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Canada lags in chronic care, study says

OTTAWA – Canada is a middle-of-the-pack performer on health, getting a B grade, in the latest Report Card on Canada: How Canada Performs: Health-Details and Analysis, released by The Conference Board of Canada.

Relative to its peers, Canada’s current 10th place ranking (out of 16 countries) is down from a much better 5th place in the 1990s. And Canada may lose this ranking if it cannot address the issues posed by chronic disease, particularly given the lack of focus on quality and accountability in the healthcare system.

Canada has one of the highest total healthcare expenditure levels – ranking 5th among comparator countries – yet it only ranks 10th on health outcomes among the leading countries in the world.

“These results raise important questions about whether Canadians are getting full value for their investment in health and healthcare,” said Glen Roberts, Director, Health Programs. “For Canada to become a world leader, it needs to rethink its investment strategies around health and healthcare. The current system focuses primarily on acute care and physicians. As our population ages, the new challenge is managing the increase in chronic diseases. The current system does not sufficiently focus on preventing disease or on maintaining quality of life for those who are afflicted.”

In this year’s analysis, Canada gets an A grade in self-reported health status and premature mortality, and a B grade on life expectancy and mortality due to: cancer; circulatory diseases; respiratory diseases, and mental disorders.

Despite this year’s overall B grade, Canada’s record on addressing mortality from mental illness has deteriorated over time. Mental illness now claims nearly 14 lives per 100,000 population, up from three deaths per 100,000 population in the 1960s. Recent Conference Board research indicates that Ontario physicians spend almost one-fifth of every hour treating patients with mental illness.

C grades on mortality due to diabetes (the fourth highest rate among the 17 countries) and musculoskeletal diseases further underscores the challenges facing the health system in preventing and managing chronic disease.

Japan and Switzerland are the only countries to receive an A grade in this year’s ranking. Most top performing countries have achieved better health outcomes by acting on the broader determinants of health, which include health promotion programs that focus on changes in lifestyle, as well as on education, income and social status.

The United Kingdom, Denmark, and the United States receive an overall D grade. The U.S. is the worst performer on indicators for: life expectancy, premature mortality and infant mortality.

How Canada Performs: A Report Card on Canada website is at