Canada Day Special: Why we live longer

Despite the global appeal of the more balanced, less frantic lifestyle in Europe—the Mediterranean diet, the work-to-live ethos, the café culture, siestas—when it comes to life expectancy, Canada is the envy of nearly every country. From the day we’re born, the average Canadian can anticipate living until the ripe old age of 81.23 years, according to the CIA’s World Factbook 2009 estimates. That puts us at number eight in the world, higher than most rich, industrialized nations, including France, Sweden, Italy, Spain, Greece, Germany, Britain, Denmark, and the U.S.

Even better, when it comes to “healthy life expectancy,” which refers to the number of disability-free years a person enjoys, Canada ranks fourth-highest at 73 years, behind countries such as Japan, Italy and Switzerland; tied with places such as France, Norway and the Netherlands; and better than Britain and Greece, among many others. “The average Canadian has a fairly long life,” says Frank Trovato, a University of Alberta demographer and editor of the journal Canadian Studies in Population. “And out of that fairly long life, most years are spent in good health. That’s exactly what countries should strive for.”

If you’re surprised to learn we live so long, it’s no wonder, given the grim reports citing rising obesity rates, lengthy medical wait times, physician and nurse shortages, and limited access to health care in remote locations. While these challenges are real and serious, longevity experts invariably agree that Canada deserves more accolades. “We don’t give ourselves a fair shake,” says Margaret Penning, a sociologist at the University of Victoria. “We’re always questioning the quality of our health care. But it’s clear that we do so much better than our neighbours in terms of health and life expectancy.”

So how did Canada achieve such high longevity compared to the rest of the world? One of the most interesting explanations suggests that it’s actually newcomers to the country who have helped boost our life expectancy. The “healthy immigrant effect” theorizes that only the most mentally and physically fit individuals can and do leave their homeland, enduring the challenges of a major move in the hopes of long-term gains. Then the immigration process, which includes rigorous health screening, further vets applicants so that only the most robust people settle here. Given that Canada has the highest immigration rate per capita in the world, this concept has become increasingly significant to demographers, says Trovato: “It’s at the forefront of health research in Canada.”

One of the aspects that makes Canada such a desirable destination is our high standard of living, say experts. We boast strong employment, education and national income per capita, Penning explains. Those socio-economic factors are getting a lot of attention among longevity researchers as more evidence reveals that poverty and low education have a strong correlation with illness. Trovato says that the big focus is on income inequality, which essentially measures the spread between the rich and poor. Canada’s income inequality gap relative to other industrialized countries falls “somewhere in the middle,” he says. In a 2008 Conference Board of Canada study, we rank 10th out of 17 wealthy nations—better than the U.S. and Britain, but not as high as the Netherlands, Denmark, Sweden and Austria, which had the least income inequality.

Our publicly funded health system helps to keep that gap from widening, and it’s a major reason for our longevity, experts agree. Nations with universally accessible health care always have longer average life expectancies, says Penning. Like Canada, many European nations such as Italy, France and Sweden also have public systems, which is reflected in their relatively high longevity, and the same goes for Japan, which has one of the highest life expectancies in the world. Meanwhile, in the U.S., where health care is privatized, when you look at the averages, people don’t live as many years, partly because some segments of the population can’t afford medical attention.

It also helps that Canadians generally avoid one of the riskiest habits out there: smoking. We have one of the lowest smoking rates in the world, according to the Organisation for Economic Co-operation and Development (OECD). Just 17.3 per cent of Canadian adults smoke, way lower than in even the most long-lived nations out there, such as France (23 per cent), Spain (28.1), Japan (29.2), and Greece (38.6). “Canada was one of the first countries to introduce very vigorous anti-smoking messages,” says Anne Martin-Matthews, scientific director of the Institute of Aging, a division of the Canadian Institutes of Health Research. “Some of the countries in Europe are just now beginning to think that would be a good idea.”

Before we get too self-congratulatory, however, longevity experts say that there are still ways that Canada could and should improve its average life expectancy. For starters, there are pockets of the population for whom access to health care services and basic needs are lacking, especially among the Aboriginal populations, says Trovato. In fact, the lives of Aboriginals are between five and eight years shorter than the lifespan of the average Canadian, according to a federal report on health indicators. Martin-Matthews points to the prevalence of swine flu on reserves as proof that this population is especially vulnerable to illness. Penning believes that improving access to health care among Aboriginals is the most important next step toward further increasing our life expectancy.

As well, there is a growing health problem in Canada that just about every rich country in the world is facing: an epidemic of obesity—and its accompanying disabilities, such as diabetes and heart disease. As of 2004, nearly a quarter of Canadian adults were obese, compared to 14 per cent in 1978, according to Statistics Canada. Another 36 per cent of us are overweight. Among teens, the percentage who are overweight or obese has doubled. The problem is so severe that Martin-Matthews suggests that the average life expectancy in Canada could eventually decrease—for the first time in decades—as more obesity-related diseases take their toll on the population.

Some observers suggest that we could also do a better job of caring for our seniors. “In Canada, many elderly people are placed in institutions,” says Laurent Martel, a demographer at Statistics Canada, whereas in Japan they are brought into the homes of their family to spend their final years surrounded by loved ones. Penning adds that providing home care services for old people has been put on the back burner as our health care dollars have become increasingly stretched.

In the future, many experts predict that the focus will not just be on making our lives longer, but on making the healthy portion of our lives longer. There is a growing appreciation among the public and scientists of the importance of quality of life over quantity of years. As the obesity crisis comes to a head, more of us will finally commit to eating better and exercising more, Trovato hopes, and medical advances will likely lead to cures for diseases that today are chronic, says Martin-Matthews. The goal now, she explains, is to “compress morbidity,” or minimize the amount of time we are sick and old. “So that you live well, and you have a fairly short period of time with illnesses, and then you die,” Martin-Matthews explains. “That would be the ideal scenario, absolutely.” Long live Canadians!