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October 22, 2008
The Unequal City - report links income and health
The Medical Officer of Health presented a report today titled The Unequal City: Income and Health Inequalities in Toronto, which links health and income, and shows that people with low income experience greater risk of illness, higher rates of disease and death at an earlier age than people with higher income.

“These inequalities are unacceptable in a society that values equal access to good health,” said Dr. David McKeown. “They represent a missed opportunity to achieve better health for the city as a whole.”

The report identifies a number of the health inequalities as cause for concern. For example, males with the lowest income are expected to die 4.5 years earlier than males with the highest income; the difference for females was 2 years. When compared to residents with the highest income:

• lung cancer incidence was 1.5 times higher for males in the lowest income group
• the gonorrhoea rate among female youth was 3.5 times higher in the lowest income group
• the percentage of female adults whose last visit to the dentist was more than three years ago was about four times greater in the lowest income group.

The report shows the relationship between income and health in Toronto is not just about the extremes of wealth and poverty. Most of the indicators show a gradient of health relative to income such that health status improves through each income increment.

The report illustrates the impact of Toronto’s health inequalities by showing what would happen if everyone was as healthy as those with the highest income, resulting annually in:

• nearly 1,100 (18 per cent) fewer premature deaths
• about 1,300 (20 per cent) fewer low birth weight babies
• about 1,600 (30 per cent) more children ready to learn at school entry
• nearly 1,000 (46 per cent) fewer teen pregnancies
• more than 30,000 (13 per cent) fewer male smokers.

“We need to close the gap on health inequalities,” said Dr. McKeown. “Reducing poverty in this city remains the best strategy for keeping residents healthy.”

In a second report presented to the Board of Health showing the cost of the Nutritious Food Basket for 2008, the average weekly cost of nutritious food for a family of four is $136.28 ($590.09 per month). This is an increase of 2.4 per cent from 2007 and 9.4 per cent over two years. The report describes a fact of life for too many people in Toronto: “Anyone living on social assistance or working for minimum wage cannot afford the nutritious foods required to maintain good health.”

Both reports are available at:

Toronto is Canada’s largest city and sixth largest government, and home to a diverse population of about 2.6 million people. It is the economic engine of Canada and one of the greenest and most creative cities in North America. In the past three years, Toronto has won numerous awards for quality, innovation and efficiency in delivering public services. Toronto’s government is dedicated to prosperity, opportunity and liveability for all its residents.

Media contact:
Rishma Govani, Toronto Public Health, 416-338-7974,



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