Immigration, Poverty + Postal Code = Diabetes Epidemic



    "Modern life taking a toll on our health"

    TORONTO, Nov. 1 /CNW/ - It's being called the 21st century epidemic.
Diabetes is growing and Toronto is losing control over the disease. Home to
some of the greatest extremes of neighbourhood wealth and poverty in the
country, where you live in Toronto makes a difference in the likelihood that
you'll develop diabetes. Here's why.
    In a three-year comprehensive study of 140 Toronto neighbourhoods by
Ontario's Institute for Clinical Evaluative Sciences (ICES) and St. Michael's
Hospital, researchers found that poverty and immigration are key factors in
developing type 2 diabetes. The first Canadian study of its kind, it examines
the role neighbourhoods play in the diabetes epidemic. Lead author, Dr. Rick
Glazier, Senior ICES Scientist and a family physician at St. Michael's
Hospital says, "there has been a dramatic 69 per cent rise in diabetes over
the last decade and obesity is contributing to the onset of the disease. The
implications are not only a burden on our health-care system, but the disease
reduces life expectancy by about 15 years. This means children may not live as
long as their parents. Modern life is taking a toll on our health and we must
change how we live. That is why neighbourhoods matter and play a crucial role
in the health of future generations."
    The ICES and SMH study, Neighbourhood Environments and Resources for
Healthy Living: A Focus on Diabetes in Toronto - ICES Atlas, examines the
following factors related to diabetes prevention and control in Toronto:
population density, service density and dispersion, immigration, socioeconomic
status, ethnic composition, crime rates, car ownership, access to healthy and
unhealthy food, opportunities for physical activity and access to health care
and its relationship to diabetes.

    
    From a societal standpoint, here's the bad news:

    -   Diabetes rates are highest in areas that have lower income levels,
        higher unemployment rates, higher proportion of visible minorities
        and higher immigration rates.
    -   Visible minorities, including people of South and East Asian, Afro-
        Caribbean and Hispanic descent, have a greater disposition to
        diabetes than persons of European descent.
    -   Areas with high rates of diabetes tend to be found outside of
        Toronto's downtown core, in suburban areas, where there is reduced
        access to healthy resources such as fruit and vegetable stores and
        where "activity friendliness" is lower (e.g. fewer amenities within
        walking distance, poorer access to public transit, greater car
        dependency).
    -   The top three affected areas with high diabetes rates in Toronto are:
        Humber Summit with the highest rate of diabetes and the least healthy
        resources, followed by Malvern and then Keelesdale-Eglinton West.

    The ICES and SMH study also found that neighbourhoods are affected
differently:

    -   Wealthy areas such as Rosedale have low diabetes rates, regardless of
        the level of access to healthy resources or activity friendliness.
    -   Downtown high risk areas such as Regent Park and Parkdale have lower
        diabetes rates than expected, most likely because of the ability to
        walk to services, better access to healthy foods, recreational
        centers and public transit.
    

    Co-lead author, SMH Endocrinologist and ICES Adjunct Scientist, Dr.
Gillian Booth says, "the flip side of modern conveniences is the fact that one
in two Canadians are now overweight. We jump into cars, children watch
television and play video games too much, we work longer hours and pick up
prepared foods in larger portion sizes. It is critical that we find ways to
incorporate physical activity and healthy eating into our daily life, but
that's only one part of the solution. The opportunity to walk to the corner
store and take children to parks without having to drive should be available
to all Canadians in the neighbourhoods where they live. The consequences of
today's epidemic will take a toll on our health for many years. We are
starting to realize how bad the problem is. We need societal changes and the
good news is - it's not too late."
    As obesity rates increase and Canada's population ages, as many as
four million Canadians will be affected by type 2 diabetes, causing a dramatic
increase in mortality by the year 2010. Placing a huge burden on the health
care system and costing $8 billion annually, diabetes, a leading cause of
blindness, kidney disease, heart and circulatory problems, can be prevented
and controlled through activity, diet and medication. Most cases occur in
people over 40, but experts are seeing children affected as young as 10 years
old.
    Dr. Rick Glazier says that "obesity and its consequences, including
diabetes, is the tobacco of the 21st century. Smoking is now down by almost
half and, just like we did with tobacco, we need to take a multi-faceted
approach to address the diabetes epidemic. We need to motivate behavior and
change environments to help people make better choices at school, at work and
particularly in the neighbourhoods they live in. When we plan and redevelop
neighbourhoods, there is an opportunity to make these healthier, especially
for those who belong to disadvantaged groups. Some of the answers lie in urban
planning, while public transit can also play a major role. It's a wake up call
for all of us."

    
    The study has the following recommendations:

    -   Invest in high-need communities to help reduce the risk of diabetes
        and improve the control of the disease in affected people. Such
        investments would enhance the overall health of residents living in
        those parts of the city.
    -   Change planning, development and zoning practices to reduce urban
        sprawl, increase residential density and promote mixed land use.
    -   Provide incentives for stores selling fresh produce and other
        services to move into high-need areas.
    -   Increase access to public transit.
    -   For neighbourhoods requiring investments, policies should take into
        account the health needs of the local population and the existing
        availability of resources to promote healthier lifestyles.
    -   Reduce consumption of high-fat/high-calorie fast foods with policies
        promoting healthier food choices by consumers and healthier menu
        offerings by food retailers.
    

    The complete study, Neighbourhood Environments and Resources for Healthy
Living: A Focus on Diabetes in Toronto - ICES Atlas is available on the
homepage of our website at www.ices.on.ca.

    Toronto neighbourhood profiles are included as an attachment to this
release. (Please click the following URL to open:
http://files.newswire.ca/650/Toronto_profiles.pdf)

    This study was conducted with funding support from BMO Financial Group.

    ICES is an independent, non-profit organization that uses
population-based health information to produce knowledge on a broad range of
health care issues. Our unbiased evidence provides measures of health system
performance, a clearer understanding of the shifting health care needs of
Ontarians, and a stimulus for discussion of practical solutions to optimize
scarce resources. ICES knowledge is highly regarded in Canada and abroad, and
is widely used by government, hospitals, planners, and practitioners to make
decisions about care delivery and to develop policy.

    St. Michael's Hospital is a large and vibrant Catholic teaching and
research hospital in the heart of Toronto. Fully affiliated with the
University of Toronto, St. Michael's Hospital leads with innovation, and
serves with compassion. Renowned for providing exceptional patient care, St.
Michael's Hospital is a regional trauma centre and downtown Toronto's
designated trauma centre for adults.





For further information:

For further information: Kristine Galka, ICES, (416) 480-4780, or cell
(416) 629-8493, kristine.galka@ices.on.ca; Julie Saccone, St. Michael's
Hospital, (416) 864-5047


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