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COVID-19 in Toronto neighbourhoods: How postal code data highlights vaccine inequities

WATCH ABOVE: COVID-19 hospitalizations are climbing, younger patients are filling up intensive care units, and health care staff are in short supply. Jeff Semple reports from the front lines at Toronto's Humber River Hospital, where variants of concerns are pushing facilities to the brink. – Apr 7, 2021

When it comes to accessing COVID-19 vaccines in Toronto, newly released data appears to reinforce how where you live can be a major difference-maker.

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According to data collected by ICES (the Institute for Clinical Evaluative Sciences), a non-profit that gathers Ontario health data to be used for public policy, between Dec. 14 and March 28 and broken down by postal code, the vaccination rates between certain neighbourhoods can be separated by as much as 400 per cent.

For example, the data showed just 5.5 per cent of all residents in the M3N postal code (the Jane and Finch and Black Creek neighbourhoods) received at least one of two COVID-19 vaccine doses compared to 22.4 per cent of all residents in the M4T postal code (the Moore Park neighbourhood, just north of Rosedale).

Of those in the M3N postal code, 41 per cent of residents 80 and older were vaccinated and 12.2 per cent of those between 70 and 79 were inoculated. In the M4T postal code, 71.1 per cent of residents 80 and older were vaccinated and 54.1 per cent of those between 70 and 79 were inoculated.

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However, when it comes to confirmed COVID-19 case totals and hospitalizations, the data comparison paints a starker picture.

In the M3N postal code, 6.94 out of 100 people had COVID-19 and 5.06 people out of 1,000 were either hospitalized and/or died of COVID-19. In the M4T postal code, 1.09 out of 100 people had COVID-19 and 0.52 people out of 1,000 were either hospitalized and/or died of COVID-19.

When it comes to the demographics of each area, the differences show two contrasting stories.

According to a 2016 City of Toronto profile for the Moore Park and Rosedale neighbourhoods, the combined population was 20,923, the median household income is $106,740 and 24.1 per cent of the population was listed as 65 and older. As of March 29, approximately 77.1 per cent of residents 80 and older received at least one COVID-19 vaccine dose.

A profile for the Black Creek neighbourhood (the M3N postal code overlaps multiple neighbourhoods) showed the population was 21,737, the median household income is $46,580 and 12.6 per cent of the population was listed as 65 and older. As of March 29, just 41 per cent of residents 80 and older received at least one COVID-19 vaccine dose.

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The data compiled by ICES was primarily done so during the bulk of phase one of the Ontario government’s vaccine strategy, which prioritized front-line health-care workers, long-term care and retirement home residents and staff, Indigenous adults and chronic home care recipients.

Laura Rosella, a scientist with the ICES, told Global News she and others have been crunching the real-time statistics in an effort to help “change our response.” She said the group receives COVID-19 and vaccination data from a variety of health sources and categorizes that data based on where people live.

Rosella said two major things stood out to her after doing a high-level look at Toronto. She noted the city, as well as Peel Region, particularly saw higher incidences of COVID-19 with lower vaccination rates.

“The biggest thing is the magnitude of the variation (in cases and vaccinations),” she said, noting similar issues were observed in the United States.

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“We just thought in Canada (with) the universal health care system we’re going to do this better, but we’re seeing the same story.

“We almost need to assume in advance there’s going to be disparities and instead of just rolling out a program, we have to think of how we’re going to put the extra effort in those places that need it most — like from the start as opposed to reacting.”

The second area of concern revolved around workplaces and ensuring workers are protected, emphasizing those settings are a “really, really critical” environment to promote and provide vaccinations.

Using the overall data and the examples cited above, Rosella said certain demographic differences don’t account for vaccine rates.

“It’s not just the age differences in different regions that are explaining the different vaccination rates. Even if we look at just the 80-plus group, we see the areas that have less COVID cases actually have a higher vaccination rate,” she said.

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Rosella went on to say access issues such as troubles making appointments, vaccine hesitancy, lack of transportation, hours of operation for where vaccines are being distributed and community outreach are all factors in why there are variations in vaccinations.

“It’s hard to nail it down to one thing. There are many things … that are attributed to these differences,” she said.

“You can’t pick one. They’re all playing a role likely.”

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While certain postal codes have larger, non-residential uses might see some vaccination rate differences, Rosella said there are still large gaps.

“There should be a five or 10 per cent difference here and there, but there shouldn’t be a 20 per cent difference (in residents 80 and older),” she said.

“That difference… there’s no age or land use that would explain a difference that wide.”

Rosella said it has been great to see the Ontario government recently make moves to address the areas where cases are soaring, she said large variations in cases and hospitalizations have been seen throughout the pandemic.

“I want to be optimistic that the changes that are going to be made are going to be enough, but I think we’re still going to see some variations,” she explained.

“I think there are some structural factors in these areas and issues around paid sick leave and other issues that aren’t going to go away, and that’s always going to create a problem.”

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Global News contacted Ontario Health Minister Christine Elliott’s office Wednesday afternoon to ask about the ICES data, but a response wasn’t received by the time of publication.

Meanwhile, the Ontario government formally announced Wednesday afternoon it was imposing a stay-at-home order in response to COVID-19 variant spread and strained capacity at intensive care units.

Officials said they plan to start vaccinating people aged 18 and older living in areas with high COVID-19 case numbers, including teachers and essential workers.

Premier Doug Ford said mobile teams will deliver vaccines in congregate settings, residential buildings, faith-based centres and spaces occupied by large employers in areas hit hard by the virus

Regions will be selected based on patterns of transmission, severe illness and mortality from COVID-19.

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The provincial government reported 3,215 new cases of COVID-19 on Wednesday and 17 more deaths linked to the virus.

— With files from The Canadian Press

A closer look at ICES data based on Toronto postal codes (first three characters)

Areas with the lowest COVID-19 cases per 100 people (all ages) — M5J (Harbourfront and Toronto Islands, 0.95 per cent), M5G (part of downtown Toronto, 1.01 per cent), M4E (part of the Beaches, 1.05 per cent), M4T (Moore Park, 1.09 per cent), M3B (part of Bridle Path and Don Mills, 1.14 per cent)
Areas with the highest COVID-19 cases per 100 people (all ages) — M3N (Black Creek and Jane and Finch, 6.94 per cent), M3L (Jane and Sheppard area, 6.68 per cent), M9V (Mount Olive, Jamestown and Thistletown, 6.64 per cent), M9M (Humbermede and Pelmo Park-Humberlea, 6.6 per cent), M9L (Humber Summit, 6.41 per cent)
Areas with the lowest COVID-19 hospitalizations and/or death per 1,000 people (all ages) — M5J (0.17), M4R (part of Lawrence Park South and Lytton Park, 0.22), M2P (part of Hoggs Hollow, York Mills and St. Andrews, 0.34), M4P (part of Midtown Toronto, 0.43), M4E (0.46)
Areas with the highest COVID-19 hospitalizations and/or death per 1,000 people (all ages) — M6L (part of Maple Leaf and Rustic, 5.10), M3N (5.06), M9N (Pelmo Park-Humberlea, 4.05), M4H (Thorncliffe Park, 3.81), M3L (3.77)

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The above statistics are cumulative incidences between Dec. 14 and March 28.

Hot spot communities designated by Ontario government

Here is the Ontario government’s list of designated hot spot communities in Toronto based on COVID-19 cases and categorized by postal codes (the first three characters) as of April 6:

  • Toronto: M1B, M1C, M1E, M1G, M1H, M1J, M1K, M1L, M1M, M1P, M1R, M1S, M1T, M1V, M1W, M1X, M2J, M2M, M2R, M3A, M3C, M3H, M3J, M3K, M3L, M3M, M3N, M4A, M4H, M4X, M5A, M5B, M5N, M5V, M6A, M6B, M6E, M6H, M6K, M6L, M6M, M6N, M8V, M9A, M9B, M9C, M9L, M9M, M9N, M9P, M9R, M9V, M9W
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