Chapter 3: The Chief Public Health Officer's report on the state of public health in Canada 2008 – Our health

Our Population, Our Health and the Distribution of Our Health

Our health

Given the diversity of the Canadian population, how is it possible to determine the state of Canadians’ health or the factors that influence it? The answers lie in the use of statistics, known as health indicators, that measure and monitor trends in the health of Canadians. The indicators shown in Table 3.1 highlight how long people can expect to live on average, what percentage of the population experiences particular health challenges, or how frequently Canadians acquire and live with specific diseases and disabilities. These indicators are widely accepted as a meaningful gauge of overall population health and can be used to provide an indication of how healthy Canadians are over time and in comparison to other countries.137, 138

Two types of health indicators are presented in Table 3.1; those that originate from official information and data sources such as the census, death records, hospitalization records, disease registries or direct measurement; and those that are self-reported from population-representative surveys where respondents identify having experienced, being diagnosed with or living with a variety of diseases and injuries as well as rating their quality and state of general and mental health. Most of these indicators are presented as rates or proportions of the overall Canadian population.

Life expectancy

Life expectancy in Canada has increased dramatically over the past century to the point where a person born here today can expect to live for about 80 years, based on current death rates in all age groups.139 Over a lifetime, some periods may be spent in less than full health, but it is estimated that Canadians can expect to live the equivalent of 70 of those 80 years in full health.140 This number is arrived at using a health-adjusted life expectancy, which is a measure of overall population health that takes into account the effects of illness and disability on peoples’ quality of life. Consequently, Canadians can expect to live a long life, with the expectation that a good health-related quality of life will be enjoyed for most of those years.

Canadians’ life expectancy at birth in 2004 was one of the highest in the world at just over 80 years – about 2.5 years more than the U.S. and 2 years less than Japan (the highest at 82 years).141 Figure 3.2 shows the steady increase in life expectancy for six OECD countries, including Canada, over the last 25 years. It also shows that Canadian life expectancy is improving, but it is not doing so at the same rate as some other top health-ranked countries such as Japan and Australia.

Figure 3.2 Life expectancy at birth, select OECD countries, 1980-2004

Figure 3.2 Life expectancy at birth, select OECD countries, 1980-2004

Source: Public Health Agency of Canada using Health Canada’s Data
Analysis and Information System (DAIS), Organisation for Economic
Co-operation and Development (OECD) Health Data, 2007.


 

Socio-economic health gradient describes the enduring pattern of the rise of health status with each level of socio-economic status.142

 

Although Canada does well overall in terms of life expectancy, certain populations within Canada do not fare as well. In urban Canada, Canadians with lower levels of education have lower life expectancy, as do those living in lower-income neighbourhoods.143

In Figure 3.3, the urban population is divided into quintiles (Q), or fifths, based on the percentage of the population in their neighbourhoods below the low-income cut-offs.144 The 20% of the population in the neighbourhoods with the highest incomes (Q1) have a higher life expectancy than those in each of the neighbourhoods with lower incomes (Q2 to Q5). The effect of health outcomes improving with each increase in income level is known as a social gradient in health.145, 146 Figure 3.3 also shows that the gradient is different for men and women, with a much steeper gradient for men.

Figure 3.3 Life expectancy at birth by neighbourhood income and sex, urban Canada, 2001

Figure 3.3 Life expectancy at birth by neighbourhood income and sex, urban Canada, 2001

Q - population divided into fifths based on the percentage of the
population in their neighbourhood below the low-income cut-offs.
Source: Wilkins et al. (2007), Statistics Canada.


 

Figure 3.4 illustrates that over time, life expectancy has increased steadily at all income levels.144 The figure also shows, however, that while the gaps between inhabitants in neighbourhoods with the highest and lowest incomes and between men and women are narrowing, they have persisted since the early 1970s with even the lowest-income women having a longer life expectancy than men with the highest income. The size of these gaps is not insignificant – they are in fact equivalent to the increase in many countries’ life expectancies which took more than two decades to achieve (see Figure 3.2).141

Figure 3.4 Life expectancy at birth by neighbourhood income and sex, urban Canada, 1971-2001

Figure 3.4 Life expectancy at birth by neighbourhood income and sex, urban Canada, 1971-2001

Q - population divided into fifths based on the percentage of the
population in their neighbourhood below the low-income cut-offs.
Source: Wilkins et al. (2007), Statistics Canada.


 

First Nations people listed in the Indian Register, according to requirements set out in the Indian Act, also have lower life expectancy.147, 148 Figure 3.5 shows that while the life expectancy for Registered Indians has increased since 1980, it has remained below that of the general population for both male and female populations.149 Although the gap is narrowing, a persistent difference remains between First Nations people and other Canadians.

Figure 3.5 Life expectancy at birth by sex, Registered Indian and general population, Canada, 1980-2001

Figure 3.5 Life expectancy at birth by sex, Registered Indian and general population, Canada, 1980-2001

Source: Indian and Northern Affairs Canada, Basic Departmental Data, 2004.


Table 3.1 Our health

 

Value

Description

Year

Who we are

 

 

 

Population

31.6

million people

2006

Aboriginal

1.17

million people

2006

First Nations

0.70

million people

2006

Métis

0.39

million people

2006

Inuit

0.05

million people

2006

Immigrant

6.2

million people

2006

By birth place

 

 

 

Africa

0.37

million people

2006

Asia and the Middle East

2.53

million people

2006

Caribbean and Bermuda

0.32

million people

2006

Central America

0.13

million people

2006

Europe

2.28

million people

2006

Oceania and other

0.06

million people

2006

South America

0.25

million people

2006

United States of America

0.25

million people

2006

By years since immigration

 

Recent (<=10 years)

2.0

million people

2006

Long-term (>10 years)

4.2

million people

2006

Urban population

80.2

percent of the population

2006

 

 

Our health status      

Life expectancy and reported health

 

Life expectancy at birth

80.4

years of expected life

2005

Health-adjusted life expectancy at birth

69.6

years of expected healthy life

2001

Infant mortality rate

5.4

deaths per one thousand live births

2005

Excellent or very good health *

60.1

percent of the population aged 12+ years

2005

Excellent or very good mental health *

72.9

percent of the population aged 12+ years

2005

Leading causes of mortality

 

Circulatory diseases

227.5

deaths per 100,000 population per year

2004

Malignant cancers

209.4

deaths per 100,000 population per year

2004

Respiratory diseases

61.3

deaths per 100,000 population per year

2004

Causes of premature mortality (ages 0 to 74)

 

Malignant cancers

1,574

potential years of life lost per 100,000 population per year

2001

Circulatory diseases

854

potential years of life lost per 100,000 population per year

2001

Unintentional injuries

640

potential years of life lost per 100,000 population per year

2001

Suicide and self-inflicted injuries

394

potential years of life lost per 100,000 population per year

2001

Respiratory diseases

162

potential years of life lost per 100,000 population per year

2001

Human Immunodeficiency Virus (HIV)

46

potential years of life lost per 100,000 population per year

2001

Causes of ill-health and disability

 

Living with chronic diseases

 

Malignant cancers

2.6

percent of the population

2003

Diabetes

5.5

percent of the population aged 1+ years

2004-2005

Obesity

24.3

percent of the population aged 18+ years

2005

Arthritis/rheumatism *

16.4

percent of the population aged 12+ years

2005

Asthma *

8.3

percent of the population aged 12+ years

2005

Heart disease *

4.8

percent of the population aged 12+ years

2005

High blood pressure *

18.3

percent of the population aged 20+ years

2005

Chronic obstructive pulmonary disease *

4.4

percent of the population aged 35+ years

2005

Living with mental Illness

 

Schizophrenia

0.3

percent of the population aged 12+ years

2002

Major depression

4.8

percent of the population aged 15+ years during a 12-month period

2002

Alcohol dependence

2.6

percent of the population aged 15+ years during a 12-month period

2002

Anxiety disorders

4.8

percent of the population aged 15+ years during a 12-month period

2002

Alzheimer’s and other dementias *

6.0-10.0

percent of the population aged 65+ years in North America

2003

Acquiring infectious diseases

 

HIV

2,300-4,500

estimated number of new cases

2005

Chlamydia

202.2

new cases per 100,000 population

2006

Gonorrhea

33.1

new cases per 100,000 population

2006

Infectious Syphilis

4.6

new cases per 100,000 population

2006

* Denotes self-reported data
Note: Some data may not be comparable. More detailed information can be found in Appendix D: Definitions and Data Sources for Indicators.
Sources: Public Health Agency of Canada using data from Statistics Canada and National Diabetes Surveillance System.

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