(March 24, 2021)<\/p>\n
By: Mansoor Tanweer, Yahoo News<\/p>\n
Natalie Mehra is the executive director of the Ontario Health Coalition, a non-profit network of grassroots community organizations. While she advocates for better health care across the province, Brampton is of particular interest to her.<\/p>\n
\u201cFor decades now, the continuum of care from hospital care to long-term care to primary care \u2026 is woefully inadequate to meet the population\u2019s needs,\u201d Mehra told NCM.<\/p>\n
The city\u2019s growing population is placing enormous pressures on the hospital system. There are two hospitals, of which only one is full-service, serving the needs of over 600,000 people; that means less than one hospital bed per 1,000 people. Chronic overcrowding is hurting the system that is bursting at the seams. \u201cHallway medicine,\u201d a colloquialism describing patients receiving health care in non-treatment spaces like hallways or closets, is a daily reality in the city.<\/p>\n
Brampton also has one of the highest rates of type 2 diabetes in Ontario and among the highest in the country. Its population is nearly three-quarters South Asian: people from the Indian Subcontinent and surrounding areas. This ethnic group is six times more likely to contract type 2 diabetes than Caucasians.<\/p>\n
Brampton\u2019s health-care needs are a great source of stress for the public. This is what pushed Mayor Patrick Brown and his council colleagues to create #FairDealForBrampton, a campaign to lobby the Government of Ontario to build a third health-care facility and to upgrade one of the existing hospitals to a full-service one. The petition has garnered 18,500 signatures as of March 2020, according to the City of Brampton.<\/p>\n
\u201cThis may be the most atrocious negligence in the province,\u201d Brown said in 2019 about what many feel is the provincial government ignoring the city\u2019s needs. Brampton Civic Hospital, the city\u2019s only full-service hospital, was built in 2007 and it was overloaded with patients almost immediately. Its emergency department was designed to serve 90,000 patients per year, but in reality, it is averaging 130,000 patients annually. Repeated calls for more beds have gone ignored.<\/p>\n
Peel Memorial Centre is the only other large health-care facility and it has been waiting for phase 2 of its development, which would turn it into a full-service hospital, for years. Peel Memorial was designed for 10,000 patients per year, but it is serving 75,000. The COVID-19 pandemic has further stretched resources in the city and has led to renewed calls for improvements. At one point, the city accounted for 20 per cent of all COVID-19 cases in Ontario.<\/p>\n
\u201cThe infrastructure just has not kept up for many years,\u201d Mehra lamented.<\/p>\n
She praised the city council for lighting a fire under the Ontario government and raising awareness about the city\u2019s lack of infrastructure. \u201cI think the municipal council has been amazing. Far better than any other places in the province,\u201d she said. \u201cI think the call that they made for the redevelopment of the Peel Memorial Centre and the very significant increase for hospital beds is absolutely right.\u201d<\/p>\n
Health experts say that immigrants are actually healthier than the Canadian-born population when they first arrive in the country. It is an area of great interest for health-care and government workers. The phenomenon even has a name: it is called the healthy immigrant effect.<\/p>\n
But once immigrants have settled, their health starts to deteriorate. The unique health needs of immigrants, who make up more than half of the population of Brampton, make healthcare policy a part of immigration policy.<\/p>\n
\u201cThe healthy immigrant effect is something that we have observed in health data around people who are newcomers to Canada,\u201d Dr. Jessica Hopkins told New Canadian Media. Dr. Hopkins used to be the medical officer of health for the Region of Peel. She is now the chief health protection and emergency preparedness officer for Public Health Ontario.<\/p>\n
One of the factors behind the effect is also a sort of positive self-selection. Those who choose to immigrate to Canada tend to be from a higher socio-economic background. They have access to better healthcare, food and recreational amenities. But, \u201cimmigrants will often adopt the behaviours they find in their new country,\u201d Hopkins said. This can include adopting diets heavy in fast food or adopting routines like driving to run simple errands.<\/p>\n
\u201cIf you look at Canada, we are largely a car-centric culture,\u201d she added. \u201cSo there might not be as much physical activity.\u201d<\/p>\n
Canada\u2019s emphasis on a suburban way of life has made cities less walkable. Longer city blocks are the norm. This, combined with segregated zoning, where one part of the city is cordoned off for housing, another for commercial use, and another for industrial, only adds to the distance and makes citizens dependent on cars.<\/p>\n
Jane Jacobs, the author of The Death and Life of Great American Cities, says that in order to accommodate cars, \u201ccity streets are broken up into loose sprawls, incoherent and vacuous for anyone afoot.\u201d<\/p>\n
Brampton is no exception. The very way the city is laid out contributes to the health problems of its immigrant population, who have their own unique challenges.<\/p>\n
As shown in a previous part of this series, Brampton is a city with one of the least pedestrian-friendly layouts. It is an urban jungle of low-slung, low-density housing coupled with long and wide streets, so it is not walkable as a result. You won\u2019t see Bramptonians run their errands on foot.<\/p>\n
Walk Score, a house-hunting website that assigns walkability scores to cities, gives Brampton 44 points out of 100. The neighbouring Mississauga is only slightly better with 49, Toronto sits at 62 and Montreal is at 65. London, Paris and Barcelona are described by the site as walkers\u2019 paradises, with a score of 100 each.<\/p>\n
All of these factors\u2014lack of health-care infrastructure, genetic predispositions towards illnesses and unhealthy lifestyles\u2014make Brampton one of the least healthy cities in Ontario, and immigrants feel the effects.<\/p>\n
Brampton is attempting to address the issue of health through urban design in its Living the Mosaic: Brampton 2040 Vision. The document lists seven \u201cvisions\u201d its framers hope to implement. Vision number six aims to make Brampton \u201ca mosaic of healthy citizens enjoying physical and mental wellness, fitness, and sports.\u201d Authors recognize that \u201chealth has to be about advocacy but also addressing urban structural deficiencies that are not health-promoting.\u201d<\/p>\n
\u201cCommunity design and environmental improvements are key, such as scaling and parameters for walkability, applying health considerations to building design, and noise mitigation,\u201d Brampton 2040 Vision reads. \u201cThe overall aspiration is to make everyone mutually accountable for Brampton\u2019s health outcomes, including civic departments, other governments, healthcare services, the education sector, as well as families and individuals. Accountability, for both physical and mental health, occurs along the entire health continuum.\u201d<\/p>\n
The 2040 Vision also lists \u201cDiabetes and Heart Disease Prevention Challenge\u201d as a top priority and calls it a \u201clocal crisis that is currently differentiating Brampton from other cities.\u201d<\/p>\n
There is no denying that Brampton\u2019s layout and lack of sufficient hospital infrastructure make the city\u2019s immigrant population vulnerable to illness. COVID-19 has only amplified Brampton\u2019s hallway medicine, a problem the city has not been able to tackle for years. A #FairDealforBrampton is long overdue.<\/p>\n