Piloting the Use of Concept Mapping to Engage Geographic Communities for Stress and Resilience Planning in Toronto, Ontario, Canada.

Martha Ta,Ketan Shankardass

doi:10.3390/ijerph182010977

Abstract

The physical and social characteristics of urban neighborhoods engender unique stressors and assets, contributing to community-level variation in health over the lifecourse. Actors such as city planners and community organizations can help strengthen resilience in places where chronic stress is endemic, by learning about perceived stressors and assets from neighborhood users themselves (residents, workers, business owners). This study piloted a methodology to identify Toronto neighborhoods experiencing chronic stress and to engage them to identify neighborhood stressors, assets, and solutions. Crescent Town was identified as one neighborhood of interest based on relatively high levels of emotional stress in Twitter Tweets produced over two one-year periods (2013–2014 and 2017–2018) and triangulation using other neighborhood-level data. Using concept mapping, community members (n = 23) created a ten-cluster concept map describing neighborhood stressors and assets, and identified two potential strategies, a Crescent Town Residents’ Association and a community fair to promote neighborhood resources and build social networks. We discuss how this knowledge has circulated through the City of Toronto and community-level organizations to date, and lessons for improving this methodology.

Highlights

This pilot study focused on enabling this process by engaging people who live or work in one Toronto neighborhood, Crescent Town, to identify sources of chronic stress that could be addressed through interventions; as well as existing neighborhood assets that could be integrated into interventions
In understanding that chronic stress is multifactorial and iterative, this study’s findings presented the neighborhood users’ identified neighborhood issues that cause them chronic stress, including some physical, social, and natural attributes of the neighborhood. This community knowledge created opportunities for different stakeholders to engage in neighborhood planning, including which areas need more attention to be paid by policymakers and service providers to understand where gaps need to be bridged between services and neighborhood users
This study highlights the valuable assets that make this neighborhood unique for its users and that Crescent Town is a resilient neighborhood in Toronto because of its neighborhood users, community services, and accessibility and security

Summary

Introduction

Health inequalities are commonly measured within urban settings, with neighborhoodlevel variation in health outcomes routinely identified [1,2]. There is increasing recognition of the role of chronic stress as an important mediator of intra-urban inequalities [5]; action to identify and address the sources of chronic stress at the neighborhood level are uncommon. Chronic stress is an overlooked target for health promotion and prevention in cities. Stress is often conceptualized as a psychological process or state rather than a health outcome, a wealth of evidence and theory connects chronic stress to a range of physiological and psychological processes that

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