Community Profiles Have Been Developed to Inform Clinical Services/ Population: 169,461 Health System Planning for Community-Based Programs at Capital Health

Community Capital Health Community Clinical Profile Services / Health System Planning Group (2014)

Created by the Capital Health Community Clinical Services/ Health System Planning Group November 2014

Contact: Primary Health Care, Capital Health Halifax [email protected] Peninsula/Chebucto

Community Health Network 2 Overview:

Community Profiles have been developed to inform Clinical Services/ Population: 169,461 Health System Planning for community-based programs at Capital Health. The Community Profiles, including citizen engagement results from the Community Health Boards, provide a community lens that will inform an evidence-based approach to future planning at a local level. The purpose of the profile is to provide a snapshot of the populations and communities within each of the five Community Health Networks (CHNs; formerly referred to as Zones). Please refer to the Glossary and Data Dictionary for key definitions and data sources for each of the indicators/concepts mentioned in the report. These community profiles build upon the work of the Population Health Status Report (Public Health, Capital Health, 2013), which can be referenced for further detail regarding demographics, methodology, and additional analysis of selected variables. A full list of contributors to this report is located in Appendix A.

Table of Contents: (for a full table of contents and list of tables and figures, refer to Appendices B-D) I. Geography II. Community Health Board Engagement III. Community Health Network Inventory IV. Population Demographics V. Health Status VI. Service Delivery Locations VII. Health Service Utilization Data VIII. Summary of Observations for each Community within the Community Health Network

GEOGRAPHY

CHN 4

CHN 5 CHN 3

CHN 1

CHN 2 Figure 1: Community Health Network 2 and Capital District Health Authority Geography. There are five proposed Community Health Networks (formerly referred to as Zones) across the district.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 1 Capital Health Community Clinical Services / Health System Planning Group (2014) Community Composition

Figure 2: Community Health Network 2 Geography

Community Health Network 2 (CHN 2) includes the communities of:

Table 1: CHN 2 Communities and Populations Community Population Community Population Armdale-Northwest Arm 9,904 Hubbards 2,082 Clayton Park 34,439 Peggy’s Cove 640 Fairview 15,789 Prospect 3,246 Hackett’s Cove 1,485 Sambro 3,835 Halifax Chebucto 18,764 Spryfield 10,864 Halifax Citadel 20,055 St. Margaret’s Bay 2,411 Halifax Needham 20,192 Tantallon 9,431 Hatchet Lake 3,201 Terence Bay 1,001 Herring Cove 2,734 Timberlea 9,388 CHN 2 Total: 169,461 Source: 2011 Canadian Census data (Government of Nova Scotia, 2013. Nova Scotia Community Counts).

The population of CHN 2 is 169,461 citizens, which accounts for 40.0% of the population of the Capital District Health Authority (CDHA). CHN 2 encompasses the Halifax Community Health Board (population: 90,932) and the Chebucto West Community Health Board (population: 73,295). Together, the two CHBs represent 97% of the population of the CHN, thus combined data for the two CHBs are used as a geographic comparator (e.g., a proxy measure of the CHN average) where aggregate data is not available. Comparisons made within CHNs are based on observation only; statistical tests for significance were not completed for the purposes of this project. Please refer to Appendix E for a data disclaimer applicable to all readers and users of this report.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 2 Capital Health Community Clinical Services / Health System Planning Group (2014) Rurality

Figure 3: CHN 2 Rurality (Canadian Census, 2011; Community Counts Community Boundaries, 2011).

Communities were categorized as being urban, suburban, or rural, using a definition1 based on population density and proximity to the urban core:

Rural Communities Rural Hackett’s Cove, Peggy’s Cove, Terrence Bay, Hatchett Lake, Hubbards, Prospect (higher 10.6% of Population population density), Sambro, St. Margaret’s Bay

Suburban Suburban Communities 12.7% of Timberlea, Tantallon, Herring Cove Population

Urban Communities Armdale-Northwest Arm, Clayton Park, Fairview, Urban Halifax Chebucto, Halifax Citadel, Halifax 76.7% of Needham, Spryfield Population

1 Urban: greater than 280 people per km2; Suburban: between 46 people per km2 and 280 people per km2 and surrounding an urban core; Rural: <46 people per km2 and/or identifying pockets of higher population density that may be above 46 people per km2, but not surrounding the urban core (definition adapted for Capital Health by Public Health & Primary Health Care, Capital Health).

Community Health Network 2: Halifax Peninsula / Chebucto Page | 3 Capital Health Community Clinical Services / Health System Planning Group (2014) Population Projections

Figure 4: Percentage of population change from 2014-2024, by community (Environics Analytics Group LTD., 2014, modeled from Census Canada data, 2011).

Population projections for communities in the Capital Health district were obtained from Environics Analytics Group Ltd (2014) and analyzed for Capital Health. This data provided five and ten year projections for six-digit postal codes in Capital Health, which were aggregated to the community level. The five and ten year projections for each community, as well as projections for the youth (<20 years of age) and senior (65 years and above) population are highlighted in Table 2. Figure 4 depicts the percent change in population for communities within the CHN over a ten year period (2014-2024). Refer to Appendix E for a detailed breakdown of all ages groups by community.

Trends in projected populations are generally consistent with the trends reported in the Ivany Report (2014) for the Halifax Regional Municipality. The Ivany Report noted a decrease in the percentage of population of youth and a 49% increase in population for the age category >64 years. This will result in a +1% net increase in population for the HRM by the year 2034 (Nova Scotia Department of Finance, 2013).

CHN 2 will experience a 16% increase in population by 2019, which is the largest percent increase in population in a five year period across all CHNs. CHN 2 will experience a 18% increase in population by 2024 (second highest percent increase in the district). Within the CHN, the community that is projected to have the highest percentage of population growth over the next five and ten years is Halifax Needham; the community’s population will increase by 63% by 2019 and remain relatively stable between 2019 and 2024. Within the CHN, the community of Clayton Park will have the larger percent increase of the youth population (21% increase by 2019; 28% increase by 2024), whereas the youth population for the whole CHN will decrease by 1% by 2019 and increase by 2% by 2024. In addition to experiencing the largest population growth by percentage, Halifax Needham will also experience the largest growth in the senior population. The senior population in Halifax Needham is expected to grow by 413% by 2019.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 4 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 2: 2019 (5 Year) and 2024 (10 year) Population Projections for Communities within the CHN 20193 20244 20142 Percent Change (%) Percent Change (%) Projected Projected Population Population Total Youth Seniors Population Total Youth Seniors CDHA 423,163 463,931 10 -7 50 476,940 13 -4 78 CHN 2 169,461 196,740 16 -1 66 200,566 18 2 87 Community Armdale- Northwest 9,904 10,353 5 -1 8 10,701 8 9 19 Arm Clayton Park 34,439 41,379 20 21 23 42,832 24 28 38

Fairview 15,789 16,585 5 3 14 16,909 7 7 31 Hacketts Cove 1,485 1,478 0 -33 25 1,469 -1 -37 42 Halifax 18,764 18,057 -4 -26 1 17,317 -8 -34 14 Chebucto Halifax Citadel 20,055 21,552 7 -11 8 21,598 8 -10 15 Halifax 20,192 32,866 63 16 413 32,638 62 25 418 Needham Hatchet Lake 3,201 3,282 3 -19 67 3,465 8 -18 129 Herring Cove 2,734 2,959 8 -16 46 3,246 19 -7 92 Hubbards 2,082 2,530 22 20 58 2,615 26 21 93 Peggy’s Cove 640 696 9 -24 31 730 14 -27 66 Prospect 3,246 3,391 4 -15 70 3,514 8 -16 125 Sambro 3,835 3,903 2 -13 64 4,134 8 -11 123 Spryfield 10,864 11,764 8 -4 42 12,137 12 -1 76 St. Margaret’s 2,411 3,475 44 13 98 3,591 49 16 141 Bay Tantallon 9,431 10,955 16 -9 81 11,700 24 -7 159 Terence Bay 1,001 1,017 2 -10 47 979 -2 -17 66 Timberlea 9,388 10,495 12 0 67 10,991 17 1 134 Net Change for CHN 2 ↑27,279 citizens ↑31,105 citizens

Source: Environics Analytics Group LTD., 2014

Note for Readers:

Throughout the report, you will notice numbers bolded in red and blue (like the above example). This is to identify the highest value within a CHN (red) and the lowest value within a CHN (blue). In some cases, bolded numbers also designate when the CHN rate is higher than the district rate (red) or lower than the district rate (blue).

2 As reported by 2011 Canadian Census Data 3 All percentages reported for population projections are relative to the 2014 population: 5 year projections are calculated based on percent change from 2014-2019 4 All percentages reported for population projections are relative to the 2014 population: 10 year projections are calculated based on percent change from 2014-2024

Community Health Network 2: Halifax Peninsula / Chebucto Page | 5 Capital Health Community Clinical Services / Health System Planning Group (2014)

COMMUNITY HEALTH BOARD (CHB) ENGAGEMENT

Halifax Community Health Board findings from 2013 Community Health Plan:

The Halifax CHB includes the communities of Halifax Chebucto, Halifax Citadel, Halifax Needham, and Fairview The Halifax CHB received feedback from seniors, newcomers, people with disabilities, mental health consumers, those facing health and social inequities, and others during community conversations We heard the desire for community driven action and will take the Health Plan back to our community We will work together with local groups to address the concerns they raised

Chebucto West Community Health Board findings from the 2013 Community Health Plan:

The Chebucto West CHB includes the communities of Armdale-Northwest Arm, Clayton Park, Hackett’s Cove, Hatchet Lake, Herring Cove, Hubbards, Peggy’s Cove, Prospect, Sambro, Spryfield, St. Margaret’s Bay, Tantallon, Terrence Bay, and Timberlea Chebucto West CHB is focused on improving access to services and information on the health priorities identified by our community (e.g., mental health and addictions, food security, transportation, chronic conditions, low or no cost activities, etc.) We will be mindful of programs and services for both urban and rural residents, building capacity/community impact with new and established community partners

Note: The information provided in this section is a brief overview only; further information regarding community consultations and priority issues and actions identified by each Community Health Board is available via the CHBs and the 2013 Community Health Plan (http://www.cdha.nshealth.ca/involving-patients-citizens/news/community-health-plan)

Community Health Network 2: Halifax Peninsula / Chebucto Page | 6 Capital Health Community Clinical Services / Health System Planning Group (2014)

COMMUNITY HEALTH NETWORK INVENTORY

The Community Health Network Inventory provides a brief overview of some of the data available regarding community assets that have an impact on health (e.g., recreation locations) and access (e.g., transportation). This is not an exhaustive list of all of the community resources and partners that exist within geographies contributing to the overall health and well-being of citizens. Other community assets that are not listed in this section include, but are not limited to: shelters, food banks, faith-based organizations, educational institutions, libraries, social clubs and organizations, community leaders, other municipal, health, social, and not-for-profit partners and organizations, and many others. Further information and details about community assets can be found through 211 Nova Scotia5 and using Nova Scotia Community Counts Map Centre6.

Food Sources

Figure 5: CHN 2 Food Source Locations. Locations for the grocery stores/fast food sites provided by Dr. S. Kirk,

Dalhousie University (2011); adapted from Population Health Status Report, Public Health, CDHA (2013)

Figure 5 depicts food availability across the CHN as indicated by locations of food sources. Observationally, clusters of food sources are evident in the urban core. Tables 3 and 4 below indicate the density per 100,000 population of grocery stores and fast food locations, respectively.

5 211 Nova Scotia: http://ns.211.ca/homepage 6 http://www.novascotia.ca/finance/communitycounts/map_centre/dha.html#

Community Health Network 2: Halifax Peninsula / Chebucto Page | 7 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 3: Density of Grocery Store Locations per 100,000 by Community within CHN 2 Density of grocery stores per 100,000 Communities within the CHN Low Density 0.0 – 45.5 Armdale – Northwest Arm, Clayton Park, Peggy’s Cove, St. Margaret’s Bay, Spryfield, Tantallon, Terrence Bay, Timberlea 45.6 – 91.1 Fairview, Halifax Chebucto, Halifax Citadel, Prospect, Sambro Medium 91.2 – 136.7 Hackett’s Cove, Hatchet Lake Density 136.8 – 182.2 Halifax Needham High Density 182.3 – 227.8 n/a Source: Dr. S. Kirk, Dalhousie University (2011); Population Health Status Report, Public Health, CDHA (2013)

Table 4: Density of Fast Food Locations per 100,000 by Community within CHN 2 Density of fast food locations per 100,000 Communities within the CHN Low Density 0.0 – 84.7 Armdale – Northwest Arm, Peggy’s Cove, Prospect, St. Margaret’s Bay, Spryfield, Tantallon, Terrence Bay, Timberlea 84.8 – 169.5 Clayton Park, Hatchet Lake, Hubbards Medium 169.6 – 254.3 Hacketts Cove, Halifax Chebucto Density 254.4 – 339.0 Halifax Needham High Density 339.1 – 433.8 Halifax Citadel Source: Dr. S. Kirk, Dalhousie University (2011); Population Health Status Report, Public Health, CDHA (2013)

Information regarding liquor store locations is based on Nova Scotia Liquor Commission (NSLC) locations including agencies and specialty stores (n = 51) that were present during the period of 2006 to 2011. It is important to note that various NSLC locations have opened and closed between 2011 and 2014 (Population Health Status Report, Public Health CDHA, 2013). Refer to Table 5.

The Halifax CHB had the greatest number of liquor stores within its CHB (10) and the second highest density of liquor stores per 100,000 population, with 13.9 stores per 1000 population. The average annual per capita sales of this CHB was $870 (highest in the district by over $300). Currently in 2014, there are 11 NSLC locations in the Halifax CHB in the communities of: Halifax Citadel (5), Halifax Chebucto (2), Halifax Needham (3), and Fairview (1). The Chebucto West CHB had five liquor stores, with a density of 5.9 stores per 100,000 population. Per capita sales were $378 annually. In 2014, there are eight NSLC locations in the Chebucto West CHB in the communities of Clayton Park (4), Spryfield (1), Hubbards (1), Sambro (1), and Tantallon (1).

Table 5: Nova Scotia Liquor Commission Data, by Community Health Board, for period 2006-2011 CHB # of Stores # of Stores per 100,000 population Sales per Capita7 Dartmouth 5 (2014: 6) 7.4 $582 Southeastern 2 4.7 $372 Halifax Peninsula 10 (2014: 11) 13.9 $870 Chebucto West 5 (2014: 7) 5.9 $378 Cobequid 8 (2014: 6) 9.6 $541 Eastern Shore Musquodoboit 4 18.6 $491 West Hants Uniacke 1 (2014: 2) 4.6 $374 Source: Population Health Status Report, Public Health, Capital Health, 2013; Nova Scotia Liquor Commission data for time period 2006-2011; Nova Scotia Liquor Commission, Store Information (2014), retrieved August 15, 2014 from http://www.mynslc.com/Pages/storeInformation.aspx

7 Annual sales per capita are not necessarily reflective of the population living in the CHB (based on total revenue of the stores in the CHBs).

Community Health Network 2: Halifax Peninsula / Chebucto Page | 8 Capital Health Community Clinical Services / Health System Planning Group (2014) Transportation

Figure 6: CHN 2 method of transportation to work by community and Metro Transit Bus Routes (Transportation: Canadian Census, 2006; Bus routes: Halifax Regional Municipality, 2014)

Transportation was measured as the method of transportation to and from work. Figure 6 depicts the breakdown of transportation methods by community, as well as the bus routes servicing CHN 2.

The general observation for the CHN is the further away citizens reside from the urban core, the more likely individuals are to use a car as their predominant mode of transportation due to limited bus routes. This applies to the communities of Tantallon, Hubbards, St. Margaret’s Bay, Hatchet Lake, Peggy’s Cove, Prospect, Terrence Bay, Hackett’s Cove, and Sambro, where there are limited or no bus routes.

CHN 2 has the highest rate of people reporting walking to work across the district. Within the CHN, the highest proportion of people reporting walking as their predominant mode of transportation to work reside in the communities of Halifax Citadel (54.6% of citizens), Halifax Needham (33.5% of citizens), and Halifax Chebucto (30.4% of citizens).

The community within the CHN where citizens report the highest use of public transit as the method of transportation to work is Fairview (23.6% of citizens). This is followed by the communities of Spryfield (22.4%), Armdale - Northwest Arm (17.7%), Halifax Chebucto (15.7%), Halifax Needham (16.7%), and Clayton Park (15.5%).

Community Health Network 2: Halifax Peninsula / Chebucto Page | 9 Capital Health Community Clinical Services / Health System Planning Group (2014) Recreation Locations

Figure 7: CHN 2 Recreation Locations by Type (Halifax Regional Municipality, HRM Park Recreation Features, 2014).

Figure 8: CHN 2 Park Locations by Type (Restricted and Limited Use Land Database, Government of Nova, 2013; Halifax Regional

Municipality, HRM Parks, 2014; Halifax Regional Municipality, Trails, 2014). Figure 7 depicts recreation locations in CHN 2, based on type of facility and location. Observationally, clusters of recreation locations are evident in the more urban areas of CHN 2. Figure 8 depicts the locations of recognized parks and trails, by type, in CHN 2.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 10 Capital Health Community Clinical Services / Health System Planning Group (2014) Public Housing

Figure 9: Public/Affordable Housing Units per 1000 population (Housing Nova Scotia, 2014).

Figure 9 depicts the density of public/affordable housing units per 1000 population in CHN 2. Data were suppressed for any community with less than five public housing units for confidentiality purposes. The community in CHN 2 with the greater density of public housing units per 1000 population is Halifax Needham. The actual number of public/affordable housing units in each community is indicated by the number on the map. “Units” may mean an apartment for one person or a home for a family with multiple occupants; therefore, the number of units is not indicative of the number of people living in public housing.

There are four public housing communities identified by the Department of Community Services (2014) within CHN 2. The public housing communities are located within: Halifax Needham: Mulgrave Park and Uniacke Square Halifax Chebucto: Bayers Westwood Spryfield: Greystone

Community Health Network 2: Halifax Peninsula / Chebucto Page | 11 Capital Health Community Clinical Services / Health System Planning Group (2014) Shelters & Homelessness

All of the shelters located in the Halifax Regional Municipality (HRM) for homeless/housing insecure individuals are located in the Peninsula area of CHN 2 in the communities of Halifax Citadel and Halifax Needham.

Within these communities, there are: Three shelters for women (Barry House located at 2706 Gottingen Street, Adsum House located at 2421 Brunswick Street, and Byrony House located 3399 Novalea Drive); Two shelters for men (Metro Turning Point located at 2170 Barrington Street and Salvation Army Centre of Hope located at 2044 Gottingen Street); One shelter for youth (Phoenix Youth Shelter located at 1094 Tower Road); and One temporary shelter anyone can access (Out of the Cold Winter Shelter located at 1479 Barrington Street). Additionally, there are many transitional, recovery, and supportive housing options located across the CHN.

Data from emergency shelters8 can serve as a proxy for measuring the homeless population in a community, keeping in mind the capacity of the shelter system can limit the number of the people accessing services (Homelessness Partnering Secretariat, 2012). In 2012, 1,716 unique individuals accessed one of the homeless shelters listed above in Halifax. This number has increased slightly from 2009 (n=1603), reflecting an increasing utilization trend over a four year period. Note that data for Byrony House is not included in this count. Approximately 63% of shelter users had only one stay during the year and approximately 37.0% of all shelter users had a stay of 30 days or longer. More males than females accessed the shelter system, with males accounting for 65.3% of shelter users and females accounting for 34.2%. In terms of age, 7.2% were children, 26.9% were youth, 63.2% were adults and 2.7% were seniors (Homelessness Partnering Secretariat, 2012). The HRM Community Progress Index for 2012 can be referenced for further detail.

8 Emergency shelters are defined as facilities providing temporary and short-term accommodation for homeless individuals and families, which may include essential services such as food, clothing and counseling.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 12 Capital Health Community Clinical Services / Health System Planning Group (2014)

COMMUNITY HEALTH NETWORK POPULATION DEMOGRAPHICS

Population Age Groups

CHN 2 and CDHA Population Pyramid, 2011 85+ yrs 80-84 yrs 75-79 yrs 70-74 yrs

65-69 yrs Female 60-64 yrs

Zone 2

55-59 yrs Female 50-54 yrs CDHA

45-49 yrs Male

40-44 yrs Zone 2 35-39 yrs Male

Age Age Group(Years) 30-34 yrs CDHA 25-29 yrs 20-24 yrs 15-19 yrs 10-14 yrs 5-9 yrs 0-4 yrs

-15 -10 -5 0 5 10 15

Percent of Total DHA Population

Figure 10: Population Pyramid for CHN 2 reflecting size, age, and sex distribution as compared to CDHA (Note: prepared using 5-year age group breakdowns from combined Halifax and Chebucto CHB; population 164,227), 2011 Canadian Census Data.

Figure 10 represents the age, sex, and gender distribution by 5-year age groups of the population of CHN 2 and of CDHA. In comparison to CDHA, CHN 2 has a notably higher percentage of the 20-29 year old population, a lower percentage of the youth (<20 years of age) population, and a relatively similar proportion of the population in the age 65 years and older age group.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 13 Capital Health Community Clinical Services / Health System Planning Group (2014)

Figure 11: CHN 2 Population Age Groups (Canadian Census, 2011)

Figure 11 represents the proportion of the population within each community that falls into the age categories of under 20 years of age, 20 to 29 years of age, 30 to 39 years of age, 40 to 49 years of age, 50 to 65 years of age, and those 65 years of age or older. This information is further detailed in Table 6.

Figure 12: CHN 2 Average Age by Community (Canadian Census, 2011) Community Health Network 2: Halifax Peninsula / Chebucto Page | 14 Capital Health Community Clinical Services / Health System Planning Group (2014)

Figure 12 depicts average age by community within CHN 2. Peggy’s Cove and Hackett’s cove have the older average age within the CHN and are among the communities with the older average age in the district. The communities with the younger average age include Tantallon, Timberlea, Hatchet Lake, Halifax Chebucto, and Halifax Citadel.

According to Table 6, in CHN 2 Tantallon (29.8%), followed by Timberlea (27.5%), has the highest rate of the youth population (<20 years of age) within the CHN and they are among the communities with the highest rate of the youth population across the district. Halifax Citadel is the community within the CHN with the lower rate of the youth population (11.8%).

CHN 2 has the highest rate of the population in the 20-29 year old age demographic across the district, with 14.9% of the population falling into this age bracket. Within CHN 2 and also across the district, the community with the highest percentage of the population in the 20-29 year old age demographic is Halifax Citadel, with 41% of the population being 20 to 29 years of age. This is likely correlated to the universities and colleges located within this community.

The communities within the CHN with the higher percentage of the population aged 65 years and older are Armdale-Northwest Arm (21.8%), Hackett’s Cove (21.8%), and Peggy’s Cove (21.3%), which is much higher than the district average of 13.3%. Hubbards, Hackett’s Cove, Peggy’s Cove, and St. Margaret's Bay have the highest percentage of age 50-64 year old within the CHN.

Fairview and Clayton have similar proportions (equal distribution) across age categories.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 15 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 6: Population breakdown by age category and community for CHN 2. % < 20 % 20 – 29 % 30 – 39 % 40 – 49 % 50 – 64 % 65 Total years years years years years years + Population Nova Scotia 21.2 12.1 11.7 15.0 23.3 16.6 921,725 CDHA 21.5 14.9 13.4 15.6 21.3 13.3 412,518 Halifax Peninsula + 18.2 20.6 13.8 13.8 19.9 13.8 164,292 Chebucto CHBs Community Armdale- 16.6 12.6 12.5 13.4 23.2 21.8 9,904 Northwest Arm Clayton Park 17.7 19.4 14.5 12.9 18.5 16.7 34,439 Fairview 17.4 19.8 13.7 14.6 20.6 13.8 15,789 Hackett’s Cove 16.2 8.6 10.4 16.6 27.5 21.8 1,485 Halifax Chebucto 19.3 24.2 13.3 12.9 18.3 12.5 18,764 Halifax Citadel 11.8 41.0 11.4 8.3 14.5 13.1 20,055 Halifax Needham 13.4 26.6 16.8 12.5 19.0 11.7 20,192 Hatchet Lake 25.9 10.9 12.9 17.3 24.2 9.4 3,201 Herring Cove 22.5 8.8 11.3 16.8 27.0 14.2 2,734 Hubbards 19.8 7.8 11.3 15.8 28.3 17.7 2,082 Peggy’s Cove 17.8 9.8 8.9 15.0 29.2 21.3 640 Prospect 23.8 8.8 12.0 18.1 26.7 11.3 3,246 Sambro 22.7 10.4 15.1 18.2 23.1 9.9 3,835 Spryfield 22.2 12.6 13.6 15.9 23.2 11.9 10,864 St. Margaret’s Bay 22.1 7.1 8.5 17.7 27.8 16.5 2,411 Tantallon 29.8 6.8 14.3 21.6 19.9 8.6 9,431 Terrence Bay 17.5 7.9 12.5 18.2 26.9 16.7 1,001 Timberlea 27.5 10.9 18.3 18.5 17.4 7.7 9,388

Source: Canadian Census, 2011

Community Health Network 2: Halifax Peninsula / Chebucto Page | 16 Capital Health Community Clinical Services / Health System Planning Group (2014) Population Density

Figure 13: CHN 2 Population density by community (Canadian Census, 2011; Community Counts Community Boundaries, 2011).

Figure 13 represents population density. The communities within CHN 2 have a wide range of population density, from densely populated urban areas to less populated rural outlying areas. The population density of the CHN is 178.1 people per km2, the second highest in the district. The communities with the highest population density are Halifax Chebucto (4096.9 people per km2), Halifax Needham (3087.5 people per km2), and Halifax Citadel (2949.3 people per km2). These three communities are the most population dense in the district.

Prospect, when compared to its neighbouring rural communities, (Hatchet Lake, Hackett’s Cove, Peggy’s Cove, Terrence Bay) has a higher population density (67.3 people per km2).

Community Health Network 2: Halifax Peninsula / Chebucto Page | 17 Capital Health Community Clinical Services / Health System Planning Group (2014)

Visible Minorities

Figure 14: Percentage of the population identifying as a visible minority in CHN 2 (National Household Survey, 2011).

Within the geography of CHN 2, approximately 12.2% of the population identify as a visible minority, which is greater than the district average of 8.8%. CHN 2 has the highest percentage of people identifying as a visible minority in the district. The highest percentages of people identifying as a visible minority reside in Halifax Needham (17.5%) and Clayton Park (17.1%), followed by Halifax Citadel (16.6%), Fairview (12.9%), and Armdale – Northwest Arm (12.8%). There are no reported people identifying as a visible minority living in Hubbards, Hatchet Lake, Herring Cove, or Terrance Bay. Figure 14 and Table 7a provides a full breakdown by community.

Within the CHN, the predominant visible minority identified with is Black, with 3.5% of the population identifying as Black. The higher percentage of individuals identifying as Black reside in Halifax Needham (8.8% of citizens), followed by Spryfield (5.2%).

6.1% of people living in CHN 2 identify as belonging to an “other” visible minority which is defined as Filipino, Latin American, Southeast Asian, which is the highest rate across all CHNs. The highest percentage of people identifying as “other” within CHN 2 and across CDHA reside in Armdale-Northwest Arm, with 8.8% of the population identifying as belonging to one of these three groups.

1.7% of CHN2 residents identify as Chinese/Korean/Japanese, which is the highest rate across all CHNs. Within the CHN and also within the district, the highest percentage of people identifying as Chinese/ Korean/Japanese reside in Halifax Citadel (5.6%). 1.5% of individuals living in CHN 2 identify as Arab/West Indian. Within the CHN and also within the district, the highest percentage of people identifying as Arab/West Asian reside in Clayton Park (5.6%). 0.2% of individuals living in the district identify as South Asian/East Indian with 1.0% of people living Spryfield identify as South Asian/East Indian, which is the highest in the CHN and across the district.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 18 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 7a: Percentage of Individuals within CHN 2 identifying as a Visible Minority Total Arab/West Chinese/ Korean/ South Asian/ Black, % Other9, % Percentage Asian, % Japanese, % East Indian, % CDHA 8.8% 3.5% 1.7% 1.4% 0.2% 2.0% Halifax Peninsula + 12.2% 2.8% 1.5% 1.7% 0.2% 6.1% Chebucto CHBs Community Armdale- 12.8 2.1 2.2 0.3 0 8.2 Northwest Arm Clayton Park 17.1 2.3 5.6 2.3 0.2 6.7 Fairview 12.9 2.6 3.8 1.3 0.2 5 Hackett’s Cove 1.8 0 0 0 0 1.8 Halifax 11.1 2.5 1.9 1.7 0.2 4.8 Chebucto Halifax Citadel 16.6 0.1 3.8 5.6 0 7.1 Halifax 17.5 8.8 2.7 0.8 0.1 5.1 Needham Hatchet Lake 0 0 0 0 0 0 Herring Cove 0 0 0 0 0 0 Hubbards 0 0 0 0 0 0 Peggy’s Cove 0.3 0 0 0 0 0.3 Prospect 0.2 0 0 0 0 0.2 Sambro 3 1.2 0 0 0 1.8 Spryfield 9.9 5.2 0.2 0.3 1.0 3.2 St. Margaret’s 0.7 0 0 0.5 0 0.2 Bay Tantallon 1.2 0 0 0.6 0 0.6 Terence Bay 0 0 0 0 0 0 Timberlea 7.2 3.5 0.6 0.6 0 2.5

Source: National Household Survey, 2011 (Note:percentages based on total number of individuals reporting through the National Household Survey).

9 Other – Filipino, Latin American, Southeast Asian

Community Health Network 2: Halifax Peninsula / Chebucto Page | 19 Capital Health Community Clinical Services / Health System Planning Group (2014)

Finally, 1.3% of citizens living in CHN 2 report being of Aboriginal identity10, which is lower than the district average of 2.5% of citizens. Within the CHN, the community with the higher number of individuals identifying with an Aboriginal group is St. Margaret’s Bay (2.9% of citizens). Refer to Table 7b.

Table 7b: Percentage of Individuals within CHN 2 identifying as Aboriginal Community Percentage identifying as Aboriginal Armdale-Northwest Arm 1.5 Clayton Park 1.2 Fairview 1.8 Hackett’s Cove 0 Halifax Chebucto 0.6 Halifax Citadel 0.3 Halifax Needham 1.9 Hatchet Lake 0.5 Herring Cove 0 Hubbards 0 Peggy’s Cove 0 Prospect 0.6 Sambro 1.4 Spryfield 2.3 St. Margaret’s Bay 2.9 Tantallon 0.9 Terence Bay 0 Timberlea 2.7 Halifax Peninsula and Chebucto CHBs 1.3 CDHA 2.5

Source: National Household Survey, 2011 (Note:percentages based on total number of individuals reporting through the National Household Survey).

10 Aboriginal Identity is not classified as a visible minority; it is a separate identity category

Community Health Network 2: Halifax Peninsula / Chebucto Page | 20 Capital Health Community Clinical Services / Health System Planning Group (2014)

Citizenship, Language, and Immigration

Figure 15: Percentage of the population identifying as being an immigrant to Canada in CHN 2 (National Household Survey, 2011).

Within CHN 2, 11.2% of the population identify as being an immigrant to Canada, which is the highest rate in the district (disrict average: 7.9%). Clayton Park has the highest rate of citizens identifying as being an immigrant to Canada (17.5%) in the CHN and also in the district. Following Clayton Park is Armdale-Northwest Arm (15.1% of residents) and Halifax Citadel (14.9% of residents). The community within the CHN with the lowest rate of citizens reporting being immigrants to Canda is Hatchet Lake (1.5%). All rates are identified in Figure 15.

Within the CHN, 93.3% of residents report being a Canadian Citizen, which is lower than the district average of 96.2% and the lowest rate of all CHNs. Within the CHN, Halifax Citadel has the highest rate of non-Canadian citizens, with 14.8% of the population reporting not being a Canadian citizen. Hackett’s Cove and Timberlea have the highest rate of Canadian citizens within the CHN (98.8% and 98.9% of citizens, respectively).

English is the predominant language reported being spoken at home in CHN 2 (91.8%). However, this is the lowest percentage across all CHNs; CHN 2 has the highest rate of languages other than English being spoken at home, with 8.2% of the population speaking a language other than English at home. The communities with the highest percentage of residents speaking languages other than English at home are Halifax Citadel (14% of the residents) and Clayton Park (13% of residents).

Community Health Network 2: Halifax Peninsula / Chebucto Page | 21 Capital Health Community Clinical Services / Health System Planning Group (2014) Total Deprivation

Figure 16: Total deprivation scores for the communities of CHN 1 (5=high/red; 1=low/blue) based on the INSPQ index (Dr. M. Terashima, Dalhousie University; Population Health Status Report, Public Health, CDHA, 2013).

According to the Population Health Status Report (Public Health, Capital Health, 2013):

“A deprivation index is a proxy measure of the health status of a population based on the aggregation of a number of variables representing the determinants of health. The index is intended for the surveillance of social inequalities in health (Gamache, Pampalon, & Hamel, 2010). The INSPQ tool measures total deprivation by describing its two distinct components: material and social deprivation. Scores are generated for each of the six factors, and then aggregated to define social, material, and total deprivation for a given geographical region.”

Deprivation by community was calculated using data provided by Dr. M. Terashima, Dalhousie University, and analyzed for Capital Health by Dr. H. D’Angelo Scott, Public Health, for the Population Health Status Report (2013) and for Community Profiles (2014). The scores for communities within CDHA were extracted and sorted into equal quintiles which were ordered to represent a range of lowest deprivation (1) to highest deprivation (5) for material, social and total deprivation. The six factors comprising total deprivation include: the proportion of persons living alone; the proportion of single-parent families; the proportion of persons who are widowed, separated or divorced; the proportion of persons without a high school degree; the ratio of employment to population (employment rate); and average individual income. Data for the six factors comprising material and social deprivation were from 2006 Canadian Census data. Community boundaries were defined by Nova Scotia Community Counts (Government of Nova Scotia, 2011).

Community Health Network 2: Halifax Peninsula / Chebucto Page | 22 Capital Health Community Clinical Services / Health System Planning Group (2014)

Total deprivation for CHN 2 is depicted in Figure 16. Within CHN 2, the communities with the highest total deprivation are Halifax Needham, Spryfield, and Terrence Bay. The communities with the lowest total deprivation are Hatchet Lake, Peggy’s Cove, Prospect, and Tantallon. Table 8 provides a detailed breakdown of the total, material, and social deprivation score for each community within CHN 2. The subsequent sections provided further details about the material and social components for CHN 2.

Table 8: Deprivation Score Summary, by Community Community Total Deprivation Material Deprivation Social Deprivation Armdale-Northwest Arm 4 1 5 Clayton Park 4 1 5 Fairview 4 2 5 Hacketts Cove 2 2 3 Halifax Chebucto 4 1 5 Halifax Citadel 4 1 5 Halifax Needham 5 3 5 Hatchet Lake 1 1 1 Herring Cove 2 2 3 Hubbards 3 3 4 Peggy’s Cove 1 3 1 Prospect 1 2 1 Sambro 2 4 2 Spryfield 5 4 5 St. Margaret’s Bay 2 2 3 Tantallon 1 1 1 Terence Bay 5 5 1 Timberlea 2 2 3

Source: Dr. M. Terashima, Dalhousie University; Population Health Status Report, Public Health, CDHA, 2013.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 23 Capital Health Community Clinical Services / Health System Planning Group (2014) Social Deprivation

Figure 17: Social deprivation scores for the communities of CHN 2 (5=high; 1=low) based on the INSPQ index (Dr. M. Terashima, Dalhousie University; Population Health Status Report, Public Health, CDHA, 2013).

Social deprivation is a component of total deprivation and is determined by three factors: The proportion of persons living alone; The proportion of single-parent families; and The proportion of persons who are widowed, separated or divorced.

As depicted in Figure 17, the full spectrum of social deprivation is observed across communities in CHN 2. Within the CHN, a common trend is observed with the urban communities having the highest social deprivation. These communities include Armdale-Northwest Arm, Clayton Park, Fairview, Halifax Chebucto, Halifax Citadel, Halifax Needham and Spryfield. The communities in the lowest category of social deprivation include Hatchet Lake, Peggy’s Cove, Prospect, Tantallon, and Terrence Bay.

One component of social deprivation, the proportion of lone parent families, is explored further detail in the next section.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 24 Capital Health Community Clinical Services / Health System Planning Group (2014)

Lone Parent Families

Figure 18: CHN 2 percentage of lone parent families, by community (National Household Survey, 2011)

CHN 2 has the second highest percentage of lone parent families within the district at 17.4% (district average: 16.6%). Within the CHN, the community of Spryfield (28.9%) has the highest percentage of lone parent families. This is followed by Halifax Needham (23.7%) and Fairview (21.9%). The higher percentage of lone parent families in contributes to the social deprivation scores observed in all three communities. The community with the CHN with the lower percentage of lone parent families is Tantallon (8%). Refer to Figure 18 and Table 9.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 25 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 9: Social Deprivation and Percentage of Lone Parent Families, by community Social Deprivation Percentage of lone parent families

Canada / Nova Scotia n/a 16.3 / 17.3 CDHA n/a 16.6 Halifax Peninsula + Chebucto CHBs n/a 17.4 By Community Armdale-Northwest Arm 5 18.2 Clayton Park 5 16.4 Fairview 5 21.9 Hacketts Cove 3 10.6 Halifax Chebucto 5 19.0 Halifax Citadel 5 9.7 Halifax Needham 5 23.7 Hatchet Lake 1 10.6 Herring Cove 3 13.2 Hubbards 4 13.9 Peggy’s Cove 1 11.4 Prospect 1 10.9 Sambro 2 11.2 Spryfield 5 28.9 St. Margaret’s Bay 3 11.6 Tantallon 1 8.0 Terence Bay 1 10.8 Timberlea 3 15.9

Source: Social Deprivation: Dr. M. Terashima, Dalhousie University; Population Health Status Report, Public Health, CDHA, 2013; Lone Parent Families: National Household Survey, 2011)

Community Health Network 2: Halifax Peninsula / Chebucto Page | 26 Capital Health Community Clinical Services / Health System Planning Group (2014) Material Deprivation

Figure 19: Material deprivation scores for the communities of CHN 2 (5=high; 1=low) based on the INSPQ index (Dr. M. Terashima, Dalhousie University; Population Health Status Report, Public Health, CDHA, 2013).

Material deprivation is a component of total deprivation and is determined by three factors: The proportion of persons without a high school degree; The ratio of employment to population (employment rate); and Average individual income.

As depicted in Figure 19, the communities in CHN 2 have a range of material deprivation scores. Within the CHN, the community of Terrance Bay scores in the highest category of material deprivation. There are several communities in the lowest category of material deprivation including: Tantallon, Hatchet Lake, Timberlea, Armdale-Northwest Arm, Halifax Chebucto, and Halifax Citadel.

The components of material deprivation and additional income-related factors are explored in further detail in the subsequent sections and Table 10 provides a summary of the factors presented in relation to material deprivation.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 27 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 10: Summary of Income-related factors and material deprivation for communities within CHN 2 Material Low Income Average Average Family # of Households 11 Deprivation Families, % Individual Income Income Receiving ESIA CDHA n/a 9.9 $36,387 $77,052 11,443 Halifax Peninsula + Unable to Unable to n/a 12.2 5,416 Chebucto CHBs estimate estimate By Community Armdale- 1 9.6 $39,449 $82,501 219 Northwest Arm Clayton Park 1 10.8 $37,443 $77,695 646 Fairview 2 15.9 $30,657 $64,064 963 Hacketts Cove 2 2.6 $36,579 $79,577 10 Halifax Chebucto 1 11.7 $36,570 $87,302 518 Halifax Citadel 1 14.4 $42,740 $114,371 350 Halifax Needham 3 20.5 $29,579 $57,765 1306 Hatchet Lake 1 5.2 $37,249 $78,159 26 Herring Cove 2 7.9 $35,194 $72,053 39 Hubbards 3 7.8 $35,728 $71,104 10 Peggy’s Cove 3 2.6 $32,575 $66,563 12 Prospect 2 2.6 $37,800 $80,794 22 Sambro 4 6.0 $31,579 $66,706 51 Spryfield 4 23.8 $27,934 $54,794 1039 St. Margaret’s Bay 2 2.8 $41,798 $88,958 24 Tantallon 1 3.1 $43,237 $92,025 40 Terrence Bay 5 4.3 $28,769 $61,776 24 Timberlea 2 7.0 $37,213 $74,547 117

Sources: Material deprivation (Dr. M. Terashima, Dalhousie University; Population Health Status Report, Public Health, CDHA, 2013); Low income families, average individual income, and average family income (Canadian Census, 2006); Employee Support and Income Assistance (ESIA Administrative Data, Department of Community Services, 2014).

11 ESIA: Employee Support and Income Assistance

Community Health Network 2: Halifax Peninsula / Chebucto Page | 28 Capital Health Community Clinical Services / Health System Planning Group (2014) Income Related Factors

Figure 20: Average Family Income in Dollars, by community, in CHN 2 (Canadian Census, 2006).

Figure 20 depicts average family income, in dollars, across CHN 2. Within the CHN, the community with the lower average family income ($54,794) and the lower average individual income ($27,934) is Spryfield, followed by Halifax Needham. The community within the CHN with the higher average individual income is Tantallon ($43,237). The community with the higher average family income is Halifax Citadel ($114,371), which is also the highest in the district.

Figure 21: Percentage of low income families in CHN 2 (Canadian Census data, 2006). Community Health Network 2: Halifax Peninsula / Chebucto Page | 29 Capital Health Community Clinical Services / Health System Planning Group (2014)

Figure 21 represents the percentage of low income families across CHN 2. CHN 2 has the highest percentage of low income families in the district, with 12.2% of families being classified as low income (district average: 9.9%). Within the CHN, the community with the highest percentage of low income families is Spryfield, with 23.8% of families being classified as low income, which is the highest rate in the district. Spryfield is followed by Halifax Needham (20.5%; second highest in the district). Hackett’s Cove, Peggy’s Cove, and Prospect are the communities with the lowest percentage of low income families in CHN 2.

Department of Community Services and Primary Health Care/DDFP, Public Health, CDHA Figure 22: Number of households receiving provincial income assistance/employment support in CHN 2(ESIA Administrative Data, March 2014)

Within the CHN, the community of Halifax Needham, followed by Spryfield, has the greatest number of households receiving employment support and income assistance provincially12, with 1306 individuals receiving support in Halifax Needham and 1039 individuals receiving support in Spryfield according to the Department of Community Services (2014). This information is summarized in Table 10 and further demographic information about citizens receiving employee support and income assistance will be available in the district summary. It is important to note that this data is not comparable across communities given data is reported by number of households (count only; not a rate) and there may be multiple people per household receiving assistance. This information is depicted in Figure 22.

12 Does not include income assistance from Federal sources, provincial only (counts)

Community Health Network 2: Halifax Peninsula / Chebucto Page | 30 Capital Health Community Clinical Services / Health System Planning Group (2014) Employment & Education

Education and employment rates for CHN 2 are similar to the district average. Table 11 provides a breakdown of the employment and education rates for the communities within CHN 2. The community with the higher number of citizens without a high school education is Terrence Bay (38.1%). The community with the lower number of people without a high school education (or highest percentage of high school completion) is Halifax Citadel (5.1% without a high school education).

Within CHN 2, the community with the highest percentage of the population aged 25 years and older employed is Timberlea (76.9% employed), making Timberlea the community with the highest number of people employed in the district. The community with the lowest percentage of the population 25 years of age or older employed is Spryfield (56.6% employed). For the population aged 15-24 years, the community with the highest percentage employed is Terrence Bay, with 78.4% of this age demographic being employed, making Terrence Bay the community with the highest percentage of youth employment in the district. The community with the lowest percentage of the population aged 15-24 years employed is Peggy’s Cove (numbers to small to report), followed by Spryfield (50.9% employed).

Table 11: Summary of education, employment, and material deprivation for communities within CHN 2 Material Percentage without Percentage employed: Percentage employed: Deprivation high school education >25 years of age 15 to 24 years of age CDHA n/a 16 65.2 58.3 Halifax Peninsula n/a 13.4 63.9 61.3 + Chebucto CHBs By Community Armdale- Northwest Arm 1 14.1 61.2 63.1 Clayton Park 1 9.2 65.9 62.4 Fairview 2 16.9 57.7 60.8 Hacketts Cove 2 20.3 63.2 70 Halifax Chebucto 1 11.1 65.2 61.1 Halifax Citadel 1 5.1 61.4 62.8 Halifax Needham 3 15 63.8 64 Hatchet Lake 1 20.3 65.1 51.9 Herring Cove 2 12.8 67 55.6 Hubbards 3 19.3 63.2 55.8 Peggy’s Cove 3 21.7 59.5 -- Prospect 2 16.9 68 51.5 Sambro 4 24.1 67.6 68.1 Spryfield 4 27.9 56.6 50.9 St. Margaret’s 2 13.2 62.6 59.1 Bay Tantallon 1 10.2 73.6 60.5 Terence Bay 5 38.1 58.8 78.4 Timberlea 2 14.2 76.9 57.5

Sources: Material deprivation (Dr. M. Terashima, Dalhousie University; Population Health Status Report, Public Health, CDHA, 2013); Education and Employment (Canadian Census, 2006)

Community Health Network 2: Halifax Peninsula / Chebucto Page | 31 Capital Health Community Clinical Services / Health System Planning Group (2014) Birth Data

Figure 23: Birth rate per 1000 women aged 15-49 for 2012-2013 by community (Public Health, Capital Health data for 1 year: 2012-2013).Birth rates for 15-19 year olds higher than the district rate are differentiated.

To describe birth rate patterns in the Capital District Health Authority, birth data for one year was provided by Public Health, Capital Health (2013). Birth rates were calculated to identify an average annual rate per community per 1000 women. Maternal age was considered in this calculation, with rates being a measure per 1000 women of a selected maternal age group, ranging from 15 to 49 years of age (age specific fertility rate; ASFR).

Figure 23 depicts the birth rate per 1000 women aged 15 to 49 years in the CHN. The figure also indicates which communities have a teenage birth rate (births among women aged 15 to 19 years) that is higher than the district rate. CHN 2 accounts for approximately 42% of all births occurring within the district. Within the CHN and also within the district, the highest number of births occurs within the community of Clayton Park, which had 374 births in -2013. The community within the CHN with the highest birth rate is Timberlea, with on average, 59.16 births occurring per 1000 women aged 15 to 49 years annually. Hubbards has the lowest birth rate within the CHN, given there were no new births in the community in 2013. A detailed breakdown of births by community is provided in Table 12.

When looking at births among women aged 15 to 19 years, the communities within the CHN that have a birth rate higher than the district rate for this age group are Halifax Chebucto, Halifax Needham, Clayton Park, Fairview, Spryfield, Herring Cove, Sambro, Hacketts Cove, Tantallon, and Timberlea. Halifax Needham has a highest rate of births among women aged 15 to 19 years in the CHN and has one of the higher rates in the district, at a rate of 33.10 births per 1000 women aged 15 to 19 years. Timberlea has the higher birth rate per

Community Health Network 2: Halifax Peninsula / Chebucto Page | 32 Capital Health Community Clinical Services / Health System Planning Group (2014)

1000 women aged 20 to 34 years and Peggy’s Cove has the higher birth rate among women aged 35 to 49 years, which is also the highest in the district for this age demographic.

Table 12: Birth data by Community for CHN 2 for 2012-2013 ASFR14 per 1000 ASFR per 1000 ASFR per 1000 Total number Total births per Community women 15-19 women 20-34 women 35-49 of births 1000 women13 years years years Armdale- 109 48.23 4.22 88.84 19.91 Northwest Arm Clayton Park 374 40.05 10.22 58.23 21.43 Fairview 166 38.71 30.30 57.90 15.02 Hacketts Cove 11 38.60 32.26 102.27 6.02 Halifax Chebucto 156 29.43 4.87 38.98 22.40 Halifax Citadel 115 17.70 7.75 18.86 17.46 Halifax Needham 206 34.90 33.10 41.89 22.12 Hatchet Lake 25 32.05 0.00 73.26 12.72 Herring Cove 18 30.25 10.00 67.42 15.77 Hubbards 0 0.00 0.00 0.00 0.00 Peggy’s Cove 6 47.24 0.00 71.43 43.48 Prospect 27 35.34 0.00 68.38 26.32 Sambro 34 35.23 9.09 87.35 7.65 Spryfield 140 51.21 30.21 98.92 15.49 St. Margaret’s 16 32.19 0.00 94.49 13.47 Bay Tantallon 101 42.28 9.17 117.65 17.93 Terence Bay 6 28.71 0.00 80.00 0.00 Timberlea 155 59.16 12.58 130.92 16.04 CHN 2 Total 1665 (41.9%) 36.21 13.54 54.08 18.34 District Total 3976 36.92 10.59 66.41 16.24

Source: Public Health, Capital Health for time period 2012-2013.

Note: Birth rate data for the smaller communities with older populations should be interpreted with caution because the total population of women in the 15-20, 20-34, and 35-49 age demographics may be small, so even a small number of births in any given age group (e.g., n=<5) could result in higher rates per 1000 population.

13 This calculation was based on women aged 15-49 years only 14 ASFR: Age Specific Fertility Rate; calculated as a measure of the number of live births per 1,000 females in a specific age group (15-19; 20-34; 35-49) for one year

Community Health Network 2: Halifax Peninsula / Chebucto Page | 33 Capital Health Community Clinical Services / Health System Planning Group (2014) Crime Rates – Halifax Regional Police

Figure 24: Crime occurrences by type, as a proportion of total crimes occurring in CHN 2 (Halifax Regional Police, 2013)

Crime data for the Capital Health district was obtained from the Halifax Regional Police and analyzed for Capital Health by Dr. H. D’Angelo Scott, Public Health, for the Population Health Status Report (2013) and for Community Profiles (2014).

Note that crimes occurring in a community are not necessarily committed by residents of that community; counts are reflective of where the crime occurred.

Based on data from 2008-2012 from the Halifax Regional Police15 (HRP) only, in CHN 2, the higher number of crimes occur in Halifax Citadel, followed by Halifax Needham, Clayton Park , and Halifax Chebucto. In terms of types of crimes occurring proportionally within communities in CHN 2, theft <$5000 is the predominant non- violent crime, followed by mischief. Refer to Figure 24 and Table 13 for a detailed breakdown by community.

15 Within CHN 2, crimes are captured though both the Halifax Regional Police (HRP), RCMP, and their Integrated Crime Unit. Many areas in CHN 2 are predominately covered by HRP.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 34 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 13: Total crimes occurring in each community, by type, as reported by Halifax Regional Police from 2008-2011 Break Impaired/ Theft Theft Youth Total by Assaults Drugs Mischief &Enter Alcohol <$5000 >$5000 Crime Community Armdale- 255 187 74 78 319 470 61 41 1485 Northwest Arm Clayton Park 723 559 246 267 1162 2890 219 68 6134 Fairview 731 480 216 182 755 1708 76 51 4199 Hacketts Cove 22 25 6 12 33 33 9 < 5 142 Halifax Chebucto 606 447 186 200 1144 3109 105 68 5865 Halifax Citadel 1811 815 459 426 2030 4221 174 31 9967 Halifax Needham 1508 769 945 443 1763 3251 120 97 8896 Hatchet Lake 47 61 46 54 85 156 26 14 489 Herring Cove 37 68 20 17 111 99 16 11 379 Hubbards 14 46 21 18 44 43 < 5 < 5 195 Peggy’s Cove < 5 17 7 < 5 17 30 < 5 < 5 85 Prospect 22 42 28 34 50 47 11 < 5 239 Sambro 65 95 23 29 92 167 30 9 510 Spryfield 807 427 208 103 692 1083 66 97 3483 St. Margaret’s 19 71 24 15 78 66 11 6 290 Bay Tantallon 133 121 132 116 291 405 32 40 1270 Terence Bay 13 21 10 9 12 13 < 5 < 5 83 Timberlea 176 109 157 101 364 463 28 57 1455 CHN 2 Total 6,994 4,360 2,808 2,109 9,042 18,254 996 603 45,166 Type as percent 15.5% 9.7% 6.2% 4.7% 20.0% 40.4% 2.2% 1.3% 100.0% of CHN crime *Crime counts of ≤5 crimes per community have been suppressed for confidentiality purposes Source: Halifax Regional Police, Crime Database, 2013 for time period 2008-2011 (five years worth of data)

Community Health Network 2: Halifax Peninsula / Chebucto Page | 35 Capital Health Community Clinical Services / Health System Planning Group (2014) Crime Rates – RCMP

As described above, crime data captured through HRP is reportable at the community and CHN level; however, RCMP16 data is captured and reported via Policing Districts. There are three policing districts that align with CHN 2: (1) Tantallon; (2) West; and (3) Central, which are represented in Figure 25. A key consideration is the boundaries of these policing districts, which do not exactly align with CHN 1 boundaries so the numbers reported below in Table 13 are not a true CHN count. Of note is the West Policing District, which covers a large portion of the Bedford/Sackville Area. 3 Similarly to the data reported by the Halifax Regional Police, Table 14 indicates that the predominant crimes in these policing districts are theft under $5000 and mischief. It is important to note that 2 crimes occurring in policing districts are not necessarily committed by residents of that community; counts are reflective of where the crime occurred. Figure 25: RCMP Policing Districts in CHN 1 (RCMP, 2014)

Table 14: Total number of crimes occurring by type in RCMP Policing Districts aligned with CHN 2 for 2013 Policing District By Count and Percentage of total CHN Crime Crime Type Tantallon West Central* Assaults 82 7.8% Any available Any available Arson <5 n/a data for the data for the Break & Enter (home/business/ other) 115 10.9% West Policing Central Theft - Over $5000 52 4.9% District was Policing Theft - Under $5000 357 33.9% suppressed District was Possession/Trafficking of stolen goods 17 1.6% due to low suppressed Fraud/Identity Theft 72 6.8% numbers – the due to low Mischief 163 15.5% geography is numbers – the Drug possession/Trafficking/ Production/ mainly geography is 70 6.6% Import covered by mainly Impaired Operation of Motor vehicle/boat 68 6.5% Halifax covered by Traffic Offences 38 3.6% Regional Halifax Youth Complaint/Crime 19 1.8% Police Regional Police CHN 2 Total RCMP Crimes 1053 *Crime counts of ≤5 crimes per type have been suppressed for confidentiality purposes Source: RCMP Crime Database for the (2014) for the January 1, 2013 – December 31,2013 Calendar Year

Note: Halifax Regional Police Data is based on five year’s worth of data; therefore, crime totals are reflective of that count. RCMP data represents one year of data; thus, the two are not comparable.

16 Within CHN 2, crimes are captured though both the Halifax Regional Police (HRP), RCMP, and their Integrated Crime Unit. Many areas in CHN 2 are predominately covered by HRP.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 36 Capital Health Community Clinical Services / Health System Planning Group (2014) Nova Scotia School Test Results

Table 15 represents school test scores provided by the Department of Education for the 2013-2014 academic year (exception: grade 8 results are from 2012-2013). 42 schools in CHN 2 contributed to the scoring results. CHN 2 trended positively or on par to the provincial average in all categories, with the exception of Grade 3 Reading. 17

Table 15: CHN 2 School Test Scores 2013-2014 Testing Category CHN 2, percentage Nova Scotia, percentage Trend Number of Schools 42 345 12.2% Average of Reading 3 65 69 ↓ Average of Math 4 74 73 ↑ Average of Reading 6 79 74 ↑ Average of Math 6 71 71 = Average of Reading 8 74 69 ↑ Average of Math 8 59 55 ↑

Source: Nova Scotia Department of Education for the 2013-2014 academic school year, with the exception of Grade 8 math, which is from the 2012-2013 academic year).

Note: One school board represents the communities of CHN 2 – the Halifax Regional School Board.

17 As reported by the Chronicle Herald newspaper: http://thechronicleherald.ca/novascotia/1216114-interactive-school- test-data-map; published June 19th, 2014

Community Health Network 2: Halifax Peninsula / Chebucto Page | 37 Capital Health Community Clinical Services / Health System Planning Group (2014)

COMMUNITY HEALTH NETWORK HEALTH STATUS

Community Engagement – 2013 Community Health Plan

Table 16: Health Concerns Halifax Peninsula/Chebucto West (n=680) Table 16 indicates the top health Access to Health Services & Information 27% concerns reported through the Physical Activity, Healthy Eating, Healthy Weight 16% Halifax Peninsula and Chebucto West Health Inequities 15% CHB Community Consultations during Mental Health 12% the preparation of the 2013 Chronic Conditions 10% Community Health Plan. This Stress 8% information is reported here to Sense of Belonging 7% provide a qualitative perspective to the data related to health status Substance Use and Addictions 6% below. Health Screenings 0% Total 100%

2009-2010 Canadian Community Health Survey Data for Self-Reported Health Status

Canadian Community Health Survey Data is reportable at the Community Health Network level only (community-level data is not available). Figures 26 and 27, along with Table 17 cross-compare selected chronic conditions and risk factors across CHNs. Comparisons were made across CHNs and with district, provincial, and national rates in Table 18.

Self Reported Risk Factors % of CHN Cross Community Health Network Comparision 80.00% 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% High Blood Smoking Stressful Daily BMI Overweight BMI Obese Intention to Pressure Daily/Occas. Life improve health in next year Risk Factor CHN 1 (Dartmouth/Southeastern) CHN 2 (Halifax Peninsula/Chebucto) CHN 3 (Bedford/Sackville) CHN 4 (Eastern Shore Musquodoboit) CHN 5 (West Hants) CDHA (district average)

Figure 26: Self-reported risk factors reported by Community Health Network (Canadian Community Health Survey, 2009) When looking at risk factors across CHNs, CHN 2 has the highest rate of citizens reporting having intent to improve health in the next year when compared to other CHNs across the district. CHN 2 also has among the highest percentage of citizens reporting having a stressful daily life.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 38 Capital Health Community Clinical Services / Health System Planning Group (2014)

Self Reported Chronic Conditions Cross Community Health Network Comparision % of CHN 35.00% 30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% Diabetes COPD Heart Disease Mood Disorder Arthritis Chronic Condition CHN 1 (Dartmouth/Southeastern) CHN 2 (Halifax Peninsula/Chebucto) CHN 3 (Bedford/Sackville) CHN 4 (Eastern Shore Musquodoboit) CHN 5 (West Hants) CDHA (district average)

Figure 27: Self-reported chronic conditions reported by Community Health Network (Canadian Community Health Survey, 2009)

When looking at select chronic conditions across CHNs, CHN 2 has the lowest percentage of citizens self- reporting having diabetes. Self report data for other chronic conditions falls within the mid-range when compared to other CHNs.

Table 17: Summary of Selected Self-reported Chronic Diseases and Risk Factors - CHN and District comparison CPCSSN Prevalence Self-reported Chronic Disease Prevalence & Selected Risk Factors, Percentage Rates, Percentage18 CHN 1 CHN 2 CHN 3 CHN 4 CHN 5 CDHA CDHA NS Diabetes 9.5 7.0 7.4 10.7 8.7 8.5 8.0 9.0 COPD 2.7 1.8 1.2 1.8 2.4 2.1 4.0 5.0 Heart Disease 5.2 5.2 3.2 6.7 6.0 5.3 - - Mood Disorder 10.5 9.6 8.6 9.2 9.9 9.7 - - Depression ------15.0 15.0 Arthritis 23.9 21.2 18.9 27.9 29.3 23.7 - - Osteoarthritis ------8.0 8.0 High BP 21.6 18.3 16.3 24.9 21.1 20.3 19.0 22.0 Smoking Daily/ 20.5 19.5 17.5 20.4 25.6 20.5 - - Occasional Stressful Daily Life 65.6 65.5 64.8 62.3 62.1 64.5 - - BMI (Overweight/ 35.3/ 36.0/ 38.9/ 40.2/ 36.9/ 38.1/ - - Obese) 22.5 22.7 28.2 28.1 29.6 25.2 Intent to improve 69.2 69.4 68.8 64.8 66.3 68.5 - - health in next year Source: Self-reported data: Canadian Community Health Survey 2009-2010; CPCSSN Prevalence: Maritime Family Practice Research Network as part of Canadian Primary Care Sentinel Surveillance Network study (CPCSSN; 2014)

18 Prevalence of index conditions based on two year contact group, n=36,640 patients in urban and rural family practices derived from extraction from family physicians’ EMR based on clinical algorithms.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 39 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 18 provides a more detailed view of additional CCHS self-reported variables for several chronic conditions, risk factors, health behaviours, and perceptions of health for a sample within CHN 2. Table 18 also and provides a comparison to the district, provincial, and national rates.

Table 18: Health Status indicator by CHN and compared to CDHA and Nova Scotia and Canada (where available) CHN 2, % CDHA, % Health Status Indicator Nova Scotia, % Canada, % (n = 805) (n = 2819) Positive Physical Health 89.4 87.1 86.8 88.6 Positive Mental Health 94.0 94.5 94.4 94.7 Satisfied with life 89.4 90.8 92.9 92.3 Stressful Daily Life 65.5 64.5 62.2 64.5 Stress at Work 71.6 71.5 64.9 71.1 Sense of Belonging 66.1 68.4 71.2 65.4 Intend on Improving Physical Health in next year: Yes 69.4 68.5 72.8 66.8 Exercise 60.8 58.3 48.2 50.7 Lose Weight 12.3 12.9 13.0 9.4 Improve Eating Habits 12.0 13.1 17.4 19.0 Quit smoking 6.6 8.5 13.5 10.8 No 29.5 30.2 27.2 33.2 Body Mass Index: Normal/Underweight 41.3 36.7 -- -- Overweight 36.0 38.1 36.5 34 Obese 22.7 25.2 24.3 18.3 No Food Security 2.2 1.7 3.4 2.3 Positive Oral Health 88.9 88.1 - - Flu Shot < 1 years ago 43.9 44.8 46.2 29.6 Arthritis 21.2 23.7 22.9 16.2 Back Problems 26.8 7.1 22.9 18.8 High blood Pressure 18.3 20.3 22.6 17.5 Migraine Headaches 15.8 15.8 11.3 10.2 Chronic Bronchitis 3.5 3.7 - - COPD 1.8 2.1 6.3 4.3 Diabetes 7.0 8.5 8.6 6.3 Heart Disease 5.2 5.3 5.8 4.8 Mood Disorder 9.6 9.7 9.0 7.1 Smoking (Daily or Occasionally) 19.5 20.5 22.8 20.1 5 or more drinks once a week or more 10.2 8.7 9.8 8.5 5 or more fruits/vegetables per day 37.9 38.4 34.0 40.5 Source: Canadian Community Health Survey, 2009-2010

When compared to district, provincial, and national rates, CHN 2 has a higher percentage of the population self-reporting having a stressful daily life (65.6%), positive physical health (89.4%), and 5 or more drinks once a week or more (10.2%). When compared to district, provincial, and national rates, CHN 2 has a lower percentage of the population self-reporting positive mental health (94.0%), being satisfied with daily life (89.4%), sense of belonging (66.1%), COPD (1.8%), and being a daily or occasional smoker (19.5%).

Community Health Network 2: Halifax Peninsula / Chebucto Page | 40 Capital Health Community Clinical Services / Health System Planning Group (2014) Sexually Transmitted Infections (STIs)

Table 19 shows the incidence rates per 10,000 population of sexually transmitted infections (chlamydia, gonorrhea and infectious syphilis) by sex, age group (years) and CHN for CDHA, 2013. The highest and lowest STI incidence rate for each age group in both females and males has been bolded. CHN 2 incidence rates for STIs are highest in the district for males, age 30 to 39 years and males aged 40 years and above. In all CHNs, the highest incidence rate of STIs in males and females was among those aged 20 to 24 years.

Table 19: Incidence rates per 10,000 population of sexually transmitted infections in Capital Health (2013) Female Males Age 15 to 40 and 15 to 20 to 25 to 30 to 40 and 20 to 24 25 to 29 30 to 39 Group 19 over 19 24 29 39 over CHN 1 247.8 340.9 161.2 43.7 1.6 61.4 163.4 71.2 24.5 2.9 CHN 2 214.2 269.8 94.5 32.2 2.6 41.4 123.9 42.2 30.4 3.1 CHN 3 209.2 229.9 72.9 32.8 1.8 24.2 86.2 45.8 21.2 2.8 CHN 4 196.3 422.0 35.7 13.1 1.4 12.2 135.6 37.7 21.1 0.0 CHN 5 280.2 330.7 159.7 14.6 3.1 39.9 75.9 85.3 24.6 0.0

Source: Public Health, Capital Health, 2013

Community Health Network 2: Halifax Peninsula / Chebucto Page | 41 Capital Health Community Clinical Services / Health System Planning Group (2014) Disability

There is a lack of data related to disability available particularly at the community level, but also at the district level for Capital Health. Table 20 provides a breakdown of the prevalence of disability for adults by age group for Nova Scotia (Canadian Survey on Disability, 2012). The prevalence of disability in Nova Scotia is 18.8%, which is higher than the Canadian average of 14.9%. There is a variance between males and females, with 18.4% of the total count being represented by males and 19.2% of the count being represented by females, which is consistent with national data of women having a higher prevalence of disability in all age groups.

Table 20: Disability Prevalence for Nova Scotia, by age category for the population aged 15 years+ Total population of NS Persons with disabilities Prevalence of disability (aged 15 years+) (count) (% of total population) Total - aged 15 and over 765,100 143,760 18.8 15 to 64 years 628,310 89,410 14.2 15 to 24 years 120,430 6,990 5.8 25 to 44 years 223,880 20,920 9.3 45 to 64 years 284,000 61,500 21.7 65 years and over 136,790 54,350 39.7 65 to 74 years 80,360 27,310 34.0 75 years and over 56,430 27,040 47.9 Source: Canadian Survey on Disability, 2012

Specific to CDHA, the Department of Community Services reports in March of 2014, there are 4,485 persons classified as having a disability on the Employment Support and Income Assistance (ESIA) caseload residing within the boundaries of the CDHA. This represents 39% of the ESIA caseload. Within this population, there is an almost equal proportion of men (52%) and women (48%); approximately 50% are 50 years of age or older, and approximately 88% are single adults without children (Department of Community Services, 2014).

Community Health Network 2: Halifax Peninsula / Chebucto Page | 42 Capital Health Community Clinical Services / Health System Planning Group (2014)

Life Expectancy at Birth

The life expectancy at birth in the Capital Health district is higher than the provincial life expectancy at birth for both females and males. Within the CHN, the majority of communities have a similar female life expectancy at birth to the district and provincial life expectancy at birth for females. With the exception of Clayton Park and Tantallon, the majority of communities in CHN 2 have a lower male life expectancy than the district average; however, many communities have a male life expectancy at birth that is similar to the provincial average of 77.7 years.

Within the CHN, life expectancy at birth is highest for females in the community of St. Margaret’s Bay (84.0 years) and lowest for females living in Halifax Needham (79.0 years). Life expectancy is highest for males in the community of Tantallon (78.9 years) and lowest for males living in Halifax Needham (73.3 years). Refer to Table 21 for a detailed breakdown by community.

Table 21: Life expectancy at birth, by community and by sex Community Female Life Expectancy (years) Male Life Expectancy (years) Armdale-Northwest Arm 80.9 74.9 Clayton Park 82.4 78.4 Fairview 81.2 76.9 Hacketts Cove, Peggy’s Cove, Terrence Bay19 83.1 76.5 Halifax Chebucto 82.0 77.7 Halifax Citadel 81.6 77.5 Halifax Needham 79.0 73.3 Hatchet Lake 82.9 76.4 Herring Cove 82.9 77.0 Hubbards 80.8 75.2 Prospect 83.0 76.8 Sambro 83.0 77.8 Spryfield 81.8 75.3 St. Margaret’s Bay 84.0 77.6 Tantallon 82.6 78.9 Timberlea 82.5 77.2 CDHA / Nova Scotia 82.7 / 82.4 78.3 / 77.7 Source: Community data: Dr. M. Terashima, Dalhousie University (2011) for time period 2003-2007. District and Provincial averages: Statistics Canada, Canadian Vital Statistics, Death Database and Demography Division (population estimates),

2007/2009

19 The communities of Hackett’s Cove, Peggy’s Cove, and Terrance Bay have been clustered together for the purposes of reporting due to population size (clusters created by Dr. M. Terashima, Dalhousie University (2011)).

Community Health Network 2: Halifax Peninsula / Chebucto Page | 43 Capital Health Community Clinical Services / Health System Planning Group (2014) Causes of Death

Cause of death data is not readily available at the community level; therefore, cause of death is reported at the district and provincial level and is listed below in Table 22. All causes listed below are reported as an age- standardized rate of death per 100,000 population.

The Capital District Health Authority has a lower rate of death per 100,000 population for the majority of identified common causes of death, with the exception of colorectal cancer, which is higher than the provincial rate, and breast cancer, which is the same as the provincial rate. Within CDHA, females have higher rates of death from breast cancer, cerebrovascular diseases and bronchitis, emphysema and asthma when compared to males. Males have higher rates of all other identified common causes of death.

Table 22: Causes of Death for NS and CDHA, rate per 100,000 population Nova Scotia (per Capital District Health Authority 100,000 population) (per 100,000 population) Cause of Death Total Total Males Females Total, all causes of death 603.8 583.4 716.4 487.3 All cancers 188.6 182.2 224.8 154.5 Colorectal cancer 18.0 18.8 23.1 15.4 Lung cancer 54.3 50.8 62.4 43.2 Breast cancer 11.9 11.9 - 21.2 Prostate cancer 9.2 8.6 23.1 - Circulatory diseases 179.6 169.9 211.7 137.7 Ischaemic heart diseases 92.5 82.5 114.7 57.9 Cerebrovascular diseases 34.9 33.5 32.0 34.0 All other circulatory diseases 52.3 54.0 65.0 45.8 Respiratory diseases 54 50.9 63.1 43.9 Pneumonia and influenza 13.9 13.3 16.0 11.9 Bronchitis, emphysema, asthma 2.4 2.4 1.6 3.0 All other respiratory diseases 37.7 35.2 45.5 29.0 Unintentional injuries 32 28.8 36.6 22.1 Suicides and self-inflicted injuries 9.1 8.6 12.8 4.6 Premature mortality 280.5 262.1 324.8 204.5 Source: All cause of death data provided by Statistics Canada, Canadian Vital Statistics, Death Database and Demography Division (population estimates), 2005/2007, with the exception of premature mortality which is from 2006/2008.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 44 Capital Health Community Clinical Services / Health System Planning Group (2014) Family Physician Visits by Chronic Disease Diagnosis

Physician Billing Data was obtained for family physician billings for four chronic conditions: Diabetes Mellitus (DM), Chronic Obstructive Pulmonary Disease (COPD), Congestive Health Failure (CHF), and Hypertension (HTN) based on patient postal code information. The data source was billing data provided by the Department of Health and Wellness from 2011/12 and 2012/13. Data was analyzed and there was no great variability between the two years; therefore, for generalization purposes, an average of the two years was calculated to estimate annual patient visits. This information provides an estimated prevalence measure of how many individuals received care from a family physician for one of the four selected chronic conditions within a certain geographic area. As such, it has been included in the health status section. All data is for adults, age 20 years and above.

Note for Readers: Throughout the report, you will notice that the number of patients/clients and

the number of visits may have decimal points (e.g., 5.5 visits or 125.5 patients). This is a result of the weighting method that was used to distribute patients in communities based on the boundaries identified by NS Community Counts using 6-digit postal code data and taking into account the population density. Decimals were retained in the reporting of data for accuracy.

1. Diabetes

Figure 28: Rate of measure for individuals receiving care from a family physician for a diagnosis of diabetes per 1000 population (Department of Health & Wellness, MSI Billing Data two year average for fiscal 2011/12; 2012/13)

The number of citizens per 1000 population accessing care from a family physician (FP) for a diagnosis of diabetes in CHN 2 is the lowest across all CHNs, with 65.5 citizens per 1000 population receiving care from an FP for diabetes (compared to 72.3 per 1000 population across CDHA). Figure 28 shows that within the

Community Health Network 2: Halifax Peninsula / Chebucto Page | 45 Capital Health Community Clinical Services / Health System Planning Group (2014) communities of St. Margaret’s Bay, Peggy’s Cove, and Terrence Bay, there is a higher rate of people per 1000 population receiving care from an FP for diabetes. Clayton Park has the highest volume of visits and patients.

Specifically, St. Margaret’s Bay has the higher rate within the CHN with 128.4 people per 1000 population receiving care from a family physician for diabetes. Halifax Citadel has the lowest rate of citizens receiving care for a diagnosis of diabetes, with 28.2 citizens per 1000 population, which is among the lowest rates in the district. The average number of visits per patient is generally consistent across the CHN, with Terrence Bay being the community with the higher number of visits per person (3.8 visits). Refer to Table 23 for a detailed breakdown by community.

Table 23: CHN overview of citizens receiving care for a diagnosis of diabetes from a family physician FP Visits for Average Visits per Patients per 1000 Community Patients Diabetes Patient population Armdale-Northwest 1706.6 624.2 2.7 75.5 Arm Clayton Park 5462.0 1955.3 2.8 69.2 Fairview 2375.4 896.3 2.7 68.8 Hacketts Cove 418.5 125.7 3.3 99.9 Halifax Chebucto 2281.4 842.5 2.7 55.2 Halifax Citadel 1197.2 498.3 2.4 28.2 Halifax Needham 3320.7 1144.9 2.9 65.5 Hatchet Lake 644.5 202.4 3.2 84.5 Herring Cove 419.6 153.5 2.7 71.9 Hubbards 438.7 144.5 3.0 85.9 Peggy’s Cove 217.1 65.5 3.3 121.6 Prospect 645.4 196.6 3.3 78.8 Sambro 547.6 216.4 2.5 73.6 Spryfield 2188.5 807.3 2.7 96.3 St. Margaret’s Bay 707.6 240.3 2.9 128.4 Tantallon 984.9 344.1 2.9 51.3 Terence Bay 370.9 97.5 3.8 118.6 Timberlea 1309.8 479.6 2.7 70.3 CHN 2 Total 25.236.4 9.035.0 2.79 65.45 District Total 66,043.3 23,951.4 2.76 72.26

Source: Department of Health & Wellness, MSI Billing Data two year average for fiscal 2011/12; 2012/13

Community Health Network 2: Halifax Peninsula / Chebucto Page | 46 Capital Health Community Clinical Services / Health System Planning Group (2014) 2. COPD

Figure 29: Rate of measure for individuals receiving care from a family physician for a diagnosis of COPD per 1000 population (Department of Health & Wellness, MSI Billing Data two year average for fiscal 2011/12; 2012/13)

The number of citizens per 1000 population accessing care from a family physician for a diagnosis of COPD is lower in CHN 2 than the district as a whole at 70.7 citizens per 1000 population receiving care from an FP for COPD (compared to 76.01 per 1000 population for the district).

Figure 29 shows that within CHN 2, there is a higher percentage of the population receiving care from a family physician for COPD residing in St. Margaret’s Bay, with 139.8 people per 1000 population receiving care for a diagnosis of COPD, followed by Spryfield. Halifax Citadel has the lowest rate of citizens receiving care for a diagnosis of COPD, with 35.9 citizens per 1000 population accessing care. The average number of visits is relatively consistent across communities within the CHN, with the community of Terrence Bay having the higher number of visits per person (2.5). Refer to Table 23 for a detailed breakdown by community.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 47 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 24: CHN overview of citizens receiving care for a diagnosis of COPD from a family physician FP Visits for Average Visits per Patients per 1000 Community Patients COPD Patient population Armdale-Northwest 1092.2 667.7 1.6 80.8 Arm Clayton Park 3021.6 1897.0 1.6 67.2 Fairview 1585.1 962.0 1.6 73.8 Hacketts Cove 211.8 89.4 2.4 71.1 Halifax Chebucto 1617.6 1020.8 1.6 66.9 Halifax Citadel 1048.1 635.1 1.7 35.9 Halifax Needham 2204.5 1239.6 1.8 70.9 Hatchet Lake 274.5 150.1 1.8 62.7 Herring Cove 295.3 190.0 1.6 88.9 Hubbards 376.7 177.6 2.1 105.6 Peggy’s Cove 57.2 33.4 1.7 62.0 Prospect 268.6 138.7 1.9 55.6 Sambro 470.6 297.2 1.6 101.1 Spryfield 1907.2 1074.3 1.8 128.1 St. Margaret’s Bay 460.2 261.5 1.8 139.8 Tantallon 606.9 388.5 1.6 57.9 Terence Bay 185.8 75.7 2.5 92.1 Timberlea 750.8 471.3 1.6 69.0 CHN 2 Total 16,434.7 9,769.9 1.68 70.77 District Total 44,016.6 25,191.6 1.75 76.01

Source: Department of Health & Wellness, MSI Billing Data two year average for fiscal 2011/12; 2012/13

Community Health Network 2: Halifax Peninsula / Chebucto Page | 48 Capital Health Community Clinical Services / Health System Planning Group (2014) 3. Congestive Heart Failure

Figure 30: Rate of measure for individuals receiving care from a family physician for a diagnosis of Congestive Heart Failure per 1000 population (Department of Health & Wellness, MSI Billing Data two year average for fiscal 2011/12; 2012/13) The number of citizens per 1000 population accessing care from a family physician for a diagnosis of Congestive Heart Failure (CHF) is lower for CHN 2 than the district as a whole, with 8.85 citizens per 1000 population receiving care from an FP for a diagnosis of CHF (compared to 9.03 per 1000 population for the district).

Figure 30 shows that within CHN 2, the highest percentage of the population receiving care from an FP for a diagnosis of CHF resides in Peggy’s Cove, with 19 people per 1000 population receiving care for CHF. This is followed by Terrence Bay, with 16.1 people per 1000 population receiving care for CHF. Tantallon has the lowest rate of citizens receiving care for a diagnosis of CHF, at 3.7 citizens per 1000 population. The average number of visits per patient is marginally lower in CHN 3 than the district, with the highest number of visits per person occurring by residents of Timberlea with a diagnosis of CHF (4.6 visits per patient). Refer to Table 24 for a detailed breakdown by community.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 49 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 25: CHN overview of citizens receiving care for a diagnosis of CHF from a family physician FP Visits for Average Visits per Patients per 1000 Community Patients CHF Patient population Armdale-Northwest Arm 328.8 121.1 2.7 14.7 Clayton Park 777.1 253.6 3.1 9.0 Fairview 366.7 109.6 3.3 8.4 Hacketts Cove 23.8 11.3 2.1 8.9 Halifax Chebucto 367.0 132.8 2.8 8.7 Halifax Citadel 289.0 80.0 3.6 4.5 Halifax Needham 753.0 221.8 3.4 12.7 Hatchet Lake 66.7 16.4 4.1 6.9 Herring Cove 52.7 12.7 4.1 6.0 Hubbards 81.9 21.8 3.8 12.9 Peggy’s Cove 38.1 10.3 3.7 19.0 Prospect 67.6 26.7 2.5 10.7 Sambro 66.4 14.9 4.5 5.1 Spryfield 286.8 88.5 3.2 10.5 St. Margaret’s Bay 68.6 25.2 2.7 13.5 Tantallon 89.3 24.8 3.6 3.7 Terence Bay 35.6 13.3 2.7 16.1 Timberlea 166.5 36.3 4.6 5.3 CHN 2 Total 3,925.5 1,221.1 3.21 8.85 District Total 10,407.9 2,994.4 3.48 9.03

Source: Department of Health & Wellness, MSI Billing Data two year average for fiscal 2011/12; 2012/13

Community Health Network 2: Halifax Peninsula / Chebucto Page | 50 Capital Health Community Clinical Services / Health System Planning Group (2014) 4. Hypertension

Figure 31: Rate of measure for individuals receiving care from a family physician for a diagnosis of Hypertension per 1000 population (Department of Health & Wellness, MSI Billing Data two year average for fiscal 2011/12; 2012/13)

The number of citizens per 1000 population accessing care from a family physician for a diagnosis of hypertension is lower for CHN 2 than the district as a whole with 149.8 citizens per 1000 population receiving care from an FP for a diagnosis of hypertension (compared to 164.3 per 1000 population for the district).

Figure 31 shows that within CHN 2, the higher rate of the population accessing care from a family physician for a diagnosis of hypertension occurs in St. Margaret’s Bay, with 323.2 citizens per 1000 population accessing care for hypertension. St. Margaret’s Bay is followed by Terrence Bay, Peggy’s Cove, and Hackett’s Cove. Consistent with other chronic conditions, Halifax Citadel has the lowest rate in the CHN. The average number of visits per patient is relatively consistent across communities. Refer to Table 25 for a detailed breakdown by community.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 51 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 26: CHN overview of citizens receiving care for a diagnosis of hypertension (HTN) from a family physician FP Visits for Average Visits per Patients per 1000 Community Patients HTN Patient population Armdale-Northwest 3021.8 1351.2 2.2 163.5 Arm Clayton Park 10,844.9 4550.9 2.4 161.1 Fairview 4785.9 1973.2 2.4 151.4 Hacketts Cove 804.8 314.4 2.6 249.9 Halifax Chebucto 4698.7 2005.5 2.3 131.4 Halifax Citadel 3223.0 1477.6 2.2 83.5 Halifax Needham 5846.1 2477.8 2.4 141.8 Hatchet Lake 1311.7 449.8 2.9 187.8 Herring Cove 748.5 364.4 2.1 170.6 Hubbards 795.7 320.7 2.5 190.6 Peggy’s Cove 423.3 145.0 2.9 269.1 Prospect 1446.2 498.3 2.9 199.7 Sambro 862.5 404.0 2.1 137.4 Spryfield 3157.7 1388.3 2.3 165.5 St. Margaret’s Bay 1376.8 604.7 2.3 323.2 Tantallon 2348.7 1012.2 2.3 150.8 Terence Bay 704.9 222.7 3.2 270.9 Timberlea 2621.5 1114.2 2.4 163.2 CHN 2 Total 49022.8 20675.0 2.37 149.77 District Total 128,405.9 54,460.0 2.36 164.31

Source: Department of Health & Wellness, MSI Billing Data two year average for fiscal 2011/12; 2012/13

Community Health Network 2: Halifax Peninsula / Chebucto Page | 52 Capital Health Community Clinical Services / Health System Planning Group (2014) Specialist Visits for Chronic Disease (Summary)

Physician Billing Data was obtained for specialist billings for four chronic conditions: Diabetes Mellitus (DM), Chronic Obstructive Pulmonary Disease (COPD), Congestive Health Failure (CHF), and Hypertension (HTN) based on patient postal code information. The data source was billing data provided by the Department of Health and Wellness from 2011/12 and 2012/13. Data was analyzed and there was no great variability between the two years; therefore, for generalization purposes, an average of the two years was calculated to estimate annual patient visits. This information is intended to complement the family physician billing data for the same four conditions over the same two year time period. All data is for adults, age 20 years and above.

Table 27 describes the number of patients per population of 1000 receiving care from a specialist for a particular chronic condition. Within CHN 2 there is generally a higher rate of people per 1000 population accessing specialist care compared to the district rate. Within the CHN, there is a higher rate of patients per 1000 population receiving care from a specialist for a diagnosis of diabetes residing in the community of St. Margaret’s Bay. The lower rate of patients per 1000 population receiving specialist care for diabetes reside in Halifax Citadel. Generally, there are a consistent number of visits per patient to a specialist for this condition across communities in CHN 2 (average: 2.7 visits per patient) (Figure 32). Within the CHN, the rate of patients accessing a specialist for a diagnosis of hypertension is marginally higher than the district rate (6.26 patients per 1000 population in CHN 3 compared to 6.0 for the district). Within the CHN, the community with the higher rate of citizens per 1000 population receiving care from a specialist for hypertension is St. Margaret’s Bay. The average number of visits per patient is consistently lower than the district rate across the CHN (Figure 33). Within the CHN, there is a marginally higher rate of patients per 1000 receiving care for COPD than the district rate. The community with the higher rate of people seeing a specialist for COPD is St. Margaret’s Bay, followed by Terrence Bay and Spryfield. The CHN has a slightly higher rate than the district rate in terms of the number of average visits per patient, with residents of Hatchet Lake having the most visits per patient (Figure 34). Finally, there is also a marginally higher rate of people per 1000 population accessing specialist care for a diagnosis of CHF within CHN 2, with the highest rate occurring in the community of St. Margaret’s Bay, showing a similar trend to the other aforementioned chronic conditions. The average number of visits per patient for the CHN is similar to the district rate; however, St. Margaret’s Bay has the highest number of visits per patient, with 11 visits per patient, twice the CHN and district rates. (Figure 35).

Community Health Network 2: Halifax Peninsula / Chebucto Page | 53 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 27: Rate of Patients per 1000 population accessing a specialist for a diagnosis of DM, HTN, COPD, or CHF Diabetes - # of Hypertension # of COPD - # of CHF - # of Patients Community Patients per Patients per Patients per per population of population of 1000 population of 1000 population of 1000 1000 Armdale-Northwest 18.1 7.3 5.8 6.2 Arm Clayton Park 16.9 6.9 6.5 5.9 Fairview 16.3 5.4 7.0 6.0 Hacketts Cove 21.3 9.5 7.7 7.0 Halifax Chebucto 15.5 6.3 7.3 4.7 Halifax Citadel 8.4 5.7 3.5 3.5 Halifax Needham 14.9 6.1 9.5 6.7 Hatchet Lake 15.7 4.2 4.7 3.6 Herring Cove 21.0 7.0 7.8 5.2 Hubbards 15.6 3.4 5.5 4.0 Peggy’s Cove 15.1 ------Prospect 14.4 5.9 7.7 4.7 Sambro 13.9 4.8 9.7 4.3 Spryfield 21.4 6.9 12.7 7.9 St. Margaret’s Bay 27.6 10.9 14.5 11.0 Tantallon 12.9 5.2 6.9 2.5 Terence Bay 14.0 -- 13.0 7.6 Timberlea 16.6 5.6 6.8 3.2 CHN 2 Total 15.56 6.26 7.22 5.37 District Total 18.04 6.00 7.09 5.24

Source: Department of Health & Wellness, MSI Billing Data two year average for fiscal 2011/12; 2012/13

Community Health Network 2: Halifax Peninsula / Chebucto Page | 54 Capital Health Community Clinical Services / Health System Planning Group (2014) 1. Specialist Care for Diabetes

Figure 32: Rate of patients per 1000 population receiving care from a specialist for Diabetes (MSI Billing Data two year average for fiscal 2011/12; 2012/13)

2. Specialist Care for Hypertension

Figure 33: Rate of patients per 1000 population receiving care from a specialist for Hypertension (MSI Billing Data two year average for fiscal 2011/12; 2012/13) Community Health Network 2: Halifax Peninsula / Chebucto Page | 55 Capital Health Community Clinical Services / Health System Planning Group (2014) 3. Specialist Care for COPD

Figure 34: Rate of patients per 1000 population receiving care from a specialist for COPD (MSI Billing Data two year average for fiscal 2011/12; 2012/13)

4. Specialist Care for Congestive Heart Failure

Figure 35: Rate of patients per 1000 population receiving care from a specialist for CHF (MSI Billing Data two year average for fiscal 2011/12; 2012/13) Community Health Network 2: Halifax Peninsula / Chebucto Page | 56 Capital Health Community Clinical Services / Health System Planning Group (2014) COMMUNITY HEALTH NETWORK SERVICE DELIVERY LOCATIONS

Capital Health Community-Based Service Locations

Figure 36: Capital Health Community Based Programs and Services locations, by Department/Program Area, Fall 2013

Figure 36 and Table 28 outline the locations where Capital Health community-based programs and services operate out of/have physical space in CHN 2. Note that this is not an inclusive list of programs offered because it does not consider district wide programs and services that are available for residents of CHN 2 to access that do not operate out of a physical space, home visits that occur in the CHN, or programs offered out of different rotating community sites; refer to the Community Program and Service Inventory20 for a full listing.

Table 28: Capital Health Community Based Program and Service Locations, by Department/Program Area Programs Mapped in Figure 36 by Department Capital Health Mental Health Community Mental Health Clinics, Community Hubs (Connections locations), & Addictions Program Addictions Community Based Services Integrated Continuing Care Care Coordinator locations, Nursing Homes Patient & Public Engagement Community Health Board Coordinator locations Primary Health Care Community Health Teams, Community Health Centres, Community Wellness Centre, Dalhousie Family Medicine, Diabetes Management Centre Public Health Drop in Centres, Youth Health Centres, Fluoride Mouthrinse Program, Prenatal Classes, Satellite Office locations (note: all elementary school locations not recorded but services provided to all e.g., vision screening) Rehabilitation Services Programs offered from DGH, HI, VMB, AJL, NSRehab, VG, Bayers Rd.

20 This document is available via the Community Clinical Services/Health System Planning Group and is a detailed inventory of all programs and services offered by the Community-based Programs district wide

Community Health Network 2: Halifax Peninsula / Chebucto Page | 57 Capital Health Community Clinical Services / Health System Planning Group (2014) Family Practice in CHN 2

Figure 37: Family Practice locations in CHN 2 (DDFP Database (Medical Services Information System; CDHA; DDFP Members; April 2014)

Figure 38: Family physician FTE per 1000 population in CHN 2 (Department of Health and Wellness Physician Resource Plan 2012 Billings)

Community Health Network 2: Halifax Peninsula / Chebucto Page | 58 Capital Health Community Clinical Services / Health System Planning Group (2014)

Figure 37 depicts locations of family physician offices, nurse practitioners, family practice nurses, and urgent care locations in CHN 2. There are approximately 144 family physician FTEs practicing in CHN 2 and the rate of family physician FTE per population for each community in CHN 2 is depicted in Figure 38. The highest number of working family physicians per 1000 population practice in the community of Halifax Citadel, in addition to Hatchet Lake and Hubbards. There are nurse practitioners affiliated with the North End and Duffus Community Health Centres and there are approximately twelve family practice nurses working across the CHN. The communities in CHN 2 without a family physician practicing in their community are Armdale-Northwest Arm, Herring Cove, Sambro, Terrence Bay, Prospect, Peggy’s Cove, and Hackett’s Cove.

Figure 39: Individuals placed with a family physician (or NP) through the Primary Health Care Connections program (Primary Health Care data for the period of March 2011 – June 2014)

Primary Health Care Connections is an initiative that assists citizens in Capital Health with finding a family practice if they do not currently have a primary care provider. People looking for a family physician for their routine care are directed to contact family practices in their community that are advertising for new patients. Those with complex health needs, such as individuals with chronic conditions, complete a medical history form with the Primary Health Care Connections coordinator and are placed with a family practice by the coordinator.

Table 28 and Figure 39 detail the number of individuals known to be placed with a family practice, by the community in which the individual resides, from March 2011-June 201421. Note that the family physician/nurse practitioner may practice out of any community. Residents of CHN 2 accounted for 50.29% of all individuals being placed with a family physician through the Primary Health Care Connections Program. Within the CHN, the highest number of citizens being placed with a family physician through the Primary Health Care

21 From November 2013 onward, the data also includes those who were re-directed with information. This is a result of the program and data collection mechanisms evolving over time. Generally, this information is intended to show communities with higher call volumes to the service.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 59 Capital Health Community Clinical Services / Health System Planning Group (2014)

Connections program reside in the community of Halifax Chebucto, with approximately 65 citizens being connected to a family doctor.

Table 29: Individuals placed with a Family Physician (or NP), by Community Community Number of Individuals Placed Percentage of CHN Total Armdale-Northwest Arm 7.77 2.43 Clayton Park 35.37 11.04 Fairview 33.14 10.35 Hacketts Cove -- -- Halifax Chebucto 65.20 20.35 Halifax Citadel 49.00 15.30 Halifax Needham 55.52 17.33 Hatchet Lake -- -- Herring Cove 6.20 1.94 Hubbards 7.70 2.40 Peggy’s Cove 0.0

Prospect -- -- Sambro 6.55 2.04 Spryfield 30.80 9.62 St. Margaret’s Bay -- -- Tantallon -- -- Terence Bay 0.00

Timberlea 12.31 3.84 CHN 2 Total 320.32 50.29 (of district total) District Total 636.98 100 *Some data suppressed due to small numbers

Source: Primary Health Care, Capital Health, for the period of March 2011 – June 2014.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 60 Capital Health Community Clinical Services / Health System Planning Group (2014) Community Pharmacies

Figure 40: Community-based pharmacy locations in CHN 2 (Pharmacy Association of Nova Scotia (PANS), 2014).

Figure 40 depicts community-based pharmacy locations in CHN 2. Observationally, clusters of community pharmacies are evident in the more urban areas of CHN 2, with few pharmacies located in the outlying rural areas of the CHN.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 61 Capital Health Community Clinical Services / Health System Planning Group (2014) Nursing Home Locations

Figure 41: Nursing Home and Residential Care Facility locations in CHN 2 (Continuing Care, Capital Health, April 2014, as retrieved from http://novascotia.ca/dhw/ccs/documents/Nursing-Homes-and-Residential-Care-Directories.pdf)

Figure 41 represents the nursing home (NH) and residential care facility (RCF) locations in CHN 2. Table 30 identifies the facilities and number and type of beds, by community. There are no nursing homes or RCFs located within the communities outside the urban core, with the exception of one NH in Hackett’s Cove.

Table 30: Nursing Home and RCF locations by Community, indicating number of beds Community Nursing Home(NH)/Residential Care Facility (RCF) Location Number of Beds Halifax Chebucto 1. St. Vincent’s Nursing Home, 2080 Windsor Street (NH) 149 NH Beds Halifax Needham 1. Northwood Care Inc, 2615 Northwood Terrace (NH + RCF) 445 NH Beds + 40 RCF Beds Clayton Park 1. Parkstone Enhanced Care, 156 Parkland Drive (NH) 190 NH Beds + 4 respite beds 2. Precision Health Group, 599 Washmill Lake Drive (RCF) 20 RCF Beds 3. Peter’s Place Halifax ABI, 12 Swan Crescent 4 NH Beds Fairview 1. Maplestone Enhanced Care, 245 Main Avenue (NH) 87 NH Beds Armdale-Northwest 1. Arborstone Enhanced Care, 126 Purcell’s Cove Road (NH) 190 NH Beds Arm 2. Melville Gardens Nursing Home, 11 Ramsgate Lane (NH + 31 NH Beds + 60 RCF Beds RCF) Spryfield 1. Melville Lodge, 50 Shoreham Lane (NH) 123 NH Beds + 1 respite bed 2. Sunshine Personal Care Home Inc, 38A Withrod Drive 3 RCF Beds (RCF) Hackett’s Cove 1. Seabright Rest Homes, 11625 Peggy’s Cove Road 6 NH Beds NH beds per 100,000: 722.9 CHN NH and RCF Beds per 100,000 population RCF beds per 100,000: 72.6

Source: Integrated Continuing Care, Capital Health, April 2014, as retrieved from http://novascotia.ca/dhw/ccs/documents/Nursing-Homes-and-Residential-Care-Directories.pdf).

Community Health Network 2: Halifax Peninsula / Chebucto Page | 62 Capital Health Community Clinical Services / Health System Planning Group (2014)

COMMUNITY HEALTH SERVICES UTILIZATION

Emergency Department Visits (Adult – Capital Health)

The number of visits per 1000 population to the Emergency Department (ED) was retrieved from the Emergency Department Information System (EDIS) for communities across the District. Both visits of high acuity (CTAS 1,2,3) and visits of low acuity (CTAS 4 and 5) as a rate per 1000 population were calculated. This data is based on the postal code of the citizen and includes all emergency departments with Capital Health (Halifax Infirmary, Dartmouth General Hospital, Hants Community Hospital, and Cobequid Community Health Centre), with the exception of the EDs located within the Tri-Facilities (data captured through the Nightingale EMR). Table 31 details emergency department (ED) utilization, by community, by type of visit.

Table 31: Emergency Department Utilization by Community for Adults using CDHA Emergency Departments CTAS 1,2,3 CTAS 4,5 CTAS 1-3 Visits per CTAS 4-5 Visits per Community Visits (#) Visits (#) Population of 1000 Population of 1000 Armdale-Northwest Arm 2000.2 962.6 242.0 116.5 Clayton Park 6837.9 3509.0 242.1 124.2 Fairview 3238.1 1782.8 248.4 136.8 Hackett’s Cove 316.7 151.7 251.7 120.6 Halifax Chebucto 3170.5 2061.0 207.7 135.0 Halifax Citadel 3136.0 2232.4 177.2 126.1 Halifax Needham 5113.7 2982.5 292.6 170.7 Hatchet Lake 463.4 266.5 193.5 111.3 Herring Cove 516.9 243.0 242.0 113.8 Hubbards 605.2 587.3 359.6 348.9 Peggy’s Cove 123.7 58.1 229.5 107.8 Prospect 461.5 257.0 185.0 103.0 Sambro 677.9 339.7 230.6 115.5 Spryfield 2968.1 1542.8 353.9 183.9 St. Margaret’s Bay 524.6 329.6 280.4 176.1 Tantallon 1177.2 713.8 175.4 106.3 Terence Bay 199.1 90.6 242.3 110.2 Timberlea 1567.6 980.3 229.7 143.6 CHN 2 Total 33,098.2 19,090.4 239.7 138.3 District (CDHA Residents Only) 90,116.6 54,946.9 271.9 165.8 Source: EDIS data for Fiscal Year 2013/14, Capital Health

CHN 2 has a lower rate of visits per 1000 population to the ED for visits of high acuity (CTAS levels 1, 2, and 3) and low acuity (CTAS level 4 and 5) when compared to the district rate. Within the CHN, the community with the highest total number of ED visits for both levels of acuity is Clayton Park. As a rate per 1000 population, Hubbards has the highest rate of visits of high acuity to the ED (359.8 visits per 1000 population) and the highest rate of visits to the ED for visits of low acuity (348.9 visits per 1000 population). The community with the lowest number of visits per 1000 population to the ED for visits of high acuity is Tantallon and for visits of lower acuity is Prospect. The rate of CTAS visits of high acuity and low acuity per 1000 population are depicted in Figures 42 and 43, respectively.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 63 Capital Health Community Clinical Services / Health System Planning Group (2014)

Figure 42: Number of visits per 1000 population to an ED within Capital Health for a visit of high acuity in CHN 2 (EDIS data for Fiscal Year 2013/14, Capital Health)

Figure 43: Number of visits per 1000 population to an ED within Capital Health for a visit of low acuity in CHN 2 (EDIS data for Fiscal Year 2013/14, Capital Health)

Community Health Network 2: Halifax Peninsula / Chebucto Page | 64 Capital Health Community Clinical Services / Health System Planning Group (2014) Emergency Department Visits (Child/Youth – IWK)

Emergency Department data was also retrieved from the IWK Health Centre to provide information related to child and youth visits to the emergency department. Both visits of high acuity (CTAS 1,2,3) and visits of low acuity (CTAS 4 and 5) as a rate per 1000 youth population were calculated (ages 0-19 years). This data is based on the postal code of the citizen and includes all ED visits occurring at the IWK Health Centre, but not for children/ youth visiting other EDs within Capital Health. Table 31 details emergency department (ED) utilization by community, by type of visit.

Table 32: IWK Health Centre Emergency Department Utilization by Community for Children/Youth CTAS 1,2,3 CTAS 4,5 CTAS 1-3 Visits per CTAS 4-5 Visits per Community Visits (#) Visits (#) Population of 1000 Population of 1000 Armdale-Northwest Arm 203.56 439.67 89.55 197.74 Clayton Park 735.14 1427.88 83.62 176.22 Fairview 392.41 646.19 96.05 175.47 Hacketts Cove 18.74 32.01 62.85 115.57 Halifax Chebucto 347.36 739.39 75.32 157.48 Halifax Citadel 193.84 433.85 66.51 133.78 Halifax Needham 394.56 800.13 100.76 209.59 Hatchet Lake 83.79 175.02 73.02 162.17 Herring Cove 53.32 103.69 66.14 125.42 Hubbards 21.25 28.35 43.84 54.09 Peggy’s Cove <5 11.14 21.49 80.17 Prospect 57.17 140.27 61.35 129.83 Sambro 107.72 205.68 73.85 169.01 Spryfield 324.28 752.06 101.99 221.75 St. Margaret’s Bay 48.52 91.28 67.43 130.20 Tantallon 279.97 483.79 75.27 137.14 Terence Bay 23.19 33.88 77.16 144.34 Timberlea 281.26 673.00 84.32 190.50 CHN 2 Total 3,570.28 7,217.28 82.33 169.95 District (CDHA Residents Only) 7,411.48 14,404.5 60.25 118.62

Source: IWK Health Centre Emergency Department data for Fiscal Year 2013/14

CHN 2 has a higher rate of children/youth per 1000 population visiting the ED for visits of both high and low acuity (CTAS levels 1-5) when compared to the district rate. Within the CHN, the community with the highest volume of IWK ED visits for visits of both high and low acuity is Clayton Park. As a rate per 1000 population, Spryfield has the highest rate of visits of high acuity to the IWK ED (101.99 visits per 1000 population) and the highest rate of visits to the ED for visits of low acuity (221.75 visits per 1000 population). Peggy’s Cove has the lowest rate of visits by children/youth to the IWK ED for visits of high acuity and Hubbards has the lowest rate of visits of low acuity. The rate of CTAS visits of high acuity and low acuity per 1000 population are depicted in Figures 44 and 45, respectively.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 65 Capital Health Community Clinical Services / Health System Planning Group (2014)

Figure 44: Number of Child/Youth visits per 1000 population to the IWK Health Centre Emergency Department for visits of high acuity (IWK Health Centre, Meditech Registrations for Time Period Fiscal 2012-2013)

Figure 45: Number of Child/Youth visits per 1000 population to the IWK Health Centre Emergency Department for visits of low acuity (IWK Health Centre, Meditech Registrations for Time Period Fiscal 2012-2013)

Community Health Network 2: Halifax Peninsula / Chebucto Page | 66 Capital Health Community Clinical Services / Health System Planning Group (2014) Hospital Admissions

Table 33 highlights the top 5 reasons for admission to hospital in CHN 2, according to the Discharge Abstract Database (DAD) for Fiscal Year 2012-2013. CHN 2 has a lower admission rate than the district rate for all of the top 5 reasons for admission, with the exception of admissions for convalescent care.

Table 33: Hospital admissions by diagnosis for CHN 2 (DAD, Fiscal 2012-2013) CHN 2 Admission District Admission NS (per 1000 ICD Code Total Rate per 1000 pop Rate per 1000 pop population) I21 Acute myocardial infarction 272 1.66 1.82 2.53 J44 Oth COPD 246 1.50 1.77 Z51 Other medical care 243 1.48 1.65 Z54 Convalescence 226 1.38 1.33 M17 Gonarthrosis [arthrosis of knee] 207 1.26 1.49

Table 34 highlights the top 5 reasons for unplanned re-admission to hospital in CHN 2 (from previous acute admit with same or related diagnosis in 0-28 days after discharge) according to the DAD for Fiscal Year 2012- 2013. In CHN 2, the readmission rates were similar district rates, with the exception of readmissions for other complications due to other internal prosthetic device, implant, and graft, which was higher for CHN 2.

Table 34: Re-admissions by Diagnosis for CHN 2(DAD, Fiscal 2012-2013) CHN 2 Admission District Admission National Re- ICD Code Total Rate per 1000 pop Rate per 1000 pop admit rate T81 Complications of procedures NEC 41 0.25 0.25 I50 Heart failure 31 0.19 0.19 21% Z51 Other medical care 20 0.12 0.14 12.5% J44 Oth chronic obstructive pulmonary 14 0.09 0.11 18.8% disease T85 Comp other int prosth/implant/ Not in top 5 for 12 0.07 grafts district

Ambulatory Care Sensitive Conditions

Table 35 describes the top five reasons for admissions for ambulatory care sensitive conditions (ACSCs) in CHN 2 according to the Discharge Abstract Database (DAD) for Fiscal Year 2012-2013.

Table 35: Admissions by ambulatory sensitive condition (DAD, Fiscal 2012-2013) CHN 2 Admission District Admission Condition Total Rate per 1000 pop Rate per 1000 pop Heart Failure and Pulmonary Edema 145 0.88 0.88 Diabetes 26 0.16 0.27 Grand mal status/other epileptic convulsion 30 0.18 0.18 COPD 227 1.38 1.62 Asthma 19 0.12 0.13 Angina 40 0.24 0.24 The ACSC hospitalization age standardized rate per 1000 population for CDHA is 3.50 per 1000 population, which is lower than the rate for NS (4.64 per 1000 population) and Canada (3.89 per 1000 population). 22 CHN 2 similar or lower rates of admission to hospital for all ACSCs listed in Table 35 when compared to the district rate.

22 Provincial and National benchmarks are provided by CIHI, where available.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 67 Capital Health Community Clinical Services / Health System Planning Group (2014) Community Mental Health and Addictions Services

Adult and Child/Youth mental health and addictions service utilization data was collected for individuals accessing services across CDHA and accessing the IWK Health Centre. The rate per population was calculated for each age demographic; however, it is important to note that Capital Health sees some child/youth mental health and addictions clients in the West Hants Area (not registered via IWK). The Capital Health data contains data for community-based mental health and addictions services only; however, the child/youth data from the IWK Health Centre includes a broad range of services offered (from specialty therapy and diagnostics to group programs and allied health visits).

1. Addictions Community Based Services (Adult – Capital Health)

Capital Health Addictions Community-Based Services offer support to individuals, in the community, for their ongoing recovery from alcohol, substances, nicotine and gambling. Services include group therapy, one-on-one counseling, and recreation therapy (Capital Health, 2014).

Figure 46: Number of clients per 1000 population accessing Addictions Community Based Services (Adult – Capital Health) in CHN 2 (STAR and Addictions Assist (Provincial Database) for time period April 2012 – September 2013) Figure 46 depicts the number of clients per 1000 population accessing Addictions Community Based Services in CHN 2. CHN 2 has a similar number of people utilizing Addictions Community Based Services per 1000 population, with 11.72 clients per 1000 population accessing services compared to the district rate of 11.79 clients per 1000 population. Within the CHN, Clayton Park has the greatest number of clients and the highest volume of visits. The community of Spryfield has highest number of clients per 1000 population, with 24.5 clients per 1000 population accessing Addictions Community Based Services. The average number of visits per client in CHN 2 is also similar to the district rate, with clients having, on average, 12.1 visits each. Clients residing in Halifax Citadel have the higher average number of visits per client (15.8 visits per client). A detailed breakdown of Addictions services utilization is provided in Table 36.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 68 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 36: Addictions Community Based Services Utilization (Adults – Capital Health) in CHN 2 Addictions Community Average Visits per # of Clients per Community Clients Based Services Visits23 Client population of 1000 Armdale- 1253.1 97.0 12.9 11.7 Northwest Arm Clayton Park 3467.5 271.9 12.8 9.6 Fairview 2545.2 200.1 12.7 15.4 Hacketts Cove 78.9 10.9 7.3 8.6 Halifax Chebucto 1856.8 137.6 13.5 9.0 Halifax Citadel 2497.8 158.1 15.8 8.9 Halifax Needham 3378.6 254.9 13.3 14.6 Hatchet Lake 241.5 27.6 8.7 11.5 Herring Cove 288.0 27.9 10.3 13.1 Hubbards 165.2 14.5 11.4 8.6 Peggy’s Cove ------Prospect 118.4 20.3 5.8 8.1 Sambro 220.1 28.6 7.7 9.7 Spryfield 2123.0 205.6 10.3 24.5 St. Margaret’s Bay 127.2 16.7 7.6 8.9 Tantallon 519.4 56.7 9.2 8.4 Terence Bay 122.0 10.3 11.9 12.5 Timberlea 501.9 75.4 6.7 11.0 CHN 2 Total 19,528.8 1,618.4 12.07 11.72 District Total 50,651.5 3,908.0 12.96 11.79

Source: STAR and Addictions Assist (Provincial Database) for time period April 2012 – Sept 2013

2. CHOICES Addictions Services (Child/Youth – IWK Health Centre)

CHOICES provides treatment services for adolescents aged 13 to 19 years who are harmfully involved with substances, gambling and/or who have a concurrent disorder. CHOICES provides voluntary services including health promotion and prevention, community cutreach, outclient clinical services, a day program and a provincial 24/7 inpatient treatment service (IWK Health Centre, 2014). Excluded from the total number of visits are registrations for inpatients of the CHOICES Residential Unit at the time of their clinic visit.

All CHOICES Addictions data should be interpreted with caution due to low numbers of clients by community. The rate of clients accessing services per 1000 child/youth population (age 0-19) 24 was mapped for some CHNs; however, some communities with small youth populations show high rates, yet the number of clients is still very small (<5 clients). Any community with less than five children/youth accessing services is noted and data are suppressed. Communty and CHN data for CHOICES is displayed in Table 37 and rates per 1000 children/youth are also depicted in Figure 47.

23 Note: total number of visits over an 18 month period (not annual) 24 This age demographic does not exactly correlate to the demographic of the population served by the program; however, it is a more accurate measure of the rate than the total population of the community (all age groups)

Community Health Network 2: Halifax Peninsula / Chebucto Page | 69 Capital Health Community Clinical Services / Health System Planning Group (2014)

* * * * * * * * * * * * * ** * * *

Figure 47: Number of clients per 1000 youth population accessing IWK CHOICES Addictions Services (IWK Health Centre, Meditech Registrations for Fiscal 2012-2013). Note: Communities designated with a *asterisk have greater than 5 clients

There is a similar rate of the population accessing CHOICES services in CHN 2 as the district rate, with 2.4 clients per 1000 youth population accessing CHOICES in CHN 2. The community with the higher rate of youth accessing the program is Fairview, with 4.0 clients per 1000 youth population. Fairview also has the higher total number of visits and the higher number of visits per client with on average, clients having 8.9 visits each.

Table 37: Addictions Community Based Services Utilization (Youth – IWK) in CHN 2 Community CHOICES Visits Clients Visits per Client Clients per 1000 youth population Armdale-Northwest Arm -- <5 -- -- Clayton Park 54.8 11.7 4.7 1.9 Fairview 98.0 11.0 8.9 4.0 Hacketts Cove -- <5 -- -- Halifax Chebucto 48.0 8.0 6.0 2.2 Halifax Citadel 40.0 5.0 8.0 2.1 Halifax Needham -- <5 -- -- Hatchet Lake -- <5 -- -- Herring Cove -- <5 -- -- Hubbards -- <5 -- -- Peggy’s Cove -- <5 -- -- Prospect -- <5 -- -- Sambro -- <5 -- -- Spryfield 32.0 8.0 4.0 3.3 St. Margaret’s Bay -- <5 -- -- Tantallon -- <5 -- -- Terence Bay -- <5 -- -- Timberlea 31.2 5.3 5.9 2.1 CHN 2 Total 462.5 74.1 6.2 2.40 District Total 1339.0 225.4 6.0 2.47 Source: IWK Health Centre, Meditech Registrations for CHOICES for Time Period Fiscal 2012-2013

Community Health Network 2: Halifax Peninsula / Chebucto Page | 70 Capital Health Community Clinical Services / Health System Planning Group (2014) 3. Community Mental Health (Adult – Capital Health)

Capital Health Community Mental Health Services offer general mental health services for adults. Hants Community also provides child and adolescent mental health services. Community/outpatient and shared care Mental Health Services are provided by inter-disciplinary teams including and the services offered vary depending on the issues/illness the person presents with. Some people are seen for assessment only; others may have a set number of individual treatment sessions or group programs, while those with more serious and persistent illness, resulting in disability, are supported by the service over a longer period of time. People may receive services in an office, in the community, or in their home (Capital Health, 2014).

Figure 48: Number of clients per 1000 population accessing Community Mental Health in CHN 2 (STAR Registrations from time period April 2012 – Sept 2013, Capital Health)

Figure 48 depicts the number of clients per 1000 population accessing Community Mental Health and Addictions Services in CHN 2. CHN 2 has a marginally lower number of people utilizing Community Mental Health services per 1000 population (29.44 per 1000 population) when compared to the district average with 31.8 clients per 1000 population accessing services.

Within the CHN, the community of Spryfield has the highest rate of the population accessing Community Mental Health, having 45.3 clients per 1000 population. Clayton Park has the highest number of clients and the highest volume of visits. The average number of visits per client is lower in CHN 2 at 6.8 visits per client, compared to the district average of 7.7 visits per client. While residents of Peggy’s Cove have the lower rate of Community Mental Health utilization per 1000 population, they also have the higher average number of visits to Community Mental Health (11.4 visits per client), which is among the highest in the district. A detailed breakdown of Community Mental Health services utilization is provided in Table 38.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 71 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 38: Community Mental Health Services Utilization in CHN 2 Community Mental Health Average # of visits # of Clients per Community Clients Visits per client population of 1000 Armdale- 1478.7 237.9 6.2 28.8 Northwest Arm Clayton Park 5359.4 796.2 6.7 28.2 Fairview 4465.8 525.1 8.5 40.3 Hacketts Cove 169.4 25.1 6.8 19.9 Halifax Chebucto 2813.1 480.0 5.9 31.4 Halifax Citadel 2881.3 381.4 7.6 21.6 Halifax Needham 4576.2 677.2 6.8 38.8 Hatchet Lake 215.4 43.4 5.0 18.1 Herring Cove 211.3 40.3 5.2 18.9 Hubbards 453.4 69.3 6.5 41.2 Peggy’s Cove 71.1 6.3 11.4 11.6 Prospect 223.2 33.6 6.6 13.5 Sambro 338.9 66.2 5.1 22.5 Spryfield 2522.8 380.3 6.6 45.3 St. Margaret’s Bay 309.6 47.0 6.6 25.1 Tantallon 421.4 96.2 4.4 14.3 Terence Bay 117.0 15.4 7.6 18.8 Timberlea 886.9 143.7 6.2 21.1 CHN 2 Total 27,514.8 4,064.7 6.8 29.44 District Total 81,272.0 10,469.7 7.7 31.6 Source: STAR Registrations from time period April 2012 – Sept 2013, Capital Health

Community Health Network 2: Halifax Peninsula / Chebucto Page | 72 Capital Health Community Clinical Services / Health System Planning Group (2014) 4. Mental Health Services (Child/Youth – IWK Health Centre)

The IWK Mental Health Program provides mental health services to children and youth up to 19 years of age. There are a variety of services offered, including community mental health, shared care, day treatment clinics, and inpatient/acute services (IWK Health Centre, 2014). Data for children/youth in inpatient or residential care were excluded from the data.

Figure 49: Number of clients per 1000 youth population accessing IWK Mental Health Diagnostic and Therapeutic Services in CHN 2 (IWK Health Centre, Meditech Registrations for Time Period Fiscal 2012-2013)

Figure 49 depicts the number of child/youth mental health clients accessing services from the IWK Health Centre as a rate per 1000 child/youth population (ages 0 to 19 years). CHN 2 has a higher number of clients per 1000 youth population accessing Mental Health Services from the IWK Health Centre when compared to the district rate (37.8 clients per 1000 youth population from CHN 2 accessing services; district rate 31.6 clients per 1000 youth population). CHN 2 also has a higher number of visits per client than the district rate, averaging 10.3 visits per patient. Residents of CHN 2 account for approximately 40% of the patient population and visit volume for the district.

Within the CHN and also within the district, the community with the highest number of IWK Mental Health clients per 1000 youth population is Fairview, with 79.9 clients per 1000 youth population accessing services. Fairview is also the community with the highest total number of clients and the highest total number of visits. The average number of visits per client is highest for those residing in Prospect, with each client having an average of 17.2 visits. The community of Peggy’s Cove has the lower rate of clients per 1000 population accessing services (data has been suppressed), followed by Halifax Citadel. Detailed information by community is provided in Table 39.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 73 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 39: Mental Health Services Utilization for Children/Youth from IWK Health Centre in CHN 2 Mental Health Total Average # of visits # of clients per Community Clients Visits per client population of 1000 Armdale-Northwest Arm 630.5 55.8 11.3 33.9 Clayton Park 1308.1 185.1 7.1 30.3 Fairview 1562.4 219.2 7.1 79.9 Hacketts Cove 90.5 12.3 7.3 51.1 Halifax Chebucto 1320.1 124.7 10.6 34.5 Halifax Citadel 367.6 40.2 9.1 17.0 Halifax Needham 721.0 103.7 7.0 38.3 Hatchet Lake 277.6 26.3 10.5 31.8 Herring Cove 153.8 20.0 7.7 32.6 Hubbards 68.3 12.4 5.5 30.0 Peggy’s Cove -- <5 -- -- Prospect 530.1 31.0 17.1 40.2 Sambro 153.9 26.2 5.9 30.2 Spryfield 1182.8 144.3 8.2 59.7 St. Margaret’s Bay 121.1 13.0 9.3 24.4 Tantallon 659.4 77.6 8.5 27.6 Terence Bay 24.5 3.6 6.9 20.4 Timberlea 962.6 95.4 10.1 37.0 CHN 2 Total 10,149.9 1,191.2 8.5 37.8 District Total 25,684.3 3,246.7 7.9 35.6

Source: IWK Health Centre, Meditech Registrations for Time Period Fiscal 2012-2013

Community Health Network 2: Halifax Peninsula / Chebucto Page | 74 Capital Health Community Clinical Services / Health System Planning Group (2014) 5. Reproductive Mental Health (Women – IWK Health Centre)

The Reproductive Mental Health Service at the IWK provides assessment, treatment and management for mental health concerns arising in reproductive care, particularly pregnancy and the postpartum period. Problems addressed include depression, anxiety disorders, high-risk obstetrical difficulties, perinatal loss, the impact of prior trauma on obstetrical care and broader adjustment issues (Making Waves, IWK Health Centre, 2011).

All Women’s Reproductive Mental Health data should be interpreted with caution due to low numbers of clients by community. The rate of clients accessing services per 1000 women (women aged 15 to 45 years) was mapped for some CHNs; however, some communities with small populations show high rates, yet the number of clients is still very small (<5 clients). Any community with less than five women accessing services is noted and data are suppressed. Communty and CHN data for IWK Women’s Mental Health services is displayed in Table 40 and rates per 1000 women are also depicted in Figure 50.

Figure 50: Number of clients per 1000 women aged 15-45 accessing IWK Reproductive Mental Services in CHN 2(IWK Health Centre, Meditech Registrations for Time Period Fiscal 2012-2013)

CHN 2 has a lower rate of the population accessing IWK Reproductive Mental Health Services than the district total, with the rate being 2.3 clients per 1000 women aged 15 to 45 years. Specifically, Spryfield has the highest rate of service utilization, with 2.3 clients per 1000 women accessing services. Fairview has the higher number of visits per client, with each client having 5.1 visits to the service, on average. The community of Clayton Park has the higher total number of clients and residents of Halifax Chebucto have the higher total number of visits.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 75 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 40: CHN Reproductive Mental Health Services Utilization for Women age 15-35, IWK Health Centre Reproductive MH Total Patients/ Average Visits per # of Patients per Community Visits Clients patient/client population of 1000 Armdale- 38.2 8.4 1.0 Northwest Arm 4.55 Clayton Park 96.4 28.7 3.36 1.0 Fairview 62.9 12.4 5.08 1.0 Hacketts Cove -- <5 -- -- Halifax Chebucto 100.5 22.5 4.46 1.5 Halifax Citadel 25.0 10.0 2.50 0.6 Halifax Needham 93.0 25.0 3.72 1.4 Hatchet Lake -- <5 -- -- Herring Cove -- <5 -- -- Hubbards -- <5 -- -- Peggy’s Cove -- <5 -- -- Prospect -- <5 -- -- Sambro -- <5 -- -- Spryfield 72.0 19.0 3.79 2.3 St. Margaret’s Bay -- <5 -- -- Tantallon 38.1 9.5 4.03 1.4 Terence Bay -- <5 -- -- Timberlea 43.9 11.6 3.78 1.7 CHN 2 Total 638.2 159.8 3.99 2.3 District Total 1283.3 322.8 3.98 3.6

Source: IWK Health Centre, Meditech Registrations for Time Period Fiscal 2012-2013

Community Health Network 2: Halifax Peninsula / Chebucto Page | 76 Capital Health Community Clinical Services / Health System Planning Group (2014) Youth Health Centres

Figure 51: Youth Health Centres in CHN 2, reporting top 5 concerns by location (Public Health, Capital Health, 2014)

Youth Health Centres promote positive outcomes for youth, including school completion, safer sexual behaviours and healthy relationships, and reduction of risks associated with substance use and other risk-taking behaviours (Youth Health Centre, Capital Health, 2014).

There are three Youth Health Centres located at high schools within CHN 2, locations depicted in Figure 51. The top five concerns reported for the 2013/14 school year by each Youth Health Centre indicate the top 5 reasons students visit the Youth Health Centre in each of the CHN’s high schools. Data was not available for J.L. Illsley.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 77 Capital Health Community Clinical Services / Health System Planning Group (2014) Community Health Teams

Figure 52: Visits to the Community Health Team per 1000 population (Primary Health Care, CDHA, STAR Registrations for time period Fiscal 2012/13

The Community Health Teams offer free wellness programs and navigation for people who live, work, or have a family doctor in the Dartmouth or Chebucto (Halifax Mainland) area of communities. There is one Community Health Team (CHT) located in CHN 1 in the community of Dartmouth East (58 Tacoma Drive); however, the CHT delivers programs throughout the majority of the CHN in various community locations (Dartmouth North, Dartmouth South, and Dartmouth East, others) as needed.

The higher number of people per 1000 population living in CHN 2 and visiting the Community Health Teams reside in Spryfield, Armdale-Northwest Arm, and Herring Cove. Figure 52 shows a visit density per 1000 population for the communities served by both the Dartmouth and Chebucto CHTs.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 78 Capital Health Community Clinical Services / Health System Planning Group (2014) Integrated Continuing Care

1. Integrated Continuing Care Client Summary

As of August 2014, Integrated Continuing Care had 5202 active clients across the district. 2249 of these clients reside in CHN 2, which accounts for 43% of all Integrated Continuing Care clients in the district. Refer to Table 41 for a synopsis, by CHN and by type of client.

Table 41: Integrated Continuing Care Client Overview by CHN Service / CHN CHN 1 CHN 2 CHN 3 CHN 4 CHN 5 CDHA Community ------300 344 644 Chronic Clients 569 932 338 29 -- 1,868 Supportive Clients 491 731 202 28 -- 1,452 Palliative Clients 52 80 41 <5 -- 176 Specialized Acute Care 40 46 13 <5 <5 102 Discharges Receiving Acute Nursing Only 310 460 170 20 -- 960 CHN Total 1462 2,249 764 382 344 5,202 % District Total 28% 43% 15% 7% 7% 100% % of Total CHN Population 1.3% 1.3% 0.8% 1.8% 1.4% 1.3% Accessing Services (all ages)

Source: Integrated Continuing Care, Capital Health, STAR Registrations April 1, 2013 to March 31, 2014

2. Community Occupational Therapy and Physiotherapy Services

Integrated Continuing Care aligns OT/PT services by municipal polling station. The polling stations that cover the communities of CHN 2 are listed below (Table 42) with the number of referrals for community occupational therapy (OT)/physiotherapy (PT) through Integrated Continuing Care that are aligned with each area. However, it is important to note overlap with other CHNs. Refer to Figure 53.

When looking at the Polling Stations that align with CHN 2, Polling District 9 – Peninsula West Armdale, has the highest number of referrals to community OT/PT, which is also the highest number of referrals across all polling stations in the district.

The average age of referral to Community OT services is 72.5 years of age. 1,048 CDHA citizens received this service last year, resulting in 2,549 visits for the fiscal year. There was an average of 2.42 visits per client. The average age of referral to Community PT services is 75.3 years of age. 893 CDHA citizens received this service last year, resulting in 2,558 visits for the fiscal year. There was an average of 2.80 visits per client. Figure 53: Rate of patients per 1000 population accessing community OT/PT via referral to Integrated Continuing Care, by numbered polling district (Integrated Continuing Care , CDHA, STAR Registrations for time period Fiscal 2013-2014) Community Health Network 2: Halifax Peninsula / Chebucto Page | 79 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 42: Integrated Continuing Care Referrals to Community OT/PT by Polling District aligned with CHNs CHN CHN 1 CHN 2 CHN 3 CHN 4 CHN 5 Polling Station 3, 4, 5, 6, 7,8,9,10,11,12, 14, 15 *1, *2 n/a *2 *13, *16 *13, *16, *1 Polling Station Polling Station Polling Station Polling Station #13 Polling Station n/a Overlap #2 overlaps #13 + #16 (large (large portion of #1 overlaps with with a large portion of Hubbards/St. CHN 3 and geography in Bedford) both Margaret’s Bay) + Polling Station CHN 4 overlap with CHN #16 overlap with #2 overlaps with 3 CHN 3 and Polling CHN 1 Station #1 overlaps with CHN 4 Total OT (%) 396 (25%) 696 (45%) 233 (16%) 126 (8%) 89 (6%) Total PT (%) 288 (25%) 530 (45%) 182 (16%) 82 (8%) 69 (6%) Total OT/PT 684 (25%) 1226 (45%) 415 (16%) 208 (8%) 158 (6%) Referrals Total Referrals to 1462 (28%) 2249 (43%) 764 (15%) 382 (7%) 345 (7%) Continuing Care

Source: Integrated Continuing Care, Capital Health, STAR Registrations April 1, 2013 to March 31, 2014

3. Home Care and/or Nursing Support Services

Data regarding Integrated Continuing Care clients is collected via Seascape, the information management system used by Integrated Continuing Care, and this data is available at the district level only. A summary of home care and/or nursing clients for CDHA is presented in Table 43. Home care clients in CDHA account for 33.4% of the total home care clients in the province. The majority of clients accessing home care services are aged 65 years and older and there are more females than males accessing services. The home care utilization rate for CDHA is 14.9% (as measured by # of home care clients per population 65+), which is lower than the provincial utilization rate of 16.2%. The top two diagnoses of home care clients is arthritis (62.2%) and hypertension (62.1%) and almost 50% of clients report being on nine or more medications (NS DHW Continuing Care Branch, 2013).

Table 43: Home Care and/or Nursing Support Client Summary for Capital District Health Authority # of Female Clients # of Male Clients Total # of Clients Age 0-19 59 74 133 Age 20-64 1,636 1,336 2,972 Age 65+ 3,591 2,123 5,714 District Total 5,286 3,533 8,819 % of NS Total 33.8% 32.8% 33.4%

Source: Nova Scotia Department of Health and Wellness, Continuing Care Branch, SEAscape Database for time period fiscal 2013-2014.

4. Care Plans, By Type

A detailed breakdown of the types of care plans created for clients over a one year period for Continuing Care Clients in Capital Health is provided in Table 44. The predominant type of care plan created is for skin care, which accounts for 20.6% of all care plans created. This is followed by activities of daily living, which accounts for 17.6% of all care plans created. The 65 and above age category accounts for the majority of care plans, with 72.6% of care plans being created for people aged 65 years and above. The predominant type of care plan

Community Health Network 2: Halifax Peninsula / Chebucto Page | 80 Capital Health Community Clinical Services / Health System Planning Group (2014) created for the 65 years and above age group is for activities of daily living. The predominant type of care plan created for the 20 to 64 year old age group was for skin care. Finally, the predominant type of care plan created for the child/youth population (age 0-19 years) was for skin care as well.

Table 44: Care plans created in 2013-2014 by type and age category for CDHA Continuing Care Clients Care Plan Type 0 to 19 Years 20 to 64 years 65 + years Total Care Plans % of Total Activities of Daily Living 43 2,014 8,897 10,954 17.6% Communication <5 89 140 229 0.4% Continence 27 967 2,737 3,733 6.0% Instrumental Activities 11 1,357 5,091 6,459 10.4% of Daily Living Medication 113 2,692 5,366 8,171 13.1% Mental Health <5 8 20 28 0.0% Musculoskeletal/ 14 131 578 723 1.2% Neurological Nutrition 23 890 4,141 5,054 8.1% Palliative <5 979 2,194 3,177 5.1% Psychosocial <5 14 83 97 0.2% Respirology/Cardiology 19 304 1,134 1,457 2.3% Skin Care 244 5,379 7,184 12,807 20.6% Support (general) 120 1,519 7,619 9,330 15.0% Total CDHA 614 16,343 45,184 62,219 100.0% % of Total Care Plans by 1.0% 26.3% 72.6% 100.0% --- Age Group

Source: Nova Scotia Department of Health and Wellness, Continuing Care Branch, SEAscape Database for time period fiscal 2013-2014.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 81 Capital Health Community Clinical Services / Health System Planning Group (2014) Ambulatory Care Clinics (Adult – Capital Health)

Data was extracted from STAR registrations, provided by the Department of Medicine and based on visits fiscal year 2011/2012 and 2012/2013, averaged for one year (adults aged 20 years and above). Table 45 describes the utilization of four ambulatory care clinics by residents of CHN 2 as a rate per 1000 population. Table 46 indicates the total visits to each of the four clinics, by community.

A summary of the ambulatory care clinic utilization data, followed by maps depicting utilization rates for each clinic, is provided below: Within the CHN, there is a higher rate of the population accessing the four ambulatory care clinics when compared to the district rate (Table 45) Residents of CHN 2 account for approximately 50% of visits to the four ambulatory care clinics, with residents of Clayton Park account for the highest total number of visits to all four ambulatory clinics (Table 46) Residents of Armdale-Northwest Arm have the highest rate of patients per 1000 population accessing the Cardiac Heart Function Clinic (Figure 54) and the highest rate of patients per 1000 population accessing the endocrinology clinic (Figure 56) Residents of Hackett’s Cove have the highest rate of patients per 1000 population accessing the Hypertension Clinic (Figure 55) Residents of St. Margaret’s Bay have the highest rate of patients per 1000 population accessing the Respirology Clinic (Figure 57)

Table 45: Ambulatory Clinic Usage by Community as a rate per 1000 population Cardiac Heart Hypertension Endocrinology Respirology Rate Community Function Rate per Rate per 1000 Rate per 1000 per 1000 1000 Population Population Population Population Armdale-Northwest Arm 18.86 4.69 16.33 44.81 Clayton Park 12.77 6.17 12.25 38.93 Fairview 8.07 5.61 8.35 31.25 Hacketts Cove -- 12.32 10.03 52.30 Halifax Chebucto 6.48 3.24 9.42 33.84 Halifax Citadel 6.10 3.41 8.93 25.59 Halifax Needham 6.43 3.79 11.66 34.10 Hatchet Lake 2.97 2.49 8.62 30.36 Herring Cove 7.18 6.55 12.50 38.79 Hubbards 9.03 -- 8.28 48.93 Peggy’s Cove 10.20 -- -- 28.49 Prospect 7.01 5.08 8.36 45.07 Sambro 9.76 6.59 9.27 45.04 Spryfield 13.25 4.16 9.07 43.51 St. Margaret’s Bay 9.90 9.65 11.84 57.07 Tantallon 4.27 6.27 10.21 31.58 Terence Bay 6.69 -- -- 36.80 Timberlea 10.16 7.49 12.34 32.22 CHN 2 Total 9.15 4.93 10.67 35.79 District Total 7.62 3.77 9.15 34.31 Source: STAR registrations, provided by the Department of Medicine and were based on visits during fiscal year 2011/2012 and 2012/2013, averaged to 1 year

Community Health Network 2: Halifax Peninsula / Chebucto Page | 82 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 46: Ambulatory Clinic Usage by Community, total number of visits per clinic Endocrinology Community Hypertension Visits Cardiac Visits Respirology Visits Visits Armdale-Northwest 134.96 38.77 155.90 370.37 Arm Clayton Park 346.05 174.37 360.66 1099.42 Fairview 108.85 73.13 105.15 407.33 Hacketts Cove 12.62 15.50 -- 65.79 Halifax Chebucto 143.75 49.44 98.98 516.63 Halifax Citadel 158.04 60.27 108.00 453.00 Halifax Needham 203.70 66.27 112.34 595.91 Hatchet Lake 20.64 5.97 7.11 72.72 Herring Cove 26.70 14.00 15.33 82.85 Hubbards 13.94 -- 15.20 82.35 Peggy’s Cove -- -- 5.50 15.36 Prospect 20.85 12.69 17.50 112.45 Sambro 27.25 19.38 28.69 132.41 Spryfield 76.05 34.92 111.14 364.95 St. Margaret’s Bay 22.15 18.06 18.53 106.78 Tantallon 68.53 42.06 28.69 211.96 Terence Bay -- -- 5.50 30.25 Timberlea 84.24 51.13 69.33 219.91 CHN 2 Total 1,473.18 680.84 1,263.54 4,940.43 District Total 3,031.15 1,248.82 2,526.25 11,372.75

Source: STAR registrations, provided by the Department of Medicine and were based on visits during fiscal year 2011/2012 and 2012/2013, averaged to 1 year

Community Health Network 2: Halifax Peninsula / Chebucto Page | 83 Capital Health Community Clinical Services / Health System Planning Group (2014) 1. Cardiology

Figure 54: CHN 2 visits per 1000 population to the QEII Cardiology Heart Function Clinic (Department of Medicine, STAR data for fiscal 2011/12 and 2012/13 averaged, CUT Cd: CARHF)

2. Hypertension

Figure 55: CHN 2 visits per 1000 population to the QEII Hypertension Clinic. (Department of Medicine,

STAR data for fiscal 2011/12 and 2012/13 averaged, CUT Cd: GMHY)

Community Health Network 2: Halifax Peninsula / Chebucto Page | 84 Capital Health Community Clinical Services / Health System Planning Group (2014) 3. Endocrinology

Figure 56: CHN 2visits per 1000 population to the QEII Endocrinology Clinic (Department of Medicine, STAR data for fiscal 2011/12 and 2012/13 averaged, CUT Cd: EN)

4. Respirology

Figure 57: CHN 2visits per 1000 population to QEII, Cobequid, Hants and DGH Respirology Clinics. (Department of Medicine, STAR data for fiscal 2011/12 and 2012/13 averaged, CUT Cd: CPP; RS; RSPF) Community Health Network 2: Halifax Peninsula / Chebucto Page | 85 Capital Health Community Clinical Services / Health System Planning Group (2014) Ambulatory Care Clinics (Child/Youth – IWK Health Centre)

1. IWK Dentistry Clinic

Figure 58: Rate of children/youth visits per 1000 accessing the IWK Dentistry Clinic for CHN 2 (IWK Health Centre, Meditech Registrations for Time Period Fiscal 2012-2013)

CHN 2 has a higher rate of children/youth accessing the IWK Dentistry Clinic when compared to the district rate, with 11.43 children/youth per 1000 population receiving care from the IWK Dentistry Clinic compared to 9.49 per 1000 population for the district25. The highest number of visits occur by residents of Clayton Park. Within the CHN, the community of Spryfield has the highest rate of children/youth accessing the IWK Dentistry Clinic, with 23.1 children/youth per 1000 population accessing the Dentistry Clinic. This is also the highest rate in the district. Refer to Figure 58 and Table 47.

25 Many dentists refer children to pediatric dentists at private clinics; therefore, this data is not indicative of the true need for pediatric dentistry services. This data also excludes visits made by inpatients and those living in residential care.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 86 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 47: Visits to the IWK Ambulatory Dentistry Clinic for Fiscal 2012-2013 Community Visits Average Visits per Patient # of Patients per population of 1000 Armdale- 33.00 1.88 10.66 Northwest Arm Clayton Park 85.27 1.40 9.98 Fairview 38.23 1.31 10.63 Hacketts Cove ------Halifax Chebucto 83.25 1.65 13.97 Halifax Citadel 40.18 1.88 9.07 Halifax Needham 58.28 1.46 14.72 Hatchet Lake 6.02 1.20 6.06 Herring Cove 6.47 1.76 6.00 Hubbards ------Peggy’s Cove ------Prospect ------Sambro 20.61 1.30 18.22 Spryfield 75.93 1.36 23.14 St. Margaret’s Bay 5.37 1.83 5.52 Tantallon 25.39 1.76 5.12 Terence Bay ------Timberlea 47.13 1.40 13.07 CHN 2 Total 535.92 1.36 11.43 District Total 1,240.28 1.34 9.49

Source: IWK Health Centre, Meditech Registrations for Time Period Fiscal 2012-2013

Community Health Network 2: Halifax Peninsula / Chebucto Page | 87 Capital Health Community Clinical Services / Health System Planning Group (2014) 2. IWK Diabetes Clinic

IWK Diabetes Clinic data should be interpreted with caution due to low numbers in some communities. Communities with low numbers of the population aged 0-19 may consequently have higher rates of service utilization, yet the number of patients is still small. Data are suppressed any community with less than five children/youth accessing services. Excluded from the total number of visits are registrations for inpatients and residential care residents.

Figure 59: Rate of children/youth accessing the IWK Diabetes Clinic for CHN 2(IWK, Meditech

Registrations for Fiscal 2012-13)

Figure 59 depicts the rate of children/youth accessing the IWK Diabetes Clinic, by community. CHN 2 has a higher rate of patients accessing the diabetes clinic at the IWK Health Centre than the district rate. Within the CHN, the higher number of patients per 1000 youth population accessing the IWK Diabetes Clinic reside in Armdale-Northwest Arm. The higher volumes (patient, visits) within the CHN come from the community of Clayton Park. Prospect is the community with the higher average number of visits per patient (4.1 visits). Refer to Table 48.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 88 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 48: Patients and Visits to the IWK Ambulatory Diabetes Clinic for Fiscal 2012-2013 Average Visits per Community # of Patients # of Patients per 1000 youth Visits Patient Armdale- 9.4 5.7 3.2 Northwest Arm 29.8 Clayton Park 27.4 4.5 82.2 3.0 Fairview 5.8 2.1 14.1 2.4 Hacketts Cove <5 4.1 <5 2.0 Halifax Chebucto 10.6 2.9 28.8 2.7 Halifax Citadel 5.4 2.3 14.2 2.6 Halifax Needham 10.0 3.7 28.0 2.8 Hatchet Lake <5 4.8 13.5 3.4 Herring Cove <5 1.6 <5 1.0 Hubbards <5 3.9 <5 2.2 Peggy’s Cove ------Prospect <5 4.5 14.4 4.1 Sambro <5 2.9 8.0 3.2 Spryfield 6.6 2.7 21.2 3.2 St. Margaret’s Bay <5 1.9 <5 3.0 Tantallon 11.4 4.1 23.7 2.1 Terence Bay ------Timberlea 9.3 3.6 31.2 3.4 CHN 2 Total 110.5 3.5 318.8 2.9 District Total 284.1 3.1 814.3 2.9 Source: IWK Health Centre, Meditech Registrations for Time Period Fiscal 2012-2013

Community Health Network 2: Halifax Peninsula / Chebucto Page | 89 Capital Health Community Clinical Services / Health System Planning Group (2014) 3. IWK Chest Clinic (Respiratory and Breathing Conditions)

IWK Chest Clinic data should be interpreted with caution due to low numbers in some communities. Communities with low numbers of the population aged 0-19 may consequently have higher rates of service utilization, yet the number of patients is still small. Data are suppressed any community with less than five children/youth accessing services. Excluded from the total number of visits are registrations for inpatients and residential care residents.

Figure 60: Child/youth visits per 1000 to the IWK Chest Clinic for CHN 2(IWK Health Centre, Meditech Registrations for Time Period Fiscal 2012-2013)

Figure 60 depicts the rate of children/youth accessing the IWK Chest Clinic (respiratory and breathing conditions), by community. As a whole, CHN 2 has a lower rate of patients per 1000 youth population accessing the IWK Chest Clinic. Within the CHN, the higher number of patients per 1000 youth population accessing the IWK Chest Clinic reside in Sambro. Terrence Bay, although reflecting one of the highest rates in Figure 60 was not reported due to low patient and visit volume.26 The community of Halifax Chebucto has the higher volume of patients and Halifax Needham has the higher volume of visits within the CHN. Refer to Table 49.

26 less than five clients

Community Health Network 2: Halifax Peninsula / Chebucto Page | 90 Capital Health Community Clinical Services / Health System Planning Group (2014)

Table 49: Patients and Visits to the IWK Chest Clinic (Respirology – Asthma) for Fiscal 2012-2013 Average Visits per Community # of Patients # of Patients per 1000 youth Visits Patient Armdale- 7.0 4.3 13.0 1.9 Northwest Arm Clayton Park 9.5 1.6 20.5 2.2 Fairview 5.0 1.8 14.0 2.8 Hacketts Cove <5 4.1 <5 -- Halifax Chebucto 12.0 3.3 20.0 1.7 Halifax Citadel 8.0 3.4 14.0 1.8 Halifax Needham 11.0 4.1 25.0 2.3 Hatchet Lake <5 1.2 <5 -- Herring Cove <5 2.3 <5 -- Hubbards ------Peggy’s Cove ------Prospect <5 2.6 5.0 2.5 Sambro 5.3 6.0 8.5 1.6 Spryfield 7.0 2.9 13.0 1.9 St. Margaret’s Bay ------Tantallon 9.9 3.5 15.3 1.6 Terence Bay <5 7.6 <5 -- Timberlea 9.6 3.7 18.9 2.0 CHN 2 Total 91.2 2.9 174.0 1.9 District Total 281.7 3.1 560.5 2.0

Source: IWK Health Centre, Meditech Registrations for Time Period Fiscal 2012-2013

4. IWK Primary Health: Halifax Regional School Board (HRSB) Nurse Visits

Within CHN 2, there were 22 children/youth who were registered for a HRSB nursing visit (home or phone visit) from IWK Primary Health. There were a total of 35 visits by this group. Data is not reportable at the community level (Source: IWK Health Centre, Meditech Registrations for Time Period Fiscal 2012-2013).

5. IWK Primary Health: Extra Supports for Parents (Groups/Classes)

Within CHN 2, there were 31 people who were registered for extra support for parents services from IWK Primary Health (includes community clinics/sessions/groups, home visits). There were a total of 73 visits by this group. Data is not reportable at the community level (Source: IWK Health Centre, Meditech Registrations for Time Period Fiscal 2012-2013).

Community Health Network 2: Halifax Peninsula / Chebucto Page | 91 Capital Health Community Clinical Services / Health System Planning Group (2014) 6. Spryfield Pediatric Clinic

An IWK Community Pediatrician sees children/youth at the Spryfield Community Wellness Centre two days per week. The community within CHN 2 with the highest rate of children/youth accessing this service is Spryfield, followed by Armdale-Northwest Arm and Sambro. 18 patients (and visits) were by children/youth outside of CHN 2.

Table 28: Spryfield Pediatric Clinic Visits and Patient Rate for 2012-2013 Fiscal Year Community Total Visits Total Patients Rate per 1000 youth population Armdale-Northwest Arm 32.1 18.5 11.3 Clayton Park 22.4 12.7 2.1 Fairview 31.6 15.3 5.6 Hacketts Cove -- <5 -- Halifax Chebucto -- <5 -- Halifax Citadel -- <5 -- Halifax Needham -- <5 -- Hatchet Lake -- <5 -- Herring Cove -- <5 -- Hubbards -- <5 -- Peggy’s Cove -- <5 -- Prospect -- <5 -- Sambro 27.0 9.6 11.1 Spryfield 132.9 56.3 23.3 St. Margaret’s Bay -- <5 -- Tantallon -- <5 -- Terence Bay -- <5 -- Timberlea -- <5 -- CHN 2 299.0 138.3 4.4 District 327.6 156.9 1.7

Source: IWK Health Centre, Meditech Registrations for Time Period Fiscal 2012-2013

Community Health Network 2: Halifax Peninsula / Chebucto Page | 92 Capital Health Community Clinical Services / Health System Planning Group (2014)

Summary of

Community

Observations

Key observations made about each community in the Community Health Network regarding demographic information, health status, and health services utilization information are summarized below. The purpose of this section of the Community Profile is to summarize some of the factors that make each community unique based on the information presented in this profile to inform planning and health services delivery. This is not a comprehensive list of all of the attributes that make a community unique, nor is it reflective of all of the assets or community partners that that contribute to the health of a community; it is a compilation of facts based on the information presented in the profile.

Armdale – Northwest Arm Total Deprivation: 4 Population: 9,904 Rurality: Urban Family Physicians: 0.0 FTE Material: 1 | Social: 5

What is distinctive about this community?

Urban community The communities within the CHN with the higher percentage of the population aged 65 years and older are Armdale-Northwest Arm (21.8%) and Hackett’s Cove (21.8%), which are both higher than the district average of 13.3%. 6.1% of people living in CHN 2 identify as belonging to an “other” visible minority which is defined as Filipino, Latin American, Southeast Asian, which is the highest rate across all CHNs. The highest percentage of people identifying as “other” within CHN 2 and across CDHA reside in Armdale- Northwest Arm (8.8% of population) Within the CHN, the urban communities have the highest social deprivation: Armdale-Northwest Arm, Clayton Park, Fairview, Halifax Chebucto, Halifax Citadel, Halifax Needham and Spryfield. There are several communities in the lowest category of material deprivation including: Tantallon, Hatchet Lake, Timberlea, Armdale-Northwest Arm, Halifax Chebucto, and Halifax Citadel. One of the communities in CHN 2 without a family physician practicing in their community The higher number of people per 1000 population living in CHN 2 and visiting the Community Health Teams reside in Spryfield, Armdale-Northwest Arm, and Herring Cove. Residents of Armdale-Northwest Arm have the highest rate of patients per 1000 population accessing the Cardiac Heart Function Clinic and the highest rate of patients per 1000 population accessing the endocrinology clinic Within the CHN, the higher number of patients per 1000 youth population accessing the IWK Diabetes Clinic reside in Armdale-Northwest Arm.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 93 Capital Health Community Clinical Services / Health System Planning Group (2014) Clayton Park Total Deprivation: 4 Population: 34,439 Rurality: Urban Family Physicians: 25.0 FTE Material: 1 | Social: 5

What is distinctive about this community?

The largest community, by population, in the CHN and in the district Urban community the CHN, the community of Clayton Park will have the larger percent increase of the youth population (21% increase by 2019; 28% increase by 2024) CHN 2 has the highest percentage of people identifying as a visible minority in the district. The highest percentages of people identifying as a visible minority reside in Halifax Needham (17.5%) and Clayton Park (17.1%) 1.5% of individuals living in CHN 2 identify as Arab/West Indian. Within the CHN and also within the district, the highest percentage of people identifying as Arab/West Asian reside in Clayton Park (5.6%) Clayton Park has the highest rate of citizens identifying as being an immigrant to Canada (17.5%) in the CHN and also in the district. Within the CHN, the urban communities have the highest social deprivation: Armdale-Northwest Arm, Clayton Park, Fairview, Halifax Chebucto, Halifax Citadel, Halifax Needham and Spryfield. Within the CHN and also within the district, the highest number of births occurs within the community of Clayton Park, which had 374 births in 2012-2013. A general trend observed for the community of Clayton Park when looking at service utilization data is that the community typically has the highest volume of patients and highest volume of visits. Clayton Park is the largest community, by population, in Capital Health which offers and explanation for the trend. Within the CHN, the community with the highest total number of ED visits for both levels of acuity is Clayton Park. Within the CHN, the community with the highest volume of IWK ED visits for visits of both high and low acuity is Clayton Park Within the CHN, Clayton Park has the greatest number of clients and the highest volume of visits to Addictions Community Based Services Clayton Park has the highest number of clients and the highest volume of visits to Community Mental Health Services, Capital Health, within the CHN

Community Health Network 2: Halifax Peninsula / Chebucto Page | 94 Capital Health Community Clinical Services / Health System Planning Group (2014) Fairview Total Deprivation: 4 Population: 15,789 Rurality: Urban Family Physicians: 10.5 FTE Material: 2 | Social: 5

What is distinctive about this community?

Urban community The community within the CHN where citizens report the highest use of public transit as the method of transportation to work is Fairview (23.6% of citizens) Within the CHN, the urban communities have the highest social deprivation: Armdale-Northwest Arm, Clayton Park, Fairview, Halifax Chebucto, Halifax Citadel, Halifax Needham and Spryfield. Within the CHN, the community with the higher rate of youth accessing the IWK CHOICES Addiction Services program is Fairview, with 4.0 clients per 1000 youth population receiving services. Fairview also has the higher total number of visits and the higher number of visits per client with on average, clients having 8.9 visits each. Within the CHN and also within the district, the community with the highest number of IWK Mental Health clients per 1000 youth population is Fairview, with 79.9 clients per 1000 youth population accessing services. Fairview is also the community with the highest total number of clients and the highest total number of visits.

Hackett’s Cove Total Deprivation: 2 Population: 1,485 Rurality: Rural Family Physicians: 0.0 FTE Material: 2 | Social: 3

What is distinctive about this community?

Rural community One of the communities were car is identified as the predominant mode of transportation to work (limited or no bus routes) Peggy’s Cove and Hackett’s cove have the older average age within the CHN and are among the communities with the older average age in the district. The communities within the CHN with the higher percentage of the population aged 65 years and older are Armdale-Northwest Arm (21.8%) and Hackett’s Cove (21.8%), which are both higher than the district average of 13.3%. Hackett’s Cove, Peggy’s Cove, and Prospect are the communities with the lowest percentage of low income families in CHN 2 (2.6% of families in each community) One of the communities in CHN 2 without a family physician practicing in their community Residents of Hackett’s Cove have the highest rate of patients per 1000 population accessing the Hypertension Clinic

Community Health Network 2: Halifax Peninsula / Chebucto Page | 95 Capital Health Community Clinical Services / Health System Planning Group (2014) Halifax Chebucto Total Deprivation: 4 Population: 18,764 Rurality: Urban Family Physicians: 13.5 FTE Material: 1 | Social: 5

What is distinctive about this community?

Community Health Network 2: Halifax Peninsula / Chebucto Page | 96 Capital Health Community Clinical Services / Health System Planning Group (2014) Halifax Citadel Total Deprivation: 4 Population: 20,055 Rurality: Urban Family Physicians: 36.1 FTE Material: 1 | Social: 5

What is distinctive about this community?

Urban community Within the CHN, the highest proportion of people reporting walking as their predominant mode of transportation to work reside in the communities of Halifax Citadel (54.6% of citizens), Halifax Needham (33.5% of citizens), and Halifax Chebucto (30.4% of citizens). All of the shelters located in the Halifax Regional Municipality (HRM) for homeless/housing insecure individuals are located in the Peninsula area of CHN 2 in the communities of Halifax Citadel and Halifax Needham. The communities with the younger average age include Tantallon, Timberlea, Hatchet Lake, Halifax Chebucto, and Halifax Citadel. The community with the highest percentage of the population in the 20-29 year old age demographic is Halifax Citadel, with 41% of the population being 20 to 29 years of age. This is likely correlated to the universities and colleges located within this community. The communities with the highest population density are Halifax Chebucto (4096.9 people per km2), Halifax Needham (3087.5 people per km2), and Halifax Citadel (2949.3 people per km2). These three communities are the most population dense in the district. 1.7% of CHN2 residents identify as Chinese/Korean/Japanese, which is the highest rate across all CHNs. Within the CHN and also within the district, the highest percentage of people identifying as Chinese/ Korean/Japanese reside in Halifax Citadel (5.6%). Within the CHN, Halifax Citadel has the highest rate of non-Canadian citizens, with 14.8% of the population reporting not being a Canadian citizen. There are several communities in the lowest category of material deprivation including: Tantallon, Hatchet Lake, Timberlea, Armdale-Northwest Arm, Halifax Chebucto, and Halifax Citadel. The community with the higher average family income is Halifax Citadel, which is also the highest in the district. Within the CHN, the community with the lower number of people without a high school education (or highest percentage of high school completion) is Halifax Citadel (5.1% without a high school education). Based on data from 2008-2012 from the Halifax Regional Police (HRP) only, in CHN 2, the higher number of crimes occur in Halifax Citadel Within the CHN, Halifax Citadel has the lowest rate of citizens receiving care for a diagnosis of diabetes from family physician, with 28.2 citizens per 1000 population, which is among the lowest rates in the district. The lower rate of patients per 1000 population receiving specialist care for diabetes also resides in Halifax Citadel. Halifax Citadel has the lowest rate of citizens receiving care for a diagnosis of COPD at 35.9 citizens per 1000 population. Consistent with other chronic conditions, Halifax Citadel has the lowest rate in the CHN for residents accessing care from a family physician for a diagnosis of hypertension The highest number of working family physicians per 1000 population practice in the community of Halifax Citadel, followed by Hatchet Lake and Hubbards Clients residing in Halifax Citadel have the higher average number of visits per client (15.8 visits per client) to Addictions Community Based Services

Community Health Network 2: Halifax Peninsula / Chebucto Page | 97 Capital Health Community Clinical Services / Health System Planning Group (2014) Halifax Needham Total Deprivation: 5 Population: 20,192 Rurality: Urban Family Physicians: 26.0 FTE Material: 3 | Social: 5

What is distinctive about this community?

Urban community Within the CHN, the community that is projected to have the highest percentage of population growth over the next five and ten years is Halifax Needham; the community’s population will increase by 63% by 2019 and remain relatively stable between 2019 and 2024. In addition to experiencing the largest population growth by percentage, Halifax Needham will also experience the largest growth in the senior population. The senior population in Halifax Needham is expected to grow by 413% by 2019. Within the CHN, the highest proportion of people reporting walking as their predominant mode of transportation to work reside in the communities of Halifax Citadel (54.6% of citizens), Halifax Needham (33.5% of citizens), and Halifax Chebucto (30.4% of citizens). The community in CHN 2 with the greater density of public housing units per 1000 population is Halifax Needham. Two public housing communities are located in this community: Mulgrave Park and Uniacke Square All of the shelters located in the Halifax Regional Municipality (HRM) for homeless/housing insecure individuals are located in the Peninsula area of CHN 2 in the communities of Halifax Citadel and Halifax Needham. The communities with the highest population density are Halifax Chebucto (4096.9 people per km2), Halifax Needham (3087.5 people per km2), and Halifax Citadel (2949.3 people per km2). These three communities are the most population dense in the district. CHN 2 has the highest percentage of people identifying as a visible minority in the district. The highest percentages of people identifying as a visible minority reside in Halifax Needham (17.5%) and Clayton Park (17.1%) Within the CHN, the predominant visible minority identified with is Black, with 3.5% of the population identifying as Black. The higher percentage of individuals identifying as Black reside in Halifax Needham (8.8% of citizens) Within CHN 2, the communities with the highest total deprivation are Halifax Needham, Spryfield, and Terrence Bay. Within the CHN, the urban communities have the highest social deprivation: Armdale-Northwest Arm, Clayton Park, Fairview, Halifax Chebucto, Halifax Citadel, Halifax Needham and Spryfield. Within the CHN, the community of Halifax Needham, followed by Spryfield, has the greatest number of households receiving employment support and income assistance provincially, with 1306 individuals receiving support in Halifax Needham and 1039 individuals receiving support in Spryfield according to the Department of Community Services (2014). Halifax Needham has a highest rate of births among women aged 15-19 in the CHN and has one of the higher rates in the district, at a rate of 33.10 births per 1000 women aged 15-19. Within the CHN, life expectancy at birth is and lowest for both males and females living in Halifax Needham (79.04 years for females; 73.25 years for males).

Community Health Network 2: Halifax Peninsula / Chebucto Page | 98 Capital Health Community Clinical Services / Health System Planning Group (2014) Hatchet Lake Total Deprivation: 1 Population: 3,201 Rurality: Rural Family Physicians: 4.3 FTE Material: 1 | Social: 1

What is distinctive about this community?

Rural community One of the communities were car is identified as the predominant mode of transportation to work (limited or no bus routes) The communities with the younger average age include Tantallon, Timberlea, Hatchet Lake, Halifax Chebucto, and Halifax Citadel. The communities with the lowest total deprivation are Hatchet Lake, Peggy’s Cove, Prospect, and Tantallon The communities in the lowest category of social deprivation include: Hatchet Lake, Peggy’s Cove, Prospect, Tantallon, and Terrence Bay. There are several communities in the lowest category of material deprivation including: Tantallon, Hatchet Lake, Timberlea, Armdale-Northwest Arm, Halifax Chebucto, and Halifax Citadel. The highest number of working family physicians per 1000 population practice in the community of Halifax Citadel, followed by Hatchet Lake and Hubbards

Herring Cove Total Deprivation: 2 Population: 2,734 Rurality: Suburban Family Physicians: 0.0 FTE Material: 2 | Social: 3

What is distinctive about this community?

Suburban community One of the communities were car is identified as the predominant mode of transportation to work (limited or no bus routes) There are no reported people identifying as a visible minority living in this community One of the communities in CHN 2 without a family physician practicing in their community The higher number of people per 1000 population living in CHN 2 and visiting the Community Health Teams reside in Spryfield, Armdale-Northwest Arm, and Herring Cove.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 99 Capital Health Community Clinical Services / Health System Planning Group (2014) Hubbards Total Deprivation: 3 Population: 2,082 Rurality: Rural Family Physicians: 3.9 FTE Material: 3 | Social: 4

What is distinctive about this community?

Rural community One of the communities were car is identified as the predominant mode of transportation to work (limited or no bus routes) There are no reported people identifying as a visible minority living in this community Hubbards has the lowest birth rate within the CHN, given there were no new births in the community the year this data was collected (2012-2013). The highest number of working family physicians per 1000 population practice in the community of Halifax Citadel, followed by Hatchet Lake and Hubbards As a rate per 1000 population, Hubbards has the highest rate of visits of high acuity to the ED (359.8 visits per 1000 population) and as well the highest rate of visits to the ED for visits of low acuity (348.9 visits per 1000 population). Hubbards has the lowest rate of visits of low acuity by children/youth to the IWK ED

Community Health Network 2: Halifax Peninsula / Chebucto Page | 100 Capital Health Community Clinical Services / Health System Planning Group (2014) Peggy’s Cove Total Deprivation: 1 Population: 640 Rurality: Rural Family Physicians: 0.0 FTE Material: 3 | Social: 1

What is distinctive about this community?

The smallest community, by population, in the CHN and in the district Rural community Peggy’s Cove and Hackett’s cove have the older average age within the CHN and are among the communities with the older average age in the district. One of the communities were car is identified as the predominant mode of transportation to work (limited or no bus routes) The communities with the lowest total deprivation are Hatchet Lake, Peggy’s Cove, Prospect, and Tantallon The communities in the lowest category of social deprivation include: Hatchet Lake, Peggy’s Cove, Prospect, Tantallon, and Terrence Bay. Hackett’s Cove, Peggy’s Cove, and Prospect are the communities with the lowest percentage of low income families in CHN 2 (2.6% of families in each community) The community with the lowest percentage of the population aged 15-24 years employed is Peggy’s Cove (numbers to small to report), followed by Spryfield (50.9% employed). Peggy’s Cove has the higher birth rate among women aged 35-45, which is also the highest in the district for this age demographic Within CHN 2, the highest percentage of the population receiving care from an FP for a diagnosis of CHF resides in Peggy’s Cove, with 19 people per 1000 population receiving care for CHF. One of the communities in CHN 2 without a family physician practicing in their community Peggy’s Cove has the lowest rate of visits by children/youth to the IWK ED for visits of high acuity While residents of Peggy’s Cove have the lower rate of Community Mental Health utilization per 1000 population, they also have the higher average number of visits to Community Mental Health (11.4 visits per client), which is among the highest in the district.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 101 Capital Health Community Clinical Services / Health System Planning Group (2014) Prospect Total Deprivation: 1 Population: 3,246 Rurality: Rural Family Physicians: 0.0 FTE Material: 2 | Social: 1

What is distinctive about this community?

Rural community Prospect, when compared to its neighbouring rural communities, (Hatchet Lake, Hackett’s Cove, Peggy’s Cove, Terrence Bay) has a higher population density (67.3 people per km2). One of the communities were car is identified as the predominant mode of transportation to work (limited or no bus routes) The communities with the lowest total deprivation are Hatchet Lake, Peggy’s Cove, Prospect, and Tantallon The communities in the lowest category of social deprivation include: Hatchet Lake, Peggy’s Cove, Prospect, Tantallon, and Terrence Bay. Hackett’s Cove, Peggy’s Cove, and Prospect are the communities with the lowest percentage of low income families in CHN 2 (2.6% of families in each community) One of the communities in CHN 2 without a family physician practicing in their community The community with the lowest number of visits per 1000 population to the ED for visits of lower acuity is Prospect

Sambro Total Deprivation: 2 Population: 3,835 Rurality: Rural Family Physicians: 0.0 FTE Material: 4 | Social: 2

What is distinctive about this community?

Rural community One of the communities were car is identified as the predominant mode of transportation to work (limited or no bus routes) One of the communities in CHN 2 without a family physician practicing in their community Within the CHN, the higher number of patients per 1000 youth population accessing the IWK Chest Clinic reside in Sambro.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 102 Capital Health Community Clinical Services / Health System Planning Group (2014) Spryfield Total Deprivation: 5 Population: 10,864 Rurality: Urban Family Physicians: 11.1 FTE Material: 4 | Social: 5

What is distinctive about this community?

Urban community One public housing community is located in this community: Greystone 0.2% of individuals living in the district identify as South Asian/East Indian with 1.0% of people living Spryfield identify as South Asian/East Indian, which is the highest in the CHN and across the district. Within CHN 2, the communities with the highest total deprivation are Halifax Needham, Spryfield, and Terrence Bay. Within the CHN, the urban communities have the highest social deprivation: Armdale-Northwest Arm, Clayton Park, Fairview, Halifax Chebucto, Halifax Citadel, Halifax Needham and Spryfield. Within the CHN, the community of Spryfield (28.9%) has the highest percentage of lone parent families. Within the CHN, the community with the lower average family income and the lower average individual income is Spryfield Within the CHN, the community with the highest percentage of low income families is Spryfield, with 23.8% of families being classified as low income, which is the highest rate in the district. Within the CHN, the community of Halifax Needham, followed by Spryfield, has the greatest number of households receiving employment support and income assistance provincially, with 1306 individuals receiving support in Halifax Needham and 1039 individuals receiving support in Spryfield according to the Department of Community Services (2014). The community with the lowest percentage of the population 25 years of age or older employed is Spryfield (56.6% employed). The community with the lowest percentage of the population aged 15-24 years employed is Peggy’s Cove (numbers to small to report), followed by Spryfield (50.9% employed). As a rate per 1000 population, Spryfield has the highest rate of visits of high acuity to the IWK ED (101.99 visits per 1000 population) and the highest rate of visits to the ED for visits of low acuity (221.75 visits per 1000 population). Within the CHN, the community of Spryfield has highest number of clients per 1000 population, with 24.5 clients per 1000 population accessing Addictions Community Based Services Within the CHN, the community of Spryfield has the highest rate of the population accessing Capital Health Community Mental Health, with 45.3 clients per 1000 population accessing services CHN 2 has a lower rate of the population accessing IWK Reproductive Mental Health Services than the district total, with the rate being 2.3 clients per 1000 women aged 15 to 45 years. Specifically, Spryfield has the highest rate of service utilization, with 2.3 clients per 1000 women accessing services The higher number of people per 1000 population living in CHN 2 and visiting the Community Health Teams reside in Spryfield, Armdale-Northwest Arm, and Herring Cove. Within the CHN, the community of Spryfield has the highest rate of children/youth accessing the IWK Dentistry Clinic, with 23.1 children/youth per 1000 population accessing the Dentistry Clinic. This is also the highest rate in the district. An IWK Community Pediatrician sees children/youth at the Spryfield Community Wellness Centre two days per week. The community within CHN 2 with the highest rate of children/youth accessing this service is Spryfield

Community Health Network 2: Halifax Peninsula / Chebucto Page | 103 Capital Health Community Clinical Services / Health System Planning Group (2014) St. Margaret’s Bay Total Deprivation: 2 Population: 2.411 Rurality: Suburban Family Physicians: 0.0 FTE Material: 2 | Social: 3

What is distinctive about this community?

Rural community One of the communities were car is identified as the predominant mode of transportation to work (limited or no bus routes) Within the CHN, the community with the higher number of individuals identifying with an Aboriginal group is St. Margaret’s Bay (2.9% of citizens) Within the CHN, life expectancy at birth is highest for females in the community of St. Margaret’s Bay (84.0 years) A trend observed in the data for family physician and specialist visits is that residents of St. Margaret’s Bay have high utilization rates of physician services for diagnoses of hypertension, diabetes, COPD, and CHF; the rate of the population accessing services appears consistently high across conditions and provider type Within the CHN, St. Margaret’s Bay has the higher rate of the population receiving care from a family physician for diabetes, with 128.4 people per 1000 population accessing care. Additionally, there is a higher rate of patients per 1000 population receiving care from a specialist for a diagnosis of diabetes residing in the community of St. Margaret’s Bay. Within CHN 2, there is a higher percentage of the population receiving care from a family physician for COPD residing in St. Margaret’s Bay, with 139.8 people per 1000 population receiving care for a diagnosis of COPD. St. Margaret’s Bay is also the community in the CHN with the higher rate of residents seeing a specialist for COPD In CHN 2, the higher rate of the population accessing care from a family physician for a diagnosis of hypertension occurs in St. Margaret’s Bay, with 323.2 citizens per 1000 population accessing care for hypertension. Also, St. Margaret’s Bay is the community within the CHN with the higher rate of citizens per 1000 population receiving care from a specialist for hypertension There is also a marginally higher rate of people per 1000 population accessing specialist care for a diagnosis of CHF within CHN 2, with the highest rate occurring in the community of St. Margaret’s Bay, showing a similar trend to the other aforementioned chronic conditions. The average number of visits per patient for the CHN is similar to the district rate; however, St. Margaret’s Bay has the highest number of visits per patient, with 11 visits per patient, double the CHN and district rates. Residents of St. Margaret’s Bay have the highest rate of patients per 1000 population accessing the Respirology Clinic

Community Health Network 2: Halifax Peninsula / Chebucto Page | 104 Capital Health Community Clinical Services / Health System Planning Group (2014) Tantallon Total Deprivation: 1 Population: 9,431 Rurality: Suburban Family Physicians: 10.3 FTE Material: 1 | Social: 1

What is distinctive about this community?

Suburban community The communities with the younger average age include Tantallon, Timberlea, Hatchet Lake, Halifax Chebucto, and Halifax Citadel. In CHN 2 Tantallon (29.8%), followed by Timberlea (27.5%), has the highest rate of the youth population (<20 years of age) within the CHN and they are among the communities with the highest rate of the youth population across the district. One of the communities were car is identified as the predominant mode of transportation to work (limited or no bus routes) The communities with the lowest total deprivation are Hatchet Lake, Peggy’s Cove, Prospect, and Tantallon The communities in the lowest category of social deprivation include: Hatchet Lake, Peggy’s Cove, Prospect, Tantallon, and Terrence Bay. There are several communities in the lowest category of material deprivation including: Tantallon, Hatchet Lake, Timberlea, Armdale-Northwest Arm, Halifax Chebucto, and Halifax Citadel. The community within the CHN with the higher average individual income is Tantallon. Within the CHN, life expectancy at birth is highest for males in the community of Tantallon (78.85 years) Tantallon has the lowest rate of citizens receiving care for a diagnosis of CHF, at 3.7 citizens per 1000 population The community with the lowest number of visits per 1000 population to the ED for visits of high acuity is Tantallon

Community Health Network 2: Halifax Peninsula / Chebucto Page | 105 Capital Health Community Clinical Services / Health System Planning Group (2014) Terrence Bay Total Deprivation: 5 Population: 1,001 Rurality: Rural Family Physicians: 0.0 FTE Material: 5 | Social: 1

What is distinctive about this community?

Rural community One of the communities were car is identified as the predominant mode of transportation to work (limited or no bus routes) There are no reported people identifying as a visible minority living in this community Within CHN 2, the communities with the highest total deprivation are Halifax Needham, Spryfield, and Terrence Bay. The communities in the lowest category of social deprivation include: Hatchet Lake, Peggy’s Cove, Prospect, Tantallon, and Terrence Bay. Within the CHN, the community of Terrance Bay scores in the highest category of material deprivation Within the CHN, the community with the higher number of citizens without a high school education is Terrence Bay (38.1%). For the population aged 15-24 years, the community with the highest percentage employed is Terrence Bay, with 78.4% of this age demographic being employed, making Terrence Bay the community with the highest percentage of youth employment in the district. Residents of Terrence Bay have the higher number of visits per person to a family physician for a diagnosis of diabetes and for a diagnosis of COPD One of the communities in CHN 2 without a family physician practicing in their community

Timberlea Total Deprivation: 2 Population: 9,388 Rurality: Suburban Family Physicians: 1.1 FTE Material: 2 | Social: 3

What is distinctive about this community?

Suburban community The communities with the younger average age include Tantallon, Timberlea, Hatchet Lake, Halifax Chebucto, and Halifax Citadel. In CHN 2 Tantallon (29.8%), followed by Timberlea (27.5%), has the highest rate of the youth population (<20 years of age) within the CHN and they are among the communities with the highest rate of the youth population across the district. There are several communities in the lowest category of material deprivation including: Tantallon, Hatchet Lake, Timberlea, Armdale-Northwest Arm, Halifax Chebucto, and Halifax Citadel. Within CHN 2, the community with the highest percentage of the population aged 25 years and older employed is Timberlea (76.9% employed), making Timberlea the community with the highest number of people employed in the district. The community within the CHN with the highest birth rate is Timberlea, with on average, 59.16 births occurring per 1000 women aged 15-49 annually. Timberlea has the higher birth rate per 1000 women aged 20-34 years within the CHN

Community Health Network 2: Halifax Peninsula / Chebucto Page | 106 Capital Health Community Clinical Services / Health System Planning Group (2014)

Please do not distribute or duplicate this document without the permission of Primary Health Care, Capital Health.

Contact Primary Health Care at: [email protected]

Community Health Network 2: Halifax Peninsula / Chebucto Page | 107 Capital Health Community Clinical Services / Health System Planning Group (2014)

APPENDIX

Appendix A: List of Contributors

Community Clinical Services/Health System Planning Steering Group Authorship, Data, Content, Mapping, Interpretation, and Review

Co-leads: Lynn Edwards, Director of Primary Health Care and District Department of Family Practice; and Dr. Rick Gibson, Chief, District Department of Family Practice, Capital Health

Project Lead: Erin Christian, Project Lead, Primary Health Care, Capital Health

Members: Christine Tompkins, Project Lead – Quality, Primary Health Care, Capital Health Dr. Holly D’Angelo-Scott, Senior Epidemiologist, Public Health, Capital Health Jill Robbins, Director, Integrated Continuing Care, Capital Health Randi Monroe, Director, Rehabilitation Services & Supportive Care and Geriatrics, Capital Health Trevor Briggs, Director, Capital Health Mental Health and Addictions Program Linda Young, Director of Public Health, Capital Health Margaret Merlin, Director of the Tri-Facilities and Cobequid Community Health Centre, Capital Health Sherri Parker, Director, Hants Community Hospital, Capital Health Geoff Wilson, Director, Patient and Public Engagement, Capital Health Nancy Hoddinott, Executive Director of Primary Health, IWK Health Centre Shauna McMahon, Director of Technology and Infrastructure Renewal, Capital Health

Community Profile Contributors Data, Content, Mapping, Interpretation and Review (in addition to Steering Group)

Max Lapierre, GIS Consultant, Primary Health Care, Capital Health Graeme Kohler, Health Services Manager, Primary Health Care, Capital Health Shannon Ryan Carson, Health Services Manager, Primary Health Care, Capital Health Julian Morrison, Practice Facilitator, Primary Health Care, Capital Health Angela Ghiz, IT Project Manager, Primary Health Care, Capital Health Sharon McNeil, Data Analyst, IWK Health Centre Suzanne Gray-Marmaroff, Manager, Integrated Continuing Care, Capital Health Suzanne Stevens, Manager, Integrated Continuing Care, Capital Health Lexie Steeves-Dorey, Manager, Integrated Continuing Care, Capital Health Christel Mueller, Project Manager, Integrated Continuing Care, Capital Health Cheri Gunn, Program Manager, Rehabilitation Services and Supportive Care, Capital Health Kim Parker, Data Analyst, Rehabilitation Services and Supportive Care, Capital Health Cindy Clark, Health Services Manager, Rehabilitation Services, Cobequid Community Health Centre Denise Titus, Program Manager, Rehabilitation and Supportive Care, Dartmouth General Hospital Susan Hare, Program Leader, Capital Health Mental Health and Addictions Program Rachel Boehm, Program Leader, Capital Health Mental Health and Addictions Program Patryk Simon, Data Analyst, Capital Health Mental Health and Addictions Program

Community Health Network 2: Halifax Peninsula / Chebucto Page | 108 Capital Health Community Clinical Services / Health System Planning Group (2014)

Robert Kiteley, Facilities Engineer, Infrastructure and Renewal, Capital Health Marilyn Cipack, Health Services Manager, Tri-Facilities, Capital Health Dianna Graham, Health Services Manager, Tri-Facilities, Capital Health Sarah Blades, Community Health Board Coordinator, Capital Health Chris Caudle, Capital Health Decision Support, Finance & eInformation Management, Capital Health Nancy MacDonald, Analyst, Decision Support, Finance & eInformation Management, Capital Health Niall Sheehy, Capital Health Decision Support, Capital Health Tom Henneberry, Data Analyst, Department of Medicine Amanda Murphy, Health Information Analyst, Decision Support, Capital Health Brenda Murray, Director, Policy, Planning & Research, Policy & Information Management, Department of Community Services Adam Holmes, GIS Analyst, Policy & Information Management, Department of Community Services Meghan MacDougall, GIS Analyst, Policy & Information Management, Department of Community Services Dr. Mikiko Terashima, Co-Director of the SILK Lab, Dalhousie University RCMP Data Division – Halifax Regional Municipality and West Hants/Windsor Division Halifax Regional Police Nirupa Varatharasan, Canadian Primary Care Sentinel Surveillance Network - Maritime Family Practice Research Network, Department of Family Medicine, Dalhousie University Emily Marshall, MAAP-NS Study, Assistant Professor, Primary Care Research Unit, Dalhousie Family Medicine and Community Health and Epidemiology Michelle Nugent, Statistics & Database Officer, Dalhousie Department of Medicine Sandy Newcombe, Coordinator of Project Management, Housing Nova Scotia Jim Graham, Program Coordinator, Affordable Housing Association of Nova Scotia Kevin Watkins, Research & Statistical Officer, Monitoring & Evaluation, Continuing Care Branch NS Department of Health and Wellness Vivian Barriault, Continuing Care Branch NS Department of Health and Wellness Nova Scotia Department of Health and Wellness, BIAP Division

All GIS Mapping for this project was completed by:

Christine Tompkins, Project Lead, Primary Health Care, Capital Health Holly D’Angelo-Scott, Senior Epidemiologist, Public Health Services, Capital Health Max Lapierre, GIS Consultant, Primary Health Care, Capital Health

An acknowledgement to Holly D’Angelo-Scott for sharing her knowledge and demographic data from her work with the Population Health Status Report to inform this project and for providing her epidemiological skills and expertise to work with Christine and Erin to review and interpret data.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 109 Capital Health Community Clinical Services / Health System Planning Group (2014) Appendix B: Table of Contents COMMUNITY PROFILE Overview ...... 1 Table of Contents ...... 1 GEOGRAPHY ...... 1 Community Composition ...... 2 Rurality ...... 3 Population Projections ...... 4 COMMUNITY HEALTH BOARD (CHB) ENGAGEMENT ...... 6 COMMUNITY HEALTH NETWORK INVENTORY ...... 7 Food Sources ...... 7 Transportation ...... 9 Recreation Locations ...... 10 Public Housing ...... 11 Shelters & Homelessness ...... 12 COMMUNITY HEALTH NETWORK POPULATION DEMOGRAPHICS ...... 13 Population Age Groups ...... 13 Population Density ...... 17 Visible Minorities ...... 18 Citizenship, Language, and Immigration ...... 21 Total Deprivation ...... 22 Social Deprivation ...... 24 Lone Parent Families ...... 25 Material Deprivation ...... 27 Income Related Factors ...... 29 Employment & Education ...... 31 Birth Data ...... 32 Crime Rates – Halifax Regional Police ...... 34 Crime Rates – RCMP ...... 36 Nova Scotia School Test Results ...... 37 COMMUNITY HEALTH NETWORK HEALTH STATUS ...... 38 Community Engagement – 2013 Community Health Plan ...... 38 2009-2010 Canadian Community Health Survey Data for Self-Reported Health Status...... 38 Sexually Transmitted Infections (STIs) ...... 41 Disability ...... 42 Life Expectancy at Birth ...... 43 Causes of Death ...... 44

Community Health Network 2: Halifax Peninsula / Chebucto Page | 110 Capital Health Community Clinical Services / Health System Planning Group (2014)

Family Physician Visits by Chronic Disease Diagnosis ...... 45 Specialist Visits for Chronic Disease (Summary) ...... 53 COMMUNITY HEALTH NETWORK SERVICE DELIVERY LOCATIONS ...... 57 Capital Health Community-Based Service Locations ...... 57 Family Practice in CHN 2 ...... 58 Community Pharmacies...... 61 Nursing Home Locations...... 62 COMMUNITY HEALTH SERVICES UTILIZATION ...... 63 Emergency Department Visits (Adult – Capital Health) ...... 63 Emergency Department Visits (Child/Youth – IWK) ...... 65 Hospital Admissions ...... 67 Ambulatory Care Sensitive Conditions ...... 67 Community Mental Health and Addictions Services ...... 68 Youth Health Centres ...... 77 Community Health Teams ...... 78 Integrated Continuing Care ...... 79 1. Integrated Continuing Care Client Summary ...... 79 2. Community Occupational Therapy and Physiotherapy Services ...... 79 3. Home Care and/or Nursing Support Services ...... 80 4. Care Plans, By Type ...... 80 Ambulatory Care Clinics (Adult – Capital Health) ...... 82 Ambulatory Care Clinics (Child/Youth – IWK Health Centre) ...... 86 IWK Primary Health: Halifax Regional School Board (HRSB) Nurse Visits ...... 91 IWK Primary Health: Extra Supports for Parents (Groups/Classes) ...... 91 COMMUNITY SUMMARIES ...... 93 Armdale – Northwest Arm ...... 93 Clayton Park ...... 94 Fairview ...... 95 Hackett’s Cove ...... 95 Halifax Chebucto ...... 96 Halifax Citadel ...... 97 Halifax Needham ...... 98 Hatchet Lake ...... 99 Herring Cove ...... 99 Hubbards ...... 100 Peggy’s Cove ...... 101

Community Health Network 2: Halifax Peninsula / Chebucto Page | 111 Capital Health Community Clinical Services / Health System Planning Group (2014)

Prospect ...... 102 Sambro ...... 102 Spryfield ...... 103 St. Margaret’s Bay ...... 104 Tantallon ...... 105 Terrence Bay ...... 106 Timberlea ...... 106 APPENDIX ...... 108 Appendix A: List of Contributors ...... 108 Appendix B: Table of Contents ...... 110 Appendix C: List of Figures ...... 113 Appendix D: List of Tables ...... 116 Appendix E: Community Profiles Data Disclaimer ...... 1188 Appendix F: Detailed 2019 (5 Year) and 2024 (10 Year) Population Projections for Capital Health...... 119

Community Health Network 2: Halifax Peninsula / Chebucto Page | 112 Capital Health Community Clinical Services / Health System Planning Group (2014) Appendix C: List of Figures

Geography ...... 1 Figure 1: Community Health Network and Capital District Health Authority Geography ...... 1 Figure 2: Community Health Network Geography ...... 2 Figure 3: Rurality ...... 3 Figure 4: Population Projections ...... 4 Community Health Network Inventory ...... 7 Figure 5: Food Source Locations...... 7 Figure 6: Method of Transportation to Work ...... 9 Figure 7: Recreation Locations by Type ...... 10 Figure 8: Park Locations ...... 10 Figure 9: Public Housing Communities ...... 11 Community Health Network Population Demographics ...... 13 Figure 10: Population Pyramid for CHN ...... 13 Figure 11: Population by Age Group ...... 14 Figure 12: Average Age by Community ...... 14 Figure 13: Population Density by Community ...... 17 Figure 14: Percentage of the Population Identified as a Visible Minority ...... 18 Figure 15: Percentage of the Population Identified as being an Immigrant to Canada ...... 21 Figure 16: Total deprivation ...... 22 Figure 17: Social deprivation ...... 24

Figure 18: Percentage of lone parent families ...... 25

Figure 19: Material deprivation ...... 27 Figure 20: Average Family Income ...... 29

Figure 21: Percentage of low income families ...... 29

Figure 22: Number of households receiving provincial income assistance/employment support ...... 30 Figure 23: Birth rate per 1000 women aged 15-49 ...... 32 Figure 24: Crime occurrences by type ...... 34 Figure 25: RCMP Policing Districts aligned with the CHN ...... 36 Community Health Network Health Status ...... 38 Figure 26: Self-reported risk factors reported by Community Health Network ...... 38 Figure 27: Self-reported chronic conditions reported by Community Health Network ...... 39

Community Health Network 2: Halifax Peninsula / Chebucto Page | 113 Capital Health Community Clinical Services / Health System Planning Group (2014)

Figure 28: Rate of individuals receiving care from a family physician for diabetes ...... 45 Figure 29: Rate of individuals receiving care from a family physician for COPD ...... 47 Figure 30: Rate of individuals receiving care from a family physician for congestive heart failure ...... 49

Figure 31: Rate of individuals receiving care from a family physician for hypertension ...... 51 Figure 32: Rate of the population receiving specialist care for diabetes ...... 55 Figure 33: Rate of the population receiving specialist care for hypertension ...... 55 Figure 34: Rate of the population receiving specialist care for COPD ...... 56 Figure 35: Rate of the population receiving specialist care for congestive heart failure ...... 56 Community Health Network Service Delivery Locations ...... 57 Figure 36: Capital Health Community Based Programs and Services locations ...... 57 Figure 37: Family Practice locations in CHN ...... 58 Figure 38: Family physician FTE per 1000 population ...... 58

Figure 39: Individuals placed with a family physician (or NP) via PHC Connections ...... 59 Figure 40: Community-based pharmacy locations ...... 61 Figure 41: Nursing Home and Residential Care Facility locations in CHN ...... 62 Community Service Utilization Data ...... 63 Figure 42: Emergency department utilization for a visit of high acuity (adult) ...... 64 Figure 43: Emergency department utilization for a visit of low acuity (adult) ...... 64

Figure 44: Emergency department utilization for a visit of high acuity (child/youth) ...... 66 Figure 45: Emergency department utilization for a visit of low acuity (child/youth) ...... 66 Figure 46: Rate of clients accessing CDHA Addictions Community Based Services (adult) ...... 68 Figure 47: Rate of clients accessing IWK CHOICES Addictions Services (youth) ...... 70 Figure 48: Rate of clients accessing CDHA Community Mental Health Services (adult) ...... 71

Figure 49: Rate of clients accessing IWK Mental Health Services (child/youth) ...... 73 Figure 50: Rate of women aged 15-49 accessing IWK Reproductive Mental Health ...... 75 Figure 51: Youth Health Centre locations and reasons for visit ...... 77 Figure 52: Community Health Team utilization by community ...... 78 Figure 53: Community OT/PT utilization via referral to Integrated Continuing Care (polling district) ...... 79 Figure 54: Rate of patients accessing the QEII Cardiology Heart Function Clinic ...... 84 Figure 55: Rate of patients accessing the QEII Hypertension Clinic ...... 84 Figure 56: Rate of patients accessing the QEII Endocrinology Clinic ...... 85 Figure 57: Rate of patients accessing QEII, Cobequid, Hants and DGH Respirology Clinics ...... 85 Figure 58: Rate of children/youth per 1000 accessing the IWK Dentistry Clinic ...... 86

Community Health Network 2: Halifax Peninsula / Chebucto Page | 114 Capital Health Community Clinical Services / Health System Planning Group (2014)

Figure 59: Rate of children/youth accessing the IWK Diabetes Clinic ...... 88 Figure 60: Rate of children/youth accessing the IWK Chest Clinic ...... 90

Community Health Network 2: Halifax Peninsula / Chebucto Page | 115 Capital Health Community Clinical Services / Health System Planning Group (2014) Appendix D: List of Tables

Geography ...... 1 Table 1: CHN Communities and Populations…………………………………………………………………………………………………..2 Table 2: Population Projections ……………………………………………………………………………………………………………………..5 Community Health Network Inventory ...... 7 Table 3: Density of Grocery Store Locations per 100,000 by Community ...... 8 Table 4: Density of Fast Food Locations per 100,000 by Community ...... 8 Table 5: Nova Scotia Liquor Commission Data, by Community Health Board ...... 8 Community Health Network Population Demographics ...... 13 Table 6: Population Breakdown by age category ...... 16 Table 7a: Percentage of Individuals identifying as a Visible Minority ...... 19 Table 7b: Percentage of Individuals within CHN identifying as Aboriginal ...... 20 Table 8: Deprivation Score Summary, by community ...... 23 Table 9: Social Deprivation and Percentage of Lone Parent Families ...... 26 Table 10: Summary of Income-related factors and material deprivation ...... 28 Table 11: Summary of education, employment, and material deprivation ...... 31 Table 12: Birth data ...... 33 Table 13: Total number of crimes occurring, by type, as reported by Halifax Regional Police ...... 35 Table 14: Total number of crimes occurring, by type, in RCMP Policing Districts ...... 36 Table 15: CHN School Test Scores 2013-2014 ...... 37 Community Health Network Health Status ...... 38 Table 16: Health Concerns – CHB Community Consultations ...... 38 Table 17: Summary of Selected Self-reported Chronic Diseases and Risk Factors ...... 39 Table 18: Health Status indicator by CHN and compared to CDHA and Nova Scotia and Canada ...... 40 Table 19: Incidence Rates of sexually transmitted infections in Capital Health ...... 41 Table 20: Disability Prevalence for Nova Scotia, by age category for the population aged 15+ ...... 42 Table 21: Life expectancy at birth, by community and by sex ...... 43 Table 22: Causes of Death for NS and CDHA ...... 44 Table 23: CHN overview of citizens receiving care for diabetes from a family physician ...... 46 Table 24: CHN overview of citizens receiving care for COPD from a family physician ...... 48 Table 25: CHN overview of citizens receiving care for CHF from a family physician ...... 50 Table 26: CHN overview of citizens receiving care for hypertension from a family physician ...... 52

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Table 27: Rate of specialist utilization for four chronic conditions ...... 54 Community Health Network Service Delivery Locations ...... 57 Table 28: Capital Health Community Based Program and Service Locations ...... 57

Table 29: Individuals placed with a family physician (or NP) via PHC Connections ...... 60 Table 30: Nursing Home and RCF locations and number of beds, by community ...... 62 Community Service Utilization Data ...... 63 Table 31: Emergency Department Utilization for Adults using CDHA Emergency Departments ...... 63 Table 32: Emergency Department Utilization for children/youth at the IWK Health Centre ...... 65 Table 33: Hospital admissions by diagnosis ...... 67 Table 34: Hospital re-admissions by diagnosis ...... 67 Table 35: Ambulatory care sensitive condition rates ...... 67 Table 36: Addictions Community Based Services Utilization (Adults – Capital Health) ...... 69 Table 37: CHOICES Addictions Services Utilization (Youth – IWK) ...... 70 Table 38: Community Mental Health Services Utilization (Adults – Capital Health) ...... 72 Table 39: Mental Health Services Utilization (Child/youth – IWK Health Centre) ...... 74 Table 40: Reproductive Mental Health Services Utilization (Women – IWK Health Centre) ...... 76 Table 41: Integrated Continuing Care client overview by CHN ...... 79 Table 42: Integrated Continuing Care referrals to community OT/PT by polling district ...... 80 Table 43: Home care and/or nursing support client summary ...... 80 Table 44: Care plans created by type and age category for CDHA Continuing Care clients ...... 81 Table 45: Rate of ambulatory care clinic usage by community ...... 82 Table 46: Total number of visits per ambulatory clinic, by community ...... 83 Table 47: IWK Ambulatory Dentistry Clinic Utilization by Children/Youth ...... 87 Table 48: IWK Ambulatory Diabetes Clinic Utilization by Children/Youth ...... 89 Table 49: IWK Ambulatory Chest Clinic Utilization by Children/Youth ...... 91 Summary of Observations by Community ...... 93

Community Health Network 2: Halifax Peninsula / Chebucto Page | 117 Capital Health Community Clinical Services / Health System Planning Group (2014) Appendix E: Community Profiles Data Disclaimer

The Community Profiles for each of the five Community Health Networks (herein referred to as the “reports”) are intended to be a composite of technical planning documents, with the primary audience being decision makers and planners at Capital District Health Authority (“Capital Health”).

Capital Health does not assume any liability for any errors, omissions, or inaccuracies in the information provided regardless of the cause and shall not be liable for any loss arising out of the use of or reliance on this information, including without limitation any direct or consequential damages. Capital Health expressly disclaims all warranties of any type, expressed or implied, including but not limited to, any warranty as to the accuracy of the data, merchantability, or fitness for a particular purpose.

Best efforts were made to ensure accuracy and correctness in data collection, interpretation, presentation, and GIS Mapping outputs and methodologies. All data are believed to be accurate by authors and reviewers; however, accuracy is not guaranteed. Data layers were compiled from various sources and are not to be construed or used as a "legal description".

Acknowledgement of all data sources and contributors was completed to the best of the authors’ ability. Time reporting periods varied (e.g., calendar year(s), fiscal year(s), etc) and therefore, there may be inconsistencies and readers should consider this when cross comparing data. Formal statistical analysis was not completed for the purpose of this project; therefore, direct associations between data elements presented cannot be assumed. Interpretation was based on observation only and interpretations have not been subject to an extensive reviewing process beyond review by Steering Group members.

Any errors, omissions, questions, or comments regarding any of the data or methodologies used to prepare these reports can be directed to Primary Health Care, Capital Health by email. Feedback is welcomed.

Please do not distribute these reports outside of Capital Health without permission of Primary Health Care, Capital Health. Please acknowledge the Capital Health Community Clinical Services/Health System Planning Steering Group (2014) as the source of these reports when data and information are used in presentations, reports, papers, publications, maps, or other products.

Use of these reports assumes that you understand and agree with the information provided in this disclaimer.

Community Health Network 2: Halifax Peninsula / Chebucto Page | 118 Capital Health Community Clinical Services / Health System Planning Group (2014) Appendix F: Detailed 2019 (5 Year) and 2024 (10 Year) Population Projections for Capital Health

Source: Environics Analytics Group Ltd (2014). Appendix F is an internal document to Capital Health and the Community Clinical Services/Health System Planning Steering Group Members. Projections modeled from 2011 Canadian Census Data. Note: Percent change and net growth is relative to the 2014 population.

CHN 2: Halifax Peninsula/Chebucto

2014 2014 2019 2024

Youth

years)

2019 % % 2019

Change Change Change Change Change Change Change Change Change Change

2024 2024 %

65+ Net 65+ Net 65+

Youth %

65+ % % 65+ %

2019 Net 2019 Net 2024

Projected Projected

% Change %

2019 (65+ 2019

YouthNet YouthNet

Population Population Population

2014 Youth 2014 Youth 2019 Youth 2024

2014 Seniors 2014 Seniors 2024 Community Change % 65+ Armdale-Northwest 9,904 1,646 2,156 10,353 449 5 1,623 -23 -1 2,333 177 8 10,701 797 8 1,795 149 9 2,556 400 19 Arm Clayton Park 34,439 6,101 5,743 41,379 6,940 20 7,363 1,262 21 7,075 1,332 23 42,832 8,393 24 7,816 1,715 28 7,949 2,206 38 Fairview 15,789 2,744 2,182 16,585 796 5 2,818 74 3 2,495 313 14 16,909 1,120 7 2,939 195 7 2,869 687 31 Hackett’s Cove 1,485 241 323 1,478 -7 0 162 -79 -33 404 81 25 1,469 -16 -1 152 -89 -37 459 136 42 Halifax Chebucto 18,764 3,619 2,354 18,057 -707 -4 2,669 -950 -26 2,374 20 1 17,317 -1,447 -8 2,390 -1,229 -34 2,682 328 14 Halifax Citadel 20,055 2,358 2,626 21,552 1,497 7 2,093 -265 -11 2,827 201 8 21,598 1,543 8 2,133 -225 -10 3,009 383 15 Halifax Needham 20,192 2,708 2,355 32,866 12,674 63 3,141 433 16 12,082 9,727 413 32,638 12,446 62 3,377 669 25 12,204 9,849 418 Hatchet Lake 3,201 829 301 3,282 81 3 673 -156 -19 503 202 67 3,465 264 8 678 -151 -18 691 390 129 Herring Cove 2,734 614 388 2,959 225 8 513 -101 -16 568 180 46 3,246 512 19 572 -42 -7 746 358 92 Hubbards 2,082 412 368 2,530 448 22 495 83 20 580 212 58 2,615 533 26 498 86 21 709 341 93 Peggy’s Cove 640 114 136 696 56 9 86 -28 -24 178 42 31 730 90 14 83 -31 -27 226 90 66 Prospect 3,246 772 366 3,391 145 4 656 -116 -15 620 254 70 3,514 268 8 647 -125 -16 824 458 125 Sambro 3,835 870 378 3,903 68 2 758 -112 -13 620 242 64 4,134 299 8 773 -97 -11 841 463 123 Spryfield 10,864 2,417 1,288 11,764 900 8 2,320 -97 -4 1,824 536 42 12,137 1,273 12 2,385 -32 -1 2,262 974 76 St. Margaret’s Bay 2,411 532 398 3,475 1,064 44 601 69 13 789 391 98 3,591 1,180 49 618 86 16 959 561 141 Tantallon 9,431 2,809 809 10,955 1,524 16 2,566 -243 -9 1,465 656 81 11,700 2,269 24 2,617 -192 -7 2,095 1,286 159 Terence Bay 1,001 175 167 1,017 16 2 158 -17 -10 245 78 47 979 -22 -2 144 -31 -17 277 110 66 Timberlea 9,388 2,580 719 10,495 1,107 12 2,575 -5 0 1,203 484 67 10,991 1,603 17 2,618 38 1 1,682 963 134 CHN 2 169,461 31,541 23,057 196,740 27,279 16 31,269 -272 -1 38,186 15,129 66 200,566 31,105 18 32,235 694 2 43,039 19,982 87 CDHA 423,163 91,150 55,869 463,931 40,768 10 85,193 -5,957 -7 83,741 27,872 50 476,940 53,777 13 87,298 -3,852 -4 99,272 43,403 78

Community Health Network 2: Halifax Peninsula / Chebucto Page | 119