Canadians healthier, live longer than Americans
TheStar.com – Health/Research
April 29, 2010. Lesley Ciarula Taylor, STAFF REPORTER
Canadians are healthier and live longer than Americans to a “striking” degree, a health investigator says after conducting an analysis of both countries.
The most dramatic differences kick in for people 40-plus, just when they need health care, said David Feeny, senior investigator at the Centre for Health Research at Kaiser Permanente Northwest in Portland, Ore.
“The magnitude of the difference was surprising,” said Feeny of the results, published Thursday.
Two factors help explain the difference, he said. Canada provides universal health care and uses social programs to reduce social and economic inequality.
“The prevalence of poverty is lower in Canada, particularly for the elderly,” Feeny told the Star. “There is a very stark difference.”
“Having lived in both places, there is a very different social contract in the United States and Canada,” said Feeny, a dual citizen who taught at McMaster University in Hamilton for 20 years, at the University of Alberta and advised the Ontario Ministry of Health.
Canadians “don’t love paying taxes but we’ll pay them while we’re earning so we can get health care when we need it. In the U.S., the attitude is, ‘I’m going to pay for what I get and I don’t particularly care if my neighbour is getting it or not.’ ”
In numbers, 6 per cent of Canadian elderly are poor while 23 per cent of American elderly are, according to 2008 figures from the Organization for Economic Cooperation and Development.
One of the notable aspects of the analysis of 8,688 Canadians and Americans, said Feeny, was that it used the Health Adjusted Life Expectancy measure of the data. Other studies have looked at differences in mortality but “that’s not the whole story.”
The HALE “is a state-of-the-art tool that also looks at morbidity in living people. It integrates both the mortality and morbidity differences.”
Bottom line? A Canadian can expect to live in perfect health for 2.7 years longer than an American. A Canadian can expect to reach 52 years in perfect health; an American, only 49.3 years.
Life expectancy in Canada is 79.7 years; in the U.S., 77.2 years. The U.S. also has a higher infant mortality rate, 7 per 1,000 live births as compared with 5.4 for Canada.
Researchers ran the analysis first with the full population and then just the white-only population in both countries after reviewers speculated that the black population in the United States, because of a history of disadvantage and slavery, might skew the results.
“Basically you get the same story. The big story is the entire population on average is healthier. It is remarkable how striking it is, given the higher level of spending on health care in the United States.”
Policy makers in both countries can take away important information from the analysis, published in the journal Population Health Metrics, he said.
“On the Canadian side, what Canada has created and invested in is something Canadians should be proud of,” said Feeny.
“Access matters and threats to access may be deleterious to the health of the population. Canada has done a very good job in dealing with poverty among the elderly. But poverty among children is another matter and that will show up in later years. The access is universal but health is not equal across Canada.”
The U.S. government has recently adopted a health care bill to create universal health care, expanding access to the 34 million people who don’t have it through work or federal health programs such as Medicare and Medicaid.
“This strengthens evidence for that access,” he said. “But we really need to address the increasing inequality in the U.S.”
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