Why averages are not enough
Two neighbourhoods in the same city can have very different health outcomes. Citywide statistics smooth those differences away, which makes it hard for community organizations to see where closer attention may be warranted.
What Evanston's data showed
Evanston is a useful example for a plain reason: its community health assessment is public, documents its sources and reports results by neighbourhood. It is not a template for Toronto.
Evanston, Illinois, adopted that assessment, the Evanston Process for the Local Assessment of Needs (EPLAN), for 2022 to 2026. The city's Health Advisory Council approved it on June 29, 2022 [1].
The EPLAN reports tract-level life expectancy estimates ranging from 75.5 years (tract 8092, in the 5th Ward) to 88.8 years (tract 8088, in the northeast corner of the city), against a citywide average of 82 years and a US average of 78.7 [1]. That is a gap of about 13 years inside one small city.
Three details matter for interpretation:
- The data period is earlier than the report. The tract estimates appear to come from the U.S. Small-area Life Expectancy Estimates Project (USALEEP), which covers 2010 to 2015 [2][3]. They describe an earlier period than the 2022 report, and the EPLAN notes that most of its data predates the pandemic [1].
- The gap tracks other conditions. Tract 8092 is 11% White, has a median household income of $44,458, and corresponds closely with a historically redlined area. Tract 8088 is 81% White with a median household income of $144,853 [1].
- Some tracts have no estimate. The EPLAN's map shades tracts with insufficient data gray [1].
None of this is surprising. Tract-level life expectancy tracks income and race across the US. The value of local detail is in showing where the pattern sits and starting a conversation about it, not in discovering something new.
Turning patterns into questions
A pattern in public data is a starting point. The useful step is deciding what a community organization should ask next.
Consider a community health centre weighing where to focus outreach. Public sources can show who lives in each neighbourhood and where mapped service records are located. Examples include Statistics Canada census indicators, City of Toronto neighbourhood geography, and selected Ontario service-location records [4]. Compared side by side, they might show an area with many older adults, a higher share of low-income households, and few mapped primary-care-related locations nearby.
That combination suggests a question worth asking. It does not show that an area is underserved. A map of service records cannot measure waiting times, appointment availability, transit barriers, language or cultural fit, or whether residents have a regular provider. Those answers come from local partners and residents.
The same comparison can point the other way. An area with high need indicators and several nearby mapped services may not need expanded outreach, though only residents can say whether those services work for them. A clean result does not clear an area. It only means public data gave no reason to prioritize it.
Data can also look better than reality. Evanston's own assessment warns that figures for its Hispanic/Latino residents may look favourable because undercounting and reluctance to answer government surveys reduce what the data capture, and it points to engagement with community partners as the corrective [1]. A reassuring number is not always a clean result.
Why Toronto is not a copy of Evanston
Evanston's figures appear to come from a US federal life-expectancy project at census-tract level [2][3]. A comparable indicator may not exist at the same resolution for Toronto's 158 neighbourhoods. Boundaries, reference years and definitions also differ across census, municipal and health datasets, so comparisons need careful documentation.
The limits worth naming are the ones that could change the conclusion. Of the limits in this piece, the one most likely to do so is whether the mapped service records are complete, since every statement about proximity depends on them.
What a useful brief looks like
A good neighbourhood evidence brief is built around one catchment and one planning question. It presents indicators with their sources and dates, maps the available service records, and proposes a few areas for closer review. It lists the evidence gaps, such as which data, permissions or community input could change the conclusions. If the available evidence cannot support the question, it says so.
A brief is useful when its question is specific enough that a finding could change a decision, every indicator has a stated source and date, and every evidence gap names who could fill it.
The illustrative Regent Park area brief shows the format. It is a six-page research draft, not a commissioned report and not a measure of healthcare access [5].
More from AQIMERYL
The Toronto scenarios in this article are hypothetical and illustrate a possible application. They do not describe a completed assessment or establish unmet healthcare need in any community.
Sources
[1] City of Evanston Health and Human Services Department. 2022 EPLAN: Evanston Process for the Local Assessment of Needs, 2022-2026. Approved by the Evanston Health Advisory Council on June 29, 2022. Pages 3, 8, 10, 11, 13, 67 and 72. https://cityofevanston.org/home/showpublisheddocument/74636/637991738675470000
[2] National Center for Health Statistics. U.S. Small-Area Life Expectancy Estimates Project (USALEEP): Life Expectancy Estimates File for Illinois, 2010-2015. 2018. A partnership of NCHS, the Robert Wood Johnson Foundation and the National Association for Public Health Statistics and Information Systems. https://www.cdc.gov/nchs/nvss/usaleep/usaleep.html
[3] City Health Dashboard. "Life Expectancy - Neighborhood-Level, 2015." Names USALEEP as the source, based on deaths in 2010-2015. https://www.cityhealthdashboard.com/metric/life-expectancy-neighborhood-level-2015
[4] AQIMERYL. "Our Data & Sources." Statistics Canada census indicators, City of Toronto geographic datasets, and selected Ontario service-location records. https://aqimeryl.biosyntel.com/
[5] AQIMERYL. "Regent Park area: Neighbourhood Evidence Brief (illustrative research draft)," 3 November 2026. https://aqimeryl.biosyntel.com/reports/regent-park-neighbourhood-evidence-brief-illustrative-draft.pdf