Toronto’s increasingly diverse population is aging and higher rates of chronic diseases are being exacerbated by decreased screening during the pandemic, according to a newly released snapshot on the city’s health and wellbeing.
The 72-page document titled ‘Toronto’s Population Health Profile: Insight on the health of our city’ was presented during Tuesday’s monthly Board of Health meeting.
Toronto’s Medical Officer of Health Dr. Eileen De Villa said during a brief presentation to the board that after three years of living through a pandemic, Toronto’s new population health profile is an opportunity to “refresh our collective understanding of that which impacts the health of Torontonians.”
De Villa said it will in turn help to better determine what areas to focus on to improve the health of the city’s residents and address health inequities.
The local data found in the report - which comes as the city is assessing the short and long-term impacts of the COVID-19 pandemic on its wellbeing - is intended to be used by Toronto Public Health (TPH), City of Toronto divisions, health care partners, social service agencies, and other public and private sector organizations.
De Villa, in her remarks, said it’s important to note that Toronto is becoming more diverse with an estimated 56 per cent of the city’s population belonging to a racialized group. She added that Toronto’s residents are getting older, with those 65 and older jumping from 16 to 17 per cent between 2016 and 2021.
She also spoke about how the city is becoming increasingly expensive, pointing to the roughly one in five residents who experienced food insecurity in 2021, the 40 per cent of tenant households that spent more than 30 per cent of their income on shelter that year, and the more than 7,300 people experiencing homelessness on any given night.
Further, De Villa said that the city is also seeing the effects of climate change with increased temperatures and more extreme weather days, which she said not only impact property and infrastructure damage but also exacerbate chronic health conditions and other “climate-sensitive infectious diseases.”
Some of the key findings of Toronto’s Population Health Profile, which the city said it would use to inform decision-making, are that mental illness and mental health worsened for Toronto residents during the pandemic, especially for women, LGBTQ seniors, Indigenous people, racialized populations, people with disabilities, and children and youth. The report found that the monthly rate of mental health and addiction-related outpatient visits increased from 5 per 100 people prior to March 2020 to 6 per 100 people for the first two years of the pandemic until December 2021.
Opioid overdoses in the city also reached record levels in 2021, which De Villa said she has “no question” were exacerbated by the COVID-19 pandemic.
“2021, unfortunately, saw that opioid toxicity deaths in the city rose to 591 confirmed deaths and the really hard part here is that these are preventable,” she said, adding solving the substance abuse and drug poisoning crises requires a public health approach that includes the decriminalization of the personal possession of drugs, harm reduction, and treatment. She noted that TPH is in the process of is updating the Toronto Drug Strategy.
A working table on housing and homelessness and health is also being convened, De Villa said.
The report also found that there was a “significant decrease” in the testing and screening, especially for sexually transmitted infections during the pandemic.
“What we know is that there was an almost 40 per cent decrease in routine sexually transmitted infection testing for chlamydia and gonorrhea,” she said, pointing to “significant missed opportunities for treatment and prevention of longer term complications associated with these infections, as well as increased risk of infection transmission.”
The prevalence of diabetes among those aged 20 years and older also continued to increase, with the rate going from 11,936 per 100,000 people in 2011 to 13,008 per 100,000 people in 2020.
A growing number of Torontonians were also found to be overdue for breast, cervical, and colorectal cancer screenings in 2020, which can lead to later stage diagnoses and poorer outcomes.
Further, data from before the pandemic found that close to a quarter of all children and youth had received preventative oral care in the previous year, a statistics that is expected to have worsened due to pandemic-related closures.
Chronic disease and its risks were also found to be on the rise in Toronto.
The report noted that the emergence of infectious diseases on a global scale is a notable threat to the health of Torontonians.
“This update to the City’s health status is a great appraisal of the situation on the ground for our residents. The data and findings in the Toronto Population Health Profile demonstrate that we are heading toward a serious crisis if we don’t act,” Councillor Chris Moise, chair of the Board of Health, said in a release.
“Stakeholders, government partners and all those involved in health care – including mental health care and addiction services – need to be engaged and at the table if we are going to make improvements on these dire situations.”
Speaking with CP24 late Tuesday afternoon following the announcement of provincial legislation expanding the role of private clinics to perform surgeries, De Villa said the Toronto’s Population Health Profile isn’t just about access to health care, but instead focuses on what actually “contributes to health.”
She said not one single issue stands out to her in the newly released report as the “factors that contribute to our health are broad and far reaching, and that is really the fundamental point.”
De Villa went on to say that despite the many challenges outlined in the city health and wellness snapshot, notably the significant lag in Torontonians getting breast, cervical, and colorectal screenings, there’s still an opportunity to recognize the good work that has been done under difficult circumstances and build on that.
“We've seen what we're able to achieve through the COVID-19 response and I know that when we work in concert with our partners, health care, and community service partners, we are actually able to achieve a great deal in support of the health of the residents of this city,” De Villa said, adding today’s new legislation may help with getting people the health care services they need, but ultimately the role of Toronto Public Health is to work with health care providers to figure out how to best address the screening challenges noted in the report. This could also include ensuring people are aware of the need for screening, that they understand its benefits, and assist them to securing access to that service, she added.
Going forward, De Villa said some of TPH’s focus areas would include improving mental health, vaccinating people against human papillomavirus, and finding ways to better care for those with liver cancer.
