Canada may be among the leading nations in the world in terms of life expectancy, but a new report from Statistics Canada serves as a humbling reminder that, within Canada, there are stark disparities in how long and how well people live.
In fact, a resident of the Nunavik region of Quebec can expect to live 12 fewer years in good health than a resident of Richmond, B.C.
"When we look at our glowing reputation internationally, we can't let that overshadow that there are vast variations within our country," said Nancy Ross, a medical geographer at McGill University in Montreal and co-author of the new study.
She said certain characteristics help explain the discrepancies: People live longer, and better, when they have higher income and better education. The ready access to health care in urban areas also appears to make a difference.
Earlier this week, the United Nations released a study that ranked Canada third in the world in terms of development. That ranking was based on life expectancy, income and education. But it did not consider disability-free years.
By contrast, the Statistics Canada report looked at disability-free life expectancy, the years a person born today can expect live without significant disability. DFLE is increasingly seen as an important measure because it expands the concept of life expectancy to include an individual's ability to function in society.
Disability-free life expectancy is estimated at 68.6 years in Canada, compared to a life expectancy of 78.3 years. That means most people can expect to live almost a decade with a significant physical or mental disability before dying.
The DFLE ranges from a high of 72.8 years in Richmond (where life expectancy is 81.2) to a low of 61 years in Nunavik (life expectancy 65.4).
Generally, there is a strong correlation between life expectancy and disability-free years: It is highest in urban areas, and increases from East to West in Canada.
But, in areas of the country where life expectancy is lower, such as rural areas and the North, people tend not only to die young, but to live fewer years with disabilities.
One intriguing anomaly in the research is the data from Quebec. In most regions of the province, disability-free life expectancy is among the highest in the country; yet life expectancy is well below average.
This suggests, on the surface, that Quebeckers don't live as long as other Canadians, but that they live better.
Dr. Ross said there is not a simple explanation. She said there is other research that shows Quebeckers report health differently, and that suggests they may have a different concept of disability from other Canadians.
André Picard