At-a-glance How Healthy are Canadians? A brief update (2024)

Introduction

The purpose of this At-a-glance is to providean update on a number of the keyfindings from the 2016 Report, “HowHealthy are Canadians?”¹ using resultsfrom the most recent edition (2018) of theCanadian Chronic Disease Indicators(CCDI; Table 1). The 2016 Report examinedtrends for the four major chronic diseases(cardiovascular disease [CVD],^†cancer, chronic respiratory disease [CRD]^‡and diabetes) and four associated crosscuttingrisk factors (tobacco smoking,physical inactivity, unhealthy eating andharmful use of alcohol) that formed thebasis of the World Health Organization(WHO) Global Action Plan for thePrevention and Control of NoncommunicableDiseases (NCDs) 2013-2020.² In addition,the 2016 Report included mood and/oranxiety disorders because of their majorimpact on the health of Canadians. Therefore,this update does not focus on allresults from the 2018 CCDI in Table 1 buthighlights specific aspects of interest,namely the mortality and morbidity experiencesof Canadians living with thesemajor chronic diseases, as well as theassociated risk factors. The reportedresults are based on the following fourdata sources: Canadian Chronic DiseaseSurveillance System (CCDSS); CanadianCommunity Health Survey (CCHS);Canadian Health Measure Survey; and,Canadian Vital Statistics–Death Database.

Main findings

Mortality

While the mortality rate associated withthe four major chronic diseases hasdecreased by a third over an 18-yearperiod (from 663/100 000 in 1998 to441/100 000 in 2015; age-standardizedmortality rates), the most dramatic declinewas observed for CVD (nearly 50%). Nonetheless,CVD is still the second leadingcause of death in Canada (196/100 000;crude mortality rate) after cancer(215/100 000; crude mortality rate), representing27% and 29% of all deaths in2015, respectively. Furthermore, the probabilityof dying between the ages of 30and 69 years (i.e., premature mortality)from one of the four major chronic diseasesdecreased by nearly a third over thesame period (from 14.9% in 1998 to10.2% in 2015). While this is a positivefinding, more still needs to be done sincedeaths due to these diseases amongCanadians of this age group are oftenpreventable.

Morbidity

One in three Canadian adults (33.7%)lives with at least one of the followingchronic diseases: CVD; cancer; CRD; diabetes;mood and/or anxiety disorders.Specifically, in 2015/16, an estimated 2.4million Canadians had ischemic heart diseaseand about 800 000 were living withthe effects of a stroke, both commonforms of CVD. Approximately 2.2 millionreported ever having been diagnosed withcancer. Furthermore, 2.1 million were livingwith chronic obstructive pulmonarydisease (COPD); one of the most commontypes of CRD, and 3.1 million Canadianswere living with diabetes. Finally, 3.9 millionreported having been diagnosed withmood and/or anxiety disorders in 2016.^§In contrast to most chronic diseases whichincrease with age, mood and/or anxietydisorders are particularly prevalent in theworking-age population (20-64-year-olds).

The number of individuals living withthese chronic diseases continues toincrease due to the aging and growth ofthe Canadian population, and the fact thatpeople are living longer with their diseasedue to advances in treatment and management(Figure 1). On the other hand,the rate of new cases every year for mostdiseases is decreasing slowly, except fordiabetes where more variations in trendswere observed.^** Most chronic diseasesaffect males and females somewhat differently,with some definitively more commonin males (such as ischemic heartdisease) and some more common infemales (such as mood and/or anxietydisorders). Overall, women tend to adoptbetter health behaviours than men exceptfor physical activity where levels areequally low for all Canadians. On theother hand, women live longer with agebeing a major, non-modifiable chronic diseaserisk factor.

Behavioural risk factors

Similar to what the 2016 Report indicated,except for tobacco smoking, Canada continuesto have high prevalence of modifiablerisk factors associated with chronicdiseases [physical inactivity (62.4% forchildren and youth and 82.5% for adults),unhealthy eating (70.0% for Canadians12+ years) and harmful use of alcohol(15.2% of Canadians 15+ years)]. In2016, 84.9% of Canadian adults reportedhaving at least one of these behaviouralrisk factors.

Chronic diseases usually develop overmany years or decades. Therefore, it isextremely important that Canadian childrenand youth adopt healthy behavioursfrom an early age. Unfortunately, only onein ten (9.5%) children aged 5 to 17 meetthe recent 24-hour movement guidelinesfor children and youth for physical activity,sedentary behaviour and sleep.³Furthermore, only one in three childrenand youth (37.6%) meet the physicalactivity guidelines^†† suggesting more workneeds to be done to increase activity inand commitment to sports and recreation,active transportation and physical activityat school.

Conclusion

Since the publication of the 2016 Report,overall and premature mortality trendshave continued to decrease at a variablerate for the four major chronic diseases.However, the number of Canadians livingwith one or more of these chronic diseasescontinues to increase imposing amajor burden on the health of Canadiansand on the health care system. Thechronic diseases included in this updaterepresent the leading causes of death anddisease burden in Canada and could belargely prevented by tackling a few commonrisk factors. Healthy living, preventionand adequate management of chronicdiseases are all necessary to ensure thatCanadians live a long, healthy and disease-freelife.

Conflicts of interest

The authors have no conflicts of interestto disclose.

Authors’ contributions and statement

LP chaired the Steering Committee anddrafted the At-a-glance, BB managed theproject and analyzed the data, PDR, PL,SO and GW analyzed and/or interpretedthe data, and all co-authors reviewed and/or revised the At-a-glance.

The content and views expressed in thisarticle are those of the authors and do notnecessarily reflect those of the Governmentof Canada.

^*Brenda Branchard, Paromita Deb-Rinker, Alejandra Dubois, Pam Lapointe, Siobhan O'Donnell, Louise Pelletier (chair), Gabriela Williams.

^†CVD includes ischemic heart disease, heart failure and stroke.

^‡CRD includes chronic obstructive pulmonary disease (COPD) and asthma.

^§This estimate differs from that in the Report “How Healthy are Canadians?” as the 2016 Report used CCDSS data (i.e., annual use of health services for mood and/or anxiety disorders) whilethe CCDI used CCHS data (i.e., self-reported, diagnosed mood and/or anxiety disorders).

^**The incidence rate (new cases over a year) based on the CCDSS data may indicate a true change in population health status, but may also reflect changes in data collection methods, coding/classification systems, clinical practices, billing methods, etc.

^††The new 2016 physical activity guidelines recommend that children and youth accumulate at least 60 minutes of moderate to vigorous physical activity (MVPA) per day on average per week(though not necessarily on each day), while the previous guidelines recommended 60 minutes of MVPA occur at least 6 days of the week. This modification to the guidelines resulted in a higherproportion of children and youth meeting the recommended level of physical activity (37.6% versus the previously reported 9.1%).

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