Life Expectancy in Canada
Increasingly in recent years, surveys of mortality rates and other indicators have shown Canadians in some parts of the country to be much healthier than those in other regions. Now, a federal study shows just how dramatically one key indicator - life expectancy - varies among Canada's regions. A joint study published last week by Statistics Canada and the Ottawa-based Canadian Institute for Health Information maps life-expectancy data for Canada's 136 provincial and territorial health regions. For the most part, it shows, southerners live longer than northerners, and Canadians concentrated mainly in the nation's most densely packed urban areas live the longest. Conversely, the findings paint a gloomy picture of life and death in the North - particularly in areas with large aboriginal populations.
The report, accompanied by maps depicting longevity rates in every part of the country, shows that in 1996 Canadians' average life expectancy at birth was 78.6 years (up from 73 years in 1970), with men living, on average, for 75.7 years and women for 81.4 years. Among industrialized nations, Canada ranks third in life expectancy behind Switzerland and Japan, and well ahead of the United States, which ranks eleventh. While there are sharp discrepancies in some regions, the report also shows the life expectancy for nearly 99 per cent of Canadians to be within 2.8 years of the national average.
The study shows that the 13 regions of the country where people live longest - for 79.5 years or longer - are mostly southern urban communities with populations between 46,000 and 850,000. They include Victoria, Vancouver, Winnipeg, Toronto and the Ottawa-Carleton region. But people also live long lives in some less-urbanized areas, including parts of southern Manitoba, a large swath of southwestern Saskatchewan and some rural districts of British Columbia. Dr. John Millar, CIHI vice-president for research and analysis, attributes the higher life expectancies in the cities mainly to higher educational and income levels and lower unemployment. The better access that city dwellers have to health-care services plays a smaller role, he says. "But clearly," adds Millar, "you can also have long-living populations in non-urban areas." In areas where life expectancy is lowest, he notes, "the remarkable thing is that you tend to find more of everything - higher rates for disease generally, for AIDs, for accidental death. That's partly because high stress levels in those areas seem to undermine people's immune systems and leave them more vulnerable."
The bleakest findings emerge from the North, with its heavy concentration of native peoples. All of the 12 health regions that the report includes in the lowest life-expectancy category - less than 75.7 years for both sexes - are in northern regions, and nine of them have large aboriginal populations. Among aboriginals, accidental injuries are the principal cause of death, but the report also points to high rates of cancer and respiratory diseases in Nunavut and the Nunavik region of northern Quebec, with lung cancer rates among women in Nunavut 4.7 times higher than the overall rate for Canadians.
Nunavut and Nunavik, home to most of Canada's Inuit people, also record Canada's highest suicide rates among men. Among Aboriginal Peoples generally, infant mortality rates are twice as high as in the overall Canadian population, while accidental injuries are four times more common among aboriginal infants, five times higher among pre-schoolers and three times higher for aboriginal teenagers.
On the other hand, in the regions with the highest life expectancies, mortality rates for cancer and other common diseases, as well as suicide and infant mortality rates, are predictably lower. But as Millar notes, the report points to socioeconomic factors as a major determinant of health. High life-expectancy scores, it notes, correlate with higher educational levels and lower unemployment rates. However, while acknowledging that some high-life-expectancy regions also show relatively high income levels, the report finds no consistent link between longer lives and income or housing costs across the country.
Looking further into the issue of health and income inequality, a separate study of Canadian and U.S. mortality statistics, released at the same time, concludes that higher incomes appear to be more closely linked to longer lives in the United States. One reason, the report suggests: Americans do not have access to the kind of publicly funded medical services generally available in Canada. That finding, at least, is a reminder of the surviving value of a health system that is increasingly under stress - economically and politically.
Maclean's April 10, 2000