Analysis identifies areas for improvement in the overall health of Canada's population

Understanding the trends in the health of a country's population is crucial for developing effective public health policies and predicting future demand for health services.

Researchers, including Schulich School of Medicine & Dentistry professor Dr. Saverio Stranges, have determined three key areas where Canada's burden of disease has increased, and found the improvement in overall health of the country's population has stalled and is trending downwards compared to other high-income countries.

In this study published in Canadian Journal of Public Health, researchers analyzed data from the 2019 Global Burden of Disease Study to compare Canada's population health trends to 204 other countries. They found that while Canadians' quality of life and life expectancy continue to improve when compared to the 1990s, relative to their peer countries, progress has slowed in Canada in recent years—having leveled off in 2011.

The global burden of disease is tied to multiple factors including cardiovascular disease; cancer; musculoskeletal, neurological and mental health conditions; and unintentional injuries.

Global burden of disease is measured in Disability-Adjusted Life Years (DALYs), which measure overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. The DALY system was developed in the 1990s to compare the overall health and life expectancy of different countries.

"There are many potential reasons for these growing burdens, including our aging population," said Stranges, chair and professor in the departments of epidemiology and biostatistics, medicine and family medicine.

In terms of the growing burden of chronic diseases, Stranges warns that if common chronic conditions, such as diabetes and hypertension, are not properly managed in primary care, then the number of preventable hospitalizations will likely increase and place more pressure on hospitals.

"There is a need to strengthen the primary care sector to reduce the burdens of these chronic conditions," said Stranges. "There are areas of concern where the relative burden of some chronic diseases seems to be particularly impactful in Canada as well as the growing burden of substance abuse and musculoskeletal diseases."

He notes that substance abuse affects different age groups at different rates and is one of the factors that will affect lifespan as well as DALY, throughout an individual's life. This indicates a need to think about a comprehensive public health strategies that consider ways to mitigate this issue over time.

Another factor that influences DALY is musculoskeletal disorders, which can be particularly common in women. As women tend to live longer than men, this factor may result in a larger increase to DALY than a disorder that is primarily represented in males.

The study concludes that while it is important to applaud the overall improvement in life expectancy and quality of life, it is also important to avoid stagnation and continue to push for better health outcomes for Canadians.

While further research is needed to identify the specific factors behind the trends shown in the Global Burden of Disease study, Stranges offers that social determinants of health, along with environmental and behavioral risk factors likely play a potential role in exacerbating some of these diseases.

"All levels and branches of government will need to work together to improve Canada's population health. We can start by implementing public health initiatives to mitigate the negative impact of social determinants of health, as well as encourage healthy lifestyle habits including diet, physical activity and sleep hygiene," he said.