Joanna Frketich

The 53-year-old man died at the scene of the three-vehicle crash in Mulmur A 53-year-old Hamilton man was killed when his motorcycle was part of a three-vehicle crash in Dufferin County.

Fewer than 10,000 people in Canada have dystonia that can affect everything from blinking to holding up your head to walking.

Residents living in Hamilton neighbourhoods in L8L, L8H and L8V have double the risk of developing an extreme response to infection called sepsis that can be deadly, a local study found. The research into what Hamilton forward sortation areas (the first three characters of a postal code) are most vulnerable to sepsis adds to a growing volume of evidence of the strong connections between health and socioeconomic factors in the city. “The major finding related to this study is really the fact that among our socially and physically disadvantaged neighbourhoods, we have about 17 per cent of the population living there and about twice the number of individuals coming into the hospital with sepsis and twice the number of individuals that are dying from sepsis from these neighbourhoods,” said Fatima Sheikh, health equity specialist at Hamilton Health Sciences (HHS) and a McMaster University PhD candidate. “It was a little bit surprising. I didn't expect to see such significant differences between communities within the same city.” A secondary finding was that those without a family doctor were at increased risk of sepsis. “We hypothesized that this might be due to the fact that early detection of sepsis is critical,” said Sheikh, who is the first author on the study. “We imagine that individuals who have a family physician might be more likely to have the condition detected earlier or to have the condition detected before it progresses to sepsis.” The study shows the importance of hospitals collecting socioeconomic data of patients so that future research can understand what is driving these inequities, Sheikh said. “We need to be really cognizant of who is developing sepsis and a huge part of that is related to data collection of social determinants of health information to identify those disparities in terms of what is going on, why and how patients and families are at increased risk … really getting to the root cause,” Sheikh said. “This is things like an individual's level of income, their race, ethnicity, who they're living with, what their social support looks like … What we don't measure, we can't necessarily address.” HHS has recently started collecting this information on a confidential and voluntary basis, Sheikh said. “That is the missing piece — there was a lack of data collection within the medical records, and that was also a key finding from the study,” Sheikh stated. “As we move to collect that information, it's an opportunity for us to uncover why we're seeing some of those disparities. It's not something we have an answer to.” The neighbourhoods found to be most at risk for sepsis in the study published in the Canadian Journal of Anesthesia in July had 33 sepsis cases per 100,000 residents compared to a rate of 15 in the rest of the city. The first forward sortation area at risk was L8L in the central north part of the lower city, which takes in Hamilton's North End, Stipley, Beasley, Gibson, Landsdale, Keith, Crown Point West and Industrial Sector neighbourhoods. It stretches from King Street to the water and from Caroline Street North to Ottawa Street North. The next vulnerable forward sortation area was east Hamilton's L8H in the lower city, which includes the McQuesten, Parkview, Normanhurst, Homeside, Crown Point East, Kentley and Industrial Sector neighbourhoods. It goes from Queenston Road to the water and from Ottawa Street North to just past Nash Road North. The last area identified in the study was central Mountain's L8V, which takes in the Eastmount, Lawfield, Macassa, Burkholme and Raleigh neighbourhoods. It stretches from the Mountain brow to Limeridge Road East and from Upper Wentworth Street in parts to just past Upper Gage Avenue. All three forward sortation areas were listed as containing “systematically disadvantaged neighbourhoods” in the study. “I think for a long time we haven't paid attention to the social and structural determinants of health and we're starting to do that now,” Sheikh said. “I'm looking forward to what that will help us uncover and importantly, how it will help us improve patient care, our programs, and ultimately our policies.” The findings are in line with The Spectator's groundbreaking Code Red project, which examined the connections between health, social and economic factors in Hamilton in a number of projects over more than a decade starting in 2010 by investigative reporter Steve Buist. “We're looking at understanding the role of social determinants of health as it relates to sepsis,” Sheikh said about the unfunded study. “We were looking … to really understand across Hamilton, who was coming into our emergency departments with sepsis and who was potentially developing sepsis in the hospital and how they were faring.” It's important to study sepsis because it is one of the most frequent causes of death worldwide. In Canada, it is involved in one in 18 deaths, Sheikh said. “Sepsis really simply is a life-threatening condition that's caused by the body's extreme response to an infection,” Sheikh said. “The reason why it's so important is because any infection can lead to sepsis, something as simple as a scrape on your finger to a lung infection. It can affect anyone. It disproportionately affects our socially and structurally marginalized communities.” The next step for the research is to look beyond Hamilton to replicate the results provincially and nationally, Sheikh said. “Different people experience disease in different ways,” Sheikh said. “We want to make sure that we're tailoring our solutions to our community.” In addition, HHS is working to make health equity data collection standard practice across its hospital sites after a pilot program at the Boris Clinic and Ron Joyce Children's Health Centre in 2023 resulted in 2,400 patients volunteering to provide information about race, ethnicity and preferred language. Since certain groups might be more likely to provide information voluntarily than others, the team is also working with different communities to inform how it is done. “We're developing a process that works for patients and families,” Sheikh said. “The other piece of this is we thought really critically about what questions we're asking, why we're asking them and what information we're providing to our families to ensure that they feel comfortable sharing information.”

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