Dr. Sharmitha Mishra awarded the 2019 CAHR-CANFAR Excellence in Research Award

For more than a decade, Dr. Sharmistha Mishra has been helping those with HIV – and the services, programs and policies that impact them the most.

And, she’s done it all using mathematical modeling.

“Mathematical modeling allows us to tease apart mechanisms that might interact and influence how infections might circulate in a population, and how things at various levels could drive transmission or help prevent transmission,” explains Dr. Mishra, who recently received the CAHR-CANFAR Excellence in Research Award in the Epidemiology/Public Health Research Stream.

As a clinician and scientist at St. Michael’s Hospital, Dr. Mishra and her lab use mathematical models to try and understand HIV and STI epidemics – which cannot be addressed through clinical trials and cohort studies alone.

Dr. Mishra uses mathematical modeling to try and understand why HIV epidemics are established and persist, where and when they persist, and what leads to differences in their size and characteristics across different regions. Her lab also uses this modeling to understand the best combinations of HIV and/or STI prevention tools, which help control epidemics…

Welcome to MAP’s new website

A message from Dr. Stephen Hwang, director of MAP Centre for Urban Health Solutions.

Earlier this year, the Centre for Urban Health Solutions (C-UHS) became MAP Centre for Urban Health Solutions. Today, we make our new name official with the launch of our new website.

Why MAP? It’s not an acronym. Instead, it represents our vision and our purpose.

Together with our community and policy partners, we are charting the way to the world’s healthiest cities: places where people, communities, and the political, economic, social, environmental, and health infrastructures come together so that everyone can thrive.

We are St. Michael’s MAP to a healthier future for all.

Although our old name (C-UHS) was relatively new, now is the right moment to update it. The past year has been a time of tremendous growth and excitement at the centre. We have expanded to almost double our team of scientists and research staff. Our two-year, $25 million fundraising campaign has reached a milestone of $18 million. This past summer, MAP scientists also received more than $18 million in federal funding and two new Canada Research Chair appointments. After many months of planning, we are on the cusp of launching 10 national, solutions-focused networks to target and interrupt the health effects of inequality in cities across Canada. These networks will come together in a MAP-hosted national symposium in March 2020.

MAP’s mission is, as always, to create a healthier future for all. Internationally recognized for groundbreaking science and innovation, MAP scientists continue to change the way the world understands the health consequences of social inequality in cities. Our focus on solutions and deep commitment to community and policy partnerships remain the same.

Please join us as we work together to address critical urban health challenges in our communities. I hope you’ll explore our new site to learn more about our scientists, our purpose and our work. Join our newsletter and follow MAP on Twitter to watch our progress and learn more about the issues we study.

This is an exciting time at MAP. Thank you for being part of it.


Dr. Stephen Hwang
Director, MAP Centre for Urban Health Solutions

We must acknowledge the impact of white-supremacist logic here, argues LaRon E. Nelson, even though it’s a difficult conversation to have

I am from Savannah, Ga., one of those places where there were very particular expectations for what black boys did after high school, and the military was one of them. My commanding officer suggested I should go to college. I had to take a special test in order for the navy to pay for my tuition. The test listed particular occupations that I would be good at, and nursing and law were first on the list. Because you had to go to graduate school to get a law degree, the military wouldn’t pay for that. So my only option was nursing. I had no interest in it, but here was my opportunity.

When I was an undergraduate, I didn’t have a lot of money, so I lived in a very rough, low-income neighbourhood. It was very different from the type of neighbourhood I grew up in and I found it fascinating. I would look out my window at night and see things that I had never seen before. People behaved in ways that were bizarre to me. I don’t think I’d ever met somebody who was high on drugs before.

I really wanted to be out in the street working with people, because when people were sick or struggling with their addiction they almost never went to the hospital, they always went to community clinics. I wanted to be there…

Expert panel calls for $15B universal, single-payer pharmacare

An advisory council set up by the Liberals has proposed the biggest change to Canadian healthcare in decades. It calls it a national project, a transformation, and a universal public program for prescription drugs. The research of Dr. Nav Persaud, a family physician and a scientist at St. Michael’s MAP Centre for Urban Health Solutions, was cited in the report as “a starting point” for determining which drugs all Canadians should have free access to.

HIV self-testing kits for blood examined for licensing in Canada

Number of new HIV cases in Canada has increased in recent years, in contrast to the downward trend elsewhere.

Researchers are launching a study on HIV self-testing kits with the aim of gaining federal approval for the first such device in Canada.

Sean Rourke, a scientist with the Centre for Urban Health Solutions at St. Michael’s Hospital, said the clinical trial will begin in Toronto on Wednesday before expanding across the country in coming weeks.

The neuropsychologist said data will be collected on 1,000 people who will take the one-minute, finger-prick blood test at sexual health clinics in several provinces.

Rourke said he’s hopeful the study’s findings will persuade Health Canada to approve the first HIV self-test for use as early as 2020.

Rourke, who serves on the board of the Canadian Foundation for AIDS Research, said the number of new HIV cases in Canada has increased in recent years, in contrast to the downward trend seen in other G7 countries…

Study finds that people with low incomes and precarious housing less likely to get screened for cancer

Adults living with low incomes are less likely to be screened for colorectal, cervical and breast cancer, says researchers from the Department of Family and Community Medicine (DFCM) in a study. It used social determinants of health to examine cancer screening disparities among patients of the St. Michael’s Hospital Academic Family Health Team.

Lead investigators Drs. Aisha Lofters and Tara Kiran, Assistant Professors at DFCM and family physicians at St. Michael’s Hospital, also found that housing status – whether the patient owns, rents or lives in a special housing arrangement– is linked with a patient’s likelihood to get screened for cancer.

“Our goal was to figure out if there are particular groups of patients where we could do a better job ensuring they are receiving regular screenings for cancer,” says Dr. Lofters, a researcher and physician at St. Michael’s Hospital.

“The point of screening is to catch cancer at an early stage or, even better, catch an abnormality before it turns into cancer so doctors can focus on treatment and prevention before it spreads.”

Transgender Canadians far less likely to be screened for cancer, raising risk

People who are transgender are significantly less likely to receive cancer screenings than the general population, raising their risk of developing the disease undetected in situations that could have been preventable.

A new study published Wednesday in the journal Canadian Family Physician found that about 33 per cent of eligible transgender patients had been screened for breast cancer, compared to 65 per cent of other eligible patients.

Screening rates for other types of cancer presented similar differences, with transgender patients being about 60 per cent less likely to have been screened for cervical cancer and 50 per cent less likely to have been screened for colorectal cancer, after adjusting for age and other risk factors.

“If they’re not getting screened, they have a higher risk of developing a cancer that we know could be prevented,” the study’s lead author, Dr. Tara Kiran of St. Michael’s Hospital in Toronto, told CTV News in an interview.

A cancer-screening approach for patients, designed by patients

There’s no question that cancer screening can catch disease early, set people on a path to treatment sooner, and ultimately save lives. The question is how to ensure that everyone is accessing the screening they need.

Researchers at MAP Centre for Urban Health Solutions have grappled with this question for years, focusing particularly on encouraging screening in communities experiencing disadvantage. In a study published today in the Journal of General Internal Medicine, they set out to find out why patients with lower incomes were less likely to be up-to-date on breast, cervical and colorectal cancer screening and what would be the best approach to bridge the gap.

“At the St. Michael’s Family Health Team, we have conducted several projects to increase overall screening,” said Dr. Aisha Lofters, a MAP scientist, family physician and lead author of the study. “Through previous work, we had already observed that among patients whose self-reported income was below the low-income threshold set by Statistics Canada, only 69 per cent were up-to-date on colorectal cancer screening compared to 75 per cent being up-to-date if their income was above the threshold.”

Drug checking takes on elevated role as illicit fentanyl sweeps country and fuels surge in overdose deaths

In Toronto, the Centre on Drug Policy Evaluation is planning to pilot drug-checking services at three harm-reduction agencies beginning in September.

Operations manager Karen McDonald said the centre will use gas chromatography-mass spectrometers (GC-MS) – sophisticated devices that provide more detailed results than the FTIR spectrometers but require highly trained technicians to operate and more time to analyze.

A new resource to measure good and bad drug policies

Think the Philippines and Russia. Now think Portugal and Mexico.

The former two have made headlines for their violent, often extrajudicial anti-drug user regimes, while the latter pair have been praised for their forward-thinking policies. But there are many more countries in the world whose approaches toward people who use drugs have not been scrutinized so publicly or thoroughly.

On March 27, the Centre on Drug Policy Evaluation (CDPE), based in Toronto, Canada, launched an interactive map to promote this further scrutiny.

Using data from the United Nations Office on Drugs and Crime on 44 countries (so far), the Drug Policy Metrics Map breaks down how governments around the world manage, police and support people who use drugs. The wealth of data on many metrics—organized in broader categories including Health, Peace & Security, Development, Human Rights, Demand Reduction, Supply Reduction and International Cooperation—allows readers to compares governments’ policies with their outcomes.