Functional health of Canadian adults, 2015 to 2024

The data used are from the Canadian Community Health Survey (CCHS) annual cycles in 2015, 2019, and 2024. This analysis includes only respondents aged 18 and older, living in the provinces, who responded to all functional health questions. Territorial data were not included in this analysis, given that the annual coverage of CCHS does not represent the entire population of the territories. Excluded from the survey's coverage are people living on reserves and other Indigenous settlements in the provinces, full-time members of the Canadian Forces, the institutionalized population, and residents of certain remote regions. All analyses are weighted to be representative of the population across the 10 provinces. This analysis is limited by the exclusion of the institutionalized population in particular, who have lower functional health than the household population, which may bias the cognition results especially.

Due to changes resulting from the 2015 CCHS redesign, which included an updated collection strategy, revised sample design, and significant content adjustments, caution should be taken when comparing data from previous cycles to data released for the 2015 cycle onward. Further, functional health tables published prior to 2015 reported the proportion with a score of 0.80 or higher as having very good to perfect functional health, rather than 0.89 or higher which is used for this analysis. The previous functional health tables can therefore not be compared to this new table.

In 2015 and 2019, CCHS was collected using computer-assisted telephone interviewing (CATI) and computer-assisted personal interviewing (CAPI). From 2022 onward, CCHS has been collected using an electronic questionnaire with CATI and CAPI follow-up for non-response. Comparisons between electronic questionnaire responses and CATI/CAPI responses showed that overall functional health results were not affected by the collection mode.

A binary variable for sex (i.e., male or female) was used for all years in this analysis instead of gender because gender was not asked on the 2015 CCHS, while both sex and gender were asked from 2019 onward.

The Health Utilities Index Mark 3 (HUI3) utility scores for overall functional health range from -0.36 to 1.00. A score of 0.89 to 1.00 indicates very good to perfect functional health. A score below 0.89 indicates moderate to poor functional health. These categories are derived from previously validated categories of HUI3 scores, and differ from the categories used for functional health estimates prior to 2015.

Each of the eight attributes of functioning are measured on a 5- or 6-level scale, from highly impaired to no difficulty. The attributes have varying impacts on the overall functional health score, as described by Feeny et al. Each attribute is reported as the proportion of individuals with no difficulty in that attribute. Cognition is reported as the percentage who can remember and think without difficulty. Dexterity describes full use of the hands and fingers. Emotional health includes those who reported being happy and interested in life. Hearing includes those able to hear without hearing aids. Mobility includes those able to walk without difficulty or aid. Pain includes those who reported no pain or discomfort. Speech includes those able to be well understood. Vision is reported as the percentage able to see well without glasses or contacts.