Mortality Due to Respiratory Diseases

Key Messages

Putting the mortality rate due to respiratory system diseases in context

Respiratory diseases include asthma, tuberculosis, bronchiolitis, emphysema, cystic fibrosis, influenza, and pneumonia. Although Canada and most of its peer countries have seen a decrease in respiratory diseases over the past few decades, aging populations in developed countries are expected to lead to a surge in these diseases in the future.

How does respiratory disease affect the quality of life of Canadians?

Over 3 million Canadians of all ages have a serious respiratory disease such as asthma, chronic obstructive pulmonary disease (COPD), lung cancer, tuberculosis (TB), cystic fibrosis, and respiratory distress syndrome. The numbers are likely much higher, however, given that data are unavailable for other respiratory conditions such as influenza, pneumonia, and bronchiolitis.¹ After cardiovascular disease and cancer, respiratory diseases (including lung cancer) are responsible for the third-highest share of hospitalizations and deaths in Canada.²

Smoking is the main preventable risk factor for respiratory diseases like lung cancer and COPD. As more women became smokers after the First World War, the incidence (number of new cases) and prevalence (total number of cases) of respiratory diseases among women increased.³ Fortunately, the proportion of smokers has dropped significantly in the past several decades. About 16 per cent of Canadians aged 15 and older smoke cigarettes every day, which represents a 26 percentage point decrease since the early 1960s.⁴

Although the proportion of smokers has dropped, Canada, like many of its peer countries, is facing an increase in chronic respiratory diseases. As a report published by Health Canada explains, “since many of these diseases affect adults over the age of 65, the number of people with respiratory diseases will increase as the population ages. The corresponding increase in demand for services will pose a significant challenge for the health care system.”⁵

How does Canada compare to its peers on mortality due to respiratory diseases?

Canada earned a “B” in 2009, ranking 9th out of 17 peer countries, for an estimated mortality rate of 38 deaths per 100,000 population.⁶ The mortality rate due to respiratory system diseases ranges from Finland’s low of 24 deaths per 100,000 population to Ireland’s high of 68 deaths. The most recent year of published data on mortality due to respiratory disease for Canada is 2004, with 43 deaths per 100,000 population.

Are fewer Canadians dying of respiratory system diseases than in the past?

Canada has reduced its death rate due to respiratory system diseases over time—from 59 deaths per 100,000 population in 1960 to an estimated 38 deaths in 2009. Germany has made the most progress since 1960, but most other countries have also reduced their mortality rates.

Ireland’s respiratory system mortality rate has improved over the years, but it remains the worst performer on this indicator.

How has Canada’s relative performance changed over time?

Relative to its peers, Canada has performed well on this indicator, scoring an “A” during four of the five decades.

Other strong performers are Australia, Austria, Finland, France, Germany, Italy, Sweden, and Switzerland.

Ireland has been a consistently poor performer, with a “D” in all five decades.

Because Denmark’s mortality rate increased over time, its grade fell from an “A” in the first three decades, to a “B” in the 1990s and a “C” in the 2000s.

Which respiratory diseases place the heaviest burden on the Canadian health-care system?

The top two leading respiratory diseases contributing to the overall Canadian respiratory disease burden are asthma and chronic obstructive pulmonary disease (COPD).

Asthma is now the most common of all respiratory diseases in Canada, with about 2.7 million cases. More than 750,000 Canadians are believed to be living with COPD.⁷

Why is influenza a concern?

Human influenza—or the flu—is a highly contagious respiratory infection caused by the influenza virus. Although most people recover within a week or so, some people develop more severe complications, such as pneumonia. Depending on the severity of the strain in a particular year, between 2,000 and 8,000 Canadians can die of influenza and its complications annually.⁸ For more information on the symptoms, prevention, and treatment of influenza and on its different strains, see the Public Health Agency of Canada’s website.

What is Canada doing to protect itself from influenza?

Influenza vaccination rates have nearly doubled across Canada since 1996–97, according to a Canadian study from the Institute for Clinical Evaluative Sciences (ICES). Yet despite the increase, high-risk groups still fall short of national vaccination targets. The study, published in the October 2007 issue of Health Reports, examined the recent trends in influenza vaccination rates in Canada, identified what makes people more likely to get a flu shot, and looked at the effects of Ontario’s universal influenza immunization program on vaccination rates.⁹

“Convincing people they need to be vaccinated and getting them vaccinated are the two biggest challenges we face in this country,” says Dr. Jeff Kwong, the study’s lead author and ICES scientist. “Not enough individuals who are considered to be high risk for serious complications, like seniors, those with chronic conditions, and young children, are getting the shot.”¹⁰

According to ICES, a national consensus conference on influenza in 1993 “set target vaccination coverage rates of 70 per cent for adults aged 65 or older and for all adults with chronic medical conditions. The national target was raised to 80 per cent in 2005 and was reached by seniors aged 75 or older with chronic conditions. Just 56 per cent of individuals aged 50 to 64 with chronic conditions were vaccinated in 2005; the figure was about one-third for those younger than 49 with chronic conditions.”¹¹

Footnotes

1 Public Health Agency of Canada, Life and Breath: Respiratory Disease in Canada (Ottawa: PHAC, 2007), 2 (accessed January 13, 2012).

2 Ibid., 3.

3 Canadian Institute for Health Information, Canadian Lung Association, Health Canada, and Statistics Canada, Respiratory Disease in Canada (Ottawa: Authors, 2001), vii (accessed June 22, 2009).

4 Organisation for Economic Co-operation and Development, OECD Health Data 2011.

5 Canadian Institute for Health Information, Canadian Lung Association, Health Canada, and Statistics Canada, Respiratory Disease in Canada (Ottawa: Authors, 2001), vii (accessed June 22, 2009).

6 Missing data up to 2009 were obtained by projecting the most recent year of data using a 10-year average annual growth rate. This was done for Australia, Belgium, Canada, Denmark, France, Germany, Italy, Sweden, Switzerland, and the United States.

7 Public Health Agency of Canada, Life and Breath: Respiratory Disease in Canada (Ottawa: PHAC, 2007), 2 (accessed January 13, 2012).

8 Public Health Agency of Canada, “Influenza” (accessed November 14, 2010).

9 Institute for Clinical Evaluative Sciences, Influenza Vaccination Rates More Than Doubled in Canada Over Past Decade: “Too Few People Who Need Them Get Them”, News Release, October 2, 2007 (accessed September 23, 2009).

10 Ibid.

11 Ibid.