Extreme hot weather is a threat to public health, and it is anticipated that the number of hot days and the duration of extreme heat events will increase with climate change. Already, heatrelated illness and mortality is the dominant natural hazard in many countries. While everybody is at risk to varying degrees, there are known factors relating to heat exposure and sensitivity that make some population groups more vulnerable than others. The objective of this paper is to assess cartographic design decisions in creating heat vulnerability maps, and how they may affect the usefulness of different map types. Spatial patterns of heat vulnerability were visualized using maps representing individual exposure and sensitivity indicators, composite vulnerability indices, and geographical hot spots of vulnerability. The composite indices were calculated using the ordered weighted averaging (OWA) multi-criteria analysis method. Hot spots were determined using local indicators of spatial association (LISA). This study is part of an ongoing project which aims to identify vulnerable populations within the City of Toronto, Canada, in order to support targeted response and mitigation. The maps were found to be a valuable addition to the hot weather planning toolkit supporting neighborhood-level interventions.

Background: Addresses in some provincial health care registries are not systematically updated. If individuals are attributed to the wrong location, this can lead to errors in health care planning and research. Our purpose was to investigate the accuracy of socioeconomic classification based on addresses in Ontario's provincial health care registry. Methods: The study setting was Toronto's inner city, an area with a population of 799,595 in 1996. We ordered enumeration areas by 1996 mean household income and divided them into five roughly equal income groups by population. We then assigned an income quintile to each individual using both the address from Ontario's provincial heath care registry and that from hospital discharge abstracts. We compared these two sets of income quintiles and also used them to generate quintile-specific rates of medical hospital admissions in the year 2000. Results: Provincial registry and hospital-based addresses agreed on the exact enumeration area for 78.1% of individuals and for income quintile for 84.8% of individuals. Disagreement by more than one income quintile occurred for 7.4% of individuals. The two methods of assigning income quintiles yielded income-specific medical hospitalization rates and rate ratios that agreed within 1%. La traduction du résumé se trouve à la fin de l'article.

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Introduction Our objective was to explore self-management practices, health services use and information-seeking for type 2 diabetes care among adult men and women from four recent immigrant communities in Toronto. Methods A structured questionnaire was adapted for the Canadian context and translated into 4 languages. A total of 184 participants with type 2 diabetes—130 recent immigrants and 54 Canadian-born—were recruited in both community and hospital settings. Results Recent immigrants were significantly less likely than the Canadian-born group to perform regular blood glucose and foot checks and significantly more likely than the Canadian-born group to be non-smokers, participate in regular physical activity and reduce dietary fat. Recent immigrants were significantly less likely than the Canadian-born group to use a specialist, alternative provider and dietician and less likely to report using dieticians, nurses and diabetes organizations as sources of diabetes-related information. Important differences were observed by sex and country of origin. Conclusion Findings suggest that diabetes prevention and management strategies for recent immigrants must address linguistic, financial, informational and systemic barriers to information and care.

Reporting health data for large urban areas presents numerous challenges. In the case of Toronto, Ontario, amalgamation in 1998 merged six census subdivisions into one megacity, resulting in the disappearance of standard reporting units. A population-based approach was used to define new health planning areas. Census tracts were used as building blocks and combined according to residential income homogeneity, respecting natural and man-made boundaries, forward sortation areas and the City of Toronto's community neighbourhoods whenever possible. Correlations and maps were used to establish area boundaries. The city was divided into 5 major planning areas which were further subdivided creating 15 minor areas. Both major and minor areas showed significant differences in population characteristics, health status and health service utilization. This commentary demonstrates the feasibility and describes the outcomes of one method for establishing planning and reporting areas in large urban centres. Next steps include the further generation of health data for these areas, comparisons with other Canadian urban areas, and application of these methods to recently announced Ontario Local Health Integration Networks. These areas can be used for planning and evaluating health service delivery, comparison with other Canadian urban areas and ongoing monitoring of and advocacy for equity in health.La traduction du résumé se trouve à la fin de l'article.