5. The Geriatric Giants
6. HIV - AIDS
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Note: Rather than attempt to provide recent health statistics on each condition – which would be hard to keep current – this page offers some background information and web links through which you may find recent statistics.
For general health information, see the World Bank web site.
The WHO Global Burden of Disease site allows you to create comparative charts showing the relative importance of diseases, and of risk factors, in different countries.
Between 55% and 60% of the decline in mortality appears to be due to changes in risk factors such as smoking (Unal B et al. Am J Public Health 2005;91:103-108). Much of the remainder is explained by therapeutic advances that reduce mortality. However, changing risk factors prevents a case completely whereas improved treatment prolongs survival for established, chronic disease.
- The WHO Cardiovascular disease page provides fact sheets
- Arrythmias set to music
Diabetes is a set of diseases characterized by the body's inability to produce insulin (type 1 diabetes) or to effectively use the insulin that it does produce (type 2 diabetes). A person with diabetes develops hyperglycemia (high blood glucose). Persistent hyperglycemia can lead to long-term damage to the heart, kidneys, eyes, nervous system, and gastrointestinal system.
Diabetes itself does not typically lead directly to death, but the complications associated with diabetes do. Although only 3.1% of all deaths in Canada were attributed to diabetes in 2007, more than a quarter (29.9%) of individuals who died in 2008/09 had diabetes. The net effect is that diabetics aged 25 to 39 can expect to live 9 years less than non-diabetics; diabetic patients aged 50 will live 7 years less (females) and 6 years less (males) compared to non-diabetics.
Diabetes is becoming increasingly common, especially among Indigenous populations.
All reports agree that Type 2 diabetes is becoming increasingly prevalent: a 70% increase over 10 years.
Currently around 2.1 million people aged 12 and over are affected.
Before 1940, there was no evidence of diabetes among indigenous groups in Canada. Today, this disease is reaching epidemic proportions, with rates approximately three times the national average.
Among Indigenous people, 10% of the population aged 15 and over, and 23% of the population 65 and older have been diagnosed with diabetes.
(Health Canada. Diabetes in Canada. Minister of Public Works, 1999. Cat No. H49-121/1999.)
This map outlines anticipated rise in diabetes in the Canadian north. It comes from a June 2010 report by ICES (the Institute for Clinical Evaluative Studies) on the risk of diabetes in Canada.
- Indigenous peoples are likely to be genetically predisposed to storing energy from foods very efficiently; this was not an issue in the traditional active lifestyle, including living off nutritious "land food". The combination of genetic susceptibility, a transition to a sedentary lifestyle, and adoption of a diet high in fats and sugar are major contributors to this dramatic increase in type 2 diabetes among Indigenous people. Current trends suggest that 27 per cent of Indigenous people will get diabetes within 20 years.
- The Sandy Lake Reserve in Northwestern Ontario already has the third highest rate of diabetes in the world. At least 26 per cent of its population has type 2 diabetes, and another 14 per cent have glucose intolerance.
- Kahnawake has a web site on approaches to preventing diabetes among children.
The Canadian Cancer Society publishes routine reports that give cancer statistics. From the 2017 report and other sources we draw the following summary points:
- Age-standardized cancer incidence rates have been declining since about 2008 among men, but are rising slightly among women. Estimated rates for 2017 were around 550 per 100,000 men, and 498 per 100,000 women.
- Age-standardized mortality has been declining since the late 1980s among men, and since the early 2000s among women; rates in 2017 were estimated at around 225 per 100,000 for men and 180 among women.
- In terms of absolute numbers, however, the total numbers of cases and of deaths has been rising in Canada. This is due to the increasing size and the aging of the population. Demographics overpower the downward pressure of improved cancer care and changing risk factors. An estimated 206,900 new cases of cancer and 80,800 deaths from cancer occurred in 2017, these will rise over time so that the demand for cancer care services will increase. (See Cancer Society report, page 15)
- About 1 in 2 Canadians will develop some form of cancer during their lifetime.
- Cancer causes about 30% of all deaths in Canada (2012 figures), compared to 20% for circulatory diseases.
- As cancers are common and may kill at early ages, cancers cause the most potential years of life lost (at around 744,000 for men in 2012, and 715,000 for women). Heart disease caused around 496,000 PYLL for men, and 202,000 for women.
- Lung cancer is the leading form of cancer death, although death rates are declining among men. However, lung cancer mortality for women has almost quadrupled since 1975, and appears to be rising steadily with the increase in smoking by women.
- Breast cancers have seen an even greater decline.
An animated web site "Inside Cancer" that covers epidemiology and biology of cancers
Does screening work? Cancer Care Ontario offers various guidelines for cancer screening.
PPT slide show on Cancer Rates in Canada (from Dr. Brenda Wilson)
Worldwide, dental caries is probably the commonest chronic health condition:
- Although cavities are largely preventable, 96% of Canadian adults have a history of cavities.
- But there is reason for optimism: only around one-quarter of children have one or more teeth with decay. And roughly 85% of Canadians have visited a dentist within the past 2 years (Source: Canadian Dental Association)
- Periodontal disease is also common: 21% of adults with teeth have, or have had, a moderate or a severe periodontal (gum) problem. (Source: 2007 Oral Health Module of the Canadian Health Measures Survey, CHMS)
- Groups at especially high risk include elderly people (especially those in institutions); poor families; Indigenous populations; people with disabilities. Dental care is often the most expensive form of health care people in Canada obtain.
DMF Index. Caries are typically recorded in terms of the number of Decayed, Missing or Filled teeth a person has.
This indicator is widely used, but there is some debate over precisely how the results should be judged.
A DMF of 0 to 1.1 teeth is regarded as very low; 1.1 to 2.77 is low; 2.78 to 4.4 is moderate, while a figure of 6.6 or more is very high.
Note, of course, that a mean DMF does not show what proportion of the population experiences the disease.
The DMF count is not reversible, so the index typically rises with age.
How can you encourage caries prevention for young children?
(1) encourage healthy snacking between meals; cut down on sugars and the acids contained in colas and fruit juices;
(2) encourage using tap water rather than bottled, to increase fluoride intake;
(3) encourage regular cleaning of the child's mouth, even before the eruption of teeth;
(4) advise against use of fluoridated toothpaste until around age 4, when the child can effectively spit it out;
(5) suggest only small amount of toothpaste - about a pea-sized amount;
(6) advise parents against leaving the child with a baby bottle containing milk or juice overnight (they can use tap water);
(7) never dip pacifiers in sweet substances;
(8) advise a dental visit by the child's first birthday. The Canadian Dental Association advises a first visit to a dentist within 6 months of eruption of the first tooth, and no later than 1 year of age. "Appropriate preventive interventions need to be planned to take into account any social challenges that the family may be experiencing and must be culturally appropriate. Health care professionals and all other stakeholders in children’s oral health should support the identification of a “dental home” for all infants by 12 months of age. "
The "First 5 Oral Health" organization provides a useful set of guidelines for monitoring a child's dental health.
(See the Mental Health page)
(see the Aging page)
(see the Infectious disease page)
(see the Indigenous Peoples page)
Updated March 2, 2018