Canadian Urban Centre Research Articles

Coming out or staying in? Disclosure experiences of lesbian and gay radiation therapists in practice

IntroductionThe healthcare environment reflects and embeds sociocultural norms, including heteronormativity. Coming out for sexual and gender minority (SGM) people is often a process of continual identity management. There is evidence that lesbian and gay people (LG), both patients and healthcare professionals, engage in significant emotional work to manage who they tell about their sexual identity, and when. This qualitative study explored the experiences of LG radiation therapists (RTs) managing their sexual identity at work, and how this impacts relationships with co-workers and patients. MethodsThe research used an authoethnographic narrative inquiry approach. Narrative inquiry incorporates story-based methods to acquire a deep understanding of how individuals make sense of events. Autoethnography uses personal experience to understand and reflect on a broader culture. Three LG participants from a Canadian urban cancer centre worked with the researcher to co-construct stories of coming out at work using their shared personal histories. ResultsThe co-constructed stories included fictionalised narratives of coming out at work, relationships with patients/peers, the experiences of sexual minority patients and the researcher's accompanying embodied research journey. They were written in a variety of genres and from a number of different perspectives. The results showed the participants engaged in highly contextualised and continual identity management which depended on a series of different strategies or tools. Additionally, it was clear that both the discourse around professionalism, and the pervasive biomedical healthcare culture served to further inhibit disclosure at work. Purposeful disclosure to LG patients was uncommon. ConclusionComing out at work might be a risky business for some lesbian and gay RTs. However, focused attention on improving the work environment so RTs can be open about their identities in the professional setting would be beneficial for patients and staff. Implications for practiceLG RTs who are out at work can be a source of support and comfort to SGM patients. They may also feel more satisfied and engaged at work. Organizations should ensure they provide overt support for SGM RTs from frontline staff to leadership roles.

Prevalence of Food Insecurity Among Pregnant Women: A Canadian Study in a Large Urban Setting.

Nutritional and financial needs increase during pregnancy, making pregnant women particularly vulnerable to food insecurity. Our objective was to document the prevalence of food insecurity among pregnant women receiving prenatal care in an urban centre in Canada and to identify factors associated with food insecurity. This cross-sectional study recruited pregnant women receiving prenatal care at one of two Toronto hospitals: Site 1 and Site 2 (serving a more disadvantaged population) between October 1, 2018 and October 1, 2019. Demographic information was collected, and the U.S. Household Food Security Survey Module was used to assess food security. Comparisons were made using χ2 tests, two-tailed t tests, or Mann-Whitney tests for categorical and continuous variables, as appropriate. Binary logistic regression and multivariate analyses were performed to assess associations with food insecurity and differences between hospitals sites. We recruited 626 participants (316 at Site 1 and 310 at Site 2). Prevalence of food insecurity was 12.8% among all participants with Site 2 having nearly 5 times the prevalence of Site 1 (66/310 [21.3%] vs. 14/316 [4.4%]; P = 0.001). Several factors were associated with food insecurity, with non-White ethnicity (OR 2.04; 95% CI 0.98-4.25, P = 0.055] and lower household income (OR 37.53; 95% CI 14.04-100, P < 0.001 when less than CAD $23000/y) being the most robust. This Canadian study documented the prevalence of and factors associated with food insecurity in pregnancy. Targeted interventions to help low-income women and programs geared towards non-White women may be beneficial in addressing food insecurity among pregnant women.

Impacts of light rail transit development on neighborhood health: A scoping review through a social determinants of health lens

IntroductionLight rail transit (LRT) has become a popular intervention for addressing the social and economic complexities associated with urban growth. LRT development can exert influence on neighborhood characteristics, such as property values, employment opportunities, and service access. Many of these changes can impact the health of nearby residents by influencing their exposure to the social determinants of health (SDOH). This study maps the literature on LRT development through an SDOH lens and comments on gaps and implications for neighborhood health and transit planning. MethodsThe Arksey and O'Malley scoping review methodology was used to examine existing literature on neighborhood-level impacts of LRT development related to the SDOH. Peer-reviewed articles were included if they focused on an LRT project in an urban center in Canada or the United States, reported on a neighborhood-level impact related to the SDOH, and were published in English between 2004 and 2019. Standardized information was extracted from each included article and thematic analysis was applied to generate impact themes. ResultsA search of three databases yielded 767 non-duplicate records and 29 studies were included in the review. Six impact themes were identified: property values, neighborhood demography, economy, development, transit, and neighborhood perceptions. LRT development was associated with residential property value increases, high-density residential development, new business openings, and increases in neighborhood household income. Articles had limited recognition of the role of LRT development in creating health disparities. ConclusionsThis review demonstrates that transit development can influence the living conditions and resource availability of surrounding areas. Since many of the impacts identified in this study can further social stratification or have differential effects by socioeconomic status, LRT development can be conceptualized as a driver of health inequities. In order to design more effective and equitable transit policy, future research should position transit development as an SDOH.

Impact of COVID-19-Related Traffic Slowdown on Urban Heat Characteristics

Governments around the world have implemented measures to slow down the spread of COVID-19, resulting in a substantial decrease in the usage of motorized transportation. The ensuing decrease in the emission of traffic-related heat and pollutants is expected to impact the environment through various pathways, especially near urban areas, where there is a higher concentration of traffic. In this study, we perform high-resolution urban climate simulations to assess the direct impact of the decrease in traffic-related heat emissions due to COVID-19 on urban temperature characteristics. One simulation spans the January–May 2020 period; two additional simulations spanning the April 2019–May 2020 period, with normal and reduced traffic, are used to assess the impacts throughout the year. These simulations are performed for the city of Montreal, the second largest urban centre in Canada. The mechanisms and main findings of this study are likely to be applicable to most large urban centres around the globe. The results show that an 80% reduction in traffic results in a decrease of up to 1 °C in the near-surface temperature for regions with heavy traffic. The magnitude of the temperature decrease varies substantially with the diurnal traffic cycle and also from day to day, being greatest when the near-surface wind speeds are low and there is a temperature inversion in the surface layer. This reduction in near-surface temperature is reflected by an up to 20% reduction in hot hours (when temperature exceeds 30 °C) during the warm season, thus reducing heat stress for vulnerable populations. No substantial changes occur outside of traffic corridors, indicating that potential reductions in traffic would need to be supplemented by additional measures to reduce urban temperatures and associated heat stress, especially in a warming climate, to ensure human health and well-being.

A Qualitative Study of Fitness Coaches' Experiences in Community Based Exercise with People Living with HIV.

Fitness coaches need to understand the needs of people living with HIV engaged in community-based exercise (CBE) to be competent in developing exercises programs with this population. Our aim was to understand coaches’ experiences engaging in a CBE intervention with PLWH in an urban center in Canada. As part of a broader study, coaches supervised weekly hour-long individualized exercise sessions with PLWH over a six-month period. Using qualitative longitudinal methods, we interviewed coaches up to three times over six months. Transcribed interviews were analyzed cross-sectionally and longitudinally. Seven coaches participated in 15 interviews. Developing confidence, improving health and experiencing a sense of community were viewed as key benefits to PLWH by the coaches. Challenges included accommodating the episodic nature of HIV and ensuring they felt prepared to work with PLWH. Understanding the experiences of coaches engaged in CBE can assist in tailoring exercise programs to meet the needs of PLWH.

Multimorbidity in large Canadian urban centres: A multilevel analysis of pooled 2015-2018 cross-sectional cycles of the Canadian Community Health Survey.

BackgroundThere is limited knowledge on how the prevalence of multimorbidity varies within and across major Canadian urban centres. The objective of this study was to investigate the between-neighbourhood variation in the prevalence of multimorbidity in Canada’s large urban centres, controlling for compositional effects associated with individual-level demographic and socioeconomic factors.MethodsCross-sectional data from the 2015–2018 cycles of the Canadian Community Health Survey (CCHS) were pooled at the microdata level. Respondents (20 years and older) residing in one of the 35 census metropolitan areas (CMAs) were included (N = 100,803). Census tracts (CTs) were used as a measure of neighbourhood. To assess the between-neighbourhood differences in multimorbidity prevalence, we fitted three sequential random intercept logistic regression models.ResultsDuring the 2015–2018 period, 8.1% of residents of large urban centres had multimorbidity. The results from the unadjusted model indicate that 13.4% of the total individual variance in multimorbidity could be attributed to the between-neighbourhood differences. After adjustment for overall characteristics of the CMAs in which these neighbourhoods are located, as well as for individual-level demographic and socioeconomic factors related to compositional effects, 11.0% of the individual variance in multimorbidity could still be attributed to the between-neighbourhood differences.ConclusionThere is significant and substantial geographic variation in multimorbidity prevalence across neighbourhoods in Canada’s large urban centres. Residing in some neighbourhoods could be associated with increased odds of having multimorbidity, even after accounting for overall characteristics of the CMAs in which these neighbourhoods are located, as well as individual-level factors.

Perceived barriers and primary care access experiences among immigrant Bangladeshi men in Canada.

ObjectiveThe study aimed to explore the experience of male members of a rapidly grown community of Bangladeshi immigrants while accessing primary healthcare (PHC) services in Canada.DesignA qualitative research was conducted among a sample of Bangladeshi immigrant men through a community-based participatory research approach. Focus group discussions were conducted to collect the qualitative data where thematic analysis was applied.SettingThe focus group discussions were held in various community centres such as individual meeting rooms at public libraries, community halls and so on arranged in collaboration with community organisations while ensuring complete privacy.ParticipantThirty-eight adults, Bangladeshi immigrant men, living in Calgary were selected for this study and participated in six different focus groups. The sample represents mostly married, educated, Muslim, Bangla speaking, aged over 25 years, full-time or self-employed and living in an urban centre in Canada >5 years.ResultThe focus groups have highlighted long wait time as an important barrier. Long wait at the emergency room, difficulties to get access to general physicians when feeling sick, slow referral process and long wait at the clinic even after making an appointment impact their daily chores, work and access to care. Language is another important barrier that impedes effective communication between physicians and immigrant patients, thus the quality of care. Unfamiliarity with the healthcare system and lack of resources were also voiced that hinder access to healthcare for immigrant Bangladeshi men in Canada. However, no gender-specific barriers unique to men have been identified in this study.ConclusionThe barriers to accessing PHC services for Bangladeshi immigrant men are similar to that of other visible minority immigrants. It is important to recognise the extent of barriers across various immigrant groups to effectively shape public policy and improve access to PHC.

Parent Experiences Caring for a Child With Bronchiolitis: A Qualitative Study.

Background:Bronchiolitis is an acute lower respiratory infection, with significant impacts on children and families and strains on the health care system. Understanding parents’ experiences and information needs caring for a child with bronchiolitis is crucial to highlight misconceptions or issues contributing to the high burden. The objective of this qualitative study was to describe parents’ experiences caring for a child with bronchiolitis.Methods:Qualitative description guided this study. Participants were recruited from the Stollery Children’s Hospital emergency department (ED), a specialized pediatric ED in a major Canadian urban center. Semi-structured interviews were conducted with 15 parents.Results:Five major themes were identified: (a) their children’s symptoms and behaviors, (b) bronchiolitis affects the entire family, (c) factors influencing parent’s decision to go to ED, (d) ED experience for parents and their children, and (e) bronchiolitis treatment and management. Interviews revealed bronchiolitis has significant effects on both children and families and parents are generally unaware of bronchiolitis symptoms, treatment, and management.Conclusions:Our study highlights that parents have knowledge deficits when it comes to recognizing the presence and severity of bronchiolitis symptoms. Parents would benefit from having more evidence-based resources to enhance their knowledge about the nature of bronchiolitis.

A qualitative investigation of unsupervised outdoor activities for 10- to 13-year-old children: “I like adventuring but I don't like adventuring without being careful”

There has been increasing recognition of the importance of children's outdoor play and independent mobility for thriving children, neighbourhoods, cities and society, which has led to calls to reverse children's retreat from the street commonplace in many Western nations. We privilege the voices of children aged 10–13 living in three diverse neighbourhoods in an urban centre in Canada to examine the factors that influence children's unsupervised outdoor activities (UOA), such as play, hanging out, and active. A total of 105 children participated in go-along interviews. Analyses revealed two themes: First, ‘feeling safe’ encompassed a sense of social and physical safety, including children's sense of neighbourliness, social dangers, discomfort around traffic, and personal agency to keep themselves safe. Second, having ‘things to do,’ included the affordances that children perceived as important in their neighbourhoods, particularly having other children to play with, diverse amenities and access to nature, and opportunities for challenge and risky play. We outline a conceptual model of children's decision process for UOA that identifies key variables that influence children's engagement in UOA.

A Qualitative Exploration of Immigrant Muslim Older Adults' Experiences and Perceptions of Physical Activity.

Physical activity is essential for healthy aging; however, there has been little exploration of physical activity in Muslim older immigrants in Canada. Over one million Canadians identify as Muslim, the majority is first-generation immigrants, with increasing cohorts entering older age. A community-based participatory research project on healthy aging was conducted with 68 older adults and community members from South Asian, Arab, and African Muslim ethnocultural communities in a Canadian urban center. A combination of individual interviews and focus groups discussions were completed, followed by thematic analysis of data. Participating community groups emphasized the importance of physical activity in older age and prioritized the need for physical activity programs. The four themes highlight Muslim older immigrants' perspectives on physical activity in Canada: (a)values and approaches to staying active; (b)health factors: pain and health limitations; (c)social factors: culture, religion, and belonging; and (d)environmental factors: safety and accessibility.

Factors influencing interprofessional team collaboration when delivering care to community-dwelling seniors: A metasynthesis of Canadian interventions

ABSTRACT The rapid growth in the proportion of adults over the age of 65 translates into greater need of complex, highly specialized care. Hence, coupled with other factors, healthcare expenditures in Canada have grown exponentially, creating tension for a high-quality care while managing costs. Interventions with community-based interprofessional teams have been piloted across Canada as a means to provide efficient specialized care. These teams must, however, work collaboratively for a more comprehensive and patient-centered care. This metasynthesis aimed to identify common factors or characteristics found to be essential for a collaborative practice among members of an interdisciplinary team delivering coordinated care to community-dwelling seniors in both rural and urban centers in Canada. Six databases (Medline, CINAHL, Sage, JSTOR, ProQuest, Web of Science) were searched for qualitative peer‐reviewed articles on community-based interventions with interprofessional teams in Canada and published between 2005–2018. Six articles were included and appraised using the COREQ guidelines for quality, followed by a thematic analysis for common themes related to team collaboration. Overarching themes related to practices of interprofessional collaboration were trust and respect, communication, and shared vision. Sub-themes included trust in the relationship between health care professional, professional identity and role clarity, interprofessional communication, communication with the client or family, and common goals. Interprofessional teams work collaboratively when trust and respect, communication, and shared vision are valued and present. Agencies coordinating interprofessional teams for community-based care could be pivotal in ensuring an environment conducive to collaboration, such as learning and team building opportunities.

Bootstrapping: The Emergent Technological Practices of Post-secondary Students with Mathematics Learning Disabilities

Drawn from an investigation of the emergent technological practices of post-secondary students with mathematics learning disabilities, this case study employs an enactivist framework in considering the bootstrapping processes our participants report engaging in when using personal electronic devices for academic support. Video-recorded, semi-structured interviews were conducted with nine post-secondary participants with mathematics learning disabilities in two western Canadian urban centres. Findings suggest that participants used technology to control and improve sensory input in order to better access mathematics course content and monitor the accuracy of their work, engage with alternate presentations of mathematical concepts to enhance their level of understanding, reduce workload, and improve organization. We discuss how their strategies in using technology relate to Bereiter’s categorization of bootstrapping resources (1985), including imitation, chance by selection, learning support systems, and piggybacking. Grounded in a “learner’s perspective,” this case study identifies technological adaptations and strategies that may be helpful to others with mathematics learning disabilities.

Seeking stability: a preliminary exploration of Canadian young adults’ financial goals

ABSTRACT Young people’s financial lives have undergone change, with delays and struggles attaining stable employment, home ownership, and financial independence. Despite such change, research on the future thinking of young adults suggests the persistent significance of such financial milestones. We conducted semi-structured interviews with 36 young adults aged 18–32 in a mid-sized, prosperous Canadian city, inquiring into their goals and perceptions of their future financial lives in light of their current situations. Findings revealed young adults’ overarching desire for financial security, notably through goals of a steady job, debt reduction, and home ownership. These findings affirm that during this transitional time of life, many young adults are involved in a search for security, hoping to attain financial independence and stability in a conventionally linear and upward fashion. This search for security and stability manifests differently across sociodemographic positions (namely age, gender, birthplace, and socioeconomic status), reflecting differing experiences of precarity, cultural representations of the life course, and positions along financial trajectories. Participants’ visions of their financial futures also appear to connect to factors in the local context, including its relative prosperity, persistence of traditional gender roles, and a relatively modest cost of living compared to other urban centres in Canada.

Access to Primary Health Care Services for Youth Experiencing Homelessness: “You shouldn’t need a health card to be healthy.”

On any given night, thousands of Canadian youth face homelessness in either absolute (living on the street) or relative (couch surfing, staying in emergency shelters) terms. This study explores influences primary health care access among youth experiencing homelessness in a large Canadian urban centre. Using a qualitative research design and convenience sampling, 8 youth participated in in-depth individual interviews and 4 clinicians with expertise in working with youth in primary care settings participated in a facilitated solutions-focused dialogue based on findings from the youth interviews. Data collection occurred from January to November 2016. Main findings included: (1) Youth experiencing homelessness feel powerless when interacting with health care providers, (2) Health care systems exist as rule-based bureaucracies and (3) Homeless youth are in survival mode when it comes to their health. The authors offer recommendations to promote more equitable access to primary health care services for homeless youth.

Implementing a trauma-informed intervention for homeless female survivors of gender-based violence: Lessons learned in a large Canadian urban centre.

Gender-based violence is associated with an elevated risk of physical and psychological harm for girls and women. This study examines service user and provider experiences of a trauma-informed, peer-facilitated group psychosocial intervention (Peer Education and Connection through Empowerment [PEACE]) targeting female-identified youth experiencing homelessness and gender-based violence. Participants were recruited among service users and providers of the intervention, delivered in Toronto, Canada. We conducted 19 semi-structured interviews between May and October 2017, engaging 12 service users and 7 additional stakeholders (including social service providers, peers and program administrators). We elicited participant perspectives on the acceptability of the intervention and key enablers of successful implementation and engagement of the target population. Qualitative transcripts were analysed using thematic analysis. Service users, including survivors of sexual exploitation, forced marriage and honour crimes, described satisfaction with and acceptability of the intervention. A number of factors were perceived by service users and providers as contributing to the intervention's successful implementation, including a focus on service user needs, program quality, flexibility and accessibility and strong inter-and intra-agency networks. Introducing peers as mentors led to challenges that could be mitigated through peer mentor education and training to maintain healthy boundaries and enhance peer mentor retention. The need for clear guidelines on the management of trauma disclosures in community settings and a systems-wide approach to service provider and administrator training in the effective integration of peer support services also emerged as important areas for future development. A group-based, trauma-informed and peer-supported psychosocial intervention was acceptable to service users and providers and successfully engaged female-identified survivors of gender-based violence who were also experiencing homelessness. Findings add to the scant knowledge base on interventions to support this population and identify important areas for future research.

Advance Care Planning and Decision-Making in a Home-Based Primary Care Service in a Canadian Urban Centre.

BackgroundAdvance care planning (ACP) is a process that enables individuals to describe, in advance, the kind of health care they would want in the future, and has been shown to reduce hospital-based interventions at the end of life. Our goal was to describe the current state of ACP in a home-based primary care program for frail homebound older people in Vancouver, Canada. We did this by identifying four key elements that should be essential to ACP in this program: frailty stage, documentation of substitute decision-makers, and decision-making with regard to both resuscitation (i.e., do not resuscitate (DNR)) and hospitalization (i.e., do not hospitalize (DNH)). While these elements are an important part of the ACP process, they are often excluded from common practice.MethodsThis was a cross-sectional, observational study of data abstracted from 200 randomly selected patient electronic medical records between July 1 and September 30, 2017. We describe the association between demographic characteristics, comorbidities, and four key elements of ACP documentation and decision-making as documented in the clinical record using bivariate comparison, a logistic regression model and multiple logistic regression analysis.ResultsIn 73% (n=146) of the patient records, there was no explicit documentation of frailty stage. Sixty-four per cent had documentation of a substitute decision-maker. Of those who had their preferences documented, 90.6% (n=144/159) indicated a preference for DNR, and 23.6% (n=29/123) indicated a preference for DNH. In multiple regression modeling, a diagnosis of dementia and older age were associated with documentation of a DNR preference, adjusted odds ratio (AOR) = 4.79 (95% CI 1.37, 16.71) and AOR = 1.14 (95% CI 1.05, 1.24), respectively. Older age, male sex, and English identified as the main language spoken were associated with a DNH preference. AOR = 1.17 (95% CI 1.06, 1.28), AOR = 4.19 (95% CI 1.41, 12.42), and AOR = 3.42 (95% CI 1.14, 10.20), respectively.ConclusionsClinician documentation of some elements of ACP, such as identification of a substitute decision-maker and resuscitation status, have been widely adopted, while other elements that should be considered essential components of ACP, such as frailty staging and preferences around hospitalization, are infrequent and provide an opportunity for practice improvement initiatives. The significant association between language and ACP decisions suggests an important role for supporting cross-cultural fluency in the ACP process.

2998 Reproductive Outcomes after the use of Tourniquet in Abdominal Myomectomy

Study Objective To determine whether the pregnancy rate and live birth rate is similar in women of childbearing age undergoing abdominal myomectomy (AM) in two major Canadian urban centers with the use of a peri-cervical tourniquet compared to women undergoing AM without the use of a tourniquet. Design A multi-center retrospective cohort study was conducted, consisting of a retrospective chart review and a self-administered study questionnaire on reproductive outcomes. Setting Sunnybrook Health Sciences Center and St. Michael's Hospital, two tertiary care centers affiliated with the University of Toronto. Patients or Participants Women of childbearing age (18-45 years old) who underwent AM between June 2002 and 2012 were consecutively sampled. 1099 patients met inclusion criteria and 144 returned the study questionnaire. After excluding patients who did not attempt to conceive post-operatively, 82 patients were included in the final statistical analysis. Interventions Use of a peri-cervical tourniquet during AM. Measurements and Main Results Unadjusted and multivariable regression analysis was used to compare the groups of patients. Mean age of patients at time of surgery was 36 years. 28% of surgeries involved use of peri-cervical tourniquet. There was no significant association between the use of tourniquet and live birth rate (p=0.35). Similarly, there was no significant difference between the use of tourniquet and length of time attempting conception after surgery (p=0.91). Data analysis is ongoing and further results will be presented. Conclusion Our study suggests no significant association between use of tourniquet and live birth outcomes. Concerns about the tourniquet's impact on fertility may therefore be unfounded, and a more widespread uptake of peri-cervical tourniquet during AM may contribute to limiting surgical blood loss. Further prospective research is warranted with a larger sample size.

Handwriting at Grade 3: More Than a Matter of ‘Neatness’

This article reports on the role of the quality and fluency of handwriting and spelling on the writing outcomes for 222 Grade 3 students who attend a large, public school in a major urban center in Canada. Findings indicate that control over the exigencies of handwriting, and fluency account for a large proportion in the variability of quality writing outcomes. Spelling is important, but only indirectly, in predicting the quality writing outcomes. Samples of student work are provided to illustrate the quality standards for handwriting. We advocate for sustained attention to handwriting instruction, effortful practice and increased opportunities to write in a variety of genres for meaningful and authentic purposes.

Tobacco outlet density, neighbourhood stressors and smoking prevalence in Toronto, Canada.

A growing body of research has shown that neighbourhood-level factors, such as the density of retail outlets selling tobacco and neighbourhood socioeconomic disadvantage affect smoking prevalence, with high levels of outlet density and neighbourhood disadvantage related to higher smoking prevalence. However, few studies have considered the role of other neighbourhood processes like stressors including perceived neighbourhood disorder in these effects. The present study examined the effects of tobacco outlet density, neighbourhood income and perceived neighbourhood disorder on smoking prevalence among a representative sample of 2,412 adult neighbourhood residents in a large urban centre in Canada. Tobacco outlet density and perceived neighbourhood disorder were significantly associated with smoking in an unadjusted multilevel model, but only perceived neighbourhood disorder remained significant in a model adjusting for other confounders. Findings suggest the need for community-based interventions to address the relationship between neighbourhood disorder and smoking, as well as more research on the combined role of tobacco availability and neighbourhood stressors, beyond neighbourhood socioeconomic disadvantage, on smoking behaviour.

Influence of Demography, Land Use, and Urban Form on West Nile Virus Risk and Human West Nile Virus Incidence in Ottawa, Canada.

Human infection by West Nile virus (WNV; family Flaviviridae), in some cases, develops into a deadly neuroinvasive disease. WNV risk is thought to be influenced by factors affecting the density of species that promote replication and transmission of the virus, namely peridomestic bird and mosquito species. Factors influencing contact between peridomestic bird and mosquito species and contact between infected mosquitoes and vulnerable human populations may also be important in determining WNV risk in an area. Several urban form and demographic factors, such as population density and the proportion of aged housing units, have been linked with increased WNV risk. Other factors, such as proportion of old-growth forest and wetlands, have been linked to decreased WNV risk. In this study, we aimed to test the effect of several demographic, land use, and urban form variables on WNV risk within neighborhoods of the city of Ottawa, Canada, based on the spatiotemporal clustering of infected mosquitoes and human WNV cases. We found a large positive effect of population density and proportion of aged housing units on WNV risk, using both entomological and epidemiological data. Interestingly, we found a large negative effect of proportion of natural areas in our epidemiological analysis, but not in our entomological analysis. Although our epidemiological data set was relatively small, these results suggest entomological surveillance results should be interpreted alongside other factors when investigating risk to humans. Our study is also one of the few to suggest an effect of demography, land use, and urban form on WNV risk in a Canadian urban center, using both entomological and epidemiological data.