Comparing population health in the United States and Canada
1 The Center for Health Research, Kaiser Permanente Northwest, 3800 N Interstate Avenue, Portland, OR, 97227, USA
2 University of Alberta and Institute of Health Economics, 10405 Jasper Avenue, #1200, Edmonton, AB, T5J 3N4, Canada
3 Health Utilities Incorporated, 88 Sydenham Street, Dundas, ON, L9H 2V3, Canada
4 Department of Community Health, Portland State University, 506 SW Mill Street, Portland, OR, 97201, USA
5 Research Associate, Center for Public Health Studies, Portland State University, 506 SW Mill Street, Portland, OR, 97201, USA
6 Departments of Psychiatry and Public Health and Preventive Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
Population Health Metrics 2010, 8:8 doi:10.1186/1478-7954-8-8Published: 29 April 2010
The objective of the paper is to compare population health in the United States (US) and Canada. Although the two countries are very similar in many ways, there are potentially important differences in the levels of social and economic inequality and the organization and financing of and access to health care in the two countries.
Data are from the Joint Canada/United States Survey of Health 2002/03. The Health Utilities Index Mark 3 (HUI3) was used to measure overall health-related quality of life (HRQL). Mean HUI3 scores were compared, adjusting for major determinants of health, including body mass index, smoking, education, gender, race, and income. In addition, estimates of life expectancy were compared. Finally, mean HUI3 scores by age and gender and Canadian and US life tables were used to estimate health-adjusted life expectancy (HALE).
Life expectancy in Canada is higher than in the US. For those < 40 years, there were no differences in HRQL between the US and Canada. For the 40+ group, HRQL appears to be higher in Canada. The results comparing the white-only population in both countries were very similar. For a 19-year-old, HALE was 52.0 years in Canada and 49.3 in the US.
The population of Canada appears to be substantially healthier than the US population with respect to life expectancy, HRQL, and HALE. Factors that account for the difference may include access to health care over the full life span (universal health insurance) and lower levels of social and economic inequality, especially among the elderly.