplantation). Results / Diabetes Measures by Region / Central West LHIN ICES 132

EXHIBIT 5.17 Locations of diabetes education programs in the Central West LHIN (5), 2011

KEY FINDINGS

• Main diabetes education programs 12 were generally located in or near 2 majorLocations urban ofcentres, Diabetes including Education Orangeville, Brampton and Toronto. Programs in Central West (5) LHIN, • Outreach andby satellites SubLHIN of the main diabetes education programs were found only inMain the central-eastDM program location and southeast endsSatellite of the of LHINDM program and were generally concentratedOutreach DM near program major urban centres. subLHIN boundary LHIN 5 LHIN boundary Dufferin County

Orangeville 5

Caledon

Woodbridge (Vaughan) TYPE OF PROGRAM

Main program Rexdale Program satellite 3 Brampton (Toronto) Outreach program Malton (Mississauga) subLHIN boundary 7 LHIN boundary 0 10 20 km LHIN 5 boundary 6

EXHIBIT 5.18 Locations of endocrinologists and eye specialists in the Central West LHIN (5), 2010/11

KEY FINDINGS

• Endocrinologists were located in the 12 central-east and southeast parts of 2 Locations theof EndocrinologistsLHIN, with some clustering and Eye within major urban centres (Brampton and Specialists in Central West (5) LHIN, Toronto). by SubLHIN • Ophthalmologists were located only in OrangevilleEndocrinologist and Brampton. However,Ophthalmologist several ophthalmology practicesOptometrist were located on or just outside the Central West LHIN’s subLHIN boundary southern border. LHIN boundary • In contrast, optometrists were LHIN 5 distributed more widely throughout Dufferin County the LHIN, with locations in urban areas (Brampton and Toronto) as well as rural areas (Dufferin County 8 and Caledon).

Orangeville 5

Caledon

Woodbridge (Vaughan) TYPE OF SPECIALIST

Endocrinologist Rexdale Ophthalmologist 3 Brampton (Toronto) Optometrist Malton (Mississauga) subLHIN boundary 7 LHIN boundary 0 10 20 km LHIN 5 boundary 6

Mississauga Halton

LOCAL HEALTH INTEGRATION NETWORK 6

Diabetes Measures by Region Results / Diabetes Measures by Region / Mississauga Halton LHIN ICES 135

EXHIBIT 6.1 Diabetes prevalence per 100 adults in the Mississauga Halton LHIN (6), by subLHIN, on March 31, 2011

KEY FINDINGS 8

• For every 100 adults in the Diabetes PrevalenceMississauga Rate Halton Per LHIN, 100 almostOntarians 10 9 (2011), inwere Mississauga living with diabetes.Halton (6) This LHIN, 5 prevalenceby SubLHIN (9.72 per 100) was slightly higher than the Ontario average (9.646.18 per - 8.00 100). • Diabetes8.01 - 9.00 prevalence was highest in 9.01Northwest - 10.00 and Southwest 7 Mississauga (10.56 and 10.37 per 10.01 - 12.00 100, respectively). Toronto 12.01 - 22.76 South Etobicoke subLHIN boundary 3 - Toronto LHIN boundary Halton Hills Southeast LHIN 6 Northwest Mississauga Mississauga Guelph Mississauga 6

Milton

Oakville

PREVALENCE PER 100 ADULTS

6.18 - 8.00 8.01 - 9.00 0 10 20 km 9.01 - 10.00 10.01 - 12.00 Burlington 12.01 - 22.76 4 subLHIN boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.2 Diabetes incidence per 100 adults in the Mississauga Halton LHIN (6), by subLHIN, 2009/10

KEY FINDINGS 8

• For every 100 adults living in the Mississauga Halton LHIN who were 9 1-Yearfree of diabetesDiabetes in IncidenceMarch 2009, Rate one Per 5 was diagnosed100 Ontarians with diabetes (2009/10), in the subsequentin Mississauga year. This Halton incidence (6) LHIN, rate (0.98 per 100)by was SubLHIN nearly identical to the Ontario average (0.97 per 100). 0.61 - 0.80 • A slightly higher incidence rate was 0.81 - 0.95 7 seen in Northwest Mississauga and 0.96 - 1.10 Toronto Southeast Mississauga (1.08 and 1.01 South per 100, respectively).1.11 - 1.40 Etobicoke 1.41 - 2.79 3 - Toronto Halton Hills subLHIN boundary Southeast LHIN boundary Northwest Mississauga LHIN 6 Mississauga Guelph Mississauga 6

Milton

Oakville

INCIDENCE PER 100 ADULTS

0.61 - 0.80 0.81 - 0.95 0 10 20 km 0.96 - 1.10 1.11 - 1.40 Burlington 1.41 - 2.79 4 subLHIN boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.3 Number, per 10,000 adults with diabetes, who had at least one hospitalization or emergency department visit for hyper- or hypoglycemia in the Mississauga Halton LHIN (6), by subLHIN, 2006/07–2010/11

5-YearKEY Rate FINDINGS of Hospitalizations and 8 Emergency Department Visits for Hyper-• Overall, or Hypoglycemia for every 100 peradults 10,000 living Ontarianswith with diabetes Diabetes in the (2006-2011),Mississauga in 9 MississaugaHalton Halton LHIN on(6) March LHIN, 31, by 2006, SubLHIN about 5 four had 272at least - 400 one hospitalization or emergency department (ED) visit 401 - 500 for hyper- or hypoglycemia in the subsequent501 five- 600 years. This rate (413 per 10,000601 adults - 700 with diabetes) was lower than701 the - 1001 provincial average 7 (486 per 10,000). Toronto subLHIN boundary South • Rates of LHINhospitalizations/ED boundary visits Etobicoke for hyper- or hypoglycemia varied LHIN 6 3 - Toronto by more than 1.5-fold across Halton Hills subLHINs. The highest rates were Southeast seen in Milton (567 per 10,000) and Northwest Mississauga Oakville (562 per 10,000). Mississauga Guelph Mississauga 6

Milton

Oakville NUMBER PER 10,000 ADULTS WITH DIABETES

272 - 400 401 - 500 0 10 20 km 501 - 600 601 - 700 Burlington 701 - 1001 4 subLHIN boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.4 Number, per 10,000 adults with diabetes, who had at least one hospitalization or emergency department visit for skin and soft tissue infection or foot ulcer in the Mississauga Halton LHIN (6), by subLHIN, 2006/07–2010/11

KEY FINDINGS 8

• For every 100 adults living with diabetes in the Mississauga Halton 9 LHIN in 2006, nearly five had at least 5 5-Yearone Rate hospitalization of Hospitalizations or emergency and Emergencydepartment Department (ED) visit Visitsfor a skin for and Skin and Softsoft Tissue tissue infection Infection or footor Foot ulcer Ulcer Per 10,000during the Ontarians subsequent with five Diabetes years. This rate (452 per 10,000 adults with (2006 – 2011), in Mississauga 7 Haltondiabetes) (6) was LHIN, notably by lowerSubLHIN than the provincial average (618 per 10,000). Toronto 277 - 450 South • There was451 some - 630 variation in rates Etobicoke across subLHINs, ranging from 631 - 820 3 - Toronto 330 per 10,000 in Northwest Halton Hills Mississauga821 to - 6211050 per 10,000 in Southeast South Etobicoke-Toronto.1051 - 1540 Northwest Mississauga Mississauga subLHIN boundary Guelph Mississauga LHIN boundary LHIN 6 6

Milton

Oakville NUMBER PER 10,000 ADULTS WITH DIABETES

277 - 450 451 - 630 0 10 20 km 631 - 820 821 - 1050 Burlington 1051 - 1540 4 subLHIN boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.5 Number, per 10,000 adults with diabetes, who had at least one hospitalization for a cardiovascular condition in the Mississauga Halton LHIN (6), by subLHIN, 2006/07–2010/11

KEY FINDINGS 8

5-Year• More Ratethan sevenof Hospitalizations in 100 adults with for diabetes living in the Mississauga Cardiovascular Conditions Per 9 Halton LHIN in 2006 were 5 10,000hospitalized Ontarians for a cardiovascular with Diabetes condition(2006 - 2011), at least in once Mississauga in the ensuingHalton five (6) LHIN,years. byThis SubLHIN rate (734 per 10,000 adults567 - with 760 diabetes) was well below761 the - 880 provincial average (888 881per -10,000). 1020 7 Toronto • The highest rate1021 of - cardiovascular1200 South hospitalizations1201 was - 1446 seen in Halton Etobicoke Hills (917 per 10,000). 3 - Toronto subLHIN boundary Halton Hills LHIN boundary Southeast LHIN 6 Northwest Mississauga Mississauga Guelph Mississauga 6

Milton

Oakville NUMBER PER 10,000 ADULTS WITH DIABETES

567 - 760 761 - 880 0 10 20 km 881 - 1020 1021 - 1200 Burlington 1201 - 1446 4 subLHIN boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.6 Number, per 10,000 adults with diabetes, who had a lower extremity amputation in the Mississauga Halton LHIN (6), by subLHIN, 2006/07–2010/11

KEY FINDINGS 8

• In the Mississauga Halton LHIN, about four of every 1,000 adults with 9 diabetes experienced a lower 5 5-Year Rate ofextremity Lower amputationExtremity betweenAmputations Per 10,0002006/07 Ontarians and 2010/11. with DiabetesThis rate (2006 - 2011),(42 per in Mississauga10,000 adults with Halton diabetes) (6) was much lower than the Ontario LHIN, by SubLHIN average (74 per 10,000). 7 • Rates22 varied - 50 by nearly two-fold across subLHINs, although all were Toronto 51 - 80 South below the provincial average. The 81 - 110 Etobicoke highest rates were seen in Milton 3 - Toronto (58 per111 10,000)- 150 and South Etobicoke- Halton Hills Southeast Toronto151 -(56 211 per 10,000). Northwest Mississauga subLHIN boundary Mississauga LHIN boundary Guelph Mississauga LHIN 6 6

Milton

Oakville NUMBER PER 10,000 ADULTS WITH DIABETES

22 - 50 51 - 80 0 10 20 km 81 - 110 111 - 150 Burlington 151 - 211 4 subLHIN boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.7 Number, per 10,000 adults with diabetes, who received chronic dialysis or kidney transplantation in the Mississauga Halton LHIN (6), by subLHIN, 2006/07–2010/11

KEY FINDINGS 8

• Overall in the Mississauga Halton LHIN, the rate of chronic dialysis or 9 kidney transplantation was 112 per 5 10,000 adults with diabetes, a level 5-Yearslightly Rate lower of than Chronic the provincial Dialysis or averageKidney (122 Transplant per 10,000). Per 10,000 • OntariansRates varied with by nearly Diabetes 1.5-fold (2006 across - 2011),subLHINs. in Mississauga The highest rate Halton was in (6) 7 OakvilleLHIN, (135 per by 10,000) SubLHIN and the 73 - 100 Toronto lowest in Milton (92 per 10,000). South 101 - 125 Etobicoke 126 - 150 3 - Toronto Halton Hills 151 - 200 Southeast 201 - 280 Northwest Mississauga subLHIN boundary Mississauga Guelph LHIN boundary Mississauga LHIN 6 6

Milton

Oakville NUMBER PER 10,000 ADULTS WITH DIABETES

73 - 100 101 - 125 0 10 20 km 126 - 150 151 - 200 Burlington 201 - 280 4 subLHIN boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.8 Number, per 100 adults with diabetes, who had an additional chronic medical condition in the Mississauga Halton LHIN (6), by subLHIN, 2006/07–2008/09

KEY FINDINGS 8

• In the Mississauga Halton LHIN overall, about 51 of every 100 adults 9 Ratewith of diabetes One or had More at least Non-Diabetes one 5 Relatedchronic Medical medical Conditions condition other Per than 100 Ontariansdiabetes with between Diabetes 2006/07 (2006 and - 2009), in2008/09. Mississauga This rate Halton (51.24 per(6) 100)LHIN, was lowerby than SubLHIN the provincial average (54.84 per 100). 44.19 - 50.00 7 • There was some50.01 variation - 54.00 in rates across subLHINs, ranging from 47.96 Toronto 54.01 - 57.00 South per 100 in Northwest Mississauga to 57.01 - 61.00 Etobicoke 55.79 per 100 in Milton. 3 - Toronto 61.01 - 65.43 Halton Hills subLHIN boundary Southeast Northwest Mississauga LHIN boundary Mississauga LHIN 6 Guelph Mississauga 6

Milton

Oakville NUMBER PER 100 ADULTS WITH DIABETES

44.19 - 50.00 50.01 - 54.00 0 10 20 km 54.01 - 57.00 57.01 - 61.00 Burlington 61.01 - 65.43 4 subLHIN boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.9 Number, per 100 adults with diabetes, who made a mental health visit for a psychotic or nonpsychotic illness in the Mississauga Halton LHIN (6), by subLHIN, 2006/07–2008/09

KEY FINDINGS 8

• In the Mississauga Halton LHIN, one-third of adults with diabetes 9 made one or more mental health 5 visits between 2006/07 and 2008/09. This rate (33.07 per 100 adults with Rate of Any Mental Health Visit For a diabetes) was very similar to the Psychoticprovincial or Nonpsychotic average (32.89 Illness per 100). Per 10 Ontarians with Diabetes (2006 - 2009), in •Mississauga There was some Halton degree (6) of LHIN, 7 variationby in SubLHIN rates across subLHINs, ranging from 29.65 per 100 in Toronto 17.52 - 24.00 South Northwest Mississauga to 36.80 Etobicoke per 100 in24.01 Oakville. - 29.00 3 - Toronto 29.01 - 33.00 Halton Hills Southeast 33.01 - 37.00 Northwest Mississauga 37.01 - 41.66 Mississauga subLHIN boundary Guelph Mississauga LHIN boundary LHIN 6 6 Milton

Oakville NUMBER PER 100 ADULTS WITH DIABETES

17.52 - 24.00 24.01 - 29.00 0 10 20 km 29.01 - 33.00 33.01 - 37.00 Burlington 37.01 - 41.66 4 subLHIN boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.10 Percentage of economic families with low income in the Mississauga Halton LHIN (6), by subLHIN, 2005

KEY FINDINGS 8

• In the Mississauga Halton LHIN, nearly nine of every 100 families 9 were living with low income in 2005. 5 This percentage (8.7%) was nearly identical to the provincial average of 8.6% of families. Prevalence of After-Tax Low Income in Economic• Levels of lowFamilies, income inwere Mississauga highestHalton in(6) Northwest LHIN, by Mississauga, SubLHIN 7 Southeast Mississauga and South Etobicoke-Toronto.2.2 - 4.0 South Toronto 4.1 - 6.0 Etobicoke 3 - Toronto 6.1 - 8.0 Halton Hills 8.1 - 14.0 Southeast 14.1 - 25.3 Northwest Mississauga Mississauga subLHIN boundary Guelph Mississauga LHIN boundary LHIN 6 6

Milton

Oakville PERCENTAGE OF LOW-INCOME ECONOMIC FAMILIES

2.2 - 4.0 4.1 - 6.0 0 10 20 km 6.1 - 8.0 8.1 - 14.0 Burlington 14.1 - 25.3 4 subLHIN boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.11 Percentage of visible minorities in the Mississauga Halton LHIN (6), by subLHIN, 2006

KEYPercentage FINDINGS of Visible Minorities*, 8 in Mississauga Halton (6) LHIN, • In the Mississauga Halton LHIN, more than 36by of SubLHINevery 100 people * Persons, other than Aboriginal peoples, 9 self-identified who are non-Caucasian as belonging in race to a or 5 visible non-white minority in colour group. This percentage (36.37%) was substantially higher0.00 - 1.00 than the provincial average1.01 - of4.00 22.82%. • Higher concentrations4.01 - 12.00 of visible 7 minorities resided12.01 in- 30.00 Northwest and Southeast30.01 Mississauga, - 78.00 and in South South Etobicoke-Toronto. Toronto subLHIN boundary Etobicoke 3 - Toronto LHIN boundary Halton Hills LHIN 6 Southeast Northwest Mississauga Mississauga Guelph 6 Mississauga

Milton

Oakville PERCENTAGE OF VISIBLE MINORITIES

0.00 - 1.00 1.01 - 4.00 0 10 20 km 4.01 - 12.00 12.01 - 30.00 Burlington 30.01 - 78.00 4 subLHIN boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.12 Diabetes prevalence per 100 adults in the Mississauga Halton LHIN (6), by census subdivision, on March 31, 2011

KEY FINDING 8

Diabetes• In all census Prevalence subdivisions Rate in Perthe 100 OntariansMississauga (2011), Halton in LHIN, Mississauga the 9 prevalence of diabetes was in a range Halton (6) LHIN, by Census 5 similar to the LHIN average (9.72 per Subdivision 100) and the provincial average (9.64 per 100). 0.00 - 9.00 9.01 - 12.00 12.01 - 16.00 7 16.01 - 24.00 Toronto 24.01 - 31.27 CSD boundary 3 LHIN boundary LHIN 6

Guelph Mississauga 6

PREVALENCE PER 100 ADULTS

0.00 - 9.00 9.01 - 12.00 0 10 20 km 12.01 - 16.00 16.01 - 24.00 Burlington 24.01 - 31.27 4 CSD boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.13 Diabetes incidence per 100 adults in the Mississauga Halton LHIN (6), by census subdivision, 2005/06–2009/10

5-Year Diabetes Incidence Rate Per 100 KEYOntarians FINDINGS (2005/06 - 2009/10), in 8 Mississauga Halton (6) LHIN, by Census • In most census subdivisions, the Subdivision incidence of diabetes in adults over 9 the five-year 0.00period - 4.00 between April 5 2005 and March4.01 2010 - 5.00 was similar to the LHIN average (4.82 per 100) and 5.01 - 6.00 the provincial average (4.85 per 100). 6.01 - 7.00 • Above-average incidence was seen 7.01 - 16.32 in Mississauga. CSD boundary 7 LHIN boundary Toronto LHIN 6 3

Guelph Mississauga 6

INCIDENCE PER 100 ADULTS

0.00 - 4.00 4.01 - 5.00 0 10 20 km 5.01 - 6.00 6.01 - 7.00 Burlington 7.01 - 16.32 4 CSD boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.14 Number, per 10,000 adults with diabetes, who had at least one hospitalization or emergency department visit for hyper- or hypoglycemia in the Mississauga Halton LHIN (6), by census subdivision, 2006/07–2010/11

KEY FINDING 8

• In all census subdivisions in Mississauga Halton, rates of 9 5-Year Rate of Hospitalizationshospitalizations and or emergency Emergency 5 Department Visits fordepartment Hyper- or visits Hypoglycemia for hyper- or Per 10,000 Ontarians withhypoglycemia Diabetes were (2006 similar - 2011), to the in Mississauga Halton (6)LHIN LHIN, average by Census(412 per 10,000 Subdivision adults with diabetes) and the provincial 0 - average480 (486 per 10,000). 481 - 650 7 651 - 930 Toronto 931 - 1400 1401 - 2168 3 CSD boundary LHIN boundary LHIN 6 Guelph Mississauga 6

NUMBER PER 10,000 ADULTS WITH DIABETES

0 - 480 481 - 650 0 10 20 km 651 - 930 931 - 1400 Burlington 1401 - 2168 4 CSD boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.15 Number, per 10,000 adults with diabetes, who had at least one hospitalization or emergency department visit for any acute complication in the Mississauga Halton LHIN (6), by census subdivision, 2006/07–2010/11

KEY FINDING 8

• Between 2006/07 and 2010/11, rates of hospitalizations or emergency 9 5-Year Rate of Hospitalizationsdepartment and Emergency visits for acute Department 5 Visits For Any Acute Complicationcomplications (Hyper- in all or census Hypoglycemia, sub Skin and Soft Tissue Infectiondivisions or were Foot in Ulcer) the same Per range 10,000, as in Mississauga Halton (6)the LHIN, LHIN byaverage Census (812 Subdivisionper 10,000 adults with diabetes) and the 0 - 1200 provincial average (1,029 per 10,000). 1201 - 1500 7 1501 - 2000 Toronto 2001 - 2800 2801 - 4431 3 CSD boundary LHIN boundary LHIN 6 Guelph Mississauga 6

NUMBER PER 10,000 ADULTS WITH DIABETES

0 - 1200 1201 - 1500 0 10 20 km 1501 - 2000 2001 - 2800 Burlington 2801 - 4431 4 CSD boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.16 Number, per 10,000 adults with diabetes, who had any chronic complication in the Mississauga Halton LHIN (6), by census subdivision, 2006/07–2010/11

KEY FINDING 8 5-Year Rate of Hospitalizations For Any Chronic Complication (Cardiovascular Conditions, •Amputations Between 2006/07 and and End-Stage 2010/11, rates Renal Disease) Per 10,000 Ontariansof chronic with Diabetes complications (2006 in all- 2011), census 9 in Mississauga Halton (6) subdivisionsLHIN, by Census in the Mississauga Subdivision 5 Halton LHIN were in the same range 0 - 1000as the LHIN average (835 per 10,000 1001 - 1300adults with diabetes) and below the 1301 - 1700provincial average (1,016 per 10,000). 1701 - 2300 7 2301 - 3371 Toronto CSD boundary LHIN boundary 3 LHIN 6

Guelph Mississauga 6

NUMBER PER 10,000 ADULTS WITH DIABETES

0 - 1000 1001 - 1300 0 10 20 km 1301 - 1700 1701 - 2300 Burlington 2301 - 3371 4 CSD boundary LHIN boundary Hamilton LHIN 6 boundary

Data sources: Ontario Health Insurance Plan Database; Canadian Organ Replacement Register Database; Canadian Institute of Health Information Discharge Abstract Database; Trillium Gift of Life Network; Ontario Diabetes Database. Technical note: Adults were defined as those aged 20 years and older. Rates were age- and sex-standardized using the same-aged population in the Ontario Diabetes Database on March 31, 2006 as the standard population. A chronic complication consisted of hospitalization for a cardiovascular condition or having a lower extremity amputation or end-stage renal disease (chronic dialysis or kidney transplantation). Results / Diabetes Measures by Region / Mississauga Halton LHIN ICES 151

EXHIBIT 6.17 Locations of diabetes education programs in the Mississauga Halton LHIN (6), by subLHIN, 2011

KEY FINDINGS 8

• Main diabetes education programs Locationswere generally of Diabetes well distributed Education 9 Programsacross in Mississauga the Mississauga Halton Halton (6) LHIN. LHIN, 5 At leastby one SubLHIN such program was located in every subLHIN. Main DM program location • Outreach diabetes education Satellite of DM program programs were found only in NorthwestOutreach DM and program Southeast 7 Mississauga.subLHIN boundary Toronto LHIN 6 South LHIN boundary Etobicoke 3 - Toronto Halton Hills Southeast Northwest Mississauga Mississauga Guelph Mississauga 6

Milton

Oakville

TYPE OF PROGRAM 0 10 20 km Main program Program satellite Burlington Outreach program 4 subLHIN boundary LHIN boundary Hamilton LHIN 6 boundary

EXHIBIT 6.18 Locations of endocrinologists and eye specialists in the Mississauga Halton LHIN (6), by subLHIN, 2010/11

KEY FINDINGS 8

• Endocrinologists and eye specialists Locations(ophthalmologists of Endocrinologists and optometrists) and Eye 9 Specialistswere in Mississauga generally clustered Halton in (6)or near LHIN, 5 majorby urban SubLHIN areas. • Compared with endocrinologists Endocrinologist and ophthalmologists, optometrists Ophthalmologistwere distributed more widely across Optometristthe LHIN. 7 subLHIN boundary Toronto LHIN boundary South LHIN 6 Etobicoke 3 - Toronto Halton Hills Southeast Northwest Mississauga Mississauga Guelph Mississauga 6

Milton

Oakville

TYPE OF SPECIALIST 0 10 20 km Endocrinologist Ophthalmologist Burlington Optometrist 4 subLHIN boundary LHIN boundary Hamilton LHIN 6 boundary