Long-form census and healthy cities

Ted Hsu
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I recently reached out to the City Manager’s Office at the City of Toronto to try to get a better understanding of how they use census data. Toronto is the most populous city in the country, and my hope was that the city would be able to give me insight into the importance of the census for municipalities.

I will be publishing some of the ways that the City of Toronto uses census data leading up to the second hour of debate for my private member’s bill, Bill C-626, which seeks to reinstate the mandatory long-form census. If you would like to share your experience with using census data, please email me at [email protected].

Toronto

The City of Toronto relies upon the data generated by Statistics Canada as part of the core data sets that guide the City’s program planning for a variety of services and supports, in order to maximize its resource allocations to meet the changing needs of Torontonians. One of the main impacts of the shift to the NHS is the ability to examine trends over time. A change in statistical collection methodology precludes direct statistical comparison of data gathered before and after the change. Previously, Statistics Canada’s adherence to the same statistical collection methodology for 35 years has allowed for accurate data comparison and invaluable trend analysis.

While some areas in the City continue to use and report on NHS data, release of such data comes with cautionary notations. The City of Toronto is continuing in its exploration on the use of NHS data, while using alternative sources where necessary and available.

Health Surveillance

Toronto Public Health (TPH) is required through provincial legislation to conduct population health assessment and surveillance to help identify arising issues and plan public health programs and services that meet local needs. This work supports TPH’s local mandate of reducing health inequities and improving the health of the whole population. As such, TPH often requires timely and accurate data on income, immigration status and ethnicity. These are important examples of health determinants that we have examined in the past, relying on data previously collected through the long-form census. Given well-documented concerns with the NHS data quality, TPH has not used the NHS for population health assessment and surveillance purposes. This has created a significant gap in the ability to understand the current Toronto population. Also contributing to this gap is the fact that TPH often relies on health surveys to inform public health practice. Some surveys must be assessed to determine how well the results represent the entire population. Typically, data from the last long-form census (2006) has also been used for this purpose. The fact that this information is now eight years old restricts TPH’s ability to assess the representativeness of these surveys. As a result of these and other concerns, TPH has consistently advocated for a return to the long-form census. This view is shared by many public health epidemiologists across Ontario.