Neighbourhood Health

Does it take you more than 10 minutes to walk to the nearest shops? Does your street wind on forever without a crossroad? If so, your neighbourhood may be bad for your health.

Gillian Booth, an endocrinologist and a professor in the department of medicine, already knew that a community’s design can affect the physical activity levels of its residents. But she wanted to find out if this translated into higher rates of Type 2 diabetes, especially among immigrants. Many Toronto newcomers arrive from regions such as the Middle East, Africa and India, where members of the population are known to be genetically susceptible to the disease. She speculated that suddenly embracing a western-style diet high in fat and refined sugar and a sedentary lifestyle could lead to higher rates of diabetes among new Canadians.

So Booth and colleagues at U of T and St. Michael’s Hospital developed a tool to rate the “walkability” of different parts of Toronto. Then they looked at all people aged 30 to 64 living in the city on April 1, 2005 who had been covered by OHIP for at least three years but did not have diabetes. They identified recent immigrants as people who had first registered for OHIP in the 10 years before.

When they checked to see how many of the group developed diabetes in the subsequent five years, they saw an association: the less walkable the neighbourhood, the higher the incidence of diabetes among its
residents. As feared, immigrants were the hardest hit. The incidence of diabetes was 50 per cent higher in the least walkable areas compared to the most walkable areas, and when poverty was added into the mix, it was 200 per cent higher. “It’s very hard for people who depend on local opportunities to be physically active if they live in places like these,” says Booth, adding that Canadians should rethink how we build communities. We could set minimum standards for density and public transit, for instance, and reevaluate how development happens, she says.