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Unhealthy Canada: Majority of Provinces Get "D" on Drivers of Health Care Demand

British Columbia is the only province to receive an overall “A” in The Conference Board of Canada’s analysis of health status of provincial populations.

Ottawa, May 16, 2013—British Columbia is the only province to receive an overall “A” in The Conference Board of Canada’s analysis of health status of provincial populations.

Six provinces received a "D" on these indicators of the health of the population, which include the incidence of and mortality rates from diseases. The health status rankings are part of a major report, Paving the Road to Higher Performance: Benchmarking Provincial Health Systems.

“Many indicators in this category are linked to health conditions that will lead to greater demand for health care services,” said Gabriela Prada, Director, Health Innovation, Policy and Evaluation.

This is a chart of the provinces health status.

“Our analysis is not meant to ‘shame and blame’ provinces that do relatively poorly on any given indicator,” said Prada. “Our intention is to identify performance achievements and gaps so that all provinces are better equipped to make decisions that will improve health care systems and population health.”

The findings released today are the first of four categories published by The Conference Board of Canada in its benchmarking of provincial health systems, produced under the Canadian Alliance for Sustainable Health Care. In all, 90 indicators are assessed in the categories of Lifestyle Factors, Health Status, Health Resources, and Health Care System Performance.

The Health Status category contains 30 indicators, which are divided into three sub-categories: 

  • life expectancy and perceived health status (nine indicators)
  • incidence of disease (13 indicators), and 
  • mortality due to disease (eight indicators).

British Columbia gets “A” grades across all three sub-categories. Alberta, Ontario and Quebec get overall “B” grades, and generally earn ‘B’ grades or better on the sub-categories. Saskatchewan, Manitoba and the four Atlantic provinces receive overall ‘D’ grades.

In the sub-category of life expectancy and perceived health status, B.C. and Quebec earn overall “A” grades, while Alberta, Ontario and Prince Edward Island obtain “B” grades.

From an international perspective, Canada performs well in low birth weight babies. Even provinces with relatively high rates of low birth-rate babies compare well against the percentages among international peers. However, Canadian provinces fare less well on infant mortality, an indicator often used to monitor child health and the well-being of a society over time. Although infant mortality has decreased by more than half since the 1980s, Canada’s top-performing provinces on this indicator are middle performers when compared with peer countries.

This is a chart of the health status of canadian provinces: mortality due to diseases.

Canada has several lackluster results on the incidence of diseases. Overall, Canada has the fourth-highest prevalence of diabetes among the 34 OECD member countries. The incidence of high blood pressure and mood disorders has also increased in Canada.

Nine provinces get “A” or “B” grades on the indicator of newly-reported HIV cases. The exception is Saskatchewan, whose recorded 2011 rate of 19.6 per 100,000 population is more than double the national average of 7.6.

In the sub-category of mortality due to diseases, Ontario and B.C. earn overall “A” grades. Alberta earns a good overall grade of “B” although it receives “C” grades on three of the eight indicators explored. On the other hand, P.E.I. and Newfoundland and Labrador, receiving “D” grades for at least half of the mortality indicators. 

Manitoba and Saskatchewan obtain “D” grades for mortality due to suicide. Given that suicide rates are five to seven times higher for First Nations and Inuit youth than for non-Aboriginal youth, the large proportion of Aboriginal populations in these provinces might explain the relatively high suicide rates.

The Conference Board of Canada benchmarks performance using an A-B-C-D report card ranking methodology. Grade levels are assigned to the indicators using the following method:

  • For each indicator, the difference between the top and bottom performer is calculated and this figure is divided by 4.
  • A province receives a report card rating of “A” on a given indicator if its score is in the top quartile, a “B” if its score is in the second quartile, a “C” if its score is in the third quartile, and a “D” if its score is in the bottom quartile.
  • This methodology helps to ensure that those regions awarded an “A” on a given indicator perform substantially better than the range of performances among the other regions.

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