Canadians, on average, are fairly healthy. Life expectancy continues to rise, fewer of us smoke and more of us are becoming physically active. That's the problem with averages. They are misleading.
In Ontario, for instance, average life expectancy is 81.5 years – a pretty decent number. It's only when you look beyond the big picture that you see the cracks.
The life expectancy of a baby born in Brampton is 84. A child born the same day in Sault Ste. Marie, less than 700 kilometres away, is 79.
Another telling metric is potentially avoidable deaths – how many people likely died unnecessarily because they didn't receive proper care after a heart attack, weren't vaccinated against a disease or suffered another preventable or treatable ailment. According to the Ontario average, 163 in 100,000 people die from a potentially avoidable death a year. But in reality, the numbers vary wildly across the province, from a low of 114 per 100,000 in cities such as Richmond Hill and Vaughan, to a high of 258 in Thunder Bay, Marathon, Dryden and the surrounding area.
These numbers are from a report released last week by Health Quality Ontario, a provincial agency mandated to improve the province's health care system. But this isn't just an Ontario problem. Across the country, the situation is much the same: startling, persistent regional health inequalities that, quite literally, are sickening and killing countless Canadians before their time.
Often, stark inequalities exist between urban and rural or remote communities, which is why northern parts of the country are so often struck by much higher rates of disease and premature death.
There are many reasons behind these differences, such as the fact that in northern communities, people tend to smoke more, be less physically active, have a much more difficult time accessing specialized medical care, have higher aboriginal populations and have lower education and income levels compared with large urban centres. Of course, many of these same problems can be found within cities, where pockets of vulnerable individuals can live just a few blocks from affluence.
But none of this explains why we as Canadians have allowed these problems to persist for so long. Why we consider it acceptable that, depending on where you live, how much you earn or what education level you have achieved, you are much more likely to die from a chronic illness or have to wait weeks longer for a loved one to get a spot in a long-term care home.
The answer, quite possibly, is that many of us have never really stopped to consider that these differences exist. That, in 2015, aboriginals in Canada are being infected with and dying of tuberculosis. Or that many patients with chronic diseases living outside of urban centres often have few resources to help them manage their conditions. Or that many communities throughout Canada face crippling doctor shortages that close emergency rooms and delay treatment.
Joshua Tepper, president and CEO of Health Quality Ontario, says that many people simply don't "understand how dramatically different health outcomes are across the province." After all, most politicians and policy-makers live in and around the urban areas where health outcomes tend to be the best. It's all too easy to forget about the people living in remote cities or rural areas.
Some will argue that it's up to people to take charge of their own health. That's true. But when the realities of daily life set them up for failure, it's a sign that change is needed from a higher level. An excellent example of this is cited by Connie Clement, scientific director of the National Collaborating Centre for Determinants of Health. She notes that the Liquor Control Board of Ontario is able to tightly regulate the price of alcohol throughout the province. Yet nothing is done about the fact that milk or fresh produce can be priced so high that few families in remote communities can afford them.
It's heartening to hear experts such as Tepper and Clement put these serious health inequality issues on the table. Now, it's up to the politicians and policy-makers to listen up and pledge to do something about it.