If I could change one thing

 
 
If I could change one thing
If I could change one thing…


                                           A community needs assessment of north Kingston neighbourhoods




                                                                                                 Final Report
                                                                                             Complete edition
                                                                                              with appendices
                                                                                               and data tables
                                                                                                   June 2010

To care. To respond. To build community.             “I think the people are the strength.”
If I could change one thing
Acknowledgements

                                                                This report was written by Brenda Melles and Cathy Cleary, who were hired by Kingston Community Health Centres
                                                                (KCHC) as independent consultants to design and lead the community needs assessment process.


                                                                We are thankful to the community needs assessment team, who guided the process over a period of three months.
                                                                Made up of KCHC staff and community members, the team met regularly to provide advice, develop interview
                                                                tools and participate in the analysis of results. Members of the team included:


                                                                    Christine Bell, Community Development Worker, KCHC
                                                                    Sara Delorme, Community Representative
                                                                    Rose Moore, Community Representative and Peer Support Worker, Street Health Centre, KCHC
                                                                    Adam Newman, Family Physician, North Kingston Community Health Centre and Street Health Centre, KCHC
                                                                    Leila Reynolds, Family and Community Support Worker, Better Beginnings for Kingston Children, KCHC
                                                                    Ron Shore, Director of Urban Health and Research, KCHC
                                                                    Cathy Cleary, Independent Consultant
                                                                    Brenda Melles, Independent Consultant


                                                                Three other community members, Mike Lindsay, Kar-bin Hui and Joan Little also provided valuable contributions
                                                                to the community needs assessment team in the early stages.


                                                                We appreciate the diligence and commitment of the 13 KCHC staff and two community members who conducted
                                                                interviews, as well as the staff at Weller Arms, Zion Foundation Housing Complex, and North Kingston Community
                                                                Health Centre who helped us organize focus groups with north Kingston seniors.


                                                                We are also grateful to the 13 service providers who shared their passion and insights about providing health, social
                                                                and community services to people who live in north Kingston.


                                                                Most of all, we are thankful to the 106 north Kingston community members, and 25 north Kingston seniors who
                                                                participated in face to face interviews and focus groups as a part of this community needs assessment process.
                                                                Because they candidly shared their views and stories, we now have a deeper insight into the health and well-being
                                                                of north Kingston residents and their communities.
For more information please contact:
                                                                All photography by Ashley O’Brien.
Ron Shore, Director of Urban Health and Research
Kingston Community Health Centres
400 Elliot Avenue
Kingston, Ontario K7K 6M9
rons@kchc.ca


A complete version of this report is available at www.kchc.ca



                                                                                                                                                                                   1
If I could change one thing
Table of Contents

    Acknowledgements ....................................................................................................................................................................1              3.3.4 Smoking ............................................................................................................................................................................24
                                                                                                                                                                                                        3.3.5 Chronic Disease for Adults and Children ..............................................................................................................25
    Executive Summary ......................................................................................................................................................................4           3.3.6 Physical activity ..............................................................................................................................................................25
                                                                                                                                                                                                        3.3.7 Kids involvement in organized sport and physical activity ............................................................................26
    1.         Understanding the community needs assessment ......................................................................................8                                                     3.3.8 Use of health services ..................................................................................................................................................27
    1.1        What was the purpose? ..................................................................................................................................................8                3.4        Services and Supports for people in north Kingston ........................................................................................28
    1.2        Why now? ............................................................................................................................................................................8   3.4.1 High and low ratings ....................................................................................................................................................28
    1.3        Who and where was the focus? ..................................................................................................................................8                         3.4.2 Service or support in most need of improvement ............................................................................................28
    1.4        What did we want to discover?....................................................................................................................................9                       3.4.3 Services and seniors ......................................................................................................................................................29
    1.4.1 Three big questions ........................................................................................................................................................9                 3.4.4 Comments on services and supports from KCHC ..............................................................................................30
    1.4.2 Defining health..................................................................................................................................................................9
    1.5        How did we get the information? ............................................................................................................................10                           4.         What have we learned from the community needs assessment? ........................................................31
    1.6        How did we recruit community members to be interviewed?......................................................................11                                                          4.1        Insights on living in north Kingston neighbourhoods ....................................................................................31
    1.7        How did we analyse the information? ....................................................................................................................12                               4.2        Insights on individual and community health in north Kingston ................................................................32
                                                                                                                                                                                                        4.3        Insights on community, health and social services for people in north Kingston ................................33
    2.         Understanding the Context ....................................................................................................................................13
    2.1        North Kingston’s neighbourhoods ..........................................................................................................................13                             5.         What are the recommendations for KCHC? ....................................................................................................34
    2.2        Does “north Kingston” = Rideau Heights? ............................................................................................................14                                   5.1        Revitalize consistent community engagement ..................................................................................................34
    2.3        Needs in the north Kingston community..............................................................................................................14                                    5.2        Consider neighbourhood differences in planning and programming ......................................................34
    2.4        Strengths in the north Kingston community ......................................................................................................17                                       5.3        Empower and equip clients to advocate on issues they care about ..........................................................35
                                                                                                                                                                                                        5.4        Research concerns and responses to housing and mental health service gaps ....................................35
    3.         What were the findings from the community needs assessment? ......................................................18                                                                     5.5        Provide preventative and treatment oriented dental services......................................................................36
    3.1        Who did we interview? ................................................................................................................................................18                 5.6        Leverage KCHC’s strengths for partnership and community building ......................................................36
    3.1.1 Which neighbourhoods? ............................................................................................................................................18                          5.7        Use this community needs assessment to renew commitment to respond to community
    3.1.2 Gender and Age..............................................................................................................................................................18                           needs and maximize community strengths ........................................................................................................36
    3.1.3 Education and Income ................................................................................................................................................19
    3.1.4 Housing..............................................................................................................................................................................19       Profile of Peter, a north Kingston community member................................................................................................38
    3.2        What it is like to live in the community of north Kingston..............................................................................20
    3.2.1 Likes and Dislikes............................................................................................................................................................20              Profile of Sara, a north Kingston community member..................................................................................................39
    3.2.2 Neighbourhood reputation, especially Rideau Heights ..................................................................................20
    3.2.3 Sense of belonging........................................................................................................................................................21                  Appendix A – North Kingston neighbourhood maps ..................................................................................................40
    3.2.4 Community involvement ............................................................................................................................................22                          Appendix B – List of documents reviewed ........................................................................................................................45
    3.2.5 Would you choose to live outside of north Kingston?......................................................................................23                                                   Appendix C – Service provider interview guide ..............................................................................................................47
    3.2.6 Improving life for people who live in north Kingston ......................................................................................23                                                 Appendix D – Community members interview consent form ..................................................................................50
    3.3        Individual health status and health behaviours..................................................................................................23                                       Appendix E – Highlights of interviews with service providers ..................................................................................51
    3.3.1 Perceived physical and mental health....................................................................................................................23                                    Appendix F – Summary of focus groups with seniors ..................................................................................................58
    3.3.2 Dental health ..................................................................................................................................................................24            Appendix G – Summary of survey with north Kingston community members ..................................................61
    3.3.3 Stress ..................................................................................................................................................................................24   Appendix H – Summary of responses to open questions from community member survey ........................89




2                                                                                                                                                                                                                                                                                                                                                                                                      3
If I could change one thing
needs impacting people who live in north Kingston include low incomes, low levels of education, food insecurity,
Executive Summary
                                                                                                                        community safety concerns, and limited access to basic services and affordable recreation. As one service provider put
1. Understanding the community needs assessment                                                                         it, “The issue is generally, poverty, and all that comes from that, or all that leads to that.” North Kingston’s community
In early 2010, Kingston Community Health Centres (KCHC) began a community needs assessment of north Kingston.           strengths include renewed attention and investment from the City of Kingston, the presence of multiple agencies
Over a period of three months, the process involved interviews with over 130 north Kingston community members           providing services and supports, and resilient residents and strong social networks.
and a dozen service providers. The purpose was to identify current community health needs and strengths in north
                                                                                                                        3. What were the findings from the community needs assessment?
Kingston in order to guide KCHC planning and programming. The process was led by two consultants alongside an
eight-member community needs assessment team made up of KCHC staff and community members. Doing                         3.1 Who did we interview?
participatory community needs assessment is an important part of living out KCHC’s values. This report outlines the     The heart of the community needs assessment was hearing the views and experience of community members who live
community needs assessment process, results, and recommendations.                                                       on low incomes in north Kingston.The assessment included face to face interviews with 106 community members using
                                                                                                                        a survey questionnaire.The strong majority were clients of KCHC. Community members came from all five north Kingston
The assessment was designed to answer three broad questions:
                                                                                                                        neighbourhoods, with a concentration in Rideau Heights (32.7%) and Inner Harbour (37.5%).The average age range was
         How healthy are the people of north Kingston?
                                                                                                                        35-39. 45% of people interviewed had not completed their high school diploma, more than four times higher than the
         What makes the community of north Kingston healthy?
                                                                                                                        Kingston average. The majority of people interviewed were on government income assistance programs, with 42.2%
         How well do health, social and community services and supports serve the people of north Kingston?
                                                                                                                        receiving Ontario Disability Support Program benefits, and 26.5% receiving Ontario Works benefits. The vast majority
                                                                                                                        were renting apartments, with less than 7% owning the place where they live. Almost a third (30.8%) were living in social
Health was defined broadly, as more than the absence of illness or disease, but rather a state of complete physical,
                                                                                                                        housing/rent geared to income housing.
mental and social well being.
                                                                                                                        3.2 What is it like to live in the community of north Kingston?
The assessment focussed on individuals and families living on low incomes in five neighbourhoods of north               Like any community experience, there are things that people like about living in their neighbourhoods and things that
Kingston, as well as on north Kingston seniors. Four methods were used to gather information: review of existing        people dislike. Responses by community members to the survey questionnaire showed that the top three likes by
information; face to face semi-structured interviews with service providers; focus groups with seniors; and face to     frequency were: location and proximity to services and amenities; social support and positive relationships with
face structured interviews with community members. Community members who were interviewed were given a                  neighbours; and parks, playgrounds and green space. Top three dislikes were social conflict and negative relationships
$10 food gift certificate in appreciation for their time.                                                               with neighbours; illicit drug activity; and neighbourhood safety issues.


The assessment does not reflect the views of a randomized and representative group of north Kingston residents.         Overall, a third of people interviewed ranked the reputation of their neighbourhood as“poor”, while the same was true
Instead, it reflects the views of the people we purposely identified to be interviewed – the majority of whom are       for almost half (47.1%) of Rideau Heights residents. However, several people interviewed (particularly seniors and service
current clients of KCHC programs.                                                                                       providers) observed that the negative reputation of Rideau Heights creates uncomfortable stigma, negatively influences
                                                                                                                        individual and community health, and is perhaps, undeserved.
2. Understanding the context
The diverse group of neighbourhoods that make up north Kingston have a total population of 22,358 people. Long          Only a third (34.6%) of people interviewed ranked their sense of belonging to their neighbourhood as good or excellent.
considered to be the“have not”area of Kingston, north Kingston’s five neighbourhoods make up about 20% of the           Though not identical in their ranking categories, set beside results from the Canadian Community Health Survey (a
total Kingston population. Across each of its five major neighbourhoods, north Kingston has a range of range of         national survey with a sample of more than 130,000 people), these rates appear to be about half of the Canadian average.
income levels and experience. Taken together, however, north Kingston average family incomes are 22% below              More than half of people interviewed reported that they would live outside of north Kingston if they had a choice.
the city average; north Kingston residents are twice as likely not to have completed high school, and twice as likely
to be living on low incomes. There is a tendency to use the term “north Kingston” as a synonym for the                  The majority of people had some involvement in their neighbourhood, with 40% reporting they belonged to a
neighbourhood of “Rideau Heights.” Among all the north Kingston neighbourhoods, Rideau Heights has the                  community group. This is close to the national volunteer average of 46%.
greatest proportion of low income families, the highest percentage of lone parent families, the highest percentage
                                                                                                                        When asked,“If you could change one thing to improve the lives of people living in north Kingston, what would it be?”,
of people without a high school diploma, the lowest labour force participation rates, and the lowest average family
                                                                                                                        the top four answers were: improve quality and affordability of housing, increase money and incomes; provide more
income. Rideau Heights also carries the burden of having the most negative reputation and social stigma.
                                                                                                                        activities and supports for children and youth; and clean up neighbourhoods and add green space. These ideas were
                                                                                                                        mirrored by service providers, who also spoke about the importance of re-visioning and re-developing the north end with
Background research, set beside interviews from the community needs assessment, tell us that the most significant
                                                                                                                        efforts toward mixed income housing.


4                                                                                                                                                                                                                                               5
If I could change one thing
3.3 Individual health status and health behaviours                                                                      4. What did we learn from the community needs assessment?
Just over a third of people (34.3%) of people interviewed ranked their physical health as good or excellent,            The assessment yielded insights in three areas: living in north Kingston neighbourhoods; individual and community
considerably lower than the national rates reported in the Canadian Community Health Survey of 60%. Further,            health in north Kingston; and community, health and social services.
just under a third of people (31.5%) ranked their mental or emotional health as good or excellent, again, well under
the Canadian average of 75%. More than a third of people interviewed (34.3%) ranked their dental health as poor.        North Kingston is made up of a diverse set of neighbourhoods where people live out a varied set of experiences.
                                                                                                                        Taken together, however, north Kingston has all the markers of a community challenged by poverty. Social networks
44.2% of people interviewed in the community needs assessment reported that they were stressed frequently or            and relationships with neighbours are what draw north Kingston community members together, and what drives
very often. At 56.7%, smoking rates were more than double the national average of 21.4%.                                them apart. Social support is what people appreciate most about their neighbourhood experience; social conflict
                                                                                                                        and negative relationships with neighbours are what people appreciate the least.
Almost 60% of people interviewed reported they are currently being prescribed medication for a chronic illness or
condition. Of these people, 61.8% were being prescribed medication for a mental health concern. Though the              The overall health of north Kingston community members is influenced by various factors including income,
sample is small, results on chronic disease and children are striking, with almost a third (29.8%) of people who were   housing, community belonging, safety and social stigma. Despite individual health challenges, many of the people
interviewed having a child on prescribed medication for a chronic disease. The lion’s share of medications for          we interviewed were engaged in activities that contribute to community health and build social inclusion. When
children were to address mental health concerns, including Attention Deficit Disorder and Oppositional Defiance         considering community health as a whole, the quality and affordability of housing stood out as the top priority.
Disorder.                                                                                                               While certainly not a fix-all solution, mixed income housing was suggested by several service providers as a
                                                                                                                        redevelopment strategy.
Almost two thirds of people interviewed reported that on average, they were physically active for more than 60
minutes a day. This is higher than the Canadian national average. Survey results also show that almost half (48.1%)     The community needs assessment identified some service gaps for people in north Kingston. However, people
of people walk or ride their bike as their main form of transport. About half of people interviewed had children        who were interviewed in the community needs assessment were far less likely to suggest a new service, than to
involved in organized clubs, sports and activities, considerably lower than the Canadian average of 75%.                speak of improving the accessibility and effectiveness of an existing one. The principles of integration and
                                                                                                                        accessibility are central. Community health centres like KCHC have a special calling to provide accessible services
Community members who participated in the assessment used a diverse range of health services. Almost a quarter          to people who experience multiple barriers to health, and to develop strong connections with other health, social
(22.8%) had received health care in a hospital emergency department in the last six months. This rate was double        and community service partners.
for children.
                                                                                                                        5. What does the community needs assessment mean for KCHC?
3.4 Services and supports for people in north Kingston                                                                  The community needs assessment process revealed rich information on the strengths and challenges of the
The five best rated services were: food bank services; library services; neighbourhood parks and playgrounds;           community of north Kingston. The report concludes with the following recommendations. Each recommendation
primary health care services; and bus transportation.                                                                   is accompanied by a list of questions for KCHC to consider. The recommendations are:
                                                                                                                                • Revitalize consistent community engagement
The five worst rated services were: dental health services,                                                                     • Consider neighbourhood differences in planning and programming
social housing supports and services; Ontario Works;                                                                            • Empower and equip clients to advocate on issues they care about
employment services; and the Ontario Disability Support                                                                         • Research concerns and responses to housing and mental health service gaps
Program.                                                                                                                        • Provide preventative and treatment oriented dental services
                                                                                                                                • Leverage KCHC’s strengths for partnership and community building
When asked“What is the one service or support that most                                                                         • Use this community needs assessment to renew commitment to respond to community needs and
needs to be improved for the people of north Kingston,”                                                                           maximize community strengths
the most frequently mentioned response was housing.
                                                                                                                        One of the consequences of inviting community input is the need to take it seriously. This community needs
Other identified service gaps include mental health services for both adults and children.
                                                                                                                        assessment created the opportunity for more than 130 community members in north Kingston to share their views
                                                                                                                        on individual and community health in order to guide KCHC planning and programming. This needs assessment
Seniors had a unique set of views about services. Their top concerns included street and roadway safety; access to
                                                                                                                        is a significant piece of input into how KCHC plans and delivers programs and services. The findings and
transportation; and access to health care services, particularly post-surgery.
                                                                                                                        recommendations of this process are an opportunity for KCHC to be even more progressive and responsive to
                                                                                                                        community strengths and challenges in north Kingston.

6                                                                                                                                                                                                                                        7
If I could change one thing
1. Understanding the community needs assessment                                                                       1.4 What did we want to discover?

1.1 What was the purpose?                                                                                             1.4.1 Three big questions
In order to plan and deliver programs that respond to community challenges and strengths, an organization needs       The community needs assessment was designed around three big questions:

to understand what they are – What do people care about? What are the major factors influencing people’s                          a. How healthy are the people of north Kingston?

individual health? What makes a difference to community health and well being? How well are community, health                     b. What makes the community of north Kingston healthy?

and social services and supports working for people? What are people’s ideas on how to make their communities                     c. How well do health, social and community services and supports serve the people of north Kingston?

healthier?
                                                                                                                      The first question is at the individual level, and focuses on health status. The second is at the community level, and
In late January 2010, Kingston Community Health Centres (KCHC) began a community needs assessment process             puts a spotlight on the determinants of health (see section 1.4.2 below). And the third is at the system level, and
in north Kingston to give deeper insight into these questions and others. Over period of three months, the needs      focuses on system performance. These three questions are roughly based on the three categories of Statistics
assessment process involved more than 130 individuals and families living on low incomes in north Kingston and        Canada health indicators.1
more than a dozen service providers. The purpose of the community needs assessment was:
                                                                                                                      1.4.2 Defining health
        To identify current community health needs and strengths in north Kingston in order to guide KCHC             As a community health centre, KCHC defines health in a broad way, and aims to support people with a higher risk
        planning and programming                                                                                      of poor health and who face multiple barriers to health. Health is more than the absence of illness or disease. Health
                                                                                                                      is a state of complete physical, mental and social well being.2 To have a sense of well being, a person must be able
The assessment was led by two consultants, alongside an eight-member community needs assessment team made
                                                                                                                      to meet their goals, satisfy their needs, and be able to change or cope with their living situation.
up of KCHC staff and community members. The team advised on the process and helped develop the needs
assessment tools and analyse the results. This report outlines the community needs assessment process, results, and
                                                                                                                      What makes people healthy or unhealthy may look like a simple question on the surface. But, the answers are
recommendations.
                                                                                                                      connected to a wide variety of factors – and not all of them are things that we consider when we think about
1.2 Why now?                                                                                                          “health”. These factors – or “determinants” – that influence health include3:
Assessment is recognized as a major component of the program cycle. KCHC staff regularly seek feedback from                       1. Income and social status
community members to inform ongoing planning. However, KCHC has not completed a significant community-                            2. Social support networks
wide needs assessment for several years. This community needs assessment helps fill that gap, and ensure that the                 3. Education and literacy
voices of community members are at the forefront of KCHC’s program and corporate planning. This assessment                        4. Employment/working conditions
strengthens KCHC’s ability to respond to the needs of people living in north Kingston, as well as to maximize their               5. Social environments
strengths as a community.                                                                                                         6. Physical environments
                                                                                                                                  7. Personal health practices and coping skills
Regular community needs assessment is also an important part of living out KCHC values, which state that “an                      8. Healthy child development
awareness and understanding of the social, political, economic, and environmental factors that influence and affect               9. Biology and genetic endowment
an individual’s health should inform the development and delivery of our services.” In keeping with these values,                 10. Health services
KCHC is committed to “promote community involvement throughout KCHC; we will solicit and utilize community                        11. Gender
input when planning, developing, delivering, and evaluating our services.”                                                        12. Culture
                                                                                                                      Because we define health broadly, and we believe that health is influenced by a variety of different determinants,
1.3 Who and where was the focus?
                                                                                                                      this community needs assessment includs questions on many different things that may not immediately be
The community needs assessment was focused on north Kingston, Ontario, defined by the area between Princess
                                                                                                                      thought of as health questions. However, things like people’s sense of belonging to their neighbourhood, what
Street and Highway 401 and east of Leroy Grant Drive to the Cataraqui River. According to the City of Kingston’s
                                                                                                                      causes them stress, and whether or not they can get good childcare when they need it, all impact health.4
neighbourhood profiles, this area is comprised of five neighbourhoods: Marker’s Acres, Rideau Heights, Inner
Harbour, Kingscourt and Williamsville. Maps of each of these neighbourhoods is included in Appendix A. Within         1 For more information, see Statistics Canada, Health Statistics Division. Health Indicators. 2008. http://www.statcan.gc.ca/pub/82-221-x/82-221-x2008001-eng.pdf
                                                                                                                      2 Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22
these neighbourhoods, the community needs assessment focused on two broad groups of people:                             July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.
                                                                                                                      3 Public Health Agency of Canada. 2008. What determines health? http://www.phac-aspc.gc.ca/ph-sp/determinants/index-eng.php Accessed May 4, 2010.
        • Individuals and families living on low incomes in north Kingston                                            4 For an excellent resource on determinants of health, including housing, food, income, education, employment and inclusion, see Primer to Action: Social
                                                                                                                        Determinants of Health. A resource for health and community workers, activists and community residents to understand how the social determinants of health
        • Seniors living in north Kingston                                                                              impact chronic disease – and what we can do about it. May 2008. Ontario Chronic Disease Prevention Alliance and Health Nexus.
                                                                                                                        http://www.healthnexus.ca/projects/primer.pdf Accessed May 12, 2010.


8                                                                                                                                                                                                                                                                                    9
If I could change one thing
1.5 How did we get the information?                                                                                   conducted with a random group of seniors who came to the focus group as a result of an
                                                                                                                      invitation flyer delivered to their doors and placed on the common bulletin board. In each focus
The community needs assessment used four methods to gather information.                                               group, the consultants led a discussion, structured around a handful of open questions about
                                                                                                                      their neighbourhood experience and ideas for improving their lives in north Kingston. A total of
a. Review of existing information
                                                                                                                      25 seniors attended the focus groups.

        To set the backdrop, we reviewed other relevant reports and studies on community health. We           d. Face-to-face structured interviews families and individuals living on low incomes (106 people)
        focused on the local level, but considered national and international data as well. For example, at
        the local level we reviewed reports on food security from Queen University School of Urban and                Led by the two consultants, the community needs assessment team designed a survey
        Regional Planning and Kingston, Frontenac Lennox & Addington (KFL&A) Public Health; reports                   questionnaire for interviews with families and individuals living on low incomes in north Kingston.
        on homelessness and housing from KFL&A United Way, and Queen’s School of Urban and Regional                   The 45-question survey included multiple choice questions with check boxes; rating questions on
        Planning; community needs assessments and reports delivered by KCHC and other agencies                        neighbourhood characteristics, health behaviours, and services; and open questions where
        providing services to north Kingston; reports on early learning and childcare from the United Way             respondents answered in their own words. A total of 106 community members were interviewed
        Success by Six project; reports on poverty and income from the Kingston Community Roundtable                  over a period of approximately three weeks. Each interview took approximately 20 minutes.
        on Poverty Reduction; and demographic and population data from the City of Kingston’s                         Community members received a $10 food gift certificate for a local grocery store in appreciation
        neighbourhood profiles. At the national and international levels our research included reports                of their participation. The interview consent form is in Appendix D.
        on the efficacy of mixed income housing; information on housing affordability from the Ontario
                                                                                                              1.6 How did we recruit community members to be interviewed?
        Non-Profit Housing Association / Co-operative Housing Federation of Canada; reports on planning
        processes for engaging communities; and information on chronic diseases from Cancer Care              To select north Kingston community members to be interviewed, we used a process of purposive sampling.
        Ontario and Southeastern Ontario CHC’s Information System User group. A list of the documents         Interviews with north Kingston community members were conducted primarily by 13 staff of KCHC from the North
        and reports reviewed is in Appendix B.                                                                Kingston Community Health Centre, the Street Health Centre, and Better Beginnings for Kingston Children. These
                                                                                                              KCHC staff selected north Kingston community members for interviews from among their list of clients. In addition,
b. Face-to-face semi-structured interviews with service providers (13 service providers)
                                                                                                              two community members (part of the community needs assessment team) conducted interviews with north
        Using an interview guide (see Appendix C), the consultants interviewed representatives from 13        Kingston community members, using their personal connections to recruit people for interviews.
        organizations that deliver community, health or social services and supports to people who live
        in north Kingston. To select which service providers to interview, the community needs                In other words, this assessment does not reflect the views of a randomized and representative group of north
        assessment team first created a community stakeholder map, brainstorming significant people           Kingston residents. Instead, it reflects the views of the people we purposely identified to be interviewed – the
        and organizations who impact community health in north Kingston. Then, using a group process,         majority of whom are current clients of KCHC programs. A breakdown of how the interviews were done by KCHC
        we prioritized a list of individual names. Service providers worked for a variety of organizations    staff and community members is below.
        including the City of Kingston Recreation and Leisure Services Department, Kingston Frontenac
                                                                                                                                                                  Where did this survey originate?
        Housing Corporation, United Way serving KFL&A, Community Response to Neighbourhood
        Concerns, Pathways for Children and Youth, Salvation Army, Partners in Mission Food Bank, Home
                                                                                                                             North Kingston Community
        Base Housing, Elizabeth Fry Society, and Hotel Dieu Hospital. We also interviewed one person                             Health Centre (KCHC)
                                                                                                                                                                                               21.7% (23)

        each from KCHC’s North Kingston Community Health Centre, Better Beginnings for Kingston
        Children, and the Street Health Centre.                                                                                   Better Beginnings for                                          22.6% (24)
                                                                                                                             Kingston Children (KCHC)


c. Focus groups with seniors (3 groups, 25 seniors)
                                                                                                                                         Street Health
                                                                                                                                       Centre (KCHC)
                                                                                                                                                                                                     23.6% (25)

        The consultants organized and led three focus groups with seniors in north Kingston - the first
        at the North Kingston Community Health Centre; the second at Weller Arms, a senior’s residence                        Community members (2)                                                               32.1% (34)

        in Rideau Heights; and the third at Zion Foundation Housing Complex, a senior’s residence in the
        Inner Harbour neighbourhood. The first focus group was conducted with a group of seniors that
                                                                                                                                                          0   5       10       15        20      25         30    35
        meet weekly at the health centre in the “Penguins” group. The second two focus groups were

10                                                                                                                                                                                                                             11
If I could change one thing
1.7 How did we analyse the information?                                                                              2. Understanding the Context
Interviews with service providers and conversations with focus groups were recorded by the consultants in detailed
written notes. The consultants then summarized these notes by theme, highlighting the most salient quotes.           2.1 North Kingston’s neighbourhoods
Summaries of service provider interviews and focus groups are included in Appendix E and Appendix F.                 The Kingston Mayor’s Task Force on poverty notes that,


Community member survey questionnaire results were inputted manually into www.surveymonkey.com. Answers                          “Princess Street continues as Kingston’s most recognized divide. It lingers in the collective consciousness
to open questions were manually grouped into categories and prioritized by frequency. An overall summary of survey               that the ‘haves’ live south of Princess and the ‘have nots” live north.”5
results is in Appendix G. A summary and analysis of responses to the survey’s open questions is in Appendix H.
                                                                                                                     North Kingston is a diverse community made up of several different neighbourhoods with a total population of
The community needs assessment team reviewed all results. The consultants then organized a “Review and               22,358 people. Key indicators for each of the five neighbourhoods are summarized below.6
Recommendations” workshop, attended by approximately 30 people including KCHC staff (the majority),
                                                                                                                     Neighbourhood              Population         Low Income                 Without           Average                 No. of            In           Home
community members, and service providers. The purpose of the workshop was to examine and analyse findings
                                                                                                                                                                   Households                 high school       Family                  Lone              labour       Ownership
from the community needs assessment and discuss what they mean for KCHC. Participants discussed findings in                                                        before tax 2005            diploma           Income                  Parent            force
four areas: how do north Kingston residents feel about their neighbourhoods; how do people describe their                                                          (City ranking/40)          (City ranking/40)                         Families

individual health status and health behaviours; how well do services and supports work for people in north
Kingston; and what are the best ways to improve community health and well-being in north Kingston.                   Inner Harbour                7390               34.7% (37)               19.9% (37)              $56,520            440             62.4%             36%
                                                                                                                     Kingscourt                   4155               16.7% (29)               22.2% (39)              $56,786            230             64.2%             61%

The consultants also presented highlights of findings to KCHC’s senior management team, and led a discussion on      Marker’s Acres               2735               12.7% (27)               19.5% (38)              $60,046            155             60.9%             66%

implications for the findings on who KCHC serves, what KCHC does, and how and where KCHC plans and delivers          Rideau Heights               5600               46.1% (39)               32.0% (40)              $39,022            555             48.4%             33%

services and programs.                                                                                               Williamsville                2478               41.4% (38)               14.7% (35)              $53,761            115             66.4%             30%
                                                                                                                     North Kingston (all

Feedback from both the Review and Recommendations Workshop, and the meeting with KCHC senior                         5 neighbourhoods) 22,358                            32.3%                   22.7%                $53,227           1495             59.5%            42.4%

management, has helped form the recommendations in this report.                                                      City of Kingston           117,207                 15.40%                  10.70%                $68,396           5360             64.1%            66.2%


                                                                                                                     The chart illustrates some of the significant differences between neighborhoods. Close to half (46.1%) of Rideau
                                                                                                                     Heights families for example, are living on low incomes while the same is true for only 12.7% of families in Marker’s
                                                                                                                     Acres. Home ownership varies from as high as 66% in Marker’s Acres and 61% in Kingscourt to as low as 33% in
                                                                                                                     Rideau Heights. Williamsville’s low home ownership rates may be partly reflective of the high proportion of Queen’s
                                                                                                                     University students who live in that neighborhood.


                                                                                                                     In summary, these five north Kingston neighbourhoods make up about 20% of the total Kingston population. Taken
                                                                                                                     together, north Kingston average family incomes are 22% below the city average. Further, north Kingston residents
                                                                                                                     are twice as likely not to have completed high school, and twice as likely to be living on low incomes.




                                                                                                                     5 Ready to do Better. A Report on the Mayor’s Task Force on Poverty October 2007, page 21.
                                                                                                                     6 All data is from Statistics Canada 2006 census, organized by the City of Kingston into neighbourhood profiles. The City defines “neighbourhoods” based on areas
                                                                                                                       of common social, physical and political attributes. Neighbourhoods are based on census dissemination areas, which are the smallest units defined by Statistics
                                                                                                                       Canada. For more information on all 43 of Kingston’s neighbourhoods, see http://www.cityofkingston.ca/cityhall/neighbourhoods/.




12                                                                                                                                                                                                                                                                                13
If I could change one thing
2.2 Does “north Kingston” = Rideau Heights?                                                                                 average. The Kingston Mayor’s Task Force on Poverty states that“Spending on health care has a relatively minor effect
Community needs assessment interviews and focus groups revealed that when people refer to “north Kingston”,                 on the health of a population compared to such determinants as employment, income and social status”. Further, “in
many of them are speaking not of the group of all five neighbourhoods in the north end, but of Rideau Heights.              Ontario, poverty-induced costs related to health care have an annual public cost of $2.9 billion.”7
Among all the north Kingston neighbourhoods, Rideau Heights has the greatest proportion of low income families,
                                                                                                                            b. Lack of available and affordable housing
the highest percentage of lone parent families, the highest percentage of people without a high school diploma,
                                                                                                                            Housing and homelessness have long been identified as a major challenge in Kingston. City shelter bed usage rates
the lowest labour force participation rates, and the lowest average family income. According to our interviews,
                                                                                                                            have increased over the past decade and many people experience a lack of available and affordable housing. In 2008,
Rideau Heights also carries the burden of having the most negative reputation and social stigma.
                                                                                                                            1090 households were on the Social Housing Registry waiting list, with anywhere from a 6-48 month wait. Rideau
                                                                                                                            Heights has the highest concentration of social housing in the city.
One service provider distinguished north Kingston’s neighbourhoods this way:
                                                                                                                            c. Low levels of education
         “Some areas are more stigmatized than others. Rideau Heights is definitely considered to be the worst.             Education is recognized as an important determinant of health. Yet, data indicate that residents of north Kingston are
         There’s a view that Kingscourt has more resources and more families. The mix of owners and renters is              twice as likely not to have completed their high school diploma than the average Kingston resident. The statistics are
         different. Inner Harbour and Williamsville are being gentrified. There is less affordable housing available        even more stark in Rideau Heights, where almost a third of people (33%) have not finished high school. Further, test
         there now. That area has the most services – two grocery stores, banks, drug stores, all walkable. Now             scores for the Early Development Instrument (EDI), a population based measure on how prepared children are for
         that’s the area where people with money live. People with lower incomes now can’t live there.”                     entry into grade one, show that in KFL&A, 18.6% of the children tested scored below the 10th percentile in one or
                                                                                                                            more domains. These children are therefore are among the most seriously at-risk for problems in school. The highest
Another service provider described north Kingston like this:
                                                                                                                            percentage of low scorers (37.1%) live in North Kingston.
         “The reality is that north Kingston is two distinct areas – one north of the industrial lands, and one
                                                                                                                            d. Food insecurity
         south of the industrial lands. People in the south have access to downtown.”
                                                                                                                            Based in north Kingston, Kingston’s primary foodbank
                                                                                                                            distributed 10,247 hampers worth $961,726 in 2009.
Though our sample was limited, these views were certainly mirrored in the focus groups we carried out with seniors
                                                                                                                            Almost six thousand unique individuals use the food
in north Kingston. For example, focus groups with seniors at Weller Arms and the North Kingston Community Health
                                                                                                                            bank every year; almost half are children under age 18.
Centre were attended by a majority of Rideau Heights residents. Neighbourhoods concerns in both these focus
                                                                                                                            A recent Queen’s University study of food security in
groups were similar – traffic safety, neighbourhood stigma, access to transport and so on. By contrast, most senior
                                                                                                                            north Kingston identified limited access and education
participants at the focus group in at the Zion United Church Foundation building in Inner Harbour expressed a
                                                                                                                            as major barriers to improving food security. The
high degree of satisfaction with available services and supports. They lived right next to a bus stop, and accessed
                                                                                                                            number one recommendation coming out of the study
most of their services – banks, shopping, groceries etc. - out of the downtown area. While the first two focus groups
                                                                                                                            was focused on affordability:“Seek approaches that will
clearly identified themselves as“north Kingston residents,” the latter identified themselves as living in the fruit belt,
                                                                                                                            aim to eliminate cycles of poverty within the community”.8 In January 2009 KFL&A Public Health reported that 11.4 %
or at the upper end of downtown.
                                                                                                                            of people claimed to experience or worry about food insecurity over the last 12 months.

In short, while the broad north Kingston neighbourhood experience is diverse, many people use “north Kingston”              e. Community safety concerns
as a synonym for Rideau Heights.                                                                                            The safety of individuals, families and children is of utmost importance to people living in communities. Proper lighting,
                                                                                                                            safe walkways, safe bus shelters, and lack of criminal activity are all signs of a safe community. The Community
2.3 Needs in the north Kingston community
                                                                                                                            Engagement Report on Wally Elmer states that “though crime is a serious concern for everyone in Rideau Heights,
         “The issue is generally, poverty, and all that comes from that, or all that leads to that” – Service provider      most see it as intense sporadic activity in specific locations, rather than pervasive safety issues across the community.”9


This community needs assessment, as well as other complementary studies done by other groups and organizations
in north Kingston reveal a number of common themes about community needs in the north Kingston community.
Common themes include:
                                                                                                                            7 Ontario Association of Food Banks. The Cost of Poverty: An Analysis of the Economic Cost of Poverty in Ontario. November 2008.
                                                                                                                            8 Ramos, Carola; Sibanda, Prince; State, Hannah; and Van Dorp Jakob. Queen’s School of Urban and Regional Planning. Assessing and Addressing Food Security in
a. Low incomes                                                                                                                North Kingston: Challenges and Opportunities for the Community and Beyond April 2008.
                                                                                                                            9 Meagher, Sean. A Community Engagement Strategy for Rideau Heights and the Wally Elmer Centre Community Hub. November 2007. page 11.
Poverty is traditionally measured in terms of income and on this indicator, north Kingston ranks well below the city


14                                                                                                                                                                                                                                                                                     15
If I could change one thing
f. Access to basic services                                                                                                                               Poverty is complex. All of these threads – including income, housing, education, food security, safety, access to
Access to basic services differs depending on where you live in north Kingston. Inner Harbour and Williamsville are in                                    services and others – are woven together and cannot be seen isolation. Depending on who you talk to, different
close proximity to the downtown core and therefore in close proximity to services including banks, grocery stores, and                                    threads leap to the surface as the most important and deserving of action. This community needs assessment aims
the central public library. Neighbourhoods further away from downtown have less access to amenities, although the                                         to amplify the voices of the more than 130 community members we interviewed in north Kingston, putting into
recent construction of a new grocery store in Rideau Heights is a positive addition. According to a recent report,                                        the light the issues that they consider the most important.
“Although services are in short supply in Rideau Heights, the ones that have shown a commitment to the community
                                                                                                                                                          2.4 Strengths in the north Kingston community
have earned trust. Better Beginnings, the Boys and Girls Club and the Community Health Centre in particular are cited
                                                                                                                                                          North Kingston has significant needs, but also, significant strengths. This community needs assessment, supported
by residents as important community assets.”10
                                                                                                                                                          by other relevant reports on north Kingston, reveals three common themes about strengths:
g. Access to affordable recreation
                                                                                                                                                          a. Renewed attention and investment by the City of Kingston
In 2004 in Ontario, 59% of adults and 28% of
                                                                                                                                                          A number of service providers shared the idea that “The City is now paying attention” to north Kingston, that “there
children and youth were either overweight or
                                                                                                                                                          is some change afoot in terms of development of the north end”, and that “north Kingston gets more attention than
obese. Evidence from recent, large-scale
                                                                                                                                                          many other similar communities in the region.” The recent construction of the No Frills grocery store, the outlet mall,
systematic reviews by the World Cancer Research
                                                                                                                                                          the splash pad, and the future Wally Elmer Community Centre were all noted as examples of positive recent
Fund has shown a convincing link between body
                                                                                                                                                          development and investment in the north end.
fatness and an increased risk of esophageal,
pancreatic, colorectal, postmenopausal breast,
endometrial, and kidney cancers and a number                                                                                                              b. Presence of multiple agencies providing services and supports
of other chronic diseases, including diabetes,                                                                                                            Service providers and community members noted that north Kingston has many agencies that provide health,
heart disease, and stroke.11 Access to affordable recreational activity is one major solution to these health related                                     community and social services and supports in north Kingston. KCHC was identified several times in interviews as
outcomes. In north Kingston, momentum has been building over the past few years to develop the Wally Elmer                                                an institutional strength. Further, there seems to be a belief among service providers that “Agencies that work in
Arena into a community centre with safe and affordable recreational activities for all ages. However, the recent                                          north Kingston are working well together. Not always, it’s not perfect. But there’s a coming together, and they know each
installation of a four pad ice arena in the city’s west end moves opportunities for recreational activity away from the                                   other and what they do.”
north Kingston community. Pro Kids, a city run program, assists parents living on low incomes to pay for their
children to participate in organized recreational activities.                                                                                             c. Resilient residents and strong social networks:
                                                                                                                                                          “I think the people are the strength,” said one service provider. “They humble me. These people live difficult lives, and just
h. Challenges for Seniors                                                                                                                                 do what they have to do. They are so resilient. And their children are growing up resilient.” Others noted the willingness
The Southeast Local Health Integration Network (SEO LHIN), reports that the Kingston, Frontenac Lennox &                                                  of community members to be involved in community action - “When I look at the struggles and challenges that many
Addington region has the highest percentage of seniors age 65+ in Ontario. Our area also ranks second highest for                                         people have, it’s amazing the amount of time and energy they give to making things better in their community.” Some
ages 55-64 at almost 14%.12 Senior citizens deal with unique challenges. The Kingston Seniors Centre and the City                                         service providers also highlighted the long-term social support networks in north Kingston, with families who have
of Kingston both offer activities for seniors; however, cost and transportation can be significant barriers to access.                                    been in the area for generations.
North Kingston Community Health Centre and some local churches also offer senior specific programs and services
in north Kingston. SEO-LHIN recently implemented two programs for seniors: Seniors Managing Independent Living
Easily (SMILE) and @Home ASAP. Both were developed to keep seniors in their own homes longer. In 2001 28.3%
of seniors over the age of 65 were living alone.13




10 Ibid.
11 Cancer Care Ontario PEBC Report #23-1 Healthy Eating, Physical Activity, and Healthy Weights Guideline for Public Health in Ontario. March 17, 2010.
12 Southeast Local Health Integration Network. Annual Business Plan. June 2009. page 21.
13 Rolland, Elizabeth. KFL&A Public Health Social Profile Report. September 2005. page 28.




16                                                                                                                                                                                                                                                                                   17
3. What were the findings from the community needs assessment?                                                                              3.1.3 Education and Income
                                                                                                                                            45 % of people interviewed had not completed their high school diploma. As noted in the chart in section 2.1, the City
3.1 Who did we interview?                                                                                                                   of Kingston average for those who have not completed high school is 10.5% while the north Kingston average is 21.7%.
To summarize, we interviewed three different categories of people over the course of the community needs assessment:
            • 13 service providers                                                                                                          18.3% of those interviewed had a college or university diploma or degree.
            • 25 north Kingston seniors, in 3 focus groups
                                                                                                                                                                                               What’s the highest level of education you have completed?
            • 106 north Kingston community members
This section provides a more specific profile on the 106 community members who participated in face to face
interviews using a survey questionnaire.                                                                                                                                Some hight school,
                                                                                                                                                                               no diploma
                                                                                                                                                                                                                                                                     39.4% (41)


                                                                                                                                                                                                                                           25.0% (26)
3.1.1 Which neighbourhoods?                                                                                                                                                Completed high
                                                                                                                                                                        shool, with diploma

We interviewed a variety of people across all five north Kingston neighbourhoods, as well as a handful of people who                                                    Completed college
                                                                                                                                                                                                                               18.3% (19)
                                                                                                                                                                         or university, with
                                                                                                                                                                        diploma or degree
were homeless, had no fixed address or were couch surfing in north Kingston. Most community members who were
                                                                                                                                                                           Grade 8 or less             5.8% (6)
interviewed lived in either Rideau Heights (32.7%) or Inner Harbour (37.5%). Rideau Heights and Inner Harbour are                                                      (elementary school)

                                                                                                                                                                 Some college or university
also the largest of the north Kingston neighbourhoods by population. Details are illustrated in the chart.                                                          no diploma or degree                5.8% (6)
                                                                                                                                                                 G.E.D. (General Education
                                                          What neighbourhood do you live in in north Kingston?                                                       Development) or other           3.8% (4)
                                                                                                                                                                     high school equivalent

                                                                                                                                                                Vocational (business, trade
                                                                                                                                                                       or technical) school        1.9% (2)
                                Inner Harbour                                                                                  37.5% (39)

                                                                                                                                                                                               0              10              20                30              40              50
                               Rideau Heights                                                                    32.7% (34)
                                                                                                                                            The majority of people interviewed were on a government income assistance program, with 42.2 percent receiving
                                  Williamsville                           11.5% (12)                                                        Ontario Disability Support Program (ODSP) benefits, and 26.5% receiving Ontario Works benefits. Only 12.7% reported
                                                                                                                                            that their main source of income in the last six months was from wages and salaries from working for an employer.
                   Homeless, no fixed address,                     7.7% (8)
                                 couch surfing
                                                                                                                                                                                                   What has been your MAIN source of income in the last six months?
                                   Kingscourt                  6.7% (7)
                                                                                                                                                                                      50



                               Marker’s Acres             3.8% (4)                                                                                                                                     42.2% (43)
                                                                                                                                                                                      40



                                                  0                 10                   20                 30                40
3.1.2 Gender and Age                                                                                                                                                                  30
                                                                                                                                                                                                                          26.5% (27)
                                                                                                                         14
We interviewed far more women than men, with 74% female, 24% male and 2% other. Age was fairly evenly distributed as
illustrated below. Half of people we interviewed were between 20 and 34.The average age range was 35-39. Under half of the                                                            20

community members we interviewed (44.2%) had children who were under age 18 currently living with them in their home.
                                                                                                                                                                                                                                            12.7% (13)
                                                                                 How old are you?
                                                                                                                                                                                      10

                                           15-19           1.9% (2)                                                                                                                                                                                             5.9% (6)          5.9% (6)
                                           20-24                                                                          22.1% (23)
                                                                                                                                                                                       0
                                           25-29                                                       14.4% (15)
                                                                                                                                                                                                     Ontario Disability   Ontario Works   Wages and salaries    Benefits from    Old Age Security
                                           30-34                                               12.5% (13)                                                                                            Support Program          (OW)        from working for an Canada or Quebec and Guaranteed In-
                                                                                                                                                                                                         (ODSP)                                employer           Pension       come Supplement
                                           35-39                              6.7% (7)
                                           40-44                         5.8% (6)
                                           45-49                                          10.6% (11)                                        3.1.4 Housing
                                           50-54                                    8.7% (9)
                                                                                                                                            Most people interviewed lived in an apartment (61.5%), while about a third lived in a house (31.3%). The vast
                                           55-59                   3.8% (4)
                                           60-64        1.0% (1)                                                                            majority were renting (84.9%), with less than 7% owning the place where they live. 15 The City of Kingston average
                                           65-69                   3.8% (4)
                                                                                                                                            for home ownership is 58.4%.
                                           70-74                   3.8% (4)
                                           75-79                    3.8% (4)
                                       80 or over       1.1% (1)

                                                    0                5               10                15           20                 25   15 According to A Home First – A Community Plan on Housing and Homelessness in Kingston. May 2009, over the last 5 years, average rents in Kingston have
14 KCHC’s active clients also show a slight gender imbalance with 43% male and 57% female.                                                     increased between 14.6% and 55.9%. Page 8.


18                                                                                                                                                                                                                                                                                                     19
You can also read
Next part ... Cancel