Canadian Metropolitan Areas Research Articles

Mental health is positively associated with biodiversity in Canadian cities

Cities concentrate problems that affect human well-being and biodiversity. Exploring the link between mental health and biodiversity can inform more holistic public health and urban planning. Here we examined associations between bird and tree species diversity estimates from eBird community science datasets and national forest inventories with self-rated mental health metrics from the Canadian Community Health Survey. We linked data across 36 Canadian Metropolitan Areas from 2007-2022 at a postal code level. After controlling for covariates, we found that bird and tree species diversity were significantly positively related to good self-reported mental health. Living in a postal code with bird diversity one standard deviation higher than the mean increased reporting of good mental health by 6.64%. Postal codes with tree species richness one standard deviation more than the mean increased reporting of good mental health by 5.36%. Our results suggest that supporting healthy urban ecosystems may also benefit human well-being.

Acceptability of built environment interventions to support active travel in 17 Canadian metropolitan areas: findings from the THEPA study

Acceptability of built environment interventions to support active travel in 17 Canadian metropolitan areas: findings from the THEPA study

Shared versus pooled automated vehicles: Understanding behavioral intentions towards adopting on-demand automated vehicles

The success of future, on-demand AVs depends on whether and how the public adopts them as regular travel modes. To this end, this study has four objectives: (a) understand the effect of current travel behavior on adopting shared automated vehicles (SAVs) and pooled automated vehicles (PooledAVs), and accordingly, propose a theoretical model for behavioral intention to use on-demand AVs based on a mediation analysis; (b) identify the commonalities and differences between the characteristics of SAVs’ and PooledAVs’ early adopters; (c) investigate Canadian residents’ intentions to adopt on-demand AVs; and (d) differentiate between shared mobility-oriented and AV technology-oriented predictors to determine whether behavioral intentions are driven by enthusiasm for AV technology or linked to shared mobility. This study uses data from an online survey administered in fall 2021 to residents of six major Canadian metropolitan areas. Workers and students aged 18 to 75 were selected for analysis (n = 3622). The study employs a full structural equation model (SEM) and a partial mediation analysis. The SEM uses seven affective motivations: attitude towards a behavior, subjective norms, perceived behavioral control, driving enthusiasm, sensation seeking, ample knowledge about AVs, and eco-friendliness. The findings of this paper paint a complex picture with respect to the application of constructs from common technology adoption models to the study of on-demand AVs. Also, results suggest that although the characteristics of early adopters differ slightly among the examined service types, individuals with positive attitudes who are current users of ride-hailing services are likely to use both on-demand service types.

Does Subsidized Housing Facilitate More Sustainable Commute Patterns? Insights From Canadian Metropolitan Areas

Housing has become increasingly unaffordable, particularly in amenity-rich and transit-accessible areas. In this paper, we conduct an empirical analysis to investigate the relationship between living in subsidized housing and commuting patterns (mode and distance) in Toronto, Montreal, and Vancouver. We find that compared to otherwise similar individuals, those in subsidized dwellings have shorter and less auto-oriented commutes at statistically significant levels. The paper positions the discussion on subsidized housing in the broader context of the relationship between housing and sustainability, and within specific metropolitan geographies and histories of housing policies. In combination with prior research, the findings provide support for policies that promote investment in subsidized housing near transit as an affordability and sustainability strategy, particularly benefiting low-income renters.

An accessibility-based methodology to prioritize public-transit investments: Application to older adults in three metropolitan regions in Canada

As governments aim to promote a modal transfer away from motorized vehicles and toward transit, important investments in public-transit systems are becoming necessary. Prioritization of projects targeting underserved communities and careful choices between Fixed Route Transit (FRT) and Demand Responsive Transit (DRT) is therefore crucial to maximize benefits from investments. In this study, we develop a methodology to target and identify policy interventions to increase accessibility by public transit where it is low and apply it to serve older adults in three Canadian metropolitan areas. A conceptual framework is presented to inform the type of public transport (FRT or DRT) or land-use interventions most relevant to improve accessibility in each area. The methodology is then applied using existing accessibility to jobs by public transit at the Census Tract level and concentration of older adults. Multiple measures are tested for both criteria to assess the effect of methodological choices on policy recommendations. Findings show the selection process is sensitive to the measure used to quantify the concentration of older adults, but not to different job types as destinations. Socioeconomic and geographical differences are observed between the types of interventions proposed. The methodology developed in this study can be of value for practitioners as they aim to orient relevant policy changes to promote increased accessibility by public transit for underserved communities such as older adults. The framework and methodology developed can be easily adapted to different sociodemographic groups and different regions where jobs, census, GTFS and road network data are available.

Regionalization and Recent Immigrants’ Access to Jobs: An Analysis of Commuting in Canadian Metropolitan Areas

Examining the transportation modes used to commute by the growing numbers of immigrants locating in medium and small metropolitan areas, this study investigates the social geographies of mobility inequality, the uneven distribution of transportation burdens and benefits. Using microdata from the 2016 Census of Canada, we compare immigrants’ propensity to commute by car, transit, and active modes (cycling and walking) among large, medium, and small metropolitan areas and we analyze the varying determinants of commuting mode in each context. In every metropolitan context, recent immigrants are more likely than established immigrants and the Canadian-born to commute on transit or by active modes. Although recent immigrants’ use of public transportation declines from large to medium and small metropolitan areas, social differentials in reliance on public transportation persist. Women, workers who are not married, people who identify as non-White and non-Aboriginal and workers who do not have dependent children use transit and active modes more than other workers. Recent immigrant women’s reliance on alternative modes is striking in metropolitan areas of all sizes. The findings indicate that policies encouraging immigrants to settle in medium and small metropolitan areas should also include investments in public transportation and pedestrian-friendly environments to reduce mobility inequality and enhance equitable access to employment.

Impact of bilingual face, arm, speech, time (FAST) public awareness campaigns on emergency medical services (EMS) activation in a large Canadian metropolitan area.

Face, arm, speech, time (FAST) public awareness campaigns improve stroke recognition in the general population. Whether this translates into improved emergency medical services (EMS) activation remains unclear. We assessed the association of five consecutive FAST campaigns with EMS calls for suspected strokes in a large urban area of Quebec, Canada. We conducted an observational study to assess data collected between June 2015 and December 2019 by the public EMS agency covering the cities of Laval and Montreal (Quebec, Canada). Five FAST campaigns were held over this period (mean duration: 9weeks). We compared daily EMS calls before and after all FAST campaigns (2015 vs 2019) with t tests and Mann-Whitney U tests. We used single-group, univariate interrupted time series to measure changes in daily EMS calls for suspected strokes following each FAST campaign (stroke categories: any, symptom onset < 5h, Cincinnati Prehospital Stroke Scale [CPSS] 3/3). Calls for headache served as negative control. After five FAST campaigns, mean daily EMS calls increased by 28% (p < 0.001) for any suspected stroke and by 61% (p < 0.001) for stroke with symptom onset < 5h, compared to 10.1% for headache (p = 0.012). Significant increases in daily EMS calls were observed after three campaigns (highest OR = 1.26; 95%CI 1.11, 1.43; p < 0.001). There were no significant changes in calls after individual campaigns for suspected stroke with symptom onset < 5h, or suspected stroke with CPSS 3/3. We observed an inconsistent impact of individual FAST campaigns on EMS calls for any suspected stroke, and did not observe significant EMS call changes after individual campaigns for acute (< 5h) and severe (CPSS 3/3) strokes. These results may help stakeholders identify potential benefits and limitations of public awareness campaigns using the FAST acronym.

PSYCHOLOGICAL WELL-BEING IN OLDER ADULTS WITH TREATMENT-RESISTANT DEPRESSION

Abstract Geriatric psychiatry research has documented the importance of psychological well-being to older adults diagnosed with depression (Lenze et al., 2016). This presentation utilizes pre-treatment data from the Optimum Study of treatment-resistant depression in older adults recruited from five USA and Canadian metropolitan areas (N = 529). Social participation was measured with the PROMIS scale: Ability to Participate in Social Roles and Activities (Hahn et al., 2014). Positive affect and life satisfaction were assessed using scales from the Psychological Well-Being subdomain (Salsman et al., 2013) of the NIH Toolbox for Assessment of Neurological and Behavioral Function - Emotion Battery (NIHTB-EB). Along with associations between social participation and positive affect (r = .38, p &amp;lt; .01) and between social participation and life satisfaction (r = .26, p &amp;lt; .01), path analyses explored social participation as a mediator of the relationship between cognitive functioning (NIHTB-CB; Weintraub et al., 2013) and psychological well-being.

Residential proximity to greenness and adverse birth outcomes in urban areas: Findings from a national Canadian population-based study

BackgroundOver the last decade, several studies have reported that residential proximity to vegetation, or ‘greenness’, is associated with improved birth outcomes, including for term birth weight (TBW), preterm birth (PTB), and small for gestational age (SGA). However, there remain several uncertainties about these possible benefits including the role of air pollution, and the extent to they are influenced socioeconomic status. MethodsWe addressed these gaps using a national population-based study of 2.2 million singleton live births in Canadian metropolitan areas between 1999 and 2008. Exposures to greenness, fine particulate matter (PM2.5), and nitrogen dioxide (NO2) were assigned to infants using the postal code of their mother's residence at the time of birth. The Normalized Difference Vegetation Index (NDVI) was used to characterize greenness, while estimates of ambient PM2.5 and NO2 were estimated using remote sensing, and a national land-use regression surface, respectively. Multivariable regression analysis was performed to describe associations between residential greenness and the birth outcomes. Stratified analyses explored whether these associations were modified by neighbourhood measures of socioeconomic status. ResultsMothers who lived in greener areas had a lower risk of low TBW, PTB, and SGA babies. These associations persisted after adjustment for ambient NO2 and PM2.5. Specifically, in fully adjusted models, an interquartile range (IQR = 0.16) increase in the NDVI within a residential buffer of 250 m yielded odds ratios of 0.93 (95% confidence interval (CI): 0.92, 0.94), 0.94 (95% CI: 0.92, 0.95), and 0.94 (95% CI: 0.93, 0.95) for the outcomes of PTB, low TBW, and SGA, respectively. Similarly, an IQR increase in greenness was associated with a 16.3 g (95% CI: 15.3, 17.4) increase in TBW. We found inverse associations between greenness and the occurrence of adverse birth outcomes regardless of the socioeconomic status of the neighbourhood. InterpretationOur findings support the hypothesis that residential greenness contributes to healthier pregnancies, that these associations are independent from exposure to air pollution. , and that proximity to greenness benefits all mothers regardless of socioeconomic status.

Purpose-built rental housing and household formation among young adults in Canadian cities, 1991–2016

In recent decades, several Canadian cities have experienced a significant restructuring of their housing demand as young adult aspirations and expectations of maintaining independent households have been confronted by soaring housing costs, falling vacancy rates, and a rental supply system that is characterized by an overreliance on rental condominiums and other provisional forms of ‘secondary’ rental housing. The study presented in this paper focuses on intra-metropolitan variation in household formation among young adults and attempts to explain it from a macro perspective, emphasizing the importance of a community’s ‘primary’ or purpose-built rental sector. Following a review of the international literature on the impacts of housing supply and availability on household formation, panel regression models are estimated to examine the effects of changes in the relative supply and real cost of purpose-built rental housing on changes in young people’s household formation in Canadian metropolitan areas between 1991 and 2016. The results indicate that a 1% increase in the relative supply of purpose-built rental housing leads to 0.24% and 0.14% increases in the rates of family and non-family household formation of young adults. These estimates are generated using instrumental variables, controlling for potential simultaneity between household formation and purpose-built rental supply.

Walk/Wheelability: An Inclusive Instrument Pair for Participatory Age-Friendly Research and Practice.

Recent critical evaluations of age-friendly efforts have highlighted the need to prioritize the disenfranchised, including people with mobility limitations. This article examines the validity of a 13-item Stakeholders Walkability/Wheelability Audit in Neighborhoods (SWAN13) scale to measure the "walk/wheelability" of street segments from the perspectives of people with mobility limitations. Data were drawn from preliminary studies of the SWANaudit which was conducted in 2 Canadian metropolitan areas. Sixty-one participants who use mobility devices (e.g., walkers, power wheelchairs) and older adults from community organizations audited 195 street segments. We factor analyzed the data from their audits. SWAN13 has a 1-factor structure. 13 items were retained from 85 SWANaudit items. SWAN13 encompassed both physical and social aspects of walk/wheelability. The alpha for the scale was .79. Convergent validity was found with the University of Alabama Life-Space Assessment (ρ = .22, p = .003), especially at the neighborhood level (ρ = .23, p = .002). Significant correlation was also found with subjective assessments of a priori walk/wheelability domains (ρ = .63, p < .001). Walk/wheelability affects the life space of older adults and people with mobility limitations. It is an important latent variable that should be addressed to promote well-being and social participation. SWAN13 may be used in city-wide surveys to identify neighborhoods that may require age-friendly interventions from mobility perspectives. Detailed audits and interventions may be carried out in tandem using the paired SWANaudit instrument. Walk/wheelability is an inclusive and measurable concept that accounts for the needs of people with various mobility needs.

The Relationship Between Unexpected Outcomes and Lottery Gambling Rates in a Large Canadian Metropolitan Area

The purchase of lottery tickets is widespread in Canada, yet little research has directly examined when and why individuals engage in lottery gambling. By leveraging a large urban dataset of lottery sales in Toronto, Canada, and using a simple computational framework popular in psychology, we examined whether city residents gamble more when local outcomes are better than expected; for example, wins by local sports teams or amounts of sunshine based on recent weather history. We found that unexpectedly sunny days predict increased rates of fixed-prize lottery gambling. The number of local sports team wins also predicted increased purchase rates of fixed-prize lottery, but unexpected positive outcomes in sports did not. Our results extend previous findings examining the linkage between sunshine and gambling in metropolitan areas beyond the US, but do not fully replicate the previously observed relationships between unexpected sports outcomes and gambling in US cities. These results suggest that the observed malleability of lottery gambling in response to incidental events in the gambler’s environment may vary considerably across geographies.

Gentrification, Urban Interventions and Equity (GENUINE): A map-based gentrification tool for Canadian metropolitan areas.

Researchers, policy makers, and urban planners require tools to better understand the complex relationship between gentrification and health. The Gentrification, Urban Interventions and Equity (GENUINE) tool is an open-access, map-based tool that allows users to explore measures of gentrification for Canadian cities and incorporate them into their work. The phenomenon of gentrification has manifested differently across cities. The GENUINE tool was developed to include four distinct gentrification measures that have been used in the United States and Canada and that rely on different combinations of change in census indicators related to income, housing, occupation, education and age. The measures were computed for all census tracts within the 36 Canadian census metropolitan areas to identify gentrifiable areas in 2006 and those that gentrified between 2006 and 2016. Depending on the measure, by 2016, 2% to 20% of census tracts had experienced gentrification, corresponding to between 2% (418,065 people) and 17% (4,266,434) of the Canadian population living in gentrified areas. Generally, metropolitan areas with populations over 1 million people had a greater proportion of their population living in gentrified areas (2% to 18%) compared with metropolitan areas with fewer than 250,000 residents (1% to 14%). With attention on healthy cities only expanding, GENUINE provides pan-Canadian indicators of gentrification, which can be an integral part of solution-oriented research and advancing cities toward designing healthy and equitable communities.

Subcentres as Destinations: Job Decentralization, Polycentricity, and the Sustainability of Commuting Patterns in Canadian Metropolitan Areas, 1996–2016

Adopting more sustainable modes of transportation and shorter daily commutes remains a fundamental challenge in the struggle for the sustainable transition of cities. While past studies on the sustainability of commuting behaviours partly focused on the place of residence and how the characteristics of commuters or residential neighbourhoods impact sustainable travel, other studies looked at the place of employment to analyze these dynamics. In this study, we investigate the extent to which the recent phase of the rise of peripheral employment has promoted more sustainable travel behaviour, based on the hypothesis that polycentricity has recently favoured a better job–housing balance and co-location. We develop a general typology of employment centres, using Census microdata at fine spatial scale over the 1996–2016 period to observe commuting modes and distances by subcentre types for six major Canadian cities. Our results show that despite recent developments in planning practices—transit-oriented development, transport infrastructure, and changing travel behaviour, the emergence of peripheral subcentres promoted less sustainable commuting patterns in most Canadian metropolitan areas over the period. However, we find sustainable commuting emerging in subcentres where large public transport infrastructure investments have been made, such as in the case of Vancouver’s Millennium and Canada lines. Our study also shows that central business districts (CBDs) and downtown subcentres are becoming relatively more sustainable over the period, which confirms the positive effect of the back-to-the-city movement and changing behaviour toward active transportation in these locations.

Living in the South, Caring in the North: Exploring Inuit Women’s Care Responsibilities

The increased Inuit population in Canadian Metropolitan Areas (CMA) has recently gained attention among the scientific community as well as within Inuit organizations. However, existing literature has overlooked the distinct experience of Inuit women and, more significantly, the importance of care responsibilities in understanding women’s mobility. This study examines the relocation experiences of 46 Inuit women across five CMAs, and the role care sites play in initiating women’s relocation to cities. Results show the key role caregiving responsibilities play in Inuit women’s decisions to move to southern urban areas, as dysfunctional care spaces in the North push them away from their communities, and the potential for safer care sites in the South act as a pulling factor.

106 Neighbourhood socioeconomic deprivation and assault injuries in urban youth

Abstract Introduction/Background Youth violence is a major global public health concern. Assault injuries are a major cause of trauma among youth, yet the causes for and medical consequences of assault victimization in this group remain uncertain. Objectives Using data from the third-largest urban area in Canada, we sought to describe the demographic, temporal and geographic influences on the incidence of youth assault injuries. Design/Methods We performed a population-based cross sectional study of Canadian youth aged 10 to 24 years seeking emergency medical care between April 2012 and March 2018 at any of the 16 hospitals in a major Canadian metropolitan area. Injury characteristics were described using graphical and statistical techniques. Neighbourhood material and social deprivation indices were examined as independent predictors of the population incidence of youth assault injury using negative binomial regression and geospatial methods. Results A total of 2,784 assaulted youth sought emergency medical care during the 6-year study interval, corresponding to an incidence rate of 101 youth assault injuries per 100,000 person-years. Assaulted youth were most commonly males between 20 and 24 years of age. Prior diagnoses of substance use and mental health disorders were common. Examination of temporal variation in the incidence of assault injury revealed a 103-fold difference between the riskiest and safest hours of the week (incident rate ratio, 103). The risk of youth assault injury in the most materially deprived quintile of neighbourhoods was more than four-fold greater than that in the wealthiest quintile (incident rate ratio per quintile increase, 1.42; 95%CI [1.27, 1.59]; p &amp;lt;0.001), and the risk of youth assault injury in the most socially deprived quintile of neighbourhoods was more than twelve-fold greater than that in the least deprived quintile (incident rate ratio per quintile increase, 1.88; 95%CI [1.69, 2.11]; p &amp;lt;0.001). Conclusion Assault injuries among youth vary substantially across time and space. Targeted violence prevention interventions might focus on weekend evenings and on socioeconomically deprived neighbourhoods.

Measuring accessibility to hospitals by public transport: An assessment of eight Canadian metropolitan regions

IntroductionThe ability to access healthcare services has long been considered a ‘right’ by Canadian citizens and is protected as such under the Canada Health Act. However, socio-spatial factors can limit access to healthcare services, especially for vulnerable populations. This paper aims to quantify the spatial accessibility to healthcare services by public transport across eight major Canadian metropolitan areas and compare accessibility to healthcare across vulnerable population groups. This is the first study, to the authors’ knowledge, to conduct an assessment of accessibility to hospitals by public transport across multiple metropolitan regions in Canada, thereby allowing to identify common trends, challenges, as well as knowledge gaps. MethodsSpatial accessibility to general medical and surgical hospitals by public transport was measured through a two-step floating catchment area method, considering both service-to-population ratios and travel time to these health services. For each metropolitan area, the average accessibility of all census tracts and the average accessibility of the 20% most vulnerable census tracts were calculated. To quantify vertical equity, an indicator was subsequently developed using the Spearman’s rank correlation coefficient between accessibility and vulnerability. Main findingsWithin metropolitan areas (except for Vancouver), residents of vulnerable census tracts generally have greater access to hospitals by public transport. Yet, larger metropolitan areas (Calgary, Toronto-Hamilton, and Vancouver) tend to underperform in terms of vertical equity and average accessibility. In line with this, vulnerable census tracts in these metropolitan areas are characterized by the lowest levels of accessibility compared to vulnerable census tracts in the other metropolitan areas. ConclusionThis research highlights the challenges associated with the suburbanization of poverty in large Canadian metropolitan regions and the need to provide efficient public transport services to reach hospitals located in the periphery. It also shed lights on the necessity to conduct more empirical research to inform the implementation of guidelines in terms of accessibility to healthcare in Canada. This study is of relevance to researchers, planners and policy-makers wishing to improve accessibility to healthcare, especially for vulnerable populations.

Implications of Canadian youth views for measuring youth mental health from a socio-economic perspective.

Developing meaningful indicators to track youth mental health (MH) is important to support the development and evaluation of responsive mental health promotion (MHP) initiatives that address the socio-economic determinants of youth MH. Development of relevant indicators is challenged, however, by the lack of knowledge regarding the relations among socio-economic factors and youth MH. Thirty diverse young people from a Canadian metropolitan area were engaged within a process of social praxis to explore their experiences of the inter-relationship between their socio-economic environments and their MH and their processes of seeking to realize their MH. Participants emphasized 'needs' as foundational to MH, whereas 'wants', driven by materialistic and wealth-oriented values and social norms, constrained their MH. Their reflections on the inter-relations among their MH and socio-economic processes highlight eight inter-related MH needs within the Canadian socio-economic context. In this paper, we present these needs and show how these needs, young people's affective states, and their access to resources within co-evolving socio-economic processes (to enable their needs) illustrate the fundamental inter-relation between young people's MH and socio-economic processes. We identify implications for measuring youth MH within MHP practice, including the importance of iterative indicator frameworks that include measures of young people's access to resources to enable their MH needs and their degree of distress.

Human rights in countries of origin and the mental health of migrants to Canada.

This study explores the effect of human rights violations in countries of origin on migrants' mental health, using archival data on human rights violations from 1970-2011, merged to a representative probability sample of 2412 adults living in a large Canadian metropolitan area. The context of exit is defined at the country level, as opposed to self-reported individual experiences of trauma. While most studies start from a question about direct exposure to human rights violations, they may miss the effect of the national-level social context - threat, instability, disruption of lives, and uncertainty - on mental health. Findings indicate that high levels of human rights violations in countries of origin have long-term effects on migrants’ mental health. The impact of human rights violations is substantially explained by the combined effect of stressors both before and after migration, suggesting a cumulative process of stress proliferation following this context of exit.

Validation of Personality Inventory for DSM-5 (PID-5) algorithms to assess ICD-11 personality trait domains in a psychiatric sample.

The International Classification of Disease (11th ed.; ICD-11) personality disorder (PD) proposal characterizes personality psychopathology using an overall impairment severity dimension as well as dysfunctional personality style on the basis of five trait domain qualifiers: Negative Affectivity, Detachment, Dissociality, Disinhibition, and Anankastia. Recent research has indicated that trait facet scales from the Personality Inventory for DSM-5 (PID-5) can be used to index these five broad domains with promising construct validity. Our goal in the current study was to validate the PID-5 algorithms for the five ICD-11 trait domains with some minor adjustments based on the updated ICD-11 text. To this end, we used 343 psychiatric outpatients from a large Canadian metropolitan area, who had completed the PID-5, the Structured Clinical Interview for DSM-IV Axis II Disorders-Personality Questionnaire, the Minnesota Multiphasic Personality Inventory-2 Restructured Form, and the Revised NEO Personality Inventory. The factor structure of the ICD-11 domains was upheld, as expected, and associations with external measures of five-factor model and Personality Psychopathology Five personality traits as well as PD symptom counts adhered to a conceptually expected pattern. (PsycINFO Database Record (c) 2019 APA, all rights reserved).