Abstract
Objective
Monitoring trends in key population health indicators is important for informing health policies. The aim of this study was to examine population health trends in Canada over the past 30 years in relation to other countries.
Methods
We used data on disability-adjusted life years (DALYs), years of life lost (YLL), years lived with disability, life expectancy (LE), and child mortality for Canada and other countries between 1990 and 2019 provided by the Global Burden of Disease Study.
Results
Life expectancy, age-standardized YLL, and age-standardized DALYs all improved in Canada between 1990 and 2019, although the rate of improvement has leveled off since 2011. The top five causes of all-age DALYs in Canada in 2019 were neoplasms, cardiovascular diseases, musculoskeletal disorders, neurological disorders, and mental disorders. The greatest increases in all-age DALYs since 1990 were observed for substance use, diabetes and chronic kidney disease, and sense organ disorders. Age-standardized DALYs declined for most conditions, except for substance use, diabetes and chronic kidney disease, and musculoskeletal disorders, which increased by 94.6%, 14.6%, and 7.3% respectively since 1990. Canada’s world ranking for age-standardized DALYs declined from 9th place in 1990 to 24th in 2019.
Conclusion
Canadians are healthier today than in 1990, but progress has slowed in Canada in recent years in comparison with other high-income countries. The growing burden of substance abuse, diabetes/chronic kidney disease, and musculoskeletal diseases will require continued action to improve population health.
Résumé
Objectif
La surveillance des tendances des indicateurs clés de la santé de la population est importante pour éclairer les politiques de santé. Dans cette étude, nous avons examiné les tendances de la santé de la population au Canada au cours des 30 dernières années par rapport à d’autres pays.
Méthodes
Nous avons utilisé des données sur les années de vie ajustées en fonction de l’incapacité (DALY), les années de vie perdues (YLL), les années vécues avec un handicap, l’espérance de vie (LE) et la mortalité infantile pour le Canada et d’autres pays entre 1990 et 2019, fournies par l’Étude mondiale sur le fardeau de la maladie.
Résultats
L’espérance de vie, les YLL ajustées selon l’âge et les DALY ajustées selon l’âge ont tous connu une amélioration au Canada entre 1990 et 2019, bien que le taux d’amélioration se soit stabilisé depuis 2011. Les cinq principales causes des DALY pour tous les âges au Canada en 2019 étaient les néoplasmes, les maladies cardiovasculaires, les affections musculosquelettiques, les affections neurologiques et les troubles mentaux. Les plus fortes augmentations des DALY pour tous les âges depuis 1990 ont été observées pour l’usage de substances, le diabète et les maladies rénales chroniques, ainsi que les troubles des organes sensoriels. Les DALY ajustées selon l’âge ont diminué pour la plupart des conditions, à l’exception de l’usage de substances, du diabète et des maladies rénales chroniques, ainsi que des troubles musculosquelettiques, qui ont augmenté de 94,6 %, 14,6 % et 7,3 % respectivement depuis 1990. Le classement mondial du Canada pour les DALY ajustées selon l’âge est diminué de la 9ième place en 1990 à la 24ième place en 2019.
Conclusion
Les Canadiens sont en meilleure santé aujourd’hui qu’en 1990, mais les progrès se sont ralentis ces dernières années par rapport à d’autres pays à revenu élevé. La croissance du fardeau lié à l’abus de substances, au diabète/maladies rénales chroniques et aux affections musculosquelettiques exigera des actions continues pour améliorer la santé de la population.
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Availability of data and material
All data used in this study are publicly available through the GBD Compare website and downloadable from the Global Health Data Exchange database.
Code availability
The tools used in this study are publicly available through the GBD Compare website and downloadable from the Global Health Data Exchange database.
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Funding
The Global Burden of Disease Study is funded by the Bill & Melinda Gates Foundation. Patten holds the Cuthbertson & Fischer Chair in Pediatric Mental Health at the University of Calgary. Tonelli holds the David Freeze Chair in Health Services Research at the University of Calgary.
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JAK designed the study and wrote the first draft of the manuscript. FP ran the analysis and created the tables and figures. SMF, HJ, BKD, AHM, ATO, SRP-P, SBP, and SY contributed to the literature review and interpretation of the results, and helped write and edit sections of the article. DAA, GA, SA, ZAB, ZAB, FJE, OE, GF, JJH, MBH, MMI, NK, DPR, TS, RS, MT, and ZW also gave critical feedback on the presentation and interpretation of the results and helped write and edit sections of the article. AA, VKC, AJI, OPK, CJLM, AR, YS, MS, and SS contributed to the acquisition of data and/or their analysis and reviewing the paper for intellectual content. JAK, FP, FJE, and MT helped revise the manuscript prior to publication. All authors have made substantive contributions to the content, helped proofread the article prior to publication, and read and approved the final manuscript.
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Since this study used publicly available, aggregate data, it did not require ethics approval. The GBD study complies with the Guideline for Accurate and Transparent Health Estimates Reporting (GATHER) recommendations.
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Conflict of interest
Hébert reports grants or contracts from Canadian Institutes of Health Research, New Brunswick Health Research Foundation, and Canadian Chiropractic Research Foundation, all outside the submitted work.
Patten reports grants or contracts from Canadian Institutes of Health Research, Multiple Sclerosis Society of Canada, The Mathison Centre at the University of Calgary, and Calgary Health Trust and support from the Cuthbertson & Fischer Chair in Pediatric Mental Health from the University of Calgary/Alberta Children’s Hospital Research Foundation, all outside the submitted work.
Rasali reports leadership or fiduciary roles in board, society, committee, or advocacy groups outside the submitted work, paid or unpaid, with Emotional Well Being Institute-Canada, a non-profit society and Canada Cluster Chapter of Emotional Well Being Institute-Geneva, as Director, all outside the submitted work.
Solmi reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Angelini, Lundbeck, Otsuka Pharmaceutical and participation on a Data Safety Monitoring Board or Advisory Board with Angelini, all outside the submitted work.
Somayaji reports grants or contracts from Sunnybrook Research Institute, University of Calgary, Calgary Health Foundation, Canadian Institutes of Health Research, Cystic Fibrosis Foundation, and Snyder Institute; payment or honoraria for cystic fibrosis education sessions from Vertex Pharmaceuticals; and participation on a Data Safety Monitoring Board with Oncovir, all outside the submitted work.
Wang reports grants or contracts from the Fonds de Recherche du Québec – Santé (FRQS) doctoral Training Scholarship and the McGill-China Scholarship Council (CSC) Joint Scholarship Program, all outside the submitted work.
Elgar reports grants from the Canadian Institutes of Health Research and Social Sciences and Humanities Research Council, all outside the submitted work.
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Kopec, J.A., Pourmalek, F., Adeyinka, D.A. et al. Health trends in Canada 1990–2019: An analysis for the Global Burden of Disease Study. Can J Public Health 115, 259–270 (2024). https://doi.org/10.17269/s41997-024-00851-3
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DOI: https://doi.org/10.17269/s41997-024-00851-3