Census Subdivision Research Articles

Cycling and Pedestrian Injuries in the Region of Peel, Ontario; An application of linked administrative health data to enhance local road safety and health service delivery, through an Applied Health Research Question (AHRQ)

ObjectivesAn Applied Health Research Question request from Peel Public Health was investigated, to provide a comprehensive overview of injury patterns and healthcare utilization, among cyclists and pedestrians in the Peel Region of Ontario. ApproachEmergency department visits and hospitalizations across the Peel region were analyzed from 2018 to 2022, and categorized by collision type (pedestrian, cyclist motor vehicle collision (MVC), and cyclist non-MVC). Data was segmented quarterly and annually, and further stratified by residence status, sex, and age, by linking individuals to other administrative health databases. Additionally, 30-day mortality outcomes were evaluated. To contextualize incidence rates with population demographics, Public Health Data Zone and Census Subdivision data were also utilized. ResultsFor ambulatory visits, a substantial majority of Peel residents received treatment within the region, evidenced by 4,483 cyclist visits (55%) and 1,338 pedestrian visits (50%). However, a noteworthy portion of Peel residents — 188 cyclists (45%) and 182 pedestrians (46%) — received treatment outside the region. Hospitalization patterns echoed these visits. Overall, non-MVCs accounted for a large proportion of cycling incidents, particularly among females, stressing the need for targeted safety measures. Still, survival rates post-incident were notable, with a 100% survival rate for cyclists after ambulatory visits. Pedestrian survival rates were similarly high. ConclusionThis study provided valuable insights into patterns of pedestrian and cyclist injuries among Peel residents, revealing considerable cross-regional healthcare utilization. ImplicationsFindings will be utilized by the Region of Peel and partner organizations, to enhance local road safety initiatives and service delivery for vulnerable road users.

Where should we go - Estimating travel times for modelling accessibility to 24-hour emergency departments in Canada

Estimating travel time to 24-hour emergency services is an important component to modelling accessibility of health services, particularly for rural areas. However, methods used to estimate travel time vary significantly, are not representative of the residential population, and are not openly validated. This makes the assessment of travel-based accessibility metrics between studies incomparable. To address this issue and develop a standardized measurement of emergency service access, this study utilized small geographic units (Dissemination Areas – DA) and geographical boundaries representative of municipal equivalents (Census Subdivision – CSD). Estimated travel times between the centroid of an inhabited DA to each 24-hr emergency department was computed with population-weighted travel times generated for each CSD. This dataset provides a nationally consistent measurement of proximity to emergency services accounting for travel pathing and population distribution. This methodology can be extended to generate estimated shortest travel routes for other healthcare resources or develop actual travel routes based on individuals’ experiences with the healthcare system.

Self-reported tick exposure as an indicator of Lyme disease risk in an endemic region of Quebec, Canada

BackgroundLyme disease (LD) and other tick-borne diseases are emerging across Canada. Spatial and temporal LD risk is typically estimated using acarological surveillance and reported human cases, the former not considering human behavior leading to tick exposure and the latter occurring after infection. ObjectivesThe primary objective was to explore, at the census subdivision level (CSD), the associations of self-reported tick exposure, alternative risk indicators (predicted tick density, eTick submissions, public health risk level), and ecological variables (Ixodes scapularis habitat suitability index and cumulative degree days > 0 °C) with incidence proportion of LD. A secondary objective was to explore which of these predictor variables were associated with self-reported tick exposure at the CSD level. MethodsSelf-reported tick exposure was measured in a cross-sectional populational health survey conducted in 2018, among 10,790 respondents living in 116 CSDs of the Estrie region, Quebec, Canada. The number of reported LD cases per CSD in 2018 was obtained from the public health department. Generalized linear mixed-effets models accounting for spatial autocorrelation were built to fulfill the objectives. ResultsSelf-reported tick exposure ranged from 0.0 % to 61.5 % (median 8.9 %) and reported LD incidence rates ranged from 0 to 324 cases per 100,000 person-years, per CSD. A positive association was found between self-reported tick exposure and LD incidence proportion (ß = 0.08, CI = 0.04,0.11, p < 0.0001). The best-fit model included public health risk level (AIC: 144.2), followed by predicted tick density, ecological variables, self-reported tick exposure and eTick submissions (AIC: 158.4, 158.4, 160.4 and 170.1 respectively). Predicted tick density was the only significant predictor of self-reported tick exposure (ß = 0.83, CI = 0.16,1.50, p = 0.02). DiscussionThis proof-of-concept study explores self-reported tick exposure as a potential indicator of LD risk using populational survey data. This approach may offer a low-cost and simple tool for evaluating LD risk and deserves further evaluation.

Investigating the association between socioeconomic and agricultural risk factors and the incidence of Salmonella Heidelberg and Salmonella Typhimurium in Ontario in 2015: A multi-level ecological approach.

The incidence of salmonellosis, and other enteric zoonotic diseases, has been associated with various food and environmental exposures and socioeconomic factors. Increasingly, there is interest in exploring differences among serotypes of Salmonella to better inform public health prevention efforts. Consequently, we investigated whether rates of Salmonella Heidelberg and Typhimurium in Ontario communities in 2015 were influenced by household characteristics, agricultural factors, and the presence of meat plants. Data for each reported case of S. Heidelberg and S. Typhimurium in Ontario in 2015 were collected. Expected cases of each serotype were calculated, stratified by age group and sex, according to the underlying population distribution from the Canadian census. Socioeconomic, agricultural census data, and data concerning provincial and federally inspected meat plants were combined with observed and expected case counts. The association between community-level agricultural, meat processing, and socioeconomic variables, serotype, and the rate of salmonellosis in each census subdivision (CSD) was explored using multilevel Poisson models, with random intercepts for CSD and census division (CD). Rates of S. Heidelberg and S. Typhimurium were associated with the proportion of married individuals in a CSD, and were higher in CSDs with the highest quantile of labour participation compared to those in the lowest quantile. There was an interaction effect between cattle, poultry and swine farm density in a CD and serotype, with rates of either serotype decreasing as cattle, poultry, or swine farm density in the encompassing CD increased. The rate of the decrease varied by serotype. Our findings concerning community-level household characteristics may be explained by the influence of family structure and occupation on food consumption patterns and environmental exposures. Rates of S. Heidelberg and S. Typhimurium may be lower in areas with increased animal farm density due to naturally acquired immunity from routine exposure to Salmonella via livestock.

The Index of Economic Disparity: Measuring trends in economic disparity across Canadian Census Subdivisions and rural and urban communities

AbstractTerritorial inequalities have long been a subject of study and concern in Canada. In the face of large structural changes such as industrial shifts and the decarbonization of our economies, there is an urgency to understand such inequalities and design effective policy interventions for those places facing persistent economic decline. This paper shares a novel composite index that measures economic disparity across Canadian Census Subdivisions (CSDs) using Census data from 2001 through 2016 and the 2011 National Household Survey. Named the “Index of Economic Disparity,” it is comprised of an equally weighted average of four sub‐indices that assign percentile rankings for all CSDs based on whether they experience persistent and substantial decline in key economic areas: population, labour force outcomes, working‐age share of population, and industrial diversity. The variation of outcomes across geographies—urban and rural—highlights the importance of place‐based policies.

A system in crisis: exploring how recent emergency department closures influence potential access to emergency care in Ontario.

Access to emergency medical care in Ontario has been under stress, mainly due to a lack of human resources (staffing of nurses and doctors). Over the past year, several emergency departments in Ontario have closed. Some of these closures are nightly, while others have closed for weeks at a time, leaving Ontario residents without access to emergency medical care which can lead to poor or more severe outcomes. The purpose of this paper was to examine how closures of ED's in Ontario have influenced potential access to emergency medical care. We performed population-level geographic information systems (GIS)-based analysis of potential access to ED hospitals in Ontario. The number of people with access to an ED was calculated when all ED's in Ontario were open, then recalculated with the 14 ED closures. Access was defined by ground travel with 30min, 45min, and 60min travel times used for analysis. Differences in the number of people at the census block level who potentially lost access were compiled and examined by census subdivision. If all 14 ED's had closed at the same time, there would be 35,808 people at 30min, 15,018 at 45min, and 12,131 at 60min travel times in Ontario who lost access to ED care. Certain areas of the province saw more significant decreases in ED access. At 45min travel times, nearly 2000 people in Central Frontenac lost access (44% of population), while 7298 people in Cochrane (North Part) lost access (20% of population). ED closures have led to decreases in potential access to emergency care for predominantly rural populations. Health human resource recovery strategies must focus on areas where lack of overlap exists.

Geographic distribution of Ontario pharmacists: A focus on rural and northern communities

Introduction:Canadians living in rural and northern communities face particular health needs and challenges in accessing primary care services. Ontario pharmacists are increasingly able to optimize patient care with a broadening scope of practice; this was highlighted during the COVID-19 pandemic. This study explores the geographic distribution of pharmacists to evaluate their potential to deliver health care in rural and northern Ontario communities.Methods:A secondary analysis of the Ontario College of Pharmacists’ registry data was undertaken, with all Part A pharmacists who had at least 1 patient care practice site included in the analysis. Full-time equivalent (FTE) hours worked at each practice site were calculated and compared with the population distribution. Ratios of FTEs per 1000 residents by census subdivision (which represents communities) were calculated and compared by geography, north vs south and urban vs rural (further subdivided by metropolitan-influenced zones).Results:The greatest availability of pharmacist FTEs was found in urban communities (with slightly better availability in the north), whereas the lowest availability was found in the most rural communities. A more granular observation revealed that northern communities were more likely to have no local pharmacist access (72%) compared with southern communities (24%).Discussion:Rural and northern communities are underserved. Novel approaches to overcoming the rural pharmacist care gap include rural practice incentives, targeted enrollment of rural students, increased rural exposure in pharmacy schools and the utilization of new technologies such as telepharmacy and drone medication deliveries.

Population Mobility and Socioeconomic Indicators in California, USA and Ontario, Canada during the COVID-19 Pandemic

PurposeTo explore the extent that socioeconomic indicators influenced mobility of populations during the COVID-19 pandemic in two jurisdictions.Methods & MaterialsWe used anonymized, population-aggregated mobile-device location data to estimate dynamic changes in population mobility patterns across the province of Ontario, Canada and the state of California, U.S.A. Data from the Ontario-Marginalization Index at the Census Subdivision (CSD) level, as well as the California Healthy Places Index (HPI) at the Census Tract (CT) level, were used to determine the census geographical units in the lowest and highest quantiles of socioeconomic indicators during the COVID-19 pandemic.Ontario was under three province-wide stay-at-home orders between March 17, 2020 and June 2, 2021. California was under state-wide stay-at-home orders from March 19, 2020 to January 25, 2021. Weekly data from March 15, 2020 to June 19, 2021 were analyzed for Ontario, and weekly data were analyzed from March 15, 2020 to March 20, 2021 for California. We used the percentage of time spent away from home as the indicator for mobility and analyzed differences in mobility trends between the populations grouped by material deprivation score (Ontario) and HPI scores.ResultsIn Ontario, populations with highest material deprivation spent an average of 25.7% of time away from home, while the populations with lowest material deprivation spent an average of 22.6% of their time away from home (difference: 3.1%, p <0.001) across the entire duration of the COVID-19 pandemic.Similarly, in California, the least advantaged populations spent an average of 30.0% of time away from their home, while the most advantaged populations spent 24.3% of their time away from home (difference: 5.7%, p <0.001).ConclusionAcross both geographical locations, the least advantaged populations observed highest mobility compared to the most advantaged populations throughout the pandemic. This indicates that populations in communities with the least advantage in Ontario and California may have less ability or inadequate resources to comply with stay-at-home orders, leading to increased risk of COVID-19 exposure among these more mobile populations. Strategies to protect those most at risk of exposure to COVID-19 are imperative for controlling spread within communities.

COVID-19 Assessment and Testing in Rural Communities During the Pandemic: Cross-sectional Analysis.

BackgroundThe COVID-19 pandemic exacerbated the need for urgent improvements in access to health care for rural, remote, and underserviced communities. The Renfrew County Virtual Triage and Assessment Centre (VTAC) was designed to provide access to COVID-19 testing and assessment with a family physician. The goal was to protect emergency departments and 911 paramedics while ensuring that nobody was left at home, suffering in silence. Residents were encouraged to call their own family physician for any urgent health needs. If they did not have a family physician or could not access their usual primary care provider, then they could call VTAC. This study reports on the output of a service model offering access to assessment and COVID-19 testing through a blend of virtual and in-person care options by a multidisciplinary team.ObjectiveThe purpose of this study was to assess the ability of VTAC to provide access to COVID-19 assessment and testing across rural, remote, and underserviced communities.MethodsWe conducted a cross-sectional analysis of the data derived from the cases handled by VTAC between March 27, 2020 (launch day), and September 30, 2020.ResultsResidents from all 19 census subdivisions and municipalities of Renfrew County accessed VTAC. A total of 10,086 family physician assessments were completed (average 64 per day). Of these, 8535 (84.6%) assessments were to unique patient users. Thirty physicians provided care. Using digital equipment setup in the patients’ home, 31 patients were monitored remotely. VTAC community paramedics completed 14,378 COVID-19 tests and 3875 home visits.ConclusionsRenfrew County’s experience suggests that there is tremendous synergy between family physicians and community paramedics in providing access to COVID-19 assessment and COVID-19 testing. The blended model of virtual and in-person care is well suited to provide improved access to other aspects of health care post pandemic, particularly for patients without a family physician.

Leveraging Hazard, Exposure, and Social Vulnerability Data to Assess Flood Risk to Indigenous Communities in Canada

This study integrates novel data on 100-year flood hazard extents, exposure of residential properties, and place-based social vulnerability to comprehensively assess and compare flood risk between Indigenous communities living on 985 reserve lands and other Canadian communities across 3701 census subdivisions. National-scale exposure of residential properties to fluvial, pluvial, and coastal flooding was estimated at the 100-year return period. A social vulnerability index (SVI) was developed and included 49 variables from the national census that represent demographic, social, economic, cultural, and infrastructure/community indicators of vulnerability. Geographic information system-based bivariate choropleth mapping of the composite SVI scores and of flood exposure of residential properties and population was completed to assess the spatial variation of flood risk. We found that about 81% of the 985 Indigenous land reserves had some flood exposure that impacted either population or residential properties. Our analysis indicates that residential property-level flood exposure is similar between non-Indigenous and Indigenous communities, but socioeconomic vulnerability is higher on reserve lands, which confirms that the overall risk of Indigenous communities is higher. Findings suggest the need for more local verification of flood risk in Indigenous communities to address uncertainty in national scale analysis.

HOW IMPORTANT IS A SCHOOL? EXAMINING THE IMPACT OF REMOTENESS FROM A SCHOOL ON CANADIAN COMMUNITIES’ ATTRACTION AND RETENTION OF SCHOOL-AGE CHILDREN

Many Canadian communities, especially rural communities, are concerned about youth outmigration as a cause of population decline, which is associated with fewer services and amenities. Proponents of keeping underattended schools open argue that removing a school from the community means that fewer families will want to live there, and that more families will consider leaving. Others view school closures as a rational response to population decline. Still other perspectives complicate the correlation between schools and population, noting phenomena such as children “learning to leave” and “place attachment” that modulate the temptation to move away. This paper offers an empirical test of discursive connections between school closures and mobilities by studying the population change of school-age children in Canadian census subdivisions indexed by distance to the nearest school. Based on this method, we conclude that there is a positive correlation between the school-age population in a community and proximity to a school in that community. Although our data do not answer the question of whether school closures cause population decline, or such a decline causes school closures, or both, we provide a quantitative foundation on which to ask it.

Studying the social determinants of COVID-19 in a data vacuum.

Race‐based and other demographic information on COVID‐19 patients is not being collected consistently across provinces in Canada. Therefore, whether the burden of COVID‐19 is falling disproportionately on the shoulders of particular demographic groups is relatively unknown. In this article, we first provide an overview of the available geographic and demographic data related to COVID‐19. We then make creative use of these existing data to fill the vacuum and identify key demographic risk factors for COVID‐19 across Canada's health regions. Drawing on COVID‐19 counts and tabular census data, we examine the association between communities’ demographic composition and the number of COVID‐19 infections. COVID‐19 infections are higher in communities with larger shares of Black and low‐income residents. Our approach offers a way for researchers and policymakers to use existing data to identify communities nationwide that are vulnerable to the pandemic in the absence of more detailed demographic and more granular geographic data.

The geographic distribution of un-immunized children in Ontario, Canada: Hotspot detection using Bayesian spatial analysis

BackgroundIn Ontario, Canada, little is currently known about the extent to which un-immunized children may cluster geographically. Our objectives were to: describe the geographic distribution of fully un-immunized children; identify geographic clusters (hotspots) of un-immunized children; and to characterize the contribution of spatial effects and covariates on hotspots, where found. MethodsOur analytic cohort consisted of Ontario students aged 7–17 years in the 2016–2017 school year. We defined students as un-immunized if they had zero doses of any vaccine and a non-medical exemption recorded in Ontario’s registry. We calculated unadjusted proportions of un-immunized students by Census Subdivision (CSD) and then used a sequential approach to identify hotspots starting first with hotspot identification at the CSD level and then probed identified hotspots further by Dissemination Area (DA) and including covariates. Hotspots were identified using the Besag-York-Mollie Bayesian spatial model and were defined as areas with >95% probability of having two times the proportion of un-immunized students, relative to the province overall. ResultsWe identified 15,208 (0.94%) un-immunized children within our cohort consisting of more than 1.61 million students. Unadjusted proportions of un-immunized students varied greatly by geography, ranging from 0% to 21.5% by CSD. We identified 16 hotspot CSDs which clustered in five distinct areas, all of which were located in southern Ontario. The contribution of covariates and spatial effects on the risk of having un-immunized students varied greatly across hotspot areas. ConclusionsAlthough the provincial proportion (0.94%) of un-immunized students is small, geographical clustering of such students is evident in Ontario and in some areas presents an important risk for future outbreaks. Further qualitative work within these hotspot areas would be a helpful next step to better characterize the factors associated with vaccine refusal in these communities.

Using geographic information systems to estimate potential pesticide exposure at the population level in Canada

Residents in close proximity to agricultural land are at risk of higher pesticide exposures. The purpose of this study was to generate national population-level exposure estimates for Canada for three commonly applied pesticides that are suspected carcinogens (2,4-dichlorophenoxyacetic acid (2,4-D), glyphosate and chlorothalonil). Using geographic information systems, pesticide exposure was estimated for every - census subdivision (CSD) in Canada (n = 5054) by combining raster-based surfaces for the distribution of crops with average crop-specific pesticide application rates data. Analyses examined all identified crops in combination with different pesticide application rates to obtain a cumulative potential total exposure. Specifically, the number of acres of particular crops were calculated for each CSD and then multiplied by the average pesticide application rates data, summed across crops, and combined with population data by CSD to provide a potential pesticide exposure estimate for each CSD. Results demonstrate that the population exposure varies greatly depending on agricultural production by CSD region. For example, in Ontario, the 2,4-D application rate was an average of 361 kg/km2, while in Saskatchewan, which primarily grows field/cereal crops, 2,4-D application rates were much higher (3810 kg/km2). The highest potential exposures to all three pesticides were in the prairie provinces (Alberta, Saskatchewan, Manitoba) along with Prince Edward Island, Southern Quebec and British Columbia. This work can be used in conjunction with other exposure assessment approaches to better understand overall pesticide exposure among Canada's general population.

Accuracy of matching residential postal codes to census geography.

Postal codes are often the only geographic identifier available to match subjects in a health dataset to census geography. This paper describes the characteristics of postal codes reported by the Canadian population on the census and, as an indicator of geocoding accuracy, the proportion that are linked to a single dissemination area (DA). Postal codes reported on the 2016 Census questionnaire were matched to a combination of the Postal Code Conversion File (PCCF) and the Postal Code Conversion File Plus (PCCF+ version 7B) (reference date November 2018) to calculate population-weighted counts and the number of matches to DAs by province or territory, delivery mode type (DMT), population centre or rural area size, and census metropolitan area. The number of single matches to census tracts (CTs), census subdivisions (CSDs) and census divisions (CDs) was also calculated. In Canada, 72.6% of the population reported postal codes that matched to a single DA. This proportion was higher in urban cores (87.1%) and among postal codes for an urban street address (DMT=A) (85.3%) or apartment building (DMT=B) (95.3%), and was lower in rural areas (26.2% to 38.1%) and among rural postal codes (13.9%). In comparison, 89.3% and 95.4% of the population reported postal codes matching to a single CSD or CD, respectively, while 92.1% of the population that live within CT boundaries were matched to a single CT. Matching postal codes to census geography is relatively accurate and frequently one to one in urban centres. In rural areas and for some types of postal code DMTs, alternative approaches to using the PCCF and PCCF+ for attaching census geography might be explored.

Visualizing the Geographic and Demographic Distribution of COVID-19

Whereas African Americans are disproportionately among the coronavirus disease 2019 (COVID-19) pandemic’s sick and dead, less is known about whether some racial/ethnic groups are more likely to be affected in Canada. In this data visualization, the authors address two issues limiting understanding of the spatial and demographic distribution of the COVID-19 pandemic in Canada: (1) COVID-19 infection and death counts are collected at a very high level of geographic aggregation, and (2) these counts are not tallied by sociodemographic group, including race/ethnicity. The authors use a bivariate choropleth map to illustrate the correlation between COVID-19 infections and the percentage of residents who are Black across census subdivisions. Canada is more similar to the United States than expected in this respect: areas with higher shares of Black Canadians also see more infections.

Spatial‐temporal trends in complementary and alternative medicine (CAM) offices in Ontario, Canada

This paper assesses complementary and alternative medicine (CAM) from a spatial‐temporal perspective; it would be of particular interest to those who evaluate health care resource accessibility over space. The analysis compares CAM supply (number of offices, employment, and sales) in Ontario by provincial district, metropolitan influence classification, and health care and social assistance employment quintiles using summary statistics, Kruskal‐Wallis and median analyses, and local spatial autocorrelation evaluation. Metropolitan areas throughout Ontario, but especially in the southcentral part of the province, are well endowed with CAM supply and tend to be most important in terms of CAM change. CAM offices are increasing in size in the most populated parts of the province and shrinking in regions that are more peripheral. CAM supply per capita is highest in census subdivisions with moderate levels of health care and social assistance employment, a result that is not offset by significant temporal change. While CAM supply is restructuring in many of Ontario's most populated urban locations, the overall attraction of CAM resources to large and small metropolitan areas is clear. If current spatial‐temporal trends continue, CAM spatial disparities will be exacerbated as accessibility to CAM in Ontario's most peripheral locations worsen.

The patterns and places of counterurbanization: A ‘macro’ perspective from Newfoundland and Labrador, Canada

Abstract Counterurbanization scholarship in Canada is dominated by micro-scale case studies, most recently conducted in the province of Newfoundland and Labrador (NL). In this article, a macro perspective is used to paint a broader picture of this downward migration stream. It seeks to determine the relative importance of counterurbanization in NL, compared to other Canadian provinces and territories; to uncover its dominant form (population decentralization or deconcentration); and to determine if counterurbanites are contributing to population growth in productivist or post-productivist municipalities. To undertake this research, migration, population, and labour force data are extracted from the 2016 census. Analysis reveals that counterurbanization is a substream movement at the sub-national scale, but a mainstream flow to small settlement areas in NL, as it is across the country. It more often involves the decentralization of metropolitan residents to urban adjacent municipalities, although in all regions, including NL, interprovincial deconcentration to isolated census subdivisions is also apparent. In-migrants are attracted to nine of ten potential destination types in NL, differentiated by the relative size of the labour force in productivist industries (agriculture, forestry, fishing, hunting, mining, utilities, quarrying, oil/gas extraction, and manufacturing), and post-productivist sectors (arts, entertainment, recreation, accommodation and food services). Counterurbanites are more numerous in post-productivist settlement types and often contribute to population growth; fewer reside in productivist settlements, which typically are experiencing population decline. This cooccurrence of productivist and post-productivist destinations is not typical of an advanced economy, but one more often found in developing states. These findings enrich Canadian counterurbanization scholarship and demonstrate the application of a counterurbanite-destination typology that can be customized for use in international settings.

Association between neighbourhood socioeconomic features and residential fire incidence, related casualties and children: a cross-sectional population-based study in 4 Canadian provinces.

This study assessed whether socioeconomic factors affect the rates of residential fire incidence and fire-related injuries and deaths, and whether children are affected differently than the general population. We employed a cross-sectional study design using data for British Columbia, Alberta, Manitoba and Ontario from the National Fire Information Database, which includes fire incidents and losses reported by provincial fire marshals across Canada between 2005 and 2015. It also contains 2011 census subdivision social domain data from Statistics Canada based on fire location. Multivariable negative binomial regressions tested the significance of relations between census subdivision socioeconomic factors (average household size, educational attainment, median income and unemployment rate) and the rates of residential fires and casualties per person-year, and casualties per fire incident. Census subdivisions with higher educational attainment and unemployment rates had higher rates of residential fires (incidence rate ratio [IRR] 1.07, 95% confidence interval [CI] 1.05-1.10, and IRR 1.24, 95% CI 1.18-1.31, respectively) and of residential fire casualties per person-year (IRR 1.09, 95% CI 1.05-1.13, and IRR 1.29, 95% CI 1.20-1.40, respectively). Census subdivisions with smaller average households had higher rates of residential fire casualties per person-year (IRR 0.43, 95% CI 0.22-0.83) and per fire incident (IRR 0.75, 95% CI 0.58-0.97), and the association was even stronger for children (IRR 0.17, 95% CI 0.08-0.36, and IRR 0.41, 95% CI 0.20-0.86, respectively). The results suggest that efforts to prevent residential fires should be prioritized in neighbourhoods with higher educational attainment and unemployment, whereas house fire safety programs should be intensified in neighbourhoods with smaller households to prevent fire casualties, especially among children, once a fire does occur.

Growing up, growing out: comparing spatial patterns of urban populations in Canada

The spatial distribution of population and related density characteristics has a significant impact on urban form; a low-density urban form is typically associated with low efficiency of service delivery, poor connectivity between communities, and a high tendency of urban sprawl, whereas higher density urban form is associated with transit-oriented development, efficient service delivery, and lower overall infrastructure costs. However, an urban area is never a homogenous environment. Depending on the general community designs, natural barriers, and massive functional infrastructures (airports, large parks), the urban population be may spread out evenly or condensed into some disjointed, isolated clusters. Given the context that Canadian cities have typically low population densities, their population distributions are subject to high spatial variabilities. We use geographic information system (GIS) techniques and geostatistical approaches (Getis–Ord [Formula: see text] hot spot analysis and HDBSCAN) to visualize and compare sub-municipal level population density of the 10 most populous census subdivisions (CSDs) in Canada. Results reveal both low-density forms and density segmentations in most municipalities, especially those without a natural or political border to constrain growth. Population segmentation is sometimes unsolvable due to natural landscapes or massive infrastructures initially planned by local municipalities; however, segmentations may be mitigated if future growth strategies maximize existing population clusters.