Spectator series leads to a national discussion

CMA holding town hall at Mohawk College


A Spectator series has once again inspired national discussion about health care.

The Canadian Medical Association is holding a town hall at Mohawk College this week that will focus on the social determinants of health – the subject of Code Red, a 2010 Spectator series by investigative reporter Steve Buist.

With help from McMaster epidemiologist Neil Johnston, Code Red found staggering disparities in the life spans and health outcomes of people living in different parts of Hamilton. A subsequent Code Red series by Buist and reporter Teri Pecoskie, called BORN, explored the link between poverty and the health of mothers and their babies.

Now the research forms part of the CMA’s new series of town halls across the country, focused on the social factors that cause poor health.

Dr. Anna Reid, president of the CMA, said the decision to hold one of the five planned public meetings in Hamilton was inspired by Code Red’s groundbreaking analysis of life and death across Hamilton neighbourhoods and census tracts.

“The thing about Code Red, it really illustrated that within Canada, which is such a supposedly developed nation, that we have these massive disparities within a short geographical distance.”

Tom Cooper, head of the Hamilton Roundtable for Poverty Reduction, said he’s seen a number of positive changes in the city’s attitude about poverty since Code Red.

“Code Red broke down any remaining doubts that poverty leads to poor health. There’s lots more work to do, but I think we’ve moved ahead significantly, ” he said in an email.

“There are new partnerships between community, the city, health care and post-secondary institutions to address the root causes identified in Code Red.

“The issue of the concentration of poverty is now an overriding concern when it comes to public policy decisions.”

Paul Johnson, director of neighbourhood development strategies for the city, agrees.

For one thing, his job didn’t exist when Code Red was published. The neighbourhood strategy was developed in 2010.

Today, the city has taken “a very holistic view of neighbourhoods, ” he said.

“Code Red provided the foundation for the neighbourhood work for the City of Hamilton. It framed the place-based approach, which is different than anything the city has tried to do in the past.”

It worked because it was a “collective approach, ” Johnson said, rather than an academic or service-based approach.

It allowed the entire city to have a conversation, he noted.

But while it spurred unquestionable change in the city, he said the “Code Red” label has also been a bit of a sting for north-end residents.

“Inadvertently, it’s also become a label … we should definitely continue using it as a baseline for what we want to achieve, but we need to be careful about how we’re portraying some of these neighbourhoods that are seeing new investment. We all live in a ‘Code Red’ neighbourhood.”

The town hall – Wednesday at Mohawk College – is free.

The CMA series kicked off in Winnipeg on Feb. 4. The other cities are Charlottetown, Calgary and Montreal.


CMA Forum on Health Care

What: Town hall meeting: “Health Care in Canada – What Makes us Sick?”

One of five public consultations across the country as part of the Canadian Medical Association’s National Dialogue on Health Care Transformation.

Where: McIntyre Performing Arts Centre, Mohawk College

When: Wednesday, March 6,7 to 9 p.m.



CMA president Dr. Anna Reid; Mark Chamberlain, president and CEO, Trivaris Ltd.; Dr. Dale Guenter, associate professor, department of family medicine, McMaster University; and Debbie Sheehan, former director of family health division, Hamilton public health services.


Code Red showed impact of poverty


The Spectator gained access to more than 400,000 pieces of hospital and death data for two years, representing every emergency room visit and hospital admission for every person who calls Hamilton home. That data was then grouped together to show a variety of health outcomes at the neighbourhood level.

Among Code Red’s findings:

Third World health conditions and Third World life spans in some parts of the city.

A 21-year difference in life expectancy between Hamilton’s best and worst neighbourhoods.

A 13-times difference in the rates of emergency room visits between the best and the worst neighbourhoods.

Twenty-five of the top 27 neighbourhoods with the highest rates of psychiatric emergencies are in the lower central city

A 90-times difference in high school dropout rates between the worst neighbourhood in the lower inner city and the best neighbourhood in Flamborough.

A followup Code Red series, called BORN, analyzed 535,000 birth records across the province and showed that those with low income and poor education suffer devastating effects when it comes to teen mothers, low-birth-weight babies and early prenatal care.


The ‘Code Red’ effect

Here are a few things that happened in the wake of the original Code Red series:

The City of Hamilton created a new staff position called director of neighbourhood development strategies and hired Paul Johnson, formerly the executive director of Wesley Urban Ministries, to fill the position. Johnson’s mandate is to find ways to improve those neighbourhoods that struggled the most in the Code Red findings.

Hamilton’s public health department and the two school boards developed a poverty-related piece of curriculum for high school students based on Code Red.

McMaster University elected to locate its new health campus downtown primarily because of the Code Red findings.

Members of McMaster’s nursing faculty received a government grant to study maternal health issues at the neighbourhood level based on Code Red’s findings.

Mohawk College announced a plan in the fall of 2010 to target resources and expertise directly into lower inner-city neighbourhoods most affected in the Code Red findings.

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