It’s hard to live in the city

When I’m not moonlighting as a millionaire-playboy transit enthusiast, I have a day job as a mild-mannered policy analyst.  Sometimes, however, my alter egos overlap and I find some pretty cool stuff.

I came across this research from the Institute for Clinical Evaluative Services when I attended a presentation by one of the authors, Dr. Richard Glazier.  The study utilizes a whole whack of data, ranging from Stats Can to City of Toronto GIS data.  It looks at diabetes prevalence across Toronto, and adds a whole bunch of fun map layers.

Most interesting is the links that are drawn between diabetes prevalence and how the urban form contributes to it.  The authors developed a measure termed the “Activity Friendly Index (AFI).”  Basically it combines a number of indicators (crime rates, income levels, car dependency, land use) which can be used to rate an area on how easy it is to be healthy.

The result? The lower the AFI score, the worse health problems an area will have.  Check out some of these maps.

[NOTE: All images from Glazier RH, Booth GL, Gozdyra P, Creatore MI, Tynan, M, editors. Neighbourhood Environments and Resources for Healthy Living—A Focus on Diabetes in Toronto: ICES Atlas. Toronto: Institute for Clinical Evaluative Sciences; 2007]

Here is what the diabetes rates in Toronto look like (click for larger version of all images):

Compare this to the socioeconomic status of neighbourhoods.  Notice any trends yet?

Note that dark = rich

Next let’s look at how people in these areas get around, first by TTC trips per person:

Daily TTC trips per person

And by walking or biking:

Trips by walking or bicycling

So if we are talking active transportation, it is clearly concentrated in the core of city and along subway lines.

And how hard is it for people with the highest rates of diabetes to access a park or get healthy food?  There’s a map for that:

Modeled walking time to a park

Modeled TTC commute time to healthy food

The urban form also plays an important role in maintaining health.  Check out this comparison of year of construction to auto dependency.  As development patterns shift towards car dependency post 1940’s, it’s fascinating (and scary) to tie it back to the previous maps:

Year of Construction

Average number of vehicles per household

And finally, the compiled AFI for Toronto:

Activity Friendly Index

So what’s the point of all these maps?  There are very clear correlations between the level of activity a person engages in and their rates of diabetes.  More importantly, there are a host of factors that contribute to how active a person can be, including the built environment, availability of mass transit, walkable neighbourhoods and access to affordable, healthy food.

Each one of these factors on their own is enough to cause significant changes in health; taken together you can see how they can change the health of hundreds of thousands of people.


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11 responses to “It’s hard to live in the city”

  1. Rb says :

    Holy, good post like!

  2. jimsey says :

    Lesson I learned today: Don’t live in Humber, you’ll get diabetes.

  3. pollutionfree says :

    Some great uses of GIS maps here
    You might be interested as well in the spatial distributon of car produced pollution (NO2) on downtown Toronto streets which is hsown in this paper
    Ref:CMAJ • SEPT. 2, 2003; 169 (5) Relation between income, air pollution and mortality: a cohort study( Finkelstein er al)

  4. Lachlan says :

    This all looks very convincing, Ben, but I think we all know that the diabeetus is caused by a lack of reading your bible, and not loving Jesus.

  5. Mark says :

    Very nice analysis, Ben. One thing I think should be clarified is that we are talking about Type 2 diabetes, right? I can’t see this holding up for the Type 1 crowd.

    @Lachlan: Nice!

  6. Mark says :

    Ben, at risk of this coming across as racist, is there a higher than average first nations population in the neighborhoods with high diabetes? In Alberta anyway, we know that first nations are susceptible. Of course, that doesn’t take away from your argument that income is important. It also would point to another way first nations people are disadvantaged in this country.

    • Ben says :

      Mark, not racist at all, those sorts of questions are the bread and butter of my work. There were some other maps with ethnoracial make up of areas, and the areas with high rates of diabetes (and yeah, Type 2 as you pointed out). In Toronto there are higher proportions of visible minorities. South Asians in particular have higher rates of diabetes, and this just piles another layer onto all the other problems highlighted above. In Toronto the urban aboriginal population is not as concentrated, but you would see similar results.

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