Toronto Community Health Essay

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Toronto

TSNS

The Toronto Strong Neighbourhoods Strategy exists to support "healthy communities across Toronto by partnering with residents, businesses and agencies to invest in people, services, programs and facilities in specific neighbourhoods" (Toronto.ca, 2015). The objective of this program is to "strengthen the social, economic and physical conditions and deliver local impact for city-wide change" (Toronto.ca). The methodology is that the City Council selects neighbourhoods that will become Neighbourhood Improvement Areas. There are 140 of these that have been designated within the City of Toronto. The goal is to identify the needs of these neighbourhoods, and by providing targeted resources to key areas of weakness, to improve these neighbourhoods with respect to programs and services. One of the key aspects is that program will get feedback from each community about what its needs are, and how well the city has performed under this program to meet those needs.

The program was launched in 2005, with 13 neighbourhoods having been selected. The latest iteration is Toronto Strong Neighbourhoods Strategy 2020, and new neighbourhoods will be featured (Toronto.ca, 2015). Some of the categories for programs are newcomers, seniors and youth. Newcomers are a target group, as the city is a magnet for immigrants and one of the most diverse cities in the world, and newcomers benefit significantly from having access to programs that help them better integrate into Canadian society. Seniors and youth are two groups that have also been shown to benefit from social programs, and their benefit is a significant quality of life issue. Wellbeing Toronto is another facet of this program, where there are measures tabulated for each neighbourhood in the city to track its social and economic progress (Toronto.ca, 2015).

The premises that underlying the Strong Neighbourhood Strategy are threefold. First, this is a City of Toronto strategy, so part of the underlying logic is that the City has the ability to deliver services that will make a difference in the quality of life for the people living in these neighbourhoods. The second premise is that by working with local stakeholders, the City can determine which neighbourhoods are most in need of such programs, and the stakeholders can also provide critical insights into what services are most needed. The third underlying premise of this program is that delivery of services should be at the local level, especially direct human services as described in this program.

TSNS is implemented by the City. It points to the fact that it has been able to gather a lot of information about the city's neighbourhoods, and has been able to identify the areas of the city that require the most assistance through this program.

UrbanHeart

UrbanHeart is a research body that seeks to measure the outcomes for each of Toronto's 140 neighbourhoods. Some of the things that are being measured are economic opportunities, civic engagement, human development, physical environment and infrastructure, and population health (Toronto.ca, 2015). UrbanHeart was originally created by the World Health Organization (Ibid). The methodology is based on a different set of premises than those that are at work in TSNS. At TSNS, the core belief is that direct feedback from the stakeholders is one of the best ways to learn about the needs of a neighbourhood. In essence, TSNS is qualitative in nature.

By contrast, the UrbanHeart system is quantitative and data-driven. The first premise is that the system development by the WHO can be of use in Toronto. The second is that gathering data will be a productive means of learning about the needs of the different neighbourhoods in the city. The third premise at work is that the city can continually learn from the measures in UrbanHeart -- the inquiry is more closed-ended than that of TSNS, which marks a fundamental difference in philosophy.

The UrbanHeart methodology was first developed in 2008 (WHO, 2015), so this is the first time it has been used in Toronto. It uses data that is publicly available to paint a picture of the different neighbourhoods and its proponents tout its abilities to help make sense of all of the data that are available for the different social outcome measures. The outcome is a survey that can be presented to Council that explains these outcomes for each neighbourhood, thus justifying the sorts of investments as would occur under the TSNS.

Poverty

The TSNS has published an information sheet on poverty in the City. It argues that 25% of children under 14 live in poverty, a total of over 100,000. It gives the population of Torontonians living in conditions of poverty at 374,530 (Toronto.ca, 2015). It also notes that many groups are more vulnerable to poverty than others. The defined income levels of poverty according to the information are $820 monthly for single adults, $1,465 for single parents, $2,055 for two-parent families (Ibid). Shepherd (2014) notes that UrbanHeart measures poverty in terms of things like unemployment rates, social assistance usage or the percentage of residents considered to be low income.

Thus, both of these tools defines poverty in quantitative terms, and both use data that are already published, typically census data. While there is some qualitative understanding of poverty, numbers are the basis for determining the number of people in each neighbourhood that are living under conditions of poverty. It is entirely statistical.

Youth Entrepreneurial Work

Youth entrepreneurial work can prove to be a valuable pathway out of poverty. The TSNS notes that many of the traditional pathways out of poverty are less effective than they used to be, noting for example that 23% of college graduates are working low-wage jobs -- there is significant stratification in the job market, leaving those without strong skills to work only low-end jobs that do not pay well and do not provide a path out of poverty (Toronto.ca, 2015). There are significant barriers to starting a business, ranging from red tape to the need for startup capital Youth entrepreneurial work, in particular with the help of an incubator, can remove some of the barriers to entry for many youth. Ultimately, when faced with the choice between low-paying jobs and jobs that provide an opportunity to tap into the skills and education that the young people have, and allow them to find their own ceiling, there is little doubt that the latter will be an effective poverty reduction strategy.

It is worth remembering that unattached people living alone, young people, recent immigrants and single parents are all among the most vulnerable to poverty. Further, when such programs are targeted at other at-risk groups, such as First Nations or racialized communities, the effects of opportunity become amplified. The measures that have been developed are basic measures based on income, and therefore any opportunity that people within the community have to increase their income should have a positive impact. Remember as well that entrepreneurial activity has a cascading effect, where successful small businesses must hire, and in many cases that hiring will first come from the same community that received the support in the first place.

I see the impact that I am predicting because such entrepreneurial programs represent an infusion of capital and a reduction in barriers to startups, two factors that reduce risk and encourage more people to engage in entrepreneurial activity. Not every business will succeed, but many will, and those that will can deliver the economic benefits to the community to the extent that such businesses increase the aggregate economic activity in the region, and if successful should also reduce unemployment as well.

Community Health Indicators

Community health indicators provide a means for authorities to understand what the actual state of health is in a given community. Aggregate statistics for health are not always gathered, unless a body like the City decides to gather them. In a city the size of Toronto, underperforming neighbourhoods can be buried under the weight of all the successful neighbourhoods. As a result, these indicators can point to specific neighbourhoods or health indicator that are underachieving, and target them for improvement.

Mothers and children are at-risk groups, especially during childbirth, so there are significant opportunities to improve health outcomes, when problem areas have been identified. The use of community health indicators provides an opportunity for health administrators and government to target their resources in such a manner as to improve health outcomes for children and mothers. Thus, the use of community health indicators can and should have a positive impact on childbirth and childhood by reducing the likelihood and intensity of medical issues among this group.

References

Shepherd, L. (2014). Toronto researchers adapt World Health Organization tool to measure the health and well-being of the city's neighbourhoods. St. Michael's Hospital. Retrieved March 13, 2015 from http://www.stmichaelshospital.com/media/detail.php?source=hospital_news/2014/20140226a_hn

Toronto.ca (2015). Website, various pages. Retrieved March 13, 2015 from http://www1.toronto.ca/wps/portal/contentonly?vgnextoid=42653745ba9a9410VgnVCM10000071d60f89RCRD

WHO. (2015). Urban health equity assessment and response tool (UrbanHEART). World Health Organization. Retrieved March 18, 2015 from http://www.who.int/kobe_centre/measuring/urbanheart/en/

Pages referenced within Toronto.ca:

"What is the strategy?" http://www1.toronto.ca/wps/portal/contentonly?vgnextoid=23cdced78eeb2410VgnVCM10000071d60f89RCRD&vgnextchannel=42653745ba9a9410VgnVCM10000071d60f89RCRD

"How will neighbourhoods be selected?" http://www1.toronto.ca/wps/portal/contentonly?vgnextoid=cfffced78eeb2410VgnVCM10000071d60f89RCRD&vgnextchannel=42653745ba9a9410VgnVCM10000071d60f89RCRD

"What will happen in Neighbourhood Improvement Areas?" http://www1.toronto.ca/wps/portal/contentonly?vgnextoid=0051ced78eeb2410VgnVCM10000071d60f89RCRD&vgnextchannel=42653745ba9a9410VgnVCM10000071d60f89RCRD…[continue]

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