West Toronto Sub-Region Profile. September 19, 2016

West Toronto Sub-Region Profile September 19, 2016

This report was prepared by the following individuals: Ranjeeta Jhaveri, Cynthia Damba, Mohamedraza Khaki, Thivya Sornalingam, Myuri Elango Pandian, Kinga Byczko (Toronto Central LHIN Health Analytics and Innovation Team); Daniel Laidsky (Reconnect MHA Services). If you have any questions about this, please contact: Ranjeeta Jhaveri (Ranjeeta.jhaveri@lhins.on.ca) and Cynthia Damba (Cynthia.Damba@lhins.on.ca) 2

Table of Contents Section 1 - Introduction to the Report and West Toronto Sub-Region... 4 Section 2 - Population Characteristics.11 Section 3 Health Status...29 Section 4 Health Service Use. 37 Section 5 Primary Care and Prevention...72 Appendix A Additional Information on Population Demographics.84 Appendix B Methodology for Identifying Primary Care Physicians...90 3

Section 1. Introduction to the Report and West Toronto Sub-Region 4

Planning at the Sub-Region Level One of the key Strategic Priorities that underpins the goals of the Toronto Central LHIN strategic plan is Taking a Population Health Approach, which will direct how we plan, prioritize, fund, and partner with other organizations to target the needs of the population and the sub-populations within. This begins with a strong understanding of what our current and future patients needs and wants are in order to improve their health status and experience with health care. This information will help to identify neighbourhoods and population segments that may need targeted interventions to achieve the desired and equitable outcomes reflected in our goals. A population based approach integrates the full spectrum of health care delivery from preventing disease (e.g. health promotion) to treatment (e.g. tertiary care). Health is greatly influenced by the social determinants of health including our environment, our social status, education, employment, gender and culture. The profiles illustrate the diversity of the population of the Toronto Central LHIN, and form a basis of understanding of the variations in populations that can impact our health outcomes. 5

Data Sources, Considerations and Report Structure Data was obtained from multiple sources for the report and years of data may vary as they are based on the most recent year available for the particular database. There may be minor differences in rates and numbers reported for different indicators due to rounding, use of different data sources and/or timing of data extraction. As we get more information, we will update indicators or add new indicators. Sub-regions are built from Statistics Canada Census Tracts. The report is divided out into 5 sections and some are further sub-divided into sub-sections. Each section starts with a summary of the highlights and then information for individual selected indicators. For each indicator, information is presented at LHIN, sub-region and wherever possible at neighbourhood level. The top 2 or 3 rates for neighbourhoods which indicate greater health risk in the summary slides are highlighted in pink. Similar slide decks are being prepared for each of the sub-regions and will be posted on the Toronto Central LHIN website. Additional informational information on sub-regions is available on Toronto Central LHIN website: 6 http://www.torontocentrallhin.on.ca/forhsps/crosssectortables.aspx

About the West Toronto Sub-Region St. Joseph s Health Centre West Park Rehab High Park Mount Dennis Roncesvalles Stonegate CHC Bounded by Eglinton Ave. West to the north, the Canadian National Railway to the East, Lake Ontario to the south, Islington Ave. (North) and Kipling Ave (South) to the West. The region contains 14 neighbourhoods and a very small proportion of one neighbourhood (Islington City Centre West). There are 3 designated neighbourhood Improvement Areas (Mount Dennis, South Parkdale, and Rockcliffe Smythe) along with higher-income neighbourhoods such as Kingsway South and Runnymede Bloor West Village. Please note: Islington City Centre West has not been included in this profile as the majority is located in Mississauga Halton LHIN. Also, Edenbridge-Humber Valley has a small portion that lies in Central LHIN. 7

West Toronto Neighborhoods (2016) Males: 48.2% Females: 51.8% Population (2011) 232,570 (20.4% of TC LHIN) % Children and Youth (ages 0-19): 20% % Seniors (ages 65+): 13.7% 8 Source: Toronto Community Health Profiles Partnership, Extracted: 2016; Census of Canada, Statistics Canada, 2011

Health Service Providers(HSP s) in Toronto Central LHIN (As of July 2016) HSP mappings are based on primary office locations. HSPs may have multiple sites. In addition, HSPs in one subregion may provide services for people in other sub-regions or LHINs. Sub-Regions Sub-Region CCAC CHC CMHA CSS Hospital Private Primary Care Total HSPs (ex LTC Hospital Physicians** FP/GP) West Toronto 4 8 5 3 0 9 155 29 Mid-West Toronto 5 20 13 5 0 12 534 55 North Toronto 1 2 3 10 3 0 3 217 21 Mid-East Toronto 4 24 15 3 0 4 199 50 East Toronto 2 5 10 2 1 8 236 28 Toronto Central LHIN 1 17 60 53 16 1 36 1341 184 **Primary Care Physicians are defined by a basket of service methodology developed by MOHLTC. General practice physicians are considered primary care providers if they either 1) belong to a Physician Enrollment Model (PEM) or 2) satisfied specific billing requirements (Appendix A) These numbers are estimates and do not include PCPs in CHCs. Numbers will be updated 9

West Toronto Sub-LHIN West Toronto Health Service Providers Hospital LTC CMH&A CSS CHC 1. Runnymede Healthcare Centre 2. St. Joseph's Health Centre 3. West Park Healthcare Centre 1. Copernicus Lodge 2. Elm Grove Living Centre Inc. 3. Garden Court, Shaparrall Limited 4. Ivan Franko Home (Etobicoke) 5. Lakeshore Lodge 6. Lakeside Long Term Care Centre 7. Norwood Nursing Home Limited 8. West Park Long Term Care Centre 9. White Eagle Residence 1. Breakaway Addiction Services 2. Family Association for Mental Health Everywhere 3. Habitat Services, Mental Health Program Services of Metropolitan Toronto, Inc. 4. Jean Tweed Treatment Centre 5. Parkdale Activity - Recreation Centre 6. Reconnect Community Health Services 7. Regeneration House Inc. 8. Working for Change 1. Etobicoke Services for Seniors 2. Humber Community Seniors' Service Inc. 3. Parkdale Golden Age Foundation 4. Storefront Humber Inc. 5. Blinds Adults 1. Four Villages Community Health Centre 2. Lakeshore Area Multi-Services Project 3. Parkdale Community Health Centre 4. Stonegate Community Association Total: 3 Total: 9 Total: 8 Total: 5 Total: 4 HSP mappings are based on primary office locations. HSPs may have multiple sites. In addition, HSPs in one sub-region may provide services for people in other sub-regions or LHINs. 10

Section 2. Population Characteristics A) Population Demographics B) Cultural and Socioeconomic Diversity Additional detailed information is available in Appendix A 11

Key Highlights Population Demographics and Diversity West Toronto has a slightly higher proportion of children and youth (ages 0-19) in 2011 (20%) compared to Toronto Central LHIN (18.8%). Lambton Baby Point and Mount Dennis has the highest proportion of children and youth in West Toronto at 26.5% and 25.7% respectively. The percentage of the West Toronto population that is over 65 years (2011) at 13.7% is similar to the Toronto Central LHIN average (13.1%). Half of the neighbourhoods of West Toronto have a higher percentage than the Toronto Central LHIN average of seniors living alone. West Toronto has the highest proportion of residents who speak English only (85.3%) among the sub-regions. This is also higher than the Toronto Central LHIN average of 83.2%. The top 3 most common languages spoken at home other than English are Spanish, Polish and Portuguese. West Toronto has a lower proportion of visible minorities (28.6%) relative to Toronto Central LHIN (33.6%). The most heavily represented visible minorities relative to Toronto Central LHIN are of people with a Latin American Descent. Neighbourhoods with the highest levels of marginalization include Rockcliffe-Smythe and South Parkdale. Roncesvalles, Rockcliffe-Smythe, Mount Dennis, New Toronto, and South Parkdale neighbourhoods have median private household income below that of the City of Toronto. 12

2a) Population Demographics 13

Data Limitations The 2011 Census and National Household Survey (NHS), and Tax filer data were the main sources for this Population Demographic section. Information on visible minorities, immigration, education, labour, and Aboriginal identity were collected as part of the 2011 National Household Survey by Statistics Canada. The National Household Survey was a voluntary survey and subject to non-response bias especially in areas where non-response rates exceeded 25%, the threshold for suppression for the 2011 Census. Non-response bias is a common issue with voluntary surveys and a reflection of the tendency that people who are inclined to respond to a survey have different characteristics from people who do not respond. Consequently, marginalized or underrepresented subpopulations are likely undercounted in the National Household Survey and comparisons between the National Household Survey and previous Censuses should be considered to be unreliable. Population estimates provided in the following profile should be considered as an approximate estimate of the population, rather than a true, full count of the population. There may be differences in total population counts due to rounding and use of different data sources. 14

West Toronto: Population Summary by Neighbourhood (2011) Population Male Total Population Children/Youth Seniors Population Female Total Population (Both Sexes) % change in population count 2006-2011, Both sexes % of Total population that are age 0-19 % change in the 0-19 population (count), 2006-2011 % of families with children that are headed by a lone parent in private households Total Population Age 65+, Both sexes % of Total population that are age 65+, Both sexes % change in the 65+ population (count), 2006-2011, Both sexes Age 65+ living alone, Both sexes % of Total population in private households that are 65+, living alone, Both sexes Edenbridge-Humber Valley 7,075 7,865 14,945 3.40% 20.6% -3.6% 26.2% 2,815 18.8% 10.6% 695 25.9% High Park North 10,100 11,190 21,300 1.6% 16.2% 2.8% 29.5% 2,550 12.0% -3.0% 970 41.4% High Park-Swansea 10,030 11,720 21,750 8.8% 19.0% 11.3% 27.0% 3,385 15.6% 3.7% 1,080 36.3% Junction Area 6,820 7,210 14,015 6.4% 20.1% -2.8% 31.8% 1,320 9.4% 14.8% 280 22.9% Kingsway South 4,330 4,845 9,175 4.6% 24.5% 1.6% 17.5% 1,720 18.7% 9.6% 420 25.9% Lambton Baby Point 3,695 4,220 7,920 1.7% 26.5% 4.5% 32.7% 905 11.4% -3.7% 275 30.6% Mimico 12,925 13,625 26,550 6.3% 14.9% -1.9% 37.0% 3,920 14.8% 16.5% 1,465 37.9% Mount Dennis 6,210 6,935 13,150 2.4% 25.7% -7.4% 47.1% 1,490 11.3% 14.2% 325 26.0% New Toronto 5,300 5,600 10,905 2.4% 19.3% -7.5% 43.3% 1,490 13.7% 5.3% 600 44.8% Rockcliffe-Smythe 10,750 11,520 22,270-0.5% 23.6% -5.9% 38.9% 3,410 15.3% 0.9% 1,255 36.8% Roncesvalles 7,430 7,620 15,050 2.7% 20.1% 6.1% 30.1% 1,620 10.8% -3.9% 580 35.9% Runnymede-Bloor West Village 4,565 5,065 9,635 0.8% 24.0% 1.5% 22.3% 1,080 11.2% -5.3% 255 23.5% South Parkdale 10,810 10,435 21,245 1.1% 16.3% -11.0% 42.8% 2,225 10.5% 0.7% 895 48.9% Stonegate- Queensway 11,935 12,745 24,690 3.7% 21.0% 5.3% 26.8% 3,975 16.1% -3.3% 1,110 28.5% Toronto Central LHIN 557,565 592,995 1,150,555 5.6% 18.7% -0.8% 31.7% 150,965 13.1% 7.1% 47,850 34.1% Source: Toronto Community Health Profiles Partnership, Extracted: 2016; Census of Canada, Statistics Canada, 2011 15

0 to 4 5 to 9 10 to 14 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85+ West Toronto: Population Demographics (2011) 5% Population by Age and Sex Distribution in West Toronto and Toronto Central LHIN 5% Total Population in 2011 3% 1% 1% 3% 5% 3% 1% 1% 3% 5% 232,570 (Toronto Central LHIN: 1.2 million) WestTorontoWomen WestTorontoMen TC LHIN - Men TC LHIN - Women Projected growth between 2011 and 2026 Most heavily represented age groups relative to the Toronto Central LHIN: +10% 85+ years +9% 5-14 years +34.6% (Toronto Central LHIN: +35%) Source: Census of Canada, Statistics Canada, 2011 16

West Toronto: Population of Children and Youth (2011) West Toronto had a higher proportion of children and youth (ages 0-19 years) in 2011 (20% ) relative to Toronto Central LHIN (18.8%). % of Total Population Ages 0-19, Both Sexes (2011) Toronto Central LHIN: 18.7% Lambton Baby Point Mount Dennis Kingsway South Runnymede-Bloor West Village Rockcliffe-Smythe Stonegate-Queensway Edenbridge-Humber Valley Roncesvalles Junction Area New Toronto High Park-Swansea South Parkdale High Park North Mimico 26.5 25.7 24.5 24.0 23.6 21.0 20.6 20.1 20.1 19.3 19.0 16.3 16.2 14.9 0.0 10.0 20.0 30.0 Most neighbourhoods have a higher than average % of children than the Toronto Central LHIN population. Lambton Baby Point and Mount Dennis neighbourhoods have the highest proportion of children in West sub-region. 17 Source: Toronto Community Health Profiles Partnership, Extracted: 2016; Census of Canada, Statistics Canada, 2011

West Toronto: Population of Seniors Age 65+ (2011) Overall, 13.7% of the West Toronto population is over 65 years (2011). This is slightly above the Toronto Central LHIN average population, currently at 13.1%. The proportion of seniors among West Toronto neighbourhoods ranges from 9.4% to 18.8%. Half of the neighbourhoods have a higher than average proportion of seniors in their neighbourhoods. Kingsway South and Edenbridge-Humber Valley have the highest proportion of seniors in West Toronto Sub-region. % of Total Population, Ages 65+, Both Sexes, (2011) Toronto Central LHIN: 13.1% Edenbridge-Humber Valley 18.8% Kingsway South 18.7% Stonegate-Queensway 16.1% High Park-Swansea 15.6% Rockcliffe-Smythe 15.3% Mimico 14.8% New Toronto 13.7% High Park North 12.0% Lambton Baby Point 11.4% Mount Dennis 11.3% Runnymede-Bloor West Village 11.2% Roncesvalles 10.8% South Parkdale 10.5% Junction Area 9.4% 0.0% 5.0% 10.0% 15.0% 20.0% 18

Percentage (%) West Toronto: Seniors Living Alone by Neighbourhood (2011) Percent (%) of seniors living alone by Neighbourhood 60.0 50.0 40.0 30.0 20.0 22.9 23.5 25.9 25.9 26.0 28.5 30.6 35.9 36.3 36.8 37.9 48.9 44.8 41.4 Toronto Central LHIN 34.1% 10.0 0.0 The proportion of seniors living alone in West Toronto neighbourhoods ranges from 22.9% to 48.9%. Half of the neighbourhoods have a higher proportion of seniors living alone compared to the Toronto Central LHIN average, with High Park North, New Toronto, South Parkdale having over 40% of seniors living alone. Source: Toronto Community Health Profiles Partnership, Extracted: 2016 19

West Toronto: Homeless Population Number of Shelters in West Toronto by Neighbourhood (2016) Junction Area West Toronto has 2 homeless shelters in (Mimico and Junction Area) in Toronto Central LHIN Mimico 0 1 2 3 4 When planning services for the homeless population, key considerations include: In 2013, the proportion of seniors doubled to 10% from 5% in 2009 High representation of the Indigenous population (16%) Almost half (46%) used the emergency department Almost one third (26%) used ambulance services Higher prevalence of mental health and addictions Higher need for transportation services Poor data quality in existing databases Source: City of Toronto, 2016, 2013 Street Needs Assessment Results 20

2b) Cultural and Socioeconomic Diversity Languages Spoken, Francophone, Visible Minorities, Aboriginals, Immigration, Newcomers, Education, Income, Social Assistance, Marginalization 21

West Toronto: Cultural and Socioeconomic Diversity Summary % No knowled ge of English/ French (2011) % Recent Immigrants of Total Immigrants (from 2006 to 2011) % Visible Minority (by Total Population in Private Households) (2011) % of persons age 25-65 with post secondary certificate, diploma or degree Persons living below low income measure (aftertax) (2010) % of Population Receiving Social Assistance (2011) % Unemployment: (# of unemployed persons age 15+/100 Persons age 15+ in the Labour Force) Ontario Marginalization Index (2006) % Population of Aboriginal Identity (Private Households) (2011) Edenbridge-Humber Valley 2.4% 12.9% 17.5% 74.3% 11.7% 5.0% 8.0% 2.0 0.1% Stonegate-Queensway 2.1% 16.0% 15.9% 75.9% 11.8% 6.5% 8.0% 1.8 0.4% High Park North 2.1% 18.3% 22.9% 81.2% 16.5% 4.9% 7.8% 1.8 0.5% High Park-Swansea 1.4% 9.9% 16.1% 82.8% 11.9% 7.7% 6.7% 2 0.4% Junction Area 3.7% 13.6% 31.2% 69.7% 18.6% 8.2% 7.9% 2.2 1.5% Kingsway South 0.4% 6.5% 11.0% 88.8% 5.8% 0.8% 5.9% 1.6 0.2% Lambton Baby Point 1.8% 9.4% 22.0% 76.1% 16.4% 13.3% 5.1% 1.8 0.5% Mimico 3.2% 14.2% 25.4% 73.0% 16.5% 9.9% 7.3% 2.4 0.6% Mount Dennis 4.6% 16.2% 64.3% 50.1% 28.0% 22.3% 13.6% 2.6 0.9% New Toronto 3.2% 12.0% 30.6% 66.3% 24.1% 14.7% 8.8% 2.6 1.3% Rockcliffe-Smythe 6.3% 9.5% 46.2% 48.3% 23.1% 15.4% 11.5% 3 1.0% Roncesvalles 7.0% 20.8% 26.0% 71.1% 21.1% 15.1% 6.4% 2.2 1.4% Runnymede-Bloor West Village 0.9% 7.9% 18.6% 83.2% 8.6% 2.6% 6.9% 1.2 1.0% South Parkdale 6.0% 32.1% 48.4% 64.1% 34.1% 21.0% 13.0% 3.2 2.1% Toronto Central LHIN 4.2% 17.6% 33.6% 74.1% 20% 10.0% 8.3% N/A 0.9% Source: Toronto Community Health Profiles Partnership, Extracted: 2016; Census of Canada, Statistics Canada, 2011; National Household Survey, Statistics Canada, 2011 22

West Toronto: Diversity Languages Spoken (2011) Percent (%) of Total population in private households that are recent immigrants: 6.1% Toronto Central LHIN 6.8% Visible Minority 28.6% Toronto Central LHIN 33.6% Aboriginal Identity 1,900 Toronto Central LHIN 10,665 Note: Persons of aboriginal identity are most likely undercounted due to limitations of the NHS Neighbourhood Name % No knowledge of English/French Roncesvalles 7.0% Rockcliffe-Smythe 6.3% South Parkdale 6.0% Mount Dennis 4.6% Junction Area 3.7% New Toronto 3.2% Mimico 3.2% Edenbridge-Humber Valley 2.4% High Park North 2.1% Stonegate-Queensway 2.1% Lambton Baby Point 1.8% High Park-Swansea 1.4% Runnymede-Bloor West Village 0.9% Kingsway South 0.4% Top 3 Languages other than English Spoken at Home (2011) #1 #2 #3 Hungarian Polish Portuguese Portuguese Spanish Vietnamese Tibetan languages Hungarian Polish Spanish Portuguese Vietnamese Portuguese Vietnamese Spanish Polish Russian Spanish Polish Tagalog (Pilipino, Filipino) Spanish Spanish Ukrainian Italian Polish Ukrainian Russian Russian Polish Spanish Ukrainian Polish Hungarian Polish Serbian Ukrainian Ukrainian Polish French Ukrainian Polish French Overall West Toronto has the highest proportion of residents who speak English only (85.3%) among the 5 sub-regions and higher compared to Toronto Central LHIN (83.2%). The most common languages spoken at home other than English include Spanish, Polish and Portuguese. Neighbourhoods with higher than Toronto Central LHIN rate of non-english/french speaking individuals include Roncesvalles, Rockcliffe-Smythe, South Parkdale and Mount Dennis. Among the Visible Minorities, West Toronto has the highest proportion of people of Latin American Descent 23 Source: Toronto Community Health Profiles Partnership, Extracted: 2016; Census of Canada, Statistics Canada, 2011

West Toronto: Language (2011) 37% 2% Mother Tongue* 61% English French Non-official languages Persons who speak French at home: 6,210 2.7% (Toronto Central LHIN: 2.9%) Persons with no knowledge of either official language: 7,855 3.4% (Toronto Central LHIN: 4.2%) Top home languages other than English spoken at home Spanish Polish Portuguese Ukrainian Russian Italian Vietnamese Tagalog Tibetan Serbian - 2,000 4,000 6,000 8,000 10,000 Population Most heavily represented languages relative to Toronto Central LHIN Tibetan Ukrainian Polish Croatian Hungarian Somali Serbian Vietnamese Chinese, n.o.s. Russian Albanian German Spanish Other languages 0.0% 50.0% 100.0% 150.0% 200.0% 250.0% 300.0% 350.0% Percent Increase over Toronto Central LHIN Note*: English and French includes non-official languages as well Source: Census of Canada, Statistics Canada, 2011 24

Population (in thousands) West Toronto: Immigration, Visible Minorities and Aboriginal Population (2011) Visible Minority 16000 Visible minorities by immigration period 14000 12000 28.6% 10000 8000 6000 4000 2000 Toronto Central LHIN: 34% 0 South Asian Chinese Black Filipino Latin American Arab Southeast Asian West Asian Korean Japanese Visible minority, n.i.e. Multiple visible minorities Non-permanent residents Immigrated between 2006 to 2011 Immigrated between 2001 to 2005 Immigrated before 2001 Canadian born Aboriginal identity 1,900 0.8% (Toronto Central LHIN: 0.9%) Most heavily represented visible minorities relative to the Toronto Central LHIN: +41.4% Latin American +83.1% Other racialized groups 25 Source: National Household Survey, Statistics Canada, 2011

West Toronto: Immigration (2011) Total immigrant population in private households by top selected places of birth Total recent immigrant population in private households by top selected places of birth (2006 to 2011) Population from Country % of Total Population in Private Households Population from Country % of Total Recent Immigrants Poland 7,630 3.4% United Kingdom 5,445 2.4% Philippines 4,660 2.1% Portugal 4,495 2.0% India 3,885 1.7% Ukraine 3,880 1.7% Viet Nam 3,100 1.4% China 2,955 1.3% Italy 2,535 1.1% Jamaica 2,265 1.0% United States 2,240 1.0% Germany 1,680 0.7% India 1,415 10.2% Philippines 1,145 8.2% China 615 4.4% Ukraine 440 3.2% Brazil 400 2.9% Nepal 370 2.7% United States 350 2.5% Russian Federation 275 2.0% Mexico 185 1.3% Colombia 185 1.3% Viet Nam 155 1.1% Cuba 135 1.0% Total Population within private households = 226,280 Total recent immigrant population in private households = 13,900 Source: National Household Survey, Statistics Canada, 2011 26

Income West Toronto: Education and Income (2011) Educational Attainment 20.0% 19% 17% 15.0% 9.8% 10.0% 8.9% 5.0% 0.0% West TC LHIN Less than High School Diploma High School Diploma Unemployment rate (2011) 8.5% Children under 18 Toronto Central LHIN: 8.3% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% Persons living below low income measure (after tax) (2013) 20.0% 17.5% 24.6% 21.7% % persons below LIM- AT % Children under 18 below LIM-AT West Toronto TC LHIN 7.1% 7.6% % Seniors 65 years and over below LIM-AT Median Private Household Income by Neighbourhood (2011) $120,000 $100,000 $80,000 $60,000 $40,000 $20,000 $0 $106,386 $74,729 $67,549 $62,463 $62,128 $58,158 $55,300 $53,804 $52,827 $46,883 $46,154 $43,790 $40,859 City of Toronto: $52,149 $32,539 Source: National Household Survey, Statistics Canada, 2011; Toronto Well-Being, Tax Filer, 2013 27

West Toronto: Low income and Marginalization 3.5 2.5 3 1.5 2 0.5 1 0 1.2 1.6 Ontario Marginalization Index - per Neighbourhood (2006) 1.8 1.8 1.8 2 2 2.2 2.2 2.4 2.6 2.6 3 3.2 City of Toronto: 2.4 At the neighbourhood level, there is variation in levels of marginalization and other socioeconomic indicators. Neighbourhoods with high levels of marginalization include: South Parkdale, Rockcliffe -Smythe, Mount Dennis, New Toronto and Mimico Indicator definition: A combined measure of 18 variables representing residential instability, ethnic concentration, dependency and material deprivation, 2006 Census, Ontario Marginalization Index % of Population - Low Income (After-Tax) (2010) City of Toronto Rate: 22.2% South Parkdale Mount Dennis New Toronto Rockcliffe-Smythe Roncesvalles Junction Area Mimico High Park North Lambton Baby Point High Park-Swansea Stonegate-Queensway Edenbridge-Humber Valley Runnymede-Bloor West Village Kingsway South 28.0 24.1 23.1 21.1 18.6 16.5 16.5 16.4 11.9 11.8 11.7 8.6 5.8 Source: Urban Heart, 2014 [2006 Census, Ontario Marginalization Index] 34.1 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 % of Population Receiving Social Assistance (2012) Mount Dennis South Parkdale Rockcliffe-Smythe Roncesvalles New Toronto Lambton Baby Point Mimico Junction Area High Park-Swansea Stonegate-Queensway Edenbridge-Humber Valley High Park North Runnymede-Bloor West Village Kingsway South City of Toronto Rate: 10% 9.9 8.2 7.7 6.5 5.0 4.9 2.6 0.8 15.4 15.1 14.7 13.3 22.3 21.0 0.0 5.0 10.0 15.0 20.0 25.0 Indicator definition: Percentage of the population living with incomes below the after-tax low income measures (LIM-AT) established in 2010 for the City of Toronto. The after tax-low income measure (LIM-AT) is the poverty measure used by the Ontario Poverty Reduction Strategy. Source: Urban Heart Toronto, 2014 [2010 TI-Family File, Statistics Canada Income Division] Indicator definition: Social Assistance: % of the population that are recipients of Ontario Works, persons on ODSP participating in OW employment programs and non-ow persons receiving assistance with medical items, 2012, Toronto Employment & Social Services. 28

Section 3: Health Status Prevalence of Disease Conditions 29

Key Highlights Health Status Overall in FY 2014/15, West Toronto sub-region had higher prevalence rates for Diabetes, Asthma, High Blood Pressure, Mental Health Visits & COPD compared to Toronto Central LHIN. Prevalence varied considerably among the neighbourhoods. New Toronto had remarkably higher rates across all conditions apart from diabetes, however there was wide variation across neighbourhoods. Four neighbourhoods have among the highest rates of chronic diseases in the West Toronto sub-region: Mount Dennis, Rockcliffe Smythe, South Parkdale and New Toronto. Rates of diabetes (Adults 20+), are particularly high in Mount Dennis (13.1%), Rockcliffe-Smythe (12.4%) and South Parkdale (11.4%). Rates of asthma (Adults 20+), are particularly high in Rockcliffe-Smythe (16.9%), New Toronto (15.1%), and Mount Dennis (14.9%). Rates of high blood pressure (Adults 20+), are particularly high in Mount Dennis (23.6%), Rockcliffe- Smythe (22.8%) and New Toronto (21.2%). Rates of mental health visits (Adults 20+), are particularly high in Mimico and New Toronto, but also high in multiple neighbourhoods as well. Rates of COPD (Adults 35+), are particularly high in New Toronto (13.7%) and South Parkdale (10.8%). 30

West Toronto: Disease Prevalence Rates by Neighbourhoods (2014/15) Age standardized Rates Neighbourhood Diabetes (Ages 20+) Asthma (Ages 20+) High Blood Pressure (Ages 20+) Mental Health Visits (Ages 20+) COPD (Ages 35+) Edenbridge-Humber Valley 8.10% 13.70% 20.20% 9.40% 7.50% High Park North 6.00% 11.00% 16.40% 9.50% 7.00% High Park-Swansea 5.90% 12.60% 16.90% 10.00% 6.90% Junction Area 9.40% 13.90% 18.60% 10.30% 7.60% Kingsway South 5.40% 13.90% 16.50% 8.70% 6.20% Lambton Baby Point 7.50% 13.90% 18.60% 9.80% 7.10% Mimico 8.30% 13.20% 19.80% 10.70% 10.20% Mount Dennis 13.10% 14.90% 23.60% 9.70% 10.10% New Toronto 9.70% 15.10% 21.20% 10.90% 13.70% Rockcliffe-Smythe 12.40% 16.90% 22.80% 10.30% 10.20% Roncesvalles 8.20% 13.20% 17.10% 10.00% 8.90% Runnymede-Bloor West Village 7.20% 13.40% 17.60% 9.50% 6.60% South Parkdale 11.40% 12.70% 19.40% 9.70% 10.80% Stonegate-Queensway 7.30% 13.00% 19.90% 9.30% 8.40% WEST TORONTO 8.5% 13.4% 19.3 9.9% 8.8% Toronto Central LHIN 8.4% 12.7% 18.3% 9.4% 8.6% Source: Ontario Community Health Profiles Partnership, Extracted: 2016 31

Age-Standardized Rate West Toronto: Diabetes Prevalence Rates by Neighbourhood (2014/15) 14.0 12.0 10.0 8.0 6.0 5.4 Age-Standardized Rate of Diabetes for Population 20+, (2014/15) 9.4 8.1 8.2 8.3 7.2 7.3 7.5 5.9 6 13.1 12.4 11.4 9.7 Toronto Central LHIN Rate: 8.4% West Toronto Sub-Region Prevalence Rate 8.5% Toronto Central LHIN Prevalence Rate : 8.4% 4.0 2.0 0.0 West Sub-Region has a similar prevalence rate of diabetes as compared to Toronto Central LHIN. Rates of diabetes are particularly high in Mount Dennis, Rockcliffe-Smythe and South Parkdale. Source: Toronto Community Health Profiles Partnership, Extracted: 2016 32

Age-Standardized Rate West Toronto: Asthma Prevalence Rates by Neighbourhood (2014/15) 18.0 16.0 14.0 12.0 10.0 8.0 6.0 4.0 2.0 0.0 Age-Standardized Rate of Asthma for Population 20+, (2014/15) 16.9 14.9 15.1 12.6 12.7 13 13.2 13.2 13.4 13.7 13.9 13.9 13.9 Toronto Central LHIN Rate: 12.7% 11 West Toronto Sub-Region Prevalence Rate 13.4% Toronto Central LHIN Prevalence Rate : 12.7% West Toronto Sub-Region has a higher prevalence rate of asthma as compared to Toronto Central LHIN. Rates of asthma are particularly high in Rockcliffe-Smythe, New Toronto, and Mount Dennis. Source: Toronto Community Health Profiles Partnership, Extracted: 2016 33

Age-Standardized Rate West Toronto: High Blood Pressure (HBP) Prevalence Rates by Neighbourhood (2014/15) 25.0 20.0 15.0 Age-Standardized Rate of HBP for Population 20+, (2014/15) 23.6 22.8 21.2 19.4 19.8 19.9 20.2 18.6 18.6 16.4 16.5 16.9 17.1 17.6 Toronto Central LHIN Rate: 18.3% West Toronto Sub-Region Prevalence Rate 19.3% Toronto Central LHIN Prevalence Rate: 18.3% 10.0 5.0 0.0 West Toronto Sub-Region has a higher prevalence rate of high blood pressure than Toronto Central LHIN. Rates of HBP are particularly high in Mount Dennis, Rockcliffe-Smythe and New Toronto Source: Toronto Community Health Profiles Partnership, Extracted: 2016 34

Age-Standardized Rate West Toronto Mental Health Visit Prevalence Rates by Neighbourhood (2014/15) 12.0 10.0 8.0 6.0 Age-Standardized Rate of Mental Health Visits for Population 20+, (2014/15) 8.7 10.7 10.9 9.3 9.4 9.5 9.5 9.7 9.7 9.8 10 10 10.3 10.3 Toronto Central LHIN Rate: 9.4% West Toronto Sub-Region Prevalence Rate 9.9% Toronto Central LHIN Prevalence Rate: 9.4% 4.0 2.0 0.0 West Toronto Sub-Region has the second highest prevalence rate of mental health visits of all 5 regions. Rates of Mental Health Visits are particularly high in New Toronto and Mimico but also high in multiple neighbourhoods as well. Source: Toronto Community Health Profiles Partnership, Extracted: 2016 35

Age-Standardized Rate West Toronto Chronic Obstructive Pulmonary Disease (COPD) Prevalence Rates by Neighbourhood (2014/15) 16.0 14.0 Age-Standardized Rate of COPD for population aged 35+, (2014/15) 13.7 West Sub-Region Prevalence Rate 8.8% 12.0 10.0 8.0 6.0 6.2 6.6 6.9 7 7.1 7.5 7.6 8.4 8.9 10.1 10.2 10.2 10.8 Toronto Central LHIN Rate: 8.6% Toronto Central LHIN Prevalence Rate: 8.6% 4.0 2.0 0.0 Overall, West Sub-Region has a prevalence rate of COPD similar to Toronto Central LHIN. Rates of COPD are particularly high in New Toronto and South Parkdale Source: Toronto Community Health Profiles Partnership, Extracted: 2016 36

Section 4: Health Service Use A. Emergency Department Care B. Inpatient Services C. Community Services Use 37

4a) Emergency Department (ED) Care Overall Age standardized rates of ED Visits (By Neighbourhood, Sub- Region and LHIN), ED Visits by Disposition Status, High Urgency and Low Urgency ED visits by Age group, ED Visits by Hospital and LHIN of Visit, Growth in ED visits, Reason for ED Visits 38

Key Highlights Health Service Use Emergency Department Utilization In FY 2014/15, there were approximately of 97,275 ED visits by West Toronto residents. The majority (82.7%) of visits were discharged home after they presented to the ED, and 11% were admitted to an inpatient unit. Majority of visits by West Toronto residents were to St Josephs Health Centre (51%) followed by Trillium Queensway(10%). Residents who visited hospitals outside of Toronto Central LHIN went to Mississauga Halton LHIN (13.8%); Central LHIN (9.5%) and Central West LHIN (1.4%). Overall, age standardized rate of ED visits per 1,000 population (All Ages 0+, Both Sexes) for West Toronto (409.8/1,000) was above the Toronto Central LHIN rate (353/1,000). Only Runnymede-Bloor West Village and Kingsway South neighbourhoods are below the Toronto Central LHIN rate for ED visits. For high urgency visits, Mount Dennis and South Parkdale had high rates. For low urgency visits, New Toronto, Mimico and Stonegate Queensway had the highest rates. All of the neighbourhoods except Mount Dennis in West Toronto are above the Toronto Central LHIN rate of 92.4 for age standardized low urgency visits. High rates of urgent ED visits are noted in South Parkdale, Mount Dennis, Roncesvalles among the following age groups : 45-64, 65-74 age groups. For 75+, South Parkdale, Junction Area and Roncesvalles have notably high rates of urgent ED visits. The majority of the neighbourhoods in West Toronto are above the Toronto Central LHIN rate of 260.7/1,000 for age standardized high urgency visits. High rates of urgent ED visits are noted in South Parkdale, Mount Dennis, Roncesvalles among the following age groups : 45-64, 65-74 age groups. For 75+, South Parkdale, Junction Area and Roncesvalles have notably high rates of urgent ED visits. ED visit volumes from FY 2010/11 to FY 2014/15 for Toronto Central LHIN rose by 9.8%. Neighbourhoods that have experienced high increases in ED visit volumes during this period include Mount Dennis (21.7%), Mimico (14.6%) and Edenbridge Humber Valley (11.6%) and Stonegate-Queensway (11.2%) Nearly half of the visits (43.8%) were for injuries/poisonings or abnormal signs and symptoms. Women (417/1,000) had a higher rate of ED visits than men (401/1,000) 39

Rate Per 1,000 Population West Toronto: Emergency Visits by Neighbourhood (FY 2014/15) 600 500 400 300 200 Age-Standardized Rate of ED Visits for Populations Ages 0+ in West Toronto Sub-Region Neighbourhoods (2014/15) Toronto Central LHIN Rate: 353.1 West Toronto agestandardized rate of ED visits per 1,000 population 409.8/1,000 (Toronto Central LHIN ED Visit rate: 353.1) 100 0 Only Runnymede-Bloor West Village and Kingsway South neighbourhoods are below the Toronto Central LHIN rate for ED visits. Source: Toronto Community Health Profiles Partnership, Extracted: 2016 40

West Toronto: Overall ED Visit Rates Per 1,000 Population, by Age group (2014/15) Neighbourhood Name All Ages (Age standardized) Age 0-4 Age 5-19 Age 20-44 Age 45-64 Age 65-74 Age 75+ Edenbridge-Humber Valley 362.6 559.6 289.6 347.5 313.8 355.4 803.3 High Park North 380 566.4 333.9 302 357.8 551 903.8 High Park-Swansea 395.3 531.2 392.4 353.7 336.2 460.8 771.3 Junction Area 414.6 539.4 313 367.2 435.7 478.9 959 Kingsway South 300.1 369.9 309.7 278.8 216.3 326.6 678.7 Lambton Baby Point 367.3 564.1 318.3 357.1 280.1 546.8 542.5 Mimico 448.4 697.3 416.5 384.2 409 560.5 868.7 Mount Dennis 476 766.5 302.9 469 491.6 555.4 778.9 New Toronto 431.5 686.7 322 404.2 418.1 562.3 721.1 Rockcliffe-Smythe 431.5 607 302.3 445.3 408.5 488.2 684 Roncesvalles 428.2 460.8 345.8 354.8 461.4 657.8 935.5 Runnymede-Bloor West Village 346.6 507.5 339.9 299.4 264.1 464.2 780.2 South Parkdale 490.4 617.3 302 387.4 671.6 713.1 1012.3 Stonegate-Queensway 399.2 653.8 382.5 366.3 322.4 458.8 698.4 West Toronto 409.8 590.5 336.4 369.5 394.2 513.6 794.2 Toronto Central LHIN 353.1 517.7 276.8 305.3 350.1 480.2 749.4 Source: Ontario Community Health Profiles Partnership, Extracted: 2016 41

West Toronto: Percent of ED Visits by Disposition Status (FY 2014/15) Proportion of ED Visits by Disposition Status for West Toronto Residents (FY 2014/15) 1.30% 0.90% 0.30% 3% Discharged Home 11.90% Client Admitted Client Left without being seen Discharged to place of Residence Transferred to another Hospital 82.70% Intrafacility transfer to clinic Source: National Ambulatory Care Reporting System (NACRS), FY2014/15, MOHLTC, IntelliHealth (Extracted: 2016) 42

Rate Per 1,000 Population Rate Per 1,000 Population Rate Per 1,000 Population Rate Per 1,000 Population West Toronto: All Emergency Department (ED) Visits That Are High Urgency (2014/15) Age Standardized Rate of High Urgency ED Visits for Ages 0+ in West Toronto Sub-Region Neighbourhoods (2014/15) Rate of ED Visits That Are High Urgency for Ages 0-4 in West Toronto Sub-Region Neighbourhoods (2014/15) 1000 900 800 700 600 500 400 300 200 100 0 388.1 371 338.4 318.8 304.3 303 281.7 279.6 276.5 260.2 256.3 250.6 245.7 188.5 Toronto Central LHIN Rate: 260.7 1000 900 800 700 600 500 400 300 200 100 0 559 474.3 469.8 430.8 426.4 401 400.9 372.6 371.7 361.9 361.3 346.4 333.3 232.3 Toronto Central LHIN Rate: 344.3 1000 900 800 700 600 500 400 300 200 100 0 Rate of ED Visits That Are High Urgency for Ages 5-19 in West Toronto Sub-Region Neighbourhoods (2014/15) Rate of ED Visits That Are High Urgency for Ages 20-44 in West Toronto Sub-Region Neighbourhoods (2014/15) 1000 900 800 700 600 500 383 400 347.2 282.9 246.1 235.6 227.2 257.6 220.8 253.4 218.4 217.3 251.1 300 248.5 212.4 246.7 244 243.6 207.2 202.9 202.4 197.2 228.4 212.9 176.4 207.8 154.6 148.2 177.8 200 Toronto Central LHIN Rate: 170.8 100 Toronto Central LHIN Rate: 221.4 0 Source: Ontario Community Health Profiles Partnership, Extracted: 2016 43

Rate Per 1,000 Population Rate Per 1,000 Population Rate Per 1,000 Population West Toronto: All Emergency Department (ED) Visits That Are High Urgency (2014/15) Rate of ED Visits That Are High Urgency for Ages 45-64 in West Toronto Sub-Region Neighbourhoods (2014/15) Rate of ED Visits That Are High Urgency for Ages 65-74 in West Toronto Sub-Region Neighbourhoods (2014/15) 1000 900 800 700 600 500 400 300 200 100 0 522.2 412.2 356.1 328.4 328 287.5 282.7 264.8 246.9 223.6 214.8 199.6 183.1 137.8 Toronto Central LHIN Rate: 270.1 1000 900 800 700 600 500 400 300 200 100 0 607.2 546.8 475.9 446.6 443.4 436.4 434 421.3 404.1 356.6 353.1 349.1 289.2 Toronto Central LHIN Rate: 399.0 236.7 Seniors 75+ have the highest rate of high urgency ED visits followed by children aged 0-4. There is considerable variation by age among the neighbourhoods. Mimico, Mount Dennis, High Park Swansea have high rates of high urgency ED visits for 0-19 age group. For 20-44, high rates of urgent ED visits are noted in Mount Dennis and Rockcliffe Smythe. For 45-74, South Parkdale, Mount Dennis and Roncesvalles have high rates of ED visits. 1000 900 800 700 600 500 400 300 200 100 0 Rate of ED Visits That Are High Urgency for Ages 75+ in West Toronto Sub-Region Neighbourhoods (2014/15) 914.9 858.1 814.5 804.6 727.7 714.3 697 679.3 662.3 613.5 584.5 569.6 553 Toronto Central LHIN Rate: 669.6 455.2 For 75+, South Parkdale, Junction Area and Roncesvalles have high rates of ED visits. Source: Ontario Community Health Profiles Partnership, Extracted: 2016 44

Rate Per 1,000 Population Rate Per 1,000 Population Rate Per 1,000 Population Rate Per 1,000 Population West Toronto: All Emergency Department (ED) Visits That Are Low Urgency (2014/15) 250 200 150 100 Age-Standardized Rate of ED Visits That Are Low Urgency in West Toronto Sub-Region Neighbourhoods (2014/15) 149.8 145.3 142.9 119.4 115.7 112 111.6 110.3 109.4 107.2 103.5 100.9 93.1 Toronto Central LHIN Rate: 92.4 87.9 250 200 150 100 Rate of ED Visits That Are Low Urgency for Ages 0-4 in West Toronto Sub-Region Neighbourhoods (2014/15) 227.5 226.3 222.9 216.3 212.4 207.5 191.5 180.6 Toronto Central LHIN Rate: 173.3 178.1 165.5 159.5 145.6 137.6 114.4 50 50 0 0 Rate of ED Visits That Are Low Urgency for Ages 5-19 in West Toronto Sub-Region Neighbourhoods (2014/15) Rate of ED Visits That Are Low Urgency for Ages 20-44 in West Toronto Sub-Region Neighbourhoods (2014/15) 250 250 200 180.9 180.2 161.6 146.3 145.6 200 150 100 135.1 126.7 124.9 121.5 Toronto Central LHIN Rate: 106.1 110 105.9 104.8 84.9 75.7 155.7 138 150 133 110.3 109.7 109.7 104.4 103.9 101.4 101 98.1 91.6 89.1 85.9 100 Toronto Central LHIN Rate: 83.9 50 50 0 0 Source: Ontario Community Health Profiles Partnership, Extracted: 2016 45

Rate Per 1,000 Population Rate Per 1,000 Population Rate Per 1,000 Population West Toronto: All Emergency Department (ED) Visits That Are Low Urgency (2014/15) 250 200 Rate of ED Visits That Are Low Urgency for Ages 45-64 in West Toronto Sub-Region Neighbourhoods (2014/15) 250 200 Rate of ED Visits That Are Low Urgency for Ages 65-74 in West Toronto Sub-Region Neighbourhoods (2014/15) 149.4 135.4 121.5 126 117.1 115.1 112.8 111 106 105.6 104.4 104.2 89.9 150 100 107.5 107.3 105.2 93 90.2 89.3 81.1 80.6 80.5 79.4 78.4 150 100 79.5 74.8 66.9 66.2 50 0 Toronto Central LHIN Rate: 80.0 50 Toronto Central LHIN Rate: 81.2 0 Children aged 0-4 have the highest rates of low urgency ED visits followed by 5-19 age group. Rate of ED Visits That Are Low Urgency for Ages 75+ in West Toronto Sub-Region Neighbourhoods (2014/15) Mimico, Stonegate Queensway, Edenbridge Humber Valley have high rates of low urgency ED visits for 0-19 age group. For 20-44, New Toronto, Stonegate Queensway and Mimico have high rates of ED visits 250 200 150 100 141 136.6 128.8 125.7 121.1 108.9 106.3 100.9 100.9 99.2 97.4 87.4 70.6 64.7 High rates of low urgency ED visits are noted in South Parkdale, New Toronto and Mimico among the 45-74 age category. 50 0 Toronto Central LHIN Rate: 79.8 For the 75+ age category, Mimico, New Toronto and Stonegate Queensway have high rates of ED visits. Source: Ontario Community Health Profiles Partnership, Extracted: 2016 46

West Toronto: Emergency Department Visits by Hospital and LHIN of Visit (FY 2014/15) Trillium - Mississauga 3% Hospital for Sick Children 3% St. Michael's Hospital 3% Mount Sinai Hospita l 4% UHN - Western 6% UHN - TGH 3% Humber - York/Finch 1% All Others 8% Humber - Memorial 8% Trillium - Queensway 10% St. Joseph s Health Centre 51% LHIN of Hospital Visit # of ED Visits % of Total ED Visits TORONTO CENTRAL 70,366 72.3% MISSISSAUGA HALTON 13,285 13.7% CENTRAL 9,254 9.5% CENTRAL WEST 1,400 1.4% NORTH SIMCOE MUSKOKA 727 0.7% CENTRAL EAST 697 0.7% SOUTH WEST 395 0.4% HAMILTON NIAGARA HALDIMAND BRANT (HNHB) 332 0.3% CHAMPLAIN 221 0.2% NORTH-EAST 191 0.2% SOUTH EAST 170 0.2% WATERLOO WELLINGTON 148 0.2% ERIE ST. CLAIR 57 0.1% NORTH-WEST 32 0.0% Grand Total 97,275 100.0% Source: National Ambulatory Care Reporting System (NACRS), MOHLTC, IntelliHealth (Extracted: 2016) 47

Rate per 1,000 Population West Toronto: Emergency Department Visit Rates (FY 2014/15) 500 Age-Standardized rate of ED visits per 1,000 population, All Ages 450 400 350 300 250 200 150 100 50 0 401.5 417.0 409.8 354.6 351.7 353.1 Male Female Both sexes West Toronto Toronto Central LHIN Age standardized rates of ED visits for all ages in West Toronto is above the Toronto Central LHIN average for both Males and Females Women have a higher rate of ED visits than Men Source: Ontario Community Health Profiles Partnership, Extracted: 2016 48

West Toronto: Percent Change in ED Visit Volumes from FY 2010/11 to FY 2014/15 25.0% 20.0% 21.7% Toronto Central LHIN % Change in ED Visit Volumes since FY 2010/11 15.0% 10.0% Toronto Central LHIN Rate: 9.6% 8.5% 10.1% 11.2% 11.6% 14.6% 9.6% 5.0% 0.0% -5.0% -2.1% -1.1% -0.8% 0.0% 1.9% 4.5% 5.7% 5.9% Neighbourhoods that have experienced significantly high increases in ED visit volumes since FY 2010/11: Mount Dennis Mimico Edenbridge-Humber Valley Stonegate-Queensway Source: National Ambulatory Care Reporting System (NACRS), MOHLTC, IntelliHealth (Extracted: 2016) 49

% of Total ED Visits West Toronto Reason for Emergency Department Visits (FY 2014/15) 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% Percent of ED visits by Reason of Visit (FY 2014/15) 8.8% 0.1%0.4%0.5% 1.0% 1.4%1.6%1.6%1.8% 3.6%3.7%4.2% 5.2%5.3%5.3%5.3% 6.3% 20.4% 23.4% Number of ED Visits in 2014/15 in West Toronto 97,275 (23.5% of total for Toronto Central LHIN residents) Nearly half (43.8%) of ED Visits in West Toronto sub-region are for injuries/poisonings or abnormal signs and symptoms Source: National Ambulatory Care Reporting System (NACRS), MOHLTC, IntelliHealth (Extracted: 2016) 50

4b) Use of Inpatient Services All hospitalizations, medical, surgical, prenatal, mental health, ambulatory care sensitive conditions (ACSC), alternate level of care (ALC) 51

Key Highlights Health Service Use: Inpatient Utilization In 2011/12, there were a total of 37,525 hospitalizations by West Toronto residents. Overall there was wide variation in all hospitalizations among the West Toronto neighbourhoods ranging from 64.3/1,000 to 91.6/1,000. A significant number of neighbourhoods were above the Toronto Central LHIN rate for all hospitalizations. The neighbourhoods with the highest rate of hospitalizations include: New Toronto (91.6), South Parkdale (90.2), Mount Dennis (87.8). For Medical Conditions: Most neighbourhoods were above the Toronto Central LHIN rate (14/1,000) for medical conditions. The neighbourhoods with the highest rate of hospitalizations include: South Parkdale (23.8), Roncesvalles (18.4), Junction Area (18.4), New Toronto (18.3), Mount Dennis (18). For Surgical Conditions: Most neighbourhoods were above the Toronto Central LHIN rate (7.9/1,000) for surgical conditions. The neighbourhoods with the highest rate of hospitalizations include: Lambton Baby Point (9.4), Kingsway South (9.2) and High Park North (9.1). For Pre-natal Conditions: All neighbourhoods apart from Edenbridge-Humber Valley were above the Toronto Central LHIN rate (17.1/1,000) for pre-natal conditions. The neighbourhoods with the highest rate of hospitalizations include: Runnymede-Bloor West Village (29.6), Lambton Baby Point (28.6), and Mount Dennis (28.2). For Mental Health Conditions: Most neighbourhoods are below the Toronto Central LHIN rate (722/100,000)for mental health conditions. South Parkdale s rate (2,237.3) is extremely high as compared to the other neighbourhoods as well as the Toronto Central LHIN rate. For Ambulatory Care Sensitive Conditions: Majority of the neighbourhoods in West Toronto sub-region are above the Toronto Central LHIN rate of 284.4/100,000 The neighbourhoods with the highest rate of hospitalizations for ambulatory care sensitive conditions are: South Parkdale (608.1), Roncesvalles (498.7), New Toronto (492.3). For % ALC Days: Neighbourhoods with highest % ALC Days: High Park Swansea (19.6), High Park North (18.7), South Parkdale (18.5), Mimico (18.3).For all neighbourhoods, Seniors have the highest rates of % ALC Days. 52

West Toronto: Inpatient Service Use Summary by Neighbourhood Neighbourhood Neighbourhood All Hospitalizations Age-adjusted average annual rate of hospitalizations Medical Conditions Surgical Conditions Pre-Natal Conditions Mental Health Conditions Ambulatory Care Sensitive Conditions Percent of Hospital Days that are ALC % ALC Days (All Ages) % ALC Days(65+) Edenbridge-Humber Valley 65.7 13.2 7.6 16.2 442.1 238 15.1 19.2 High Park North 71.4 16.2 9.1 18.1 758.4 319.7 18.7 25.8 High Park-Swansea 73.8 15.1 8.5 17.8 586.5 141 19.6 26.1 Junction Area 69 18.4 8.5 24.7 826.5 305.6 12.9 19.6 Kingsway South 64.3 9.3 9.2 19.1 419.1 106.8 15.7 20.2 Lambton Baby Point 69 15.6 9.4 28.6 556.7 223 14.3 19.9 Mimico 67.8 16.4 8.6 23.5 596.9 337.3 18.3 25.8 Mount Dennis 87.8 18 8.1 28.2 837.8 337.8 14.2 20.4 New Toronto 91.6 18.3 8.3 22.3 660.7 492.3 14.2 18.6 Rockcliffe-Smythe 83.4 15.3 8.5 26.9 685.6 338.1 15 22.5 Roncesvalles 79.8 18.4 8.3 22.7 867.6 498.7 14.2 19.7 Runnymede-Bloor West Village 84 13.2 8 29.6 637.6 146.4 12.7 21.5 South Parkdale 90.2 23.8 7.6 19.2 2,237.3 608.1 18.5 24.9 Stonegate-Queensway 76.4 13.4 8.4 25.5 373.2 211.2 17 22.8 Toronto Central LHIN 72.1 14 7.9 17.1 722 284.4 14.0 19.7 Source: Ontario Community Health Profiles Partnership, Extracted: 2016 53

Rate per 1,000 Population West Toronto: Hospital Admissions: All Hospitalizations by Neighbourhood (2011-12) 100.0 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 Age-adjusted average annual rate of all hospitalizations per 1,000 population, All Ages (2011-12) 64.3 65.7 67.8 69.0 69.0 71.4 73.8 76.4 79.8 83.4 84.0 87.8 90.2 91.6 Toronto Central LHIN Rate: 72.1 Rate of Hospitalizations in Toronto Central LHIN (per 1,000): 72.1 A significant number of neighbourhoods are above the Toronto Central LHIN rate. The neighbourhoods with the highest rate of hospitalizations include: New Toronto (91.6) South Parkdale (90.2) Mount Dennis (87.8) 54 Source: Toronto Community Health Profiles Partnership, Extracted: 2016

Rate per 1,000 Population West Toronto: Hospital Admissions: Hospitalizations for Medical Conditions by Neighbourhood (2011-12) 25.0 20.0 15.0 10.0 Age-adjusted average annual rate of hospitalizations for medical conditions per 1,000 population, All Ages (2011-12) 9.3 13.2 13.2 13.4 15.1 15.3 15.6 16.2 16.4 18 18.3 18.4 18.4 23.8 Toronto Central LHIN Rate: 14.0 Rate of Hospitalizations for Medical Conditions in Toronto Central LHIN (per 1,000): 14.0 Most neighbourhoods are above the Toronto Central LHIN rate. 5.0 0.0 The neighbourhoods with the highest rate of hospitalizations include: South Parkdale (23.8) Roncesvalles (18.4) Junction Area (18.4) New Toronto (18.3) Mount Dennis (18) Source: Toronto Community Health Profiles Partnership, Extracted: 2016 55

Rate per 1,000 Population West Toronto: Hospitalizations for Surgical Conditions (2011-12) 10.0 9.0 8.0 7.0 Age-adjusted average annual rate of hospitalizations for surgical conditions per 1,000 population, All Ages (2011-12) 7.6 7.6 9.1 9.2 9.4 8 8.1 8.3 8.3 8.4 8.5 8.5 8.5 8.6 Toronto Central LHIN Rate: 7.9 Rate of Hospitalizations for Surgical Conditions for Toronto Central LHIN (per 1,000): 7.9 6.0 5.0 4.0 3.0 2.0 Most neighbourhoods are above the Toronto Central LHIN rate. 1.0 0.0 The neighbourhoods with the highest rate of hospitalizations include: Lambton Baby Point (9.4) Kingsway South (9.2) High Park North (9.1) Source: Toronto Community Health Profiles Partnership, Extracted: 2016 56

Rate per 1,000 Population West Toronto: Hospitalizations for Prenatal Conditions, Women, Ages 15-49 (2011-2012) Age-adjusted average annual rate of hospitalizations for prenatal conditions per 1,000 population (2011-2012) 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 16.2 17.8 18.1 19.1 19.2 22.3 22.7 23.5 24.7 25.5 26.9 28.2 28.6 29.6 Toronto Central LHIN Rate: 17.1 Rate of Hospitalizations for Prenatal Conditions for Toronto Central LHIN (per 1,000): 17.1 All neighbourhoods apart from Edenbridge-Humber Valley are above the Toronto Central LHIN rate. The neighbourhoods with the highest rate of hospitalizations include: Runnymede-Bloor West Village (29.6) Lambton Baby Point (28.6), and Mount Dennis (28.2). Prenatal Condition: Prenatal hospitalizations refer to pregnancy related hospitalizations before childbirth Source: Toronto Community Health Profiles Partnership, Extracted: 2016 57

Rate per 100,000 Population West Toronto: Hospitalizations for Mental Health Conditions, Ages 20+ (2012/13 2013/14) 2,500.0 Age-standardized average annual rate of hospitalizations for mental health conditions per 100,000 population (2012/13 and 2013/14) 2237.3 Rate of Hospitalizations for Mental Health Conditions in Toronto Central LHIN (per 100,000): 2,000.0 722.0 1,500.0 1,000.0 500.0 Toronto Central LHIN Rate: 722..0 373.2 419.1 442.1 556.7 586.5 596.9 637.6 660.7 685.6 758.4 826.5 837.8 867.6 Most neighbourhoods are below the Toronto Central LHIN rate. 0.0 South Parkdale s rate (2,237.3) is extremely high as compared to the other neighbourhoods as well as the Toronto Central LHIN rate. Source: Toronto Community Health Profiles Partnership, Extracted: 2016 58

Rate per 100,000 Population West Toronto: Hospitalizations for Ambulatory Care Sensitive Conditions, Ages 20-74 (2012/13 and 2013/14) 700.0 600.0 500.0 Age-standardized average annual rate of hospitalizations for ambulatory care sensitive conditions per 100,000 population (2012/13 and 2013/14) 492.3 498.7 608.1 Total Rate of Hospitalization for ACSC for Toronto Central LHIN (per 100,000): 284.4 400.0 300.0 200.0 100.0 106.8 141 146.4 211.2 223 238 305.6 319.7 337.3 337.8 338.1 Toronto Central LHIN Rate: 284.4 The neighbourhoods with highest rate of hospitalizations for ambulatory care sensitive conditions are: 0.0 South Parkdale (608.1) Roncesvalles (498.7 New Toronto (492.3) Source: Toronto Community Health Profiles Partnership, Extracted: 2016 59

% ALC Days in Hospital West Toronto: Percent of Hospital Days that are Alternate Level of Care (ALC), All Ages (2011-12) Percent of hospital days that are ALC, All Ages (2011-12) 25.0 19.6 20.0 18.3 18.5 18.7 17.0 15.7 15.0 15.1 15.0 14.2 14.2 14.2 14.3 12.7 12.9 Toronto Central LHIN Rate: 14% Percent (%) ALC Days in Toronto Central LHIN (2011/12): 14.0% 10.0 5.0 0.0 Neighbourhoods with highest % ALC Days: High Park Swansea (19.6%) High Park North (18.7%) South Parkdale (18.5%) Mimico (18.3%) 60 Source: Toronto Community Health Profiles Partnership, Extracted: 2016

% ALC Days in Hospital West Toronto: Percent of Hospital Days that are Alternate Level of Care (ALC), Age 65+ (2011-12) 30.0 25.0 20.0 15.0 Percent of hospital days that are ALC, Age 65+ (2011-12) 25.8 25.8 26.1 24.9 22.5 22.8 21.5 19.2 19.6 19.7 19.9 20.2 20.4 Toronto Central LHIN Rate: 19.7% 18.6 Percent (%) ALC Days in Toronto Central LHIN (2011/12) for residents above age 65: 19.7% 10.0 5.0 0.0 Neighbourhoods with highest % ALC Days for Seniors : High Park Swansea (26.1%) High Park North (25.8%) Mimico (25.8%) South Parkdale (24.9%) 61 Source: Toronto Community Health Profiles Partnership, Extracted: 2016

4c) Community Health Service Use from Community Business Intelligence (CBI) Data i. Community-based Addictions Treatment-Substance Abuse ii. Community-based Case Management-Mental Health Service use iii. Community-based Meals Delivery 62

Considerations about Community Business Intelligence (CBI) Data Community Business Intelligence (CBI) database captures client demographics, admissions, and discharges at the functional centre level from community-based health service providers (HSPs) in the Toronto Central LHIN. Currently, implementation is still in progress across the Toronto Central LHIN; therefore, data for some functional centres are incomplete due to pending upgrades to HSP client management systems. HSPs that were not uploading to CBI in FY2015-16 have been noted where applicable. These missing data should be considered when interpreting the maps and tables. Some client records are missing postal code information and Toronto Central LHIN residents who access services from providers based in other LHINs are not recorded; therefore, overall service utilization, especially in neighbourhoods along the Toronto Central LHIN boundaries, is inherently undercounted and should be regarded as a minimum value. Finally, a small number of health service providers with funding from multiple LHINs may combine data from service locations outside of the Toronto Central LHIN when programs from multiple funders share the same functional centre. 63

Key Highlights: Community Health Service Use in West Toronto Addiction Treatment Substance Abuse The West and Mid-West Toronto Sub-Regions have the highest volume and utilization rates for Addictions Treatment-SA services. Roncesvalles has the highest volume in the West Toronto Sub-Region and the Toronto Central LHIN. This may be driven by postal codes recorded at Breakaway Addictions Services which is based in this neighbourhood. Case Management Mental Health Overall, the number of clients is significantly correlated with the number of service providers (r = 0.97, p < 0.01) which suggests a strong relationship between proximity and service utilization. Most sub-regions except for West Toronto have higher utilization in neighbourhoods along subway lines. Volumes in the West Toronto Sub-Region appears to be highest in and around the sub-region s three neighbourhood improvement areas (Mount Dennis, South Parkdale and Rockcliffe Smythe). South Parkdale has the highest volume and rates in the West Toronto Sub-Region. Meals on Wheels Most Meals on Wheels catchment areas span multiple sub-regions. Service utilization is more uniform across neighbourhoods compared to other functional centres. Due to missing data in three out of the five sub-regions, service patterns cannot be assessed with confidence. 64

West Toronto: Addictions Treatment-Substance Abuse Utilization in 2015-16 Clients Served by Sub-Region of Residence West Toronto 326 28% Mid-West Toronto 423 36% North Toronto 87 7% Mid-East Toronto 154 13% East Toronto 177 15% Toronto Central LHIN 1,167 100% Outside of Toronto Central LHIN 1,239 No Postal Code 284 Total Clients 2,690 How to read the map: The size of the circles represents the count of active clients per neighbourhood within the Toronto Central LHIN. The colour gradation represents the rate of addictions treatment-substance abuse utilization per 10,000 adults (over 16 years old) in each neighbourhood for the West Toronto sub region. The neighbourhoods with the largest circles have the highest number of people using the service and the neighbourhoods with the darkest shading have the highest proportion of people utilizing the service relative to the overall population Roncesvalles has the highest volume in the West Toronto Sub-Region for Addictions Treatment- Substance Abuse services. Breakaway Addictions Services and Jean Tweed Centre are the providers based in West Toronto delivering Addictions Treatment-Substance Abuse services 65

West Toronto: Addictions Treatment-Substance Abuse Health Service Providers that serve West Toronto residents in 2015-16 HSPs based in West Toronto Sub-Region Breakaway Addiction Services* Jean Tweed Treatment Centre* HSPs based in other Sub-Regions University Health Network (Mid-West) Hospital for Sick Children (Mid-West) Centre for Addiction and Mental Health (Mid- West) 416 Community Support for Women (Mid-East) Pine River Institute (Mid-East) St. Stephen's Community House (Mid-West) Salvation Army Homestead- Harbour Light Centre (Mid-East) *denotes highest volume HSPs that serve >50% of all clients in Sub-Region 66

West Toronto: Case Management-Mental Health in 2015-16 Clients Served by Sub-Region of Residence West Toronto 415 22% Mid-West Toronto 529 28% North Toronto 104 5% Mid-East Toronto 536 28% East Toronto 318 17% Toronto Central LHIN 1,902 100% Outside of Toronto Central LHIN 956 No Postal Code 2,126 Total Clients 4,984 How to read the map: The size of the circles represents the count of active clients per neighbourhood within the Toronto Central LHIN. The colour gradation represents the rate of case management-mental health utilization per 10,000 adults (over 16 years old) in each neighbourhood for the West Toronto sub region. The neighbourhoods with the largest circles have the highest number of people using the service and the neighbourhoods with the darkest shading have the highest proportion of people utilizing the service relative to the overall population Volume in the West Toronto Sub-Region appears to be highest in and around the sub-region s three neighbourhood improvement areas (Mount Dennis, South Parkdale and Rockcliffe Smythe). South Parkdale has the highest volume and rates in the West Toronto Sub-Region. 67

West Toronto: Case Management-Mental Health Service Providers that serve West Toronto residents in 2015-16 HSPs based in West Toronto Sub-Region Reconnect Community Health Services* Regeneration House Inc.* Parkdale Activity - Recreation Centre Jean Tweed Treatment Centre HSPs based in other Sub-Regions Fred Victor Centre (Mid-East) LOFT Community Services (Mid-East) Cota Health (Mid-East) Central Toronto Youth Services - New Outlook (Mid-East) Native Canadian Centre of Toronto (Mid-West) Sistering - A Woman's Place (Mid-West) 416 Community Support for Women (Mid-East) Street Health Community Nursing Foundation (Mid-East) Alternatives (East) West Neighbourhood House (Mid-West) *denotes highest volume HSPs that serve >50% of all clients in Sub-Region HSPs not uploading to CBI (Sub-Region name, clients budgeted for FY2015-16): Centre for Addiction and Mental Health (Mid-West, 233 clients) Michael Garron Hospital (East, 160 clients) St. Joseph s Health Centre (West, 75 clients) St. Michael s Hospital (Mid-East, 275 clients) 68

Meals on Wheels Methodological Notes Meals on Wheels service is delivered based on specific catchment areas For the purposes of comparing service rates with the population of seniors, individuals under 65 years old, or 15% of the sample size, have been excluded from this analysis. In addition, a small number of HSPs delivering meals were not uploading data to CBI as of the extraction date. These were: Canadian Red Cross Society, Ontario Zone East York Meals on Wheels (East) Yorkminster Park Meals on Wheels Meals Delivery services are largely structured on a non-overlapping catchment basis. Areas covered by HSPs that were not uploading to CBI are indicated as No Primary HSP Data" on the maps. Because of these geographical gaps in the data, service volume totals have not been calculated for each sub-region (see next slide). 69

West Toronto: Meals on Wheels Catchment Areas in 2015-16 70

West Toronto: Meals on Wheels Utilization in 2015-16 Because non-toronto Central LHIN providers are not currently uploading to CBI, utilization patterns for this sub-region could not be assessed. How to read the map: The size of the circles represents the count of active clients per neighbourhood within the Toronto Central LHIN. The colour gradation represents the rate of Meals on Wheels utilization per 10,000 adults (over 16 years old) in each neighbourhood for the West Toronto sub region. The neighbourhoods with the largest circles have the highest number of people using the service and the neighbourhoods with the darkest shading have the highest proportion of people utilizing the service relative to the overall population 71