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Technical Report/User Guide Urban HEART @Toronto: Technical Report/User Guide Centre for Research in Inner City Health Toronto, ON March 2014 i Centre for Research in Inner City Health (2014). Urban HEART @Toronto: Technical Report/User Guide. March 2014. To learn more about Urban HEART @Toronto, contact: [email protected] http://www.torontohealthprofiles.ca/urbanheartattoronto.php ii TABLE OF CONTENTS TABLE OF CONTENTS ................................................................................................... iii LIST OF TABLES .............................................................................................................. v LIST OF FIGURES .......................................................................................................... vii 1. Introduction: Using Urban HEART @Toronto .............................................................. 1 2. General Overview: Indicator Selection and Testing ....................................................... 3 Indicator Testing and Validation .................................................................................... 3 Quality Variations ........................................................................................................... 5 Challenges ....................................................................................................................... 5 Conclusions ..................................................................................................................... 5 3. General Overview of Benchmarks and Targets Selection ............................................ 10 4. Statistical Methods Used to Create Indices .................................................................. 20 5. Description of Indicators ............................................................................................... 26 5.1. Economic Opportunity ........................................................................................... 26 Indicator 1: Unemployment Rate .............................................................................. 26 Indicator 2: Low Income ........................................................................................... 32 Indicator 3: Social Assistance ................................................................................... 38 5.2. Social and Human Development ........................................................................... 43 Indicator 4: High School Graduation ........................................................................ 44 Indicator 5: Marginalization ..................................................................................... 47 Indicator 6: Post-secondary Education ..................................................................... 51 5.3. Governance and Civic Engagement ....................................................................... 61 Indicator 7: Voter Participation ................................................................................ 62 5.4. Physical Environment and Infrastructure ............................................................... 69 Indicator 8: Access to Meeting and Gathering Places .............................................. 69 Indicator 9: Walkability ............................................................................................ 73 Indicator 10: Access to Healthier Food Stores ......................................................... 78 Indicator 11: Green Space ......................................................................................... 82 5.5. Population Health................................................................................................... 90 Indicator 12: Premature Mortality Rate .................................................................... 91 Indicator 13: Mental Health ...................................................................................... 96 Indicator 14: Potentially Preventable Hospitalizations/Ambulatory Case Sensitive Conditions Hospitalization Rate ............................................................................. 102 Indicator 15: Diabetes Prevalence .......................................................................... 107 iii 6. Accountability and Acknowledgements ..................................................................... 116 References ....................................................................................................................... 118 Appendix A: The National Household Survey (NHS) ................................................... 120 Appendix B: Correlation Analyses ................................................................................. 123 Appendix C: Urban HEART @Toronto master matrix .................................................. 128 iv LIST OF TABLES Table 1. Indicator testing and validation guidelines ........................................................... 3 Table 2. Indicator definition and data sources .................................................................... 5 Table 3. Advantages, disadvantages, and examples of specific cut-off points ................. 12 Table 4. Comparison cities used to determine selected benchmarks and target cut-off points ................................................................................................................................. 18 Table 5. List of external comparator health regions and comparator cities ...................... 18 Table 6. Comparison between ‘sum of colour categories’ method and ‘score range transformation’ method across all domains ...................................................................... 23 Table 7. Economic opportunity indices ............................................................................ 24 Table 8. External comparators for unemployment rate .................................................... 29 Table 9. Potential cut-off measures for unemployment to determine ‘red’ and ‘green’ neighbourhoods ................................................................................................................. 30 Table 10. Unemployment rate by neighbourhood income quintile, 2011 ........................ 31 Table 11. Correlation analysis for unemployment rate ..................................................... 31 Table 12. Comparison between two neighbourhood census tracts before and after modifications..................................................................................................................... 34 Table 13. Correlation matrix for income .......................................................................... 34 Table 14. Potential cut-off measures for low income to determine ‘red’ and ‘green’ neighbourhoods ................................................................................................................. 35 Table 15. Low income by neighbourhood income quintile, 2010 .................................... 36 Table 16. External comparators for low income ............................................................... 37 Table 17. Potential cut-off measures for social assistance to determine ‘red’ and ‘green’ neighbourhoods ................................................................................................................. 40 Table 18. Social assistance by neighbourhood income quintile, 2012 ............................. 41 Table 19. Social and human development indices ............................................................ 43 Table 20. List of indicators used for high school completion rates .................................. 46 Table 21. Potential cut-off measures for the ON-MARG index to determine ‘red’ and ‘green’ neighbourhoods .................................................................................................... 49 Table 22. ON-MARG index by neighbourhood income quintile, 2006 ........................... 50 Table 23. Correlations between NHS, TSBS, and census education variables (N=140).. 53 Table 24. Potential cut-off measures for post-secondary completion rates to determine ‘red’ and ‘green’ neighbourhoods ..................................................................................... 54 Table 25. Post-secondary completion by neighbourhood income quintile ....................... 55 Table 26. Comparison of external comparators of post-secondary completion rates, 15 comparison Canadian cities .............................................................................................. 56 Table 27. Social and human development summary table: High school graduation, marginalization, and post-secondary completion ............................................................. 57 Table 28. Governance and civic engagement: Municipal voting .................................... 61 Table 29. Potential cut-off measures for voting participation to determine ‘red’ and ‘green’ neighbourhoods .................................................................................................... 63 Table 30. Voter participation by neighbourhood income quintile, 2010 .......................... 64 Table 31. Comparison of external comparators of voter participation rates, 10 comparison Canadian cities .................................................................................................................. 65 v Table 32 summarizes the municipal voting domain by colour codes. .............................. 66 Table 33. Potential cut-off measures for voting participation to determine ‘red’ and ‘green’ neighbourhoods ...................................................................................................
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