Health-adjusted life expectancy in Canada: Recent trends at birth and age 65 years, 2019, 2020 and 2023
Released: 2026-01-09
Health-adjusted life expectancy (HALE) provides a measure of both longevity and health status of Canadians, offering a more complete picture of population health than life expectancy alone. Estimates are now available for 2019, 2020 and 2023. Results show that in 2023, HALE at birth was 66.9 years, nearly two years lower than in 2019 and 2020. In 2023, HALE at age 65 years was 15.3 years and remained relatively stable since 2019.
Understanding health-adjusted life expectancy as a measure of health-related quality of life
Population health is not only about how long people live, but how well they live. Quality of life encompasses many dimensions of well-being, including life satisfaction, sense of meaning and purpose, prosperity, environment, society, good governance and health. Health-adjusted life expectancy (HALE) is a standard indicator used to measure health-related quality of life.
Life expectancy (LE) measures the average number of years a person is expected to live based on current age- and sex-specific death rates. It is one of the most widely used indicators of population health.
HALE refines this measure and reflects the number of years in good health an individual is expected to live given their current health status and LE. It incorporates Health Utilities Index Mark 3 (HUI3) scores from the Canadian Community Health Survey, a summary measure of health status and health-related quality of life across eight attributes of functioning (vision, hearing, speech, ambulation, dexterity, emotion, cognition and pain). HUI3 values range from -0.36 (a state worse than death) to 1.00 (perfect health), with 0 representing death.
HALE is measured at two key life stages. At birth, representing the average number of years a newborn is expected to live in good health. At age 65, representing the expected number of healthy years remaining for older adults, a useful indicator of aging and quality of life in later life.
A decline in HALE may result from reductions in life expectancy, declines in health status (HUI3) or a combination of both.
Long-term gains in health-adjusted life expectancy disrupted in recent years
HALE in Canada improved steadily through the early 2000s (Chart 1), reflecting gains in longevity and overall health in the Canadian population. From the 2000-to-2002 period to the 2010-to-2012 period, HALE at birth increased by nearly two years, peaking at 70.4 years, while HALE at age 65 years rose more gradually, increasing by 1.5 years. However, data released today reveal that these gains were not sustained. By 2023, HALE at birth had declined to 66.9 years, down 3.5 years from its peak in the 2010-to-2012 period, erasing more than a decade of progress.
HALE at age 65 years remained stable, at 15.2 years in 2019 and 15.1 years in 2020. By 2023, HALE at age 65 years reached 15.3 years, comparable with levels seen before the pandemic. While this suggests that gains in HALE at age 65 years have been preserved, estimates should be viewed in the context of the pandemic. The unique health status and mortality patterns among older adults, especially those in long-term care, during this time may explain the stability in HALE at age 65 years.
International and national trends can provide further context. The World Health Organization reported declines in global healthy life expectancy during and after the pandemic, including a 1.6-year drop at birth and a 1.1-year drop at age 60 years from 2019 to 2021. In Canada, declines in life expectancy post-pandemic coincided with worsening self-reported health until 2023. HALE may reflect the combined impact of these changes, offering insight into the trends observed across age groups.
Chart 1
Health-adjusted life expectancy (HALE) at birth and age 65 years, both sexes, Canada, 2000 to 2023
Females live longer but males live a greater share of healthy life
Canadian females consistently outlive males and therefore spend more years in good health than males, according to life expectancy and HALE measures. However, because they live longer overall, females spend more years in poor health than males and live a smaller share of their lifespan in good health.
In 2023, females had a life expectancy of 84.0 years at birth and a HALE of 67.7 years. In comparison, males had a life expectancy of 79.6 years and a HALE of 66.4 years. This represents a gap of 4.4 years in total life expectancy and 1.3 years in healthy life expectancy. From 2019 to 2023, HALE at birth declined by 1.9 years for females and 1.7 years for males.
In 2023, at age 65 years, females could expect to live another 22.3 years, with 15.8 of those years in good health. Males aged 65 years had a remaining life expectancy of 19.7 years and a HALE of 14.7 years. This translates to Canadian females living 2.6 more years overall and 1.1 more healthy years than males. However, females spend 6.5 more years with health limitations after age 65 years, compared with 5.0 more years for males.
Although females live longer in both absolute and healthy years, males spend a greater share of their lives in good health. At birth, 81% of the female lifespan is lived in good health, compared with 83% for males. By age 65 years, the percentage of remaining years spent in good health declines to 71% for females and 75% for males.
While life expectancy has risen for both males and females over the past two decades, there has been little evidence of compression of morbidity. Ideally, an increase in life expectancy would coincide with an equivalent or greater gain in healthy years, though this has not been the case. At birth, increases in life expectancy have not matched increases in healthy years, reducing the share of life spent in good health. At age 65 years, Canadians have gained additional years of life, but these include healthy years and years lived in poor health, leading to modest improvements in the share of later life spent in good health.
Socioeconomic disparities in health-adjusted life expectancy persist across the life course
HALE continues to vary by income, both at birth and at age 65 years. Canadian males and females in higher income quintiles generally live longer in good health compared with those in lower income quintiles.
At birth, HALE decreased by roughly three years across all income quintiles from 2019 to 2023 (Chart 2). In 2023, estimates ranged from 61.9 years in the lowest income quintile to 70.0 years in the highest. This 8.1-year gap is similar to gaps observed in 2019 (8.3 years) and 2020 (8.1 years) and is slightly wider than that from 2015 to 2017 (7.8 years).
HALE at age 65 years declined by approximately one year in every income quintile from 2019 to 2023 (Chart 3). In 2023, estimates ranged from 13.6 years in the lowest income quintile to 16.0 years in the highest, representing a 2.4-year gap. This gap is slightly narrower than that in 2020 (2.7 years), 2019 (2.8 years) and 2015 to 2017 (2.8 years).
Chart 2
Health-adjusted life expectancy (HALE) at birth by income quintile, both sexes, Canada, 2000 to 2023
Chart 3
Health-adjusted life expectancy (HALE) at age 65 years by income quintile, both sexes, Canada, 2000 to 2023
Health-adjusted life expectancy varies across provinces and territories
HALE at birth (Chart 4) declined in most provinces from 2019 to 2020, with the largest decreases being observed in Alberta (-1.2 years) and Manitoba (-0.6 years) and the largest increases being in New Brunswick (+1.7 years) and Nova Scotia (+0.9 years). From 2020 to 2023, HALE at birth fell across all provinces. New Brunswick (-4.1 years) experienced the largest decrease and Alberta (-0.6 years) saw the smallest. Quebec maintained the highest HALE at birth across all three years, reaching 70.4 years in 2023, while Newfoundland and Labrador reached 63.0 years that year. Among the territories, Nunavut recorded the lowest HALE at birth in the combined 2019-to-2020 period (61.6 years).
From 2019 to 2020, provinces generally saw small shifts in HALE at age 65 years (Chart 5). Newfoundland and Labrador (+0.6 years) recorded the largest increase over this period. From 2020 to 2023, the largest decreases were observed in New Brunswick (-1.2 years) and Newfoundland and Labrador (-1.1 years), while the largest increases were recorded in Quebec (+0.8 years) and Alberta (+0.6 years). In 2023, HALE at age 65 years was highest in Quebec (16.0 years) and lowest in Newfoundland and Labrador (13.4 years). Among the territories, Nunavut recorded the lowest HALE at age 65 years in the combined 2019-to-2020 period (13.1 years).
Chart 4
Health-adjusted life expectancy (HALE) at birth by province and territory, both sexes, Canada, 2019 to 2023
Chart 5
Health-adjusted life expectancy (HALE) at age 65 years by province and territory, both sexes, Canada, 2019 to 2023
Looking ahead
As Canada continues to recover from the direct and indirect impacts of the pandemic, future HALE estimates can provide insight into how the health of Canadians is evolving over time. Additional data for the territories are essential to provide a more complete national picture. Ongoing analysis will offer insight into the factors driving these trends, including healthcare access, chronic conditions and broader determinants of health, such as educational attainment, housing and social support. Another important area for future research is developing an up-to-date and comprehensive understanding of health utility in the institutionalized population and examining the unique impacts of the pandemic on this group. Together, this work can help identify emerging health disparities and guide efforts to improve the quantity and quality of life for Canadians.
Note to readers
Quality of life is defined using Canada's Quality of Life Framework from Statistics Canada. For more information, see Canada's Quality of Life Framework and access the latest releases, data publications and reference material on subjective and objective measures of well-being.
Health-adjusted life expectancy (HALE) estimates draw on life expectancy data from the Canadian Vital Statistics—Birth Database and the Canadian Vital Statistics Death Database, Health Utilities Index Mark 3 (HUI3) scores from the Canadian Community Health Survey (CCHS) and the National Population Health Survey (NPHS) for the institutionalized population, and the Census of Population for population counts. For additional details, see Quality of life indicator: Health-adjusted life expectancy.
HALE is calculated using the Sullivan method, which combines life tables generated using Statistics Canada's internal methodology with HUI3 scores. HUI3 multi-attribute scores are derived from survey responses using the methodology described by Feeny et al., 2002. For each sex, age group and region, the person-years lived from the life table are multiplied by the corresponding mean HUI3 score to produce quality-weighted years lived. These quality-weighted values are then summed across all subsequent ages to estimate total remaining health-adjusted years. Finally, this total is divided by the number of survivors in the age group to yield HALE.
Beginning in 2019, updated methodology was used to calculate life expectancy compared with the archived Table 13-10-0370-01. Life tables were generated using revised methods, including an updated separation factor and a more conservative estimation of "number of life years lived" (Lx). Validation showed minimal impact on earlier life expectancy and HALE estimates, ensuring continuity of the time series and comparability across years.
Household and institutionalized populations are both included in the HALE estimates. HUI3 scores for the household population are derived from the CCHS, while institutional health status estimates are based on 1994/1995 NPHS data, stratified by age, sex and region. These are weighted using updated institutional population proportions to reflect the distribution across demographic groups. Because income-specific institutional HUI3 data are not available, a single estimate is applied across all income groups for this population.
The institutionalized population are those who live in institutional collective dwellings, including hospitals, nursing homes, facilities that are a mix of a nursing home and a residence for seniors, residential care facilities (such as group homes for persons with disabilities or addictions), shelters, and correctional and custodial facilities.
Institutionalized population proportions for 2019 and 2020 HALE estimates used the 2016 Census to better represent pre-COVID-19 pandemic conditions in collective dwellings. The institutionalized population largely differed in size and composition from the 2016 to 2021 censuses, particularly in older age groups. All remaining components (income and population estimates) were based on the 2021 Census. Readers should note that the 2021 Census reflects population structures as of 2021 and may not fully represent conditions in 2023. These contexts should be considered when interpreting the findings. For more information on 2021 Census collection methods in collective dwellings, please see the Type of Dwelling Reference Guide, Census of Population, 2021.
HALE estimates are currently limited to reference years when sufficient HUI3 data are available from the CCHS. As a result, reporting is restricted to select periods that align with available health utility data.
Income quintiles are based on the QABTIPPE variable, an area-based measure from the Postal Code Conversion File Plus (PCCF+). QABTIPPE assigns dissemination areas to income quintiles using median household income before tax from the Census and applies these to individuals through their postal code. As this reflects neighbourhood-level income, it may not represent individual household income. Disaggregated data by period, age, sex, province or territory and income are presented as observed, without adjustment for potential confounding factors.
HALE estimates are based on survey data and are subject to sampling variability. Confidence intervals (95%) are available in the accompanying data tables (Table 13-10-0370-01 [2000 to 2017] and Table 13-10-0971-01 [2019 to 2023]).
Sex is assigned at birth based on a person's reproductive system and other physical characteristics. Whereas gender is an individual's personal and social identity as a man, woman or non-binary person. The sex variable in census years prior to 2021 and the two-category gender variable in the 2021 Census are included together in tables and analyses. Although sex and gender refer to two different concepts, the introduction of gender is not expected to have a significant impact on data analysis and historical comparability, given the small size of the transgender and non-binary populations. For additional details, see Age, Sex at Birth and Gender Reference Guide, Census of Population, 2021.
Compression of morbidity refers to an increase in life expectancy and an increase in the proportion of life spent in good or excellent health.
Contact information
For more information, or to enquire about the concepts, methods or data quality of this release, contact us (toll-free 1-800-263-1136; 514-283-8300; infostats@statcan.gc.ca) or Media Relations (statcan.mediahotline-ligneinfomedias.statcan@statcan.gc.ca).
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