Introduction to the annual report 2002

The third in the series of annual reports published by Statistics Canada on the health of Canadians highlights communities, with new information, mainly from the 2000/01 Canadian Community Health Survey (CCHS).

Communities are viewed from several perspectives:

• Geographically, with analyses of the health regions that have been created by provincial health departments.
• Culturally, with articles examining two specific communities - Aboriginal Canadians living off-reserve and immigrants.
• Socio-economically, with studies of urban neighbourhoods defined by their level of income.

The strategy for releasing this annual report has changed this year. Individual articles will be published electronically over the next two months, and a final report will be printed and distributed in the fall.

The first section of the report describes the health of Canadians at the community level, comparing 139 health regions in the country, grouped into "peer groups" on the basis of their socio-demographic characteristics. One of the articles in this section compares health outcomes (life expectancy, disability-free life expectancy and self-reported health) and risk factors (for example, smoking and obesity) within peer groups. A second article asks, using multi-level analysis, whether the community itself influences health. The analysis demonstrates that while individual factors are the most influential, differences between communities remain even when many of these individual factors are taken into account. A final article in this section shows wide variations between health regions in the level of self-reported unmet health care needs.

The section of the report focusing on cultural communities contains one article on the off-reserve Aboriginal population, and two on immigrants. Information from the 2000/01 CCHS shows the off-reserve Aboriginal population to generally have poorer health status than the rest of the Canadian population. This pattern, however, prevailed in the provinces, but not in the north. Many of the health inequalities are attributable not only to socio-economic status, but also to health behaviours, such as smoking and obesity. Contacts with health care professionals whose services are publicly funded were similar between the Aboriginal and non-Aboriginal populations, although there was a difference in the use of services that are not funded, notably dentists.

One of the articles dealing with immigrants shows that while immigrants tend to be healthier than the Canadian-born population, as their time in Canada lengthens, differences diminish. The second article focuses on the prevalence of depression and on alcohol use among immigrants.

The final section of the report presents two analyses of trends in key mortality indicators and specific causes of death in association with neighbourhood income. There has been overall significant improvement during the past 30 years, reflected in longer life expectancy and reduced disparities between lower- and higher-income Canadians.