Living Well in Canada: How Does Your Province Rate?

It’s one of the things we give consideration before we take that job in another province, before we leave our small town for the big city, before we trade in security for the great unknown. We have to ask ourselves, am I moving somewhere better? Everyone wants to live where the environment is clean, where health care is comprehensive and responsive, and where jobs are plentiful. So, YW went on a fact-finding mission to compare our provinces and territories, using Health Indicators 2008, compiled by Statistics Canada and The Canadian Institute for Health Information, and National Health Expenditure Trends 1975-2008, published by the Canadian Institute for Health Information.

Wherever possible, we have included information from all 10 provinces and three territories, but data collection in the territories and Quebec sometimes differs from the rest of Canada and so is not always included in the statistics made available in these reports.

Health Factors
Total Life Expectancy at Birth
On average, Canadian women tend to live to be 82.7 years old, whereas the average male in Canada has a life expectancy of 78 years. Combining the sexes in the calculation of life expectancy brings down the average below what it would normally be for the female population. Other factors such as pollution, work safety and lifestyle choices also affect one’s longevity.

Still, this measurement does give us some sense as to whether a particular part of the country is conducive to long life.

Self-Reported Asthma
As a health condition, asthma is becoming more commonplace in children and adults, with the rise in levels of irritating particulates in the air we breathe. These statistics measure the household population aged 12 and older diagnosed by a medical professional as having asthma. The newest statistics available for this category are from 2005, so we may extrapolate that conditions have worsened or improved somewhat in areas where air quality has changed.

According to the most current Air Quality Summary issued by Environment Canada, Newfoundland has less of a problem with smog, though strong winds can bring it in from other parts of Canada, but this form of pollution can be a big problem in New Brunswick, Nova Scotia and PEI, comprising 7% of the total of particulate matter generated in Canada.
With wood-burning stoves being popular in Quebec, smog has become a major problem in the province. However, Ontario has the smoggiest city in Canada—Windsor—and Toronto’s industrial economy produces a number of other irritating pollutants besides the ground-level ozone that makes up smog. Manitoba tends to keep its air quality problems at the local level caused by industry, vehicle emissions and manufactured materials.

Saskatchewan is only second to Alberta for carbon dioxide emissions, mostly from coal plants. This province also has a problem with particulate matter produced by wind erosion and smoke and residues from burning crop stubble. Alberta is working closely with Environment Canada to address the pollutants it produces as a result of the oil and natural gas industry. About 30% of the carbon, 26% of the nitrogen oxide, and 23% of the sulphur oxide generated in Canada starts in Alberta. British Columbia’s bone of contention is the smog created in the Okanagan and Fraser valleys, because of urban growth and transportation exhaust, not to mention particulates from industry and from residential wood burning. Smog in the Yukon is also a result of wood burning and motor vehicle exhaust.

Of special concern in Nunavut and the Northwest Territories are the pollutants carried there from around the world via the air currents that gravitate to the Arctic. Cold temperatures there can trap pollutants, which then become involved in the food chain. Local pollutants from heat and transportation are also a source of concern.

Cancer
The most current statistics for cancer in Health Indicators 2008 were compiled in 2004. We looked at the incidence of all cancers per 100,000 people, recognizing that there are many factors involved in this disease, including genetics, lifestyle, and environment. Still, it’s worthwhile to be aware of those areas where cancers may be higher than normal, which may indicate an environmental or lifestyle concern particular to that area.

Hip Surgery Wait Time and In-Hospital Heart Attack Mortality
These factors give us some idea as to the quality and responsiveness of the health care system where we live. We looked at the percentage of the population that was able to have hip surgery on the same day, the next day, or the day after the incident. While there is a dramatic difference in some areas between the percentage of the people who had surgery with 48 hours and those that had to wait an extra day, the report points out that in some cases medications needed to be given to patients before they could receive the operation, thus making the extra day delay necessary to their recovery.

Acute myocardial infarctions or heart attacks that led to mortality while in hospital give us some indication of the quality of care if a medical facility is generally able to keep this mortality rate low.

Availability of General Physicians and Specialists
The lack of family physicians has been a bone of contention for many Canadians in recent years. Bearing in mind that the statistics compiled for general physicians date from 2005 and that some improvements may have been made in certain areas, having access to a general physician’s care is still a problem for many families who have to rely on hospital emergency rooms and walk-in clinics for medical treatment.

In areas where specialists are lacking, families must take into account the extra expense and stress of travelling to find care for specific conditions. The statistics for specialists date from 2006.

Public Health Expenditures
This measurement gives us a good idea as to what is covered by government health programs in a given area, and how much has to come out of one’s own pocket. It’s worthwhile to note that while 10% of Canada’s GDP goes to health care, U.S. citizens benefit from 15% of their GDP being spent on their well-being.

Unemployment Rate
This is a straightforward look at the unemployment rate breakdown from January 2009.
While we’ve isolated some key factors that affect a decision about where to work and live in Canada, there are many variables that come into play. So often, there is a contradiction between the big picture and what we individually do to ensure our health and employment. Life is what we make it. Wherever we choose to live in this vast country of ours, ultimately our lifestyle plays a significant part in making our experience a happy, healthy one.

Coast to Coast Comparison
Canada’s North
Life in Canada’s far north is adventurous. The terrain is rugged, and communities are remote, often with limited access to the amenities freely available in the provinces. It may not be surprising for some that the north has the lowest life expectancy rate of all areas of Canada at an average of 76.3 years per person. Yet, Nunavut has the lowest asthma rate and joins the Northwest Territories and the Yukon as having the lowest number of cancer cases in Canada.

You’ll wait longer in the Yukon and the Northwest Territories for hip surgery than anywhere else in the country, but you have the best chance of recovering from a heart attack in a Yukon hospital. You’re going to be a lot luckier in finding a family physician there as well, with 202 GPs to every 100,000 people, but you won’t fare as well in the Northwest Territories or Nunavut, with 83 and 32 physicians per 100,000 respectively. You’ll also be harder up for a specialist here than anywhere in Canada.

Still public health care expenditure is highest here, with Nunavut health being funded at 94%, the Northwest Territories at 82% and the Yukon at 80%.

British Columbia
This province stands out as having the highest average life expectancy in Canada at 81.2 years and the second shortest wait time for hip surgery, with 88% receiving care within 72 hours. B.C. is tied with Quebec for third place in providing access to general physicians at 109 per 100,000 and is in fourth place with Ontario for providing 90 specialists per 100,000.

Don’t expect much from the public purse for health spending, as B.C. is second lowest at 69% of the GDP, and with a rising unemployment rate at 6.2% as of January, you may scramble for a job to cover those additional costs. Still, it’s a rate that beats that of the east coast. The jobless rate in Newfoundland is 14.3%.

Alberta
Here, you can expect to live to be 80.3 years old on average. That’s one of the higher expectancy rates in Canada. Yet, Alberta also has one of the highest cancer rates at 402 cases per 100,000 people. This suggests that long life in Alberta does not necessarily mean a life of quality. Still, the province has the second lowest rate of in-hospital mortality from heart attack at 8.4% and, as of January 2009, Alberta still boasts the second lowest unemployment rate at 4.4%.

Saskatchewan
Saskatchewan stands out as having the best unemployment rate in the country at 4.1%. It has one of the better in-hospital heart attack mortality rates of 9.6% despite the low rate of specialists: 69 per 100,000 compared to 106 per 100,000 in Quebec.

Manitoba
This province has the second lowest asthma rate in Canada at 7.9% and the third best in-hospital heart attack mortality rate of 9.2%. The unemployment rate of 4.6% is the third best in the country, but only 76.3% of hip surgeries happen in the first 72 hours.

Ontario
Ontario has the second highest rate of life expectancy in Canada at 80.7 years and the third best asthma rate of 8%, but Ontarians pay privately for health care more than anywhere else in Canada, with public expenditure only amounting to 67.5%. Ontario also has one of the worst ratios of doctors to patients, at 84 GPs to 100,000 people.

Quebec
Not all data was available for Quebec medical care, but la belle province does stand out for having the highest ratio of specialists to population at 106 per 100,000. Quebec is tied with B.C. for the general physician ratio of 109 to 100,000 and the province also has the third highest rate of life expectancy at 80.4 years. It’s tied with Alberta for its higher cancer rate, but it offers less public money toward health care at 71.2%.

New Brunswick
New Brunswick stands out as one of the better places to get hip surgery with 85.3% receiving care within 72 hours, and it has one of the higher ratios of general physicians to population. However, only 70.3% of public funds go to
health care. With 400.5 cancer cases per 100,000 compared to the Yukon’s 318.4 cases, patients may find themselves more out of pocket for health care in New Brunswick.

Nova Scotia
Nova Scotia has the second best ratio in the country for GPs and specialists to the population, with ratios of 120 and 99 respectively. However, it has the worst asthma rate at 9.3%, and one of the worst cancer rates at 441.8 cases per 100,000. Given the low public health expenditure rate of 70.9% and the relatively high unemployment rate of 8.8%, falling ill in this province could be costly.

Prince Edward Island
Expect to be whisked into OR for hip surgery on the Island. It has the best wait time in Canada, with 89.5% getting care within 72 hours. However, PEI also has the highest rate of cancer in the country, at 443.1 cases per 100,000 and the worst in-hospital heart attack mortality rate at 12.8%, compared to 7.8% in the Yukon. It’s also one of the more difficult places to get a physician, with a GP ratio of 92 to 100,000 and a specialist ratio of 58 to 100,000. With only 71.6% of public funding going to health and an abysmal unemployment rate of 11.9%, there is cause to think twice about relocating to PEI.

Newfoundland and Labrador
While this part of the country has one of the highest rates of asthma (9.2%) and is a close second to PEI for in-hospital heart attack mortality at 12.1%, it has the third best ratio of specialists with 97 to every 100,000 people and the fourth best rate of public health expenditure at 77.2%. This is good news, given that Newfoundland has the highest unemployment rate in the country at 14.3%.

OVERALL CHART