The number of Canadians dying early from potentially avoidable causes has plummeted over the past 30 years, but the gains made greatly depend on a person’s income and neighbourhood.
A new report from the Canadian Institute for Health Information shows deaths that potentially could have been avoided through disease prevention or health-care services dropped from 373 per 100,000 Canadians in 1979 to 185 per 100,000 in 2008. A significant portion of the decline is thanks to prevention and better treatment of heart disease.
In the report, “avoidable” deaths refers to those that shouldn’t occur with proper prevention and access to effective health services.
Avoidable mortality from preventable causes dropped by 46 per cent, from 225 per 100,000 in 1979 to 119 per 100,000 in 2008. The shift reflects a societal move toward adopting healthier lifestyles, with fewer people smoking and more people paying attention to nutrition than 30 years ago, for instance. Other preventative measures could include vaccinations or seatbelt laws. Avoidable mortality from treatable causes declined by 56 per cent, explained by advances in screening, early detection and improved treatment of diseases.
But people living in low-income areas still face higher risks of avoidable deaths. The report found that those living in the poorest neighbourhoods in Canada are twice as likely to die from preventable causes than those living in the most affluent areas. The trend is even more significant when separated by gender: Men in the poorest areas were four times as likely to die from preventable causes than females living in the most well-off neighbourhoods.
The findings reflect a growing recognition that people in lower socioeconomic groups often fare worse than others when it comes to health because of a complex range of factors, such as higher rates of obesity and smoking. But the continued existence of this disparity suggests more action is needed to curb rates of preventable mortality among the poor.
“We’re not making huge gains in driving the [disease]prevention messages down into the lower groups,” said Kira Leeb, director of health system performance at CIHI.
Overall, circulatory diseases, such as heart disease, saw the biggest decline in potentially avoidable deaths, dropping 72 per cent over the study period. Avoidable deaths from digestive disorders, including chronic liver disease and gallbladder disorders, dropped 61 per cent. Avoidable deaths from injuries are down 49 per cent, from alcohol and drug use by 46 per cent, and from maternal disorders, including death in childbirth, by 45 per cent.
Men experienced a more significant decline in avoidable mortality of 55 per cent from 1979 to 2008, compared to a 43-per-cent reduction among women. But the CIHI report points out that’s because men have higher rates of avoidable deaths than women, even after the gains that were made over the past three decades.
Defining avoidable deaths
The new Canadian Institute for Health Information report quantifies how many Canadians are dying from avoidable causes.
The report defines “premature” mortality as deaths that occur before age 75. But a subset of that is “avoidable” deaths: “untimely deaths that should not occur in the presence of timely and effective health care, including prevention.”
Avoidable deaths are divided into two categories: those from preventable causes and those from treatable causes.
Preventable refers to deaths that shouldn’t occur based on efforts to reduce the incidence of illness, such as quitting smoking or trimming excess weight.
Treatable refers to deaths that shouldn’t occur based on access to necessary health-care interventions once a person has a disease or illness, such as taking medication to reduce high blood pressure or undergoing surgery to open up clogged arteries.