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Age- and sex-specific income gradients in alcohol-related hospitalization rates in an urban area.

https://arctichealth.org/en/permalink/ahliterature177156
Source
Ann Epidemiol. 2005 Jan;15(1):56-63
Publication Type
Article
Date
Jan-2005
Author
Stephen W Hwang
Mohammad M Agha
Maria I Creatore
Richard H Glazier
Author Affiliation
Inner City Health Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada. hwangs@smh.toronto.on.ca
Source
Ann Epidemiol. 2005 Jan;15(1):56-63
Date
Jan-2005
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Alcohol-Related Disorders - economics - epidemiology
Female
Hospitalization - statistics & numerical data
Humans
Income
Male
Middle Aged
Ontario - epidemiology
Residence Characteristics
Social Class
Urban Health - statistics & numerical data
Abstract
This study examines the effects of age and sex on the relationship between neighborhood income and alcohol-related hospitalization rates in a large urban area.
Adults in Toronto, Canada, who were hospitalized with an alcohol-related condition between 1995 and 1998 were identified using discharge diagnoses. Income quintiles were determined based on area of residence. Annual rates of hospitalization for alcohol-related conditions per 10,000 individuals were calculated.
Rates of hospitalization with a primary diagnosis of an alcohol-related condition were similar among men age 20 to 39 in all incomes quintiles, but were inversely associated with income among men age 40 to 64 (28.8 and 13.3 per 10,000 in the lowest and highest income quintiles). Among women age 40 to 64, the lowest income quintile had the highest hospitalization rate (12.1 per 10,000), but women in all other income quintiles had relatively low hospitalization rates (5.9 to 7.7 per 10,000). As age increased above 65 years, rates of hospitalization with a primary diagnosis of an alcohol-related condition decreased or stabilized in both men and women.
The inverse association between income level and alcohol-related hospitalization rates becomes apparent after age 40. A gradient in hospitalization rates is seen in men across all income levels, but in women a prominent effect is seen only in those with the lowest income.
PubMed ID
15571994 View in PubMed
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Assessment of police calls for suicidal behavior in a concentrated urban setting.

https://arctichealth.org/en/permalink/ahliterature171591
Source
Psychiatr Serv. 2005 Dec;56(12):1606-9
Publication Type
Article
Date
Dec-2005
Author
Flora I Matheson
Maria I Creatore
Piotr Gozdyra
Rahim Moineddin
Sean B Rourke
Richard H Glazier
Author Affiliation
Centre for Research on Inner City Health, St. Michael's Hospital, and Department of Public Health Sciences, University of Toronto, Ontario, Canada. mathesonf@smh.toronto.on.ca
Source
Psychiatr Serv. 2005 Dec;56(12):1606-9
Date
Dec-2005
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Canada
Crisis Intervention
Emergency Services, Psychiatric
Female
Hotlines
Humans
Male
Middle Aged
Police
Sex Factors
Suicide - prevention & control - psychology - trends
Urban Population
Abstract
As a result of deinstitutionalization over the past half-century, police have become frontline mental health care workers. This study assessed five-year patterns of police calls for suicidal behavior in Toronto, Canada. Police responded to an average of 1,422 calls for suicidal behavior per year, 15 percent of which involved completed suicides (24 percent of male callers and 8 percent of female callers). Calls for suicidal behavior increased by 4 percent among males and 17 percent among females over the study period. The rate of completed suicides decreased by 22 percent among males and 31 percent among females. Compared with women, men were more likely to die from physical (as opposed to chemical) methods (22 percent and 43 percent, respectively). The study results highlight the importance of understanding changes in patterns and types of suicidal behavior to police training and preparedness.
PubMed ID
16339628 View in PubMed
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Density, destinations or both? A comparison of measures of walkability in relation to transportation behaviors, obesity and diabetes in Toronto, Canada.

https://arctichealth.org/en/permalink/ahliterature256371
Source
PLoS One. 2014;9(1):e85295
Publication Type
Article
Date
2014
Author
Richard H Glazier
Maria I Creatore
Jonathan T Weyman
Ghazal Fazli
Flora I Matheson
Peter Gozdyra
Rahim Moineddin
Vered Kaufman Shriqui
Gillian L Booth
Author Affiliation
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada ; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada ; Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada ; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada ; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Source
PLoS One. 2014;9(1):e85295
Date
2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Behavior
Bicycling
Child
Child, Preschool
Diabetes Mellitus - epidemiology - physiopathology
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Obesity - epidemiology - physiopathology
Ontario - epidemiology
Population Density
Transportation - statistics & numerical data
Walking
Young Adult
Abstract
The design of suburban communities encourages car dependency and discourages walking, characteristics that have been implicated in the rise of obesity. Walkability measures have been developed to capture these features of urban built environments. Our objective was to examine the individual and combined associations of residential density and the presence of walkable destinations, two of the most commonly used and potentially modifiable components of walkability measures, with transportation, overweight, obesity, and diabetes. We examined associations between a previously published walkability measure and transportation behaviors and health outcomes in Toronto, Canada, a city of 2.6 million people in 2011. Data sources included the Canada census, a transportation survey, a national health survey and a validated administrative diabetes database. We depicted interactions between residential density and the availability of walkable destinations graphically and examined them statistically using general linear modeling. Individuals living in more walkable areas were more than twice as likely to walk, bicycle or use public transit and were significantly less likely to drive or own a vehicle compared with those living in less walkable areas. Individuals in less walkable areas were up to one-third more likely to be obese or to have diabetes. Residential density and the availability of walkable destinations were each significantly associated with transportation and health outcomes. The combination of high levels of both measures was associated with the highest levels of walking or bicycling (p
Notes
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PubMed ID
24454837 View in PubMed
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Diabetes screening among immigrants: a population-based urban cohort study.

https://arctichealth.org/en/permalink/ahliterature126770
Source
Diabetes Care. 2012 Apr;35(4):754-61
Publication Type
Article
Date
Apr-2012
Author
Maria I Creatore
Gillian L Booth
Douglas G Manuel
Rahim Moineddin
Richard H Glazier
Author Affiliation
Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada. creatorem@smh.ca
Source
Diabetes Care. 2012 Apr;35(4):754-61
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cohort Studies
Diabetes Mellitus - diagnosis - epidemiology
Emigrants and Immigrants - statistics & numerical data
Female
Health Status Disparities
Healthcare Disparities - statistics & numerical data
Humans
Male
Mass Screening
Middle Aged
Ontario - epidemiology
Retrospective Studies
Urban Population - statistics & numerical data
Abstract
To examine diabetes screening, predictors of screening, and the burden of undiagnosed diabetes in the immigrant population and whether these estimates differ by ethnicity.
A population-based retrospective cohort linking administrative health data to immigration files was used to follow the entire diabetes-free population aged 40 years and up in Ontario, Canada (N = 3,484,222) for 3 years (2004-2007) to determine whether individuals were screened for diabetes. Multivariate regression was used to determine predictors of having a diabetes test.
Screening rates were slightly higher in the immigrant versus the general population (76.0 and 74.4%, respectively; P
Notes
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PubMed ID
22357181 View in PubMed
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Inadequacy of cervical cancer screening among urban recent immigrants: a population-based study of physician and laboratory claims in Toronto, Canada.

https://arctichealth.org/en/permalink/ahliterature163875
Source
Prev Med. 2007 Jun;44(6):536-42
Publication Type
Article
Date
Jun-2007
Author
Aisha Lofters
Richard H Glazier
Mohammad M Agha
Maria I Creatore
Rahim Moineddin
Author Affiliation
Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
Source
Prev Med. 2007 Jun;44(6):536-42
Date
Jun-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Communication Barriers
Educational Status
Emigration and Immigration - statistics & numerical data
Female
Health Care Surveys
Humans
Insurance Claim Reporting - statistics & numerical data
Mass Screening - statistics & numerical data
Middle Aged
Minority Groups
Ontario
Papanicolaou test
Practice Guidelines as Topic
Quality of Health Care - statistics & numerical data
Registries
Residence Characteristics - statistics & numerical data
Socioeconomic Factors
Urban Health - statistics & numerical data
Uterine Cervical Neoplasms - diagnosis
Vaginal Smears - statistics & numerical data
Women's health
Abstract
In Canada, Pap smears are recommended from 18 to 69. Self-reported socioeconomic gradients in screening have been documented in North America but there have been few direct measures of Pap smear use among immigrants or socially disadvantaged groups. Our purpose was to investigate whether socioedemographic factors are related to cervical cancer screening in Toronto, Canada.
Pap smears were identified using fee and laboratory codes in Ontario physician service claims for 3 years (2000-2002 inclusive) for women aged 18-66. Area-level socioeconomic factors were derived from the 2001 census. At the individual level, recent registrants for health coverage, over 80% of whom are expected to be recent immigrants, were identified as women first registering after January 1, 1993.
Among 724,584 women, 55.4% had Pap smears within 3 years. Recent immigration, visible minority, foreign language, low income and low education were all associated with significantly lower area rates. Recent registrants had much lower rates than non-recent registrants (36.9% versus 60.9%).
Pap smear rates in Toronto fall below those dictated by evidence-based practice. Recent registrants, a largely immigrant group, have particularly low rates. Efforts to improve coverage need to emphasize women who recently immigrated and those with socioeconomic disadvantage.
PubMed ID
17467782 View in PubMed
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Neighbourhood recent immigration and hospitalization in Toronto, Canada.

https://arctichealth.org/en/permalink/ahliterature179729
Source
Can J Public Health. 2004 May-Jun;95(3):I30-4
Publication Type
Article
Author
Richard H Glazier
Maria I Creatore
Andrea A Cortinois
Mohammad M Agha
Rahim Moineddin
Author Affiliation
Inner City Health Research Unit, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8. richard.glazier@utoronto.ca
Source
Can J Public Health. 2004 May-Jun;95(3):I30-4
Language
English
Publication Type
Article
Keywords
Adult
Canada
Emigration and Immigration - statistics & numerical data
Female
Health planning
Hospitalization - statistics & numerical data
Humans
Income
Male
Ontario
Urban health
Abstract
Recent immigrants to Canada tend to initially settle in low-income urban core areas. The relationships among immigration, neighbourhood effects and health are poorly understood. This study explored the risk of hospitalization in high recent-immigration areas in Toronto compared to other Toronto neighbourhoods. The study used 1996 hospitalization and census data. Regression was used to examine the effects of recent immigration on neighbourhood hospitalization rates. Most hospitalization categories showed significantly higher rates of admission as the proportion of recent immigrants increased. Income was also significantly associated with all categories of hospitalization except surgical admissions. Average household income was almost 60% lower (dollar 36,122) in the highest versus the lowest immigration areas (dollar 82,641) suggesting that, at the neighbourhood level, the effects of immigration and income may be difficult to disentangle. These findings have important implications for health care planning, delivery, and policy.
PubMed ID
15191130 View in PubMed
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Socioeconomic misclassification in Ontario's Health Care Registry.

https://arctichealth.org/en/permalink/ahliterature186001
Source
Can J Public Health. 2003 Mar-Apr;94(2):140-3
Publication Type
Article
Author
Richard H Glazier
Maria I Creatore
Mohammad M Agha
Leah S Steele
Author Affiliation
Inner City Health Research Unit, St. Michael's Hospital, Toronto, ON. richard.glazier@utoronto.ca
Source
Can J Public Health. 2003 Mar-Apr;94(2):140-3
Language
English
Publication Type
Article
Keywords
Humans
Income - classification
Ontario
Registries - standards
Residence Characteristics - classification
Social Class
Urban Population - classification
Abstract
Addresses in some provincial health care registries are not systematically updated. If individuals are attributed to the wrong location, this can lead to errors in health care planning and research. Our purpose was to investigate the accuracy of socioeconomic classification based on addresses in Ontario's provincial health care registry.
The study setting was Toronto's inner city, an area with a population of 799,595 in 1996. We ordered enumeration areas by 1996 mean household income and divided them into five roughly equal income groups by population. We then assigned an income quintile to each individual using both the address from Ontario's provincial heath care registry and that from hospital discharge abstracts. We compared these two sets of income quintiles and also used them to generate quintile-specific rates of medical hospital admissions in the year 2000.
Provincial registry and hospital-based addresses agreed on the exact enumeration area for 78.1% of individuals and for income quintile for 84.8% of individuals. Disagreement by more than one income quintile occurred for 7.4% of individuals. The two methods of assigning income quintiles yielded income-specific medical hospitalization rates and rate ratios that agreed within 1%.
Although address inaccuracy was found in Ontario's health care registry, serious socioeconomic misclassification occurred at a relatively low rate and did not appear to introduce significant bias in the calculation of hospital rates by socioeconomic group. Updating of addresses at regular intervals is highly desirable and would result in improved accuracy of provincial health care registries.
PubMed ID
12675172 View in PubMed
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Unwalkable neighborhoods, poverty, and the risk of diabetes among recent immigrants to Canada compared with long-term residents.

https://arctichealth.org/en/permalink/ahliterature120610
Source
Diabetes Care. 2013 Feb;36(2):302-8
Publication Type
Article
Date
Feb-2013
Author
Gillian L Booth
Maria I Creatore
Rahim Moineddin
Peter Gozdyra
Jonathan T Weyman
Flora I Matheson
Richard H Glazier
Author Affiliation
Centre for Research on Inner City Health, The Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada. boothg@smh.ca
Source
Diabetes Care. 2013 Feb;36(2):302-8
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adult
Canada - epidemiology
Cohort Studies
Diabetes Mellitus - epidemiology
Emigrants and Immigrants - statistics & numerical data
Environment Design
Female
Humans
Incidence
Male
Middle Aged
Residence Characteristics
Retrospective Studies
Walking
Abstract
This study was designed to examine whether residents living in neighborhoods that are less conducive to walking or other physical activities are more likely to develop diabetes and, if so, whether recent immigrants are particularly susceptible to such effects.
We conducted a population-based, retrospective cohort study to assess the impact of neighborhood walkability on diabetes incidence among recent immigrants (n = 214,882) relative to long-term residents (n = 1,024,380). Adults aged 30-64 years who were free of diabetes and living in Toronto, Canada, on 31 March 2005 were identified from administrative health databases and followed until 31 March 2010 for the development of diabetes, using a validated algorithm. Neighborhood characteristics, including walkability and income, were derived from the Canadian Census and other sources.
Neighborhood walkability was a strong predictor of diabetes incidence independent of age and area income, particularly among recent immigrants (lowest [quintile 1 {Q1}] vs. highest [quintile 5 {Q5}] walkability quintile: relative risk [RR] 1.58 [95% CI 1.42-1.75] for men; 1.67 [1.48-1.88] for women) compared with long-term residents (Q1 to Q5) 1.32 [1.26-1.38] for men; 1.24 [1.18-1.31] for women). Coexisting poverty accentuated these effects; diabetes incidence varied threefold between recent immigrants living in low-income/low walkability areas (16.2 per 1,000) and those living in high-income/high walkability areas (5.1 per 1,000).
Neighborhood walkability was inversely associated with the development of diabetes in our setting, particularly among recent immigrants living in low-income areas.
Notes
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PubMed ID
22988302 View in PubMed
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