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The Unequal City: Income and Health Inequalities in Toronto 2008

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The Unequal City: Income and Health Inequalities in Toronto 2008 The Unequal City: Income and Health Inequalities in Toronto 2008 The Unequal City Income and Health Inequalities in Toronto 2008 October, 2008 Reference: Toronto Public Health: The Unequal City: Income and Health Inequalities in Toronto, 2008, October 2008. Authors: David McKeown, MDCM, MHSc, FRCPC, Karen MacCon, PhD, Nancy Day, MHSc, Paul Fleiszer, MSc, Fran Scott, MD, CCFP, MSc, FRCPC, Scott A. Wolfe MA. Acknowledgements: The authors acknowledge with gratitude, the contributions of the following individuals and organizations: Barbara Emanuel, Gene Long, and Carol Timmings of Toronto Public Health, for their guidance and comments on draft versions of the report. Fred Goettler, Deepika Grover, Romilla Gupta, Simon Hanukov, Mary-Jo Makarchuk, Safoura Moazami, Mariam Mir, Wil Ng, Janet Phillips, Sujitha Ratnasingham, Karen Wade, Caroline Wai, Charles Yim, Catalina Yokingco, and Vladi Struchkov (student) of Toronto Public Health for their technical and subject knowledge. Cancer Care Ontario for their analysis of the cancer incidence data. Dianne Patychuk of Steps to Equity and Russell Wilkins of Statistics Canada for their review and feedback. Distribution: Copies of this document are available on the Toronto Public Health Web site: www.toronto.ca/health, or by: Phone: 416-338-7600 TTY: 416-392-0658 email: [email protected] The Unequal City | Toronto Public Health i Table of Contents Executive Summary..................................................................................................................................................1 1. Introduction ..........................................................................................................................................................3 2. Income Inequalities in Toronto ...........................................................................................................................5 3. Health Inequalities in Toronto ............................................................................................................................8 Analytic Approach..................................................................................................................................................8 Life Expectancy at Birth.........................................................................................................................................9 All Cause Premature Mortality.............................................................................................................................10 Self-Rated Health .................................................................................................................................................11 Singleton Low Birth Weight Rate ........................................................................................................................12 Readiness to Learn ...............................................................................................................................................13 Teen Pregnancy ....................................................................................................................................................14 Smoking................................................................................................................................................................15 Physical Inactivity ................................................................................................................................................16 Overweight/Obesity..............................................................................................................................................17 Lung Cancer Incidence.........................................................................................................................................18 Cardiovascular Disease Premature Mortality .......................................................................................................19 Chlamydia Infection in Youth ..............................................................................................................................20 Gonorrhoea Infection in Youth.............................................................................................................................21 Breast Cancer Incidence.......................................................................................................................................22 Dental Visits .........................................................................................................................................................23 4. Discussion ............................................................................................................................................................24 5. Conclusion...........................................................................................................................................................26 Appendix A – Definition of Terms ........................................................................................................................27 Appendix B –Methodology ....................................................................................................................................29 Selection of Indicators..........................................................................................................................................29 Analytic Approach................................................................................................................................................29 Appendix C – Data Sources and Limitations.......................................................................................................31 Appendix D – Health Inequality Indicators.........................................................................................................35 References ...............................................................................................................................................................38 The Unequal City | Toronto Public Health ii List of Figures Figure 1: Trends in Census Tract Income, Toronto, 1970 to 20002 .......................................................................6 Figure 2a: Life Expectancy at Birth, by Income, Males, Toronto, 2001, 2003 & 2004 Combined.........................9 Figure 2b: Life Expectancy at Birth, by Income, Females, Toronto, 2001, 2003 & 2004 Combined................................................................................................................................................9 Figure 3a: All Cause Mortality Rate, by Income, Males less than 75 Years, Toronto, 2001, 2003 & 2004 Combined.................................................................................................................................10 Figure 3b: All Cause Mortality Rate, by Income, Females less than 75 Years, Toronto, 2001, 2003 & 2004 Combined........................................................................................................................10 Figure 4a: Percent Rated Health as ‘Fair/Poor’, by Income, Males Aged 20-64 Years, Toronto, 2001, 2003 & 2005 Combined..............................................................................................................11 Figure 4b: Percent Rated Health as ‘Fair/Poor’, by Income, Females Aged 20-64 Years, Toronto, 2001, 2003 & 2005 Combined...............................................................................................11 Figure 5: Singleton Low Birth Weight Rate, by Income, Toronto, 2004-2007....................................................12 Figure 6: Readiness to Learn at School Entry, by Income, Toronto, 2004/05 .....................................................13 Figure 7: Teen Pregnancy Rate, by Income, Toronto, 2004-2006 .......................................................................14 Figure 8a: Percent Current Smoker, by Income, Males Aged 20-64 Years, Toronto, 2001, 2003 & 2005 Combined.................................................................................................................................15 Figure 8b: Percent Current Smoker, by Income, Females Aged 20-64 Years, Toronto, 2001, 2003 & 2005 Combined........................................................................................................................15 Figure 9a: Percent Physically Inactive, by Income, Males Aged 20-64 Years, Toronto, 2001, 2003 & 2005 Combined........................................................................................................................16 Figure 9b: Percent Physically Inactive, by Income, Females Aged 20-64 Years, Toronto, 2001, 2003 & 2005 Combined........................................................................................................................16 Figure 10a: Percent Overweight/Obese, by Income, Males Aged 20-64 Years, Toronto, 2001, 2003 & 2005 Combined........................................................................................................................17 Figure 10b: Percent Overweight/Obese, by Income, Females Aged 20-64 Years, Toronto, 2001, 2003 & 2005 Combined........................................................................................................................17 Figure 11a: Age Standardized Lung Cancer Incidence Rate, by Income, Males, Toronto, 1999 - 2003 Combined.....................................................................................................................................18
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