Health of Canadians
Health outcomes

1.0 General and mental health status 

Key findings

• Most parents reported the general (90.9%) and mental (87.8%) health of their children (aged 1 to 11) as very good or excellent in 2019.^{Note 3}
• More than half of Canadians aged 12 and older rated their general (59.7%) and mental (59.0%) health as very good or excellent in 2021.
• Declines in self-reported mental health from 2015 to 2021 were observed across all ages but were especially prominent among young adults aged 18 to 34. In 2021, fewer females (55.1%) than males (63.0%) reported very good or excellent mental health, and sex differences were largest among youth aged 12 to 17.
• In 2020, life expectancy at birth was 81.7 years overall, with males’ and females’ life expectancy at 79.5 and 84.0 years, respectively.
• Canadians are expected to spend about 71.3 years of their life in good health.

Self-rated health is how people rate their own health and is an accurate indicator of overall health. Lower rates of self-rated health are associated with functional decline, morbidity, and mortality.^{Note 4}

General and mental health

In 2019, 90.9% of parents or guardians perceived that their children aged 1 to 11 had very good or excellent general health and that 87.8% had very good or excellent mental health.^{Note 3} More than half of Canadians aged 12 and older rated their general health (59.7%) and mental health (59.0%) as very good or excellent in 2021.

While general health has remained relatively stable since 2015, the percentage of Canadians reporting very good or excellent mental health has been declining (Chart 1.0). Decreases were observed from 2015 to 2021 across all ages but were especially prominent among young adults aged 18 to 34 (-21 percentage points, Chart 1.0).

Data table for Chart 1.0



Data table for chart 1.0
Table summary
This table displays the results of Data table for chart 1.0 2015, 2016, 2017, 2018, 2019, 2020 and 2021, calculated using percent units of measure (appearing as column headers).

	2015	2016	2017	2018	2019	2020	2021
	percent
12 to 17 years	77.9	77.4	76.0	74.1	73.0	68.6	62.3
18 to 34 years	72.5	69.8	68.7	64.0	60.9	59.0	51.1
35 to 49 years	72.4	71.1	69.9	68.5	66.6	64.2	56.9
50 to 64 years	72.0	70.4	70.0	69.4	69.6	66.5	61.1
65 years and older	70.5	70.3	71.4	72.2	70.8	71.0	68.2
All ages	72.4	70.9	70.3	68.6	67.1	65.0	59.0
Note: Estimates exclude those living in the territories. Sources: Statistics Canada, Canadian Community Health Survey, 2015 to 2021, Table 13-10-0096-01 Health characteristics, annual estimates.

In 2021, a lower proportion of Canadians aged 65 and older reported very good or excellent general health, compared with other age groups (Chart 1.1). Positive mental health was highest among children and youth, was lowest among those aged 18 to 34 and then increased with age (Chart 1.1).

A lower proportion of females than males reported very good or excellent general and mental health, and sex differences were largest among youth aged 12 to 17 (Chart 1.1).

Data table for Chart 1.1



Data table for chart 1.1
Table summary
This table displays the results of Data table for chart 1.1 General health (males), General health (females), Mental health (males) and Mental health (females), calculated using percent units of measure (appearing as column headers).

	General health (males)	General health (females)	Mental health (males)	Mental health (females)
	percent
1 to 4 years	91.8	93.2	93.4	94.9
5 to 11 years	89.0	90.8	81.3	85.6
12 to 17 years	74.9	68.7	72.1	52.2
18 to 34 years	66.6	65.6	56.1	45.8
35 to 49 years	62.0	60.7	61.4	52.4
50 to 64 years	56.1	55.9	64.2	58.0
65 years and older	48.4	51.2	69.8	66.7
Notes: Estimates exclude those living in the territories. General and mental health was reported by the person most knowledgeable for ages 1 to 11 and self-reported for ages 12 and older. Sources: Statistics Canada, Canadian Health Survey on Children and Youth, 2019; and Canadian Community Health Survey, 2021, Table 13-10-0096-01 Health characteristics, annual estimates.

A higher proportion of heterosexual Canadians (60.7%) than bisexual or pansexual Canadians (45.3%) reported positive general health. A higher proportion of heterosexual Canadians (60.1%) also reported positive mental health, compared with gay or lesbian (52.8%) and bisexual or pansexual (21.6%) Canadians (Chart 1.2).

Data table for Chart 1.2



Data table for chart 1.2
Table summary
This table displays the results of Data table for chart 1.2 General health and Mental health, calculated using percent units of measure (appearing as column headers).

	General health	Mental health
	percent
Heterosexual	60.7	60.1
Gay or lesbian	63.1	52.8
Bisexual or pansexual	45.3	21.6
Notes: Estimates exclude those living in the territories. Sexual orientation not elsewhere classified was excluded because of wide confidence intervals. Source: Statistics Canada, Canadian Community Health Survey, 2021.

Did you know?

Bullying has a negative impact on mental health. In 2019, 7 in 10 youth aged 15 to 17 had experienced at least one form of bullying in the past year.^{Note 5} The most common forms of bullying were being made fun of, called names, or insulted by others (58.7%); having rumours spread by others (35.2%); and being excluded from activities (32.4%).^{Note 5} Sexually and gender diverse youth were nearly twice as likely to report weekly or daily bullying and multiple forms of bullying.^{Note 5}

A greater proportion of people living in households in the highest income quintile reported excellent or very good general (68.9%) and mental (62.5%) health compared with people in the lowest household income quintile (49.5% and 54.2%, respectively). Nunavut had the lowest proportion of people reporting positive general health (41.3%) and mental health (47.4%) compared with the rest of Canada.

Life expectancy at birth and health-adjusted life expectancy

While life expectancy had been rising over the last four decades in many countries, including Canada, it declined in 2020 because of COVID-19 and increases in deaths associated with substance-related harms^{Note 6} (Chart 1.3). In 2020, life expectancy at birth in Canada was 81.7 years. Canadian males and females could expect to live 79.5 and 84.0 years, respectively (Chart 1.3), and the gap between males and females has been narrowing.

Data table for Chart 1.3



Data table for chart 1.3
Table summary
This table displays the results of Data table for chart 1.3 Males and Females, calculated using life expectancy (years) units of measure (appearing as column headers).

	Males	Females
	life expectancy (years)
1980	71.59	78.79
1981	72.01	79.16
1982	72.33	79.29
1983	72.68	79.61
1984	73.01	79.82
1985	73.02	79.80
1986	73.22	79.87
1987	73.53	80.19
1988	73.61	80.27
1989	73.92	80.49
1990	74.30	80.73
1991	74.53	80.81
1992	74.76	81.07
1993	74.70	80.86
1994	74.94	80.95
1995	75.07	81.03
1996	75.43	81.15
1997	75.71	81.25
1998	75.97	81.41
1999	76.20	81.61
2000	76.64	81.82
2001	76.92	82.00
2002	77.16	82.02
2003	77.32	82.23
2004	77.68	82.42
2005	77.82	82.52
2006	78.29	82.91
2007	78.29	82.91
2008	78.51	83.05
2009	78.91	83.33
2010	79.21	83.54
2011	79.39	83.68
2012	79.61	83.82
2013	79.74	83.85
2014	79.76	83.91
2015	79.84	83.89
2016	79.92	84.03
2017	79.75	84.02
2018	79.80	83.99
2019	80.18	84.38
2020	79.49	83.96
2021	79.27	84.02
Notes: Average number of years remaining to be lived by people surviving to age x if those people experienced, during their lifetime, the mortality observed over the reference period. Data on deaths that occurred in Yukon and deaths of residents of Yukon that occurred in other provinces or territories are not available for 2017, 2018, 2019, 2020 and 2021. For this reason, data for Yukon were not included in the calculation of life tables for Canada (as well as in the imputation process used when the population or death numbers were insufficient for a combination of sex, age and province [or territory] for these periods). Source: Statistics Canada, Table 13-10-0837-01 Life expectancy and other elements of the complete life table, single-year estimates, Canada, all provinces except Prince Edward Island.

While Canadians were living longer in 2020 than their counterparts in the United States and the United Kingdom, life expectancy in Canada was below that in other countries, including Japan, France and Italy.^{Note 7} In 2019, Canadians could expect to spend about 71.3 years of life in good health compared with 66.1 years for people in the United States, 70.1 years in the United Kingdom and 74.1 years in Japan (Chart 1.4).^{Note 8}

Data table for Chart 1.4



Data table for chart 1.4
Table summary
This table displays the results of Data table for chart 1.4 life expectancy (in years) (appearing as column headers).

	life expectancy (in years)
Japan	74.1
France	72.1
Italy	71.9
Canada	71.3
Germany	70.9
United Kingdom	70.1
United States	66.1
Source: World Health Organization, Health-Adjusted Life Expectancy (HALE) at birth (years), 2019.

Did you know?

While Canadians enjoy long life expectancy on average, there are differences and inequities among key population groups. Statistics Canada integrates census and mortality data to monitor longevity by population group. In 2011, life expectancy at age 1 was about 10 years shorter for First Nations people, 5 years shorter for Métis and about 11 years shorter for Inuit compared with non-Indigenous people.^{Note 9}

2.0 Reproductive health

Key findings

• The overall crude birth rate has been declining in Canada and varies across the provinces and territories.
• The total fertility rate in Canada has been declining and, as of 2021, was 1.4, which places the total Canadian fertility rate below the population replacement level of 2.1. Additionally, women are delaying pregnancy and having children later in life.
• Stillbirth rates have been rising, while infant mortality rates have been declining.
• Infant mortality in Canada remains higher than in most Organisation for Economic Co-operation and Development (OECD) countries.
• Maternal mortality is increasing, but total numbers are relatively low compared with other causes of death.

Crude birth rate

In 2021, there were 367,684 live births in Canada—an increase of 1.9% from 2020 (360,552).^{Note 10} The crude birth rate, defined as the number of live births per 1,000 population, has declined from 11.1 in 1999 to 9.6 in 2021.^{Note 11}

Despite a brief increase in some provinces in the mid-2000s, the crude birth rate has declined across all provinces and territories.^{Note 11} In 2021, Saskatchewan (12.1 per 1,000), Alberta (11.3 per 1,000), Manitoba (10.3 per 1,000), Nunavut (19.9 per 1,000) and the Northwest Territories (12.0 per 1,000) all had crude birth rates that were higher than that of Canada.^{Note 11}

Fertility rate

In 2021, the total fertility rate (an estimate of the average number of live births a woman can be expected to have in her lifetime, based on the age-specific fertility rates of a given year) was 1.4 children per woman aged 15 to 49 (Chart 2.0). This is lower than in 2000, when the total fertility rate was 1.5.^{Note 11} Currently, the total fertility rate is below the population replacement level of 2.1 children per woman, meaning that the population will mainly rely on international migration for continued growth.^{Note 12}

At the provincial and territorial level, Nunavut (2.6 children per woman) had the highest total fertility rate in 2021, making it the only jurisdiction with a fertility rate above the population replacement rate (Chart 2.0).

Data table for Chart 2.0



Data table for chart 2.0
Table summary
This table displays the results of Data table for chart 2.0 number of children per woman (appearing as column headers).

	number of children per woman
Canada	1.43
N.L.	1.36
P.E.I.	1.43
N.S.	1.11
N.B.	1.44
Que.	1.58
Ont.	1.37
Man.	1.50
Sask.	1.84
Alta.	1.55
B.C.	1.21
N.W.T.	1.61
Nvt.	2.56
Notes: The total fertility rate is an estimate of the average number of live births a woman can be expected to have in her lifetime, based on the age-specific fertility rates of a given year. The total fertility rate is the sum of a single year of age-specific fertility rates divided by 1,000. The horizontal line at 2.1 represents the replacement level (i.e., the fertility level required to replace the population in the absence of migration and taking into account mortality conditions between 0 and 15 years old, usually when the fertility period starts). Data for Yukon are not available for the specific reference period. Source: Statistics Canada, Table 13-10-0418-01 Crude birth rate, age-specific fertility rates and total fertility rate (live births).

From 2001 to 2021, age-specific fertility rates declined among women aged 15 to 29 and increased among those aged 30 and older (Chart 2.1). Pregnancy among mothers older than 40 is associated with multiple births because of increased use of reproductive technology, greater risk of gestational diabetes, high blood pressure, and likelihood of a caesarean section.^{Note 13} For infants, higher maternal age is associated with increases in preterm delivery, low birth weight, perinatal death, and neonatal intensive care unit admission.^{Note 14}

Data table for Chart 2.1



Data table for chart 2.1
Table summary
This table displays the results of Data table for chart 2.1. The information is grouped by Age group (years (appearing as row headers), 2001, 2011 and 2021, calculated using number of children per 1000 women units of measure (appearing as column headers).

Age group (years)	2001	2011	2021
	number of children per 1000 women
15 to 19	16.1	12.4	4.9
20 to 24	56.8	46.2	27.1
25 to 29	101.3	96.5	76.7
30 to 34	91.3	107.6	106.4
35 to 39	35.5	52.5	57.8
40 to 44	6.0	10.3	12.2
45 to 49	0.3	0.5	0.8
Notes: The age-specific fertility rate is the number of children per 1,000 women in a specific age group. The calculation consists of dividing the number of births by the population of women, for each unique age, and then multiplying by 1,000. Five-year age groups were used in these tabulations (ranging from 15 to 19 years to 45 to 49 years). Source: Statistics Canada, Table 13-10-0418-01 Crude birth rate, age-specific fertility rates and total fertility rate (live births).

Stillbirths

A stillbirth is the death of a fetus at or after 20 weeks of pregnancy or weighing 500 grams or more.^{Note 15} Although stillbirths are rare, they have increased over the last two decades from around 6.1 per 1,000 total births in 2000 to 8.6 per 1,000 total births in 2021, corresponding to 3,174 stillbirths in 2021.

The rate of stillbirths in multiple deliveries is significantly higher than that in single deliveries (Chart 2.2). While it fluctuated from 2000 to 2021, this is expected given the small number of occurrences. The rate of stillbirths in single deliveries increased from 5.7 per 1,000 births in 2000 to 8.2 per 1,000 in 2021 (Chart 2.2), a rise that can be explained at least in part by definitional changes in some provinces.

In 2021, the rate of stillbirths ranged from 7.0 per 1,000 total births in Newfoundland and Labrador to 28.3 per 1,000 in Nunavut.^{Note 16} Risk factors associated with stillbirths include maternal weight, smoking, and age.^{Note 17}

Data table for Chart 2.2



Data table for chart 2.2
Table summary
This table displays the results of Data table for chart 2.2 Stillbirth rate, single births and Stillbirth rate, multiple births, calculated using rate per 1,000 total births units of measure (appearing as column headers).

	Stillbirth rate, single births	Stillbirth rate, multiple births
	rate per 1,000 total births
2000	5.71	17.33
2001	5.68	19.80
2002	5.80	15.55
2003	6.01	19.06
2004	5.76	16.63
2005	6.06	17.63
2006	5.98	18.33
2007	6.80	16.84
2008	6.99	16.40
2009	6.91	13.43
2010	6.65	17.69
2011	7.13	15.55
2012	7.42	16.01
2013	7.67	18.01
2014	7.95	17.68
2015	7.75	17.65
2016	7.58	18.55
2017	8.07	16.27
2018	7.91	15.72
2019	8.23	16.92
2020	8.09	20.91
2021	8.25	18.52
Source: Statistics Canada, Table 13-10-0428-01 Live births and fetal deaths (stillbirths), by type of birth (single or multiple).

Infant mortality

Infant mortality includes deaths before the age of 1 and consists of neonatal mortality (deaths in the first 27 days of life) and post-neonatal mortality (deaths up to age 1). In 2020, neonatal mortality accounted for 77% of all infant deaths in Canada.

The top 5 causes of neonatal mortality are congenital malformations; disorders related to short gestation and low birth weight; complications of pregnancy; complications of the placenta, cord and membrane; and complications of labour and delivery.^{Note 18} The causes of post-neonatal mortality can be structural or functional birth defects, infections, lack of oxygen, immaturity (not fully grown), or sudden infant death syndrome.^{Note 19} Risk factors of both neonatal and post-neonatal mortality include low maternal education, inadequate housing, lack of access to health care, food insecurity, poverty, and unemployment.^{Note 19}

Infant mortality rates have been declining for almost a century.^{Note 20} While the infant mortality rate in Canada declined from 5.3 per 1,000 live births in 2000 to 4.5 per 1,000 in 2020 (Chart 2.3), it remains higher than in other OECD countries.^{Note 21}

Data table for Chart 2.3



Data table for chart 2.3
Table summary
This table displays the results of Data table for chart 2.3 Total infant mortality rate, Neonatal mortality rate and Post-neonatal mortality rate, calculated using rate per 1,000 live births units of measure (appearing as column headers).

	Total infant mortality rate	Neonatal mortality rate	Post-neonatal mortality rate
	rate per 1,000 live births
2000	5.3	3.6	1.7
2001	5.2	3.8	1.4
2002	5.4	3.9	1.5
2003	5.3	3.9	1.3
2004	5.3	4.0	1.3
2005	5.4	4.1	1.3
2006	5.0	3.7	1.3
2007	5.1	3.8	1.3
2008	5.1	3.7	1.4
2009	4.9	3.7	1.2
2010	5.0	3.8	1.2
2011	4.9	3.7	1.2
2012	4.8	3.6	1.2
2013	5.0	3.8	1.2
2014	4.7	3.6	1.0
2015	4.5	3.5	1.0
2016	4.5	3.4	1.2
2017	4.6	3.5	1.1
2018	4.8	3.6	1.2
2019	4.4	3.4	1.1
2020	4.5	3.5	1.1
Note: Neonatal mortality is defined as deaths in the first 27 days of life, while post-neonatal mortality includes deaths up to age 1. Source: Statistics Canada, Canadian Vital Statistics - Birth database and Death database, Table 13-10-0713-01 Infant deaths and mortality rates, by age group.

In 2021, Nunavut (14.3 per 1,000 live births), the Northwest Territories (9.0 per 1,000), Manitoba (6.4 per 1,000), and Saskatchewan (5.3 per 1,000) had infant mortality rates that were higher than in Canada overall (4.5 per 1,000) (Chart 2.4).

Data table for Chart 2.4



Data table for chart 2.4
Table summary
This table displays the results of Data table for chart 2.4 rate per 1,000 live births (appearing as column headers).

	rate per 1,000 live births
Canada	4.5
N.L.	5.0
P.E.I.	4.6
N.S.	3.7
N.B.	4.7
Que.	4.1
Ont.	4.2
Man.	6.7
Sask.	6.7
Alta.	5.3
B.C.	3.7
N.W.T.	9.0
Nvt.	14.3
Y.T.	Note ..: not available for a specific reference period
.. not available for a specific reference period Note: Data for Yukon are not available for the specific reference period. The horizontal line at 4.5 represents Canada. Source: Statistics Canada, Canadian Vital Statistics - Birth database and Death database, Table 13-10-0713-01 Infant deaths and mortality rates, by age group.

Maternal mortality

Maternal mortality includes deaths from obstetric causes that occurred within one year of delivery or the end of a pregnancy. It is typically divided into mortality during two periods: 1) during pregnancy or within 42 days of delivery or the end of the pregnancy, or 2) from 42 days to 1 year after delivery or the end of the pregnancy. Risk factors for maternal mortality include nutritional status, history of illness, occupational status, method of delivery, postpartum complications, nulliparity, low birth weight, and the age of the mother.^{Note 14Note 22Note 23}

The maternal mortality rate within one year of delivery or the end of a pregnancy increased from 3.1 per 100,000 live births in 2000 to 8.1 per 100,000 in 2020.^{Note 24}

Maternal mortality during pregnancy or within 42 days of delivery or the end of the pregnancy also increased over time, more than doubling from 0.6 per 100,000 live births in 2000 to 1.4 per 100,000 in 2020 (Chart 2.5).

Data table for Chart 2.5



Data table for chart 2.5
Table summary
This table displays the results of Data table for chart 2.5 Maternal mortality more than 42 days after delivery or end of pregnancy and Maternal mortality during pregnancy or within 42 days of delivery or end of pregnancy, calculated using rate per 100,000 live births units of measure (appearing as column headers).

	Maternal mortality more than 42 days after delivery or end of pregnancy	Maternal mortality during pregnancy or within 42 days of delivery or end of pregnancy
	rate per 100,000 live births
2000	0.61	2.74
2001	0.30	7.49
2002	0.61	3.95
2003	0.30	6.56
2004	0.00	5.93
2005	0.58	8.18
2006	0.85	7.05
2007	0.00	6.52
2008	0.26	8.73
2009	0.00	7.61
2010	0.80	5.57
2011	0.26	4.50
2012	0.79	4.98
2013	0.26	5.78
2014	1.04	4.95
2015	1.05	6.01
2016	0.78	5.48
2017	0.80	6.36
2018	0.53	8.29
2019	0.54	8.06
2020	1.39	6.97
Note: Yukon data are available only for years 2000 to 2016. Source: Statistics Canada, Canadian Vital Statistics - Birth database and Death database, Table 13-10-0756-01 Number of maternal deaths and maternal mortality rates for selected causes.

3.0 Chronic conditions

Key findings

• Almost half (45.1%) of Canadians lived with at least one major chronic disease in 2021. The prevalence and number of chronic conditions increased with age and were higher for females compared with males across all age groups.
• Some of the most common chronic conditions in Canada in 2021 were overweight (35.5%), obesity (29.2%), arthritis (19.5%) and high blood pressure (17.7%).
• In 2021, Canadians with the lowest household incomes had greater multimorbidity and prevalence of chronic disease compared with those with the highest household incomes.
• While the prevalence of most chronic diseases is highest among people aged 65 and older, asthma is most prevalent among people aged 12 to 17.
• A higher proportion of South Asian people (44.2%) are overweight compared with non-racialized people (31.9%).
• The prevalence of heart disease and obesity is rising.
• In 2021, over 3.3 million Canadians aged 12 and older (10.4%) reported having been diagnosed with an anxiety disorder, and over 3.1 million (9.6%) reported having a mood disorder.
• The prevalence of anxiety and mood disorders increased from 2015 to 2021 and was higher among females (vs. males), First Nations people living off reserve and Métis (vs. non-Indigenous people), and those in the lowest income quintile (vs. the highest income quintile).

Chronic diseases and conditions can affect activities of daily living, reduce quality of life, and increase the risk of mortality. A variety of factors affect chronic disease incidence and prevalence, including age and behavioural risk factors such as tobacco use, unhealthy diet, and physical inactivity.

Prevalence of common chronic conditions

In 2021, over 14.6 million Canadians (45.1%) reported having one or more of the following chronic conditions or risk factors: arthritis, high blood pressure, diabetes, cancer (ever diagnosed), heart disease (ever diagnosed), stroke, mood disorders and anxiety.

The most common chronic conditions in Canada in 2021 were overweight, obesity, arthritis, and high blood pressure (Table 3.0). A greater proportion of people aged 65 and older reported having each chronic condition other than obesity and asthma compared with other age groups (Chart 3.0).

Cardiovascular disease

Cardiovascular disease is a general term describing conditions that affect blood vessels or the heart. Cardiovascular disease risk can be reduced with healthy eating, adequate physical activity, and controlled substance use.^{Note 25} Two of the most common cardiovascular diseases are heart disease and stroke, with high blood pressure being a risk factor for both.

High blood pressure

Untreated or uncontrolled high blood pressure can cause heart attacks, stroke, heart failure, dementia, renal failure, and blindness.^{Note 26} Risk factors for high blood pressure include sedentary behaviours, obesity, and high sodium consumption.^{Note 27}

In 2021, 17.7% of Canadians aged 12 and older reported having been diagnosed with high blood pressure (Table 3.0), and this had increased from 2015 to 2021. High blood pressure prevalence was highest in those aged 65 and older (44.0%) compared with all other age groups (Chart 3.0). A higher proportion of people in households in the lowest income quintile reported high blood pressure compared with those in the highest income quintile (Chart 3.1). A lower proportion of First Nations people living off reserve reported high blood pressure compared with non-Indigenous people (Chart 3.2).

A higher percentage of the population in Newfoundland and Labrador, Nova Scotia, New Brunswick, and Saskatchewan had high blood pressure compared with the rest of Canada (Table 3.0). A higher proportion of Filipino (19.9%) and Japanese (20.4%) Canadians reported having high blood pressure compared with the total population.

Did you know?

Results from the Canadian Health Measures Survey (2012 to 2015) indicate that males aged 20 to 39 are more likely than females and older males to have untreated and uncontrolled hypertension.^{Note 28}

Heart disease

In 2020, heart disease was the second leading cause of death in Canada after cancer, accounting for 17.5% of all deaths. In 2021, 6.5% of Canadians aged 12 and older reported ever having been diagnosed with heart disease (Table 3.0). Higher proportions of the population in Newfoundland and Labrador, Prince Edward Island, Nova Scotia, New Brunswick, and Quebec reported having heart disease compared with the rest of Canada (Table 3.0). The prevalence of heart disease was highest among those aged 65 and older (Chart 3.0). A higher proportion of people in the lowest income quintile reported having heart disease compared with the highest quintile (Chart 3.1).

Stroke

Stroke, also called cerebrovascular disease, is a sudden loss of brain function that occurs when a blockage prevents blood from flowing to the brain.^{Note 25} In 2020, stroke was the fifth leading cause of death in Canada, responsible for 4.5% of deaths. In 2021, 1.1% of the Canadian population aged 12 and older reported suffering from the effects of stroke (Table 3.0), and this share has been stable since 2015. Like heart disease and high blood pressure, more people in the lowest income quintile reported suffering from the effects of stroke compared with those in the highest quintile (Chart 3.1).

Chronic respiratory diseases

Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) accounted for 3.8% of all deaths in Canada in 2020.^{Note 29}

Asthma

Asthma is a chronic condition characterized by cough, shortness of breath, chest tightness, and wheezing. Asthma symptoms and attacks usually occur after exercise, exposure to allergens or irritants, or viral respiratory infections.^{Note 30}

In 2019, 5.9% of children aged 1 to 11 had asthma. This was higher among boys (7.2%) than girls (4.6%). Asthma may increase the risk of severe allergic reactions.^{Note 31} Among children aged 1 to 11 who had a diagnosed allergy, one in five (21.1%) were also reported to have asthma. By comparison, 4.3% of children who did not have an allergy had asthma.

In 2020, 8.7% of Canadians aged 12 and older reported having been diagnosed with asthma (Table 3.0), a proportion consistent with 2015.

Chronic obstructive pulmonary disease

COPD is a chronic and progressive condition characterized by gradual airway obstruction, shortness of breath, cough, and sputum production.^{Note 32} In 80% to 90% of COPD cases, cigarette smoking is the principal underlying cause.^{Note 32} Other risk factors include exposure to second-hand smoke, occupational exposure to dusts and fumes, outdoor air pollution, and repeated childhood respiratory tract infections.^{Note 32} Declining smoking rates have contributed to decreasing mortality from COPD.^{Note 33}

In 2020, 3.9% of the Canadian population aged 35 and older reported having been diagnosed with chronic bronchitis, emphysema, or COPD (Table 3.0). This prevalence is consistent with that in 2015.

The prevalence of COPD increases with age (Chart 3.0). In 2020, a higher proportion of people in the lowest income quintile reported having COPD compared with the highest quintile (Chart 3.1).

Did you know?

Results from lung function tests suggest that the prevalence of COPD may be closer to 12.0% in adults aged 35 to 79. Nearly 9 in 10 adults with impaired lung function reported not having been previously diagnosed with COPD, according to results from the Canadian Health Measures Survey.^{Note 34}

Endocrine and metabolic disorders

Diabetes

Diabetes is a chronic condition that occurs when the body is unable to produce enough insulin or properly use it.^{Note 35} Diabetes can lead to many complications, including cardiovascular disease, vision loss or blindness, kidney failure, nerve damage, problems with pregnancy, oral disease, and depression.^{Note 35}

In 2021, 7.3% of Canadians aged 12 and older reported having type 1, type 2 or gestational (for females aged 15 and older) diabetes (Table 3.0).

Did you know?

Results from the Canadian Health Measures Survey suggest that nearly 2% of adults in Canada may be living with undiagnosed diabetes.^{Note 36}

The self-reported prevalence of diabetes in Canada has fluctuated since 2015. In 2021, it was higher in provinces with older populations, such as Newfoundland and Labrador, New Brunswick, and Nova Scotia, compared with the rest of Canada (Table 3.0). More people in the lowest income quintile reported having diabetes compared with those in the highest quintile (Chart 3.1).

Did you know?

In 2020, diabetes was the leading cause of death in Newfoundland and Labrador, accounting for 5.1% of deaths compared with an average of 2.5% in the rest of Canada.^{Note 29}

Overweight and obesity

Overweight and obesity are risk factors for several chronic diseases, such as diabetes, high blood pressure, heart disease, stroke, arthritis, and cancer. Obesity is also a chronic health condition. In 2021, 27.2% of youth aged 12 to 17 were classified as overweight or obese (Table 3.0), up from 24.5% in 2015. Among adults aged 18 and older, 35.5% were classified as overweight and 29.2% as obese (Table 3.0). The proportion of overweight adults has remained stable across Canada since 2015, but obesity has trended upwards (26.1% in 2015).

The prevalence of obesity among adults in Newfoundland and Labrador, New Brunswick, and the Northwest Territories was higher than in the rest of Canada (Table 3.0). More youth in the Northwest Territories (44.8%), Newfoundland and Labrador (39.7%), and Saskatchewan (39.8%) were obese, compared with youth in the rest of Canada (27.2%) (Table 3.0). A higher proportion of South Asian people (44.2%) were classified as overweight, compared with non-racialized people (35.6%).

Did you know?

Results from the Canadian Health Measures Survey suggest that children aged 6 to 10 with an obese parent are at increased risk of being overweight or obese themselves.^{Note 37}

Musculoskeletal disorders

Arthritis

Arthritis is associated with mobility limitations and dependency in activities of daily living.^{Note 38} In 2021, 19.5% of Canadians aged 15 and older had arthritis (Table 3.0). The prevalence of arthritis varied across Canada, being higher in Newfoundland and Labrador, Nova Scotia, and New Brunswick (Table 3.0). Arthritis prevalence increased with age; it was almost 16 times higher in those aged 65 and older (46.6%) compared with those aged 18 to 34 (2.7%) (Chart 3.0). Like other chronic conditions, a higher proportion of people in the lowest income quintile reported having arthritis compared with those in the highest quintile (Chart 3.1). As the population ages and obesity increases, the prevalence of arthritis and the use of associated medications are expected to rise.^{Note 38}



Data table for Chart 3.0



Data table for chart 3.0
Table summary
This table displays the results of Data table for chart 3.0 Overweight, Obesity, Arthritis, High blood pressure, Asthma, Cancer, Diabetes, Heart disease, COPD and Stroke, calculated using percent units of measure (appearing as column headers).

	Overweight	Obesity	Arthritis	High blood pressure	Asthma	Cancer	Diabetes	Heart disease	COPD	Stroke
	percent
18 to 34 years	30.8	22.2	2.7	2.2	10.7	1.0	1.1	1.1		0.2
35 to 49 years	36.6	32.8	9.2	9.6	7.6	2.8	4.3	2.3	0.8	0.3
50 to 64 years	36.5	33.4	27.0	25.0	7.9	9.6	10.1	6.3	3.8	1.3
65 years and older	39.2	29.1	46.6	44.0	8.0	21.4	17.6	19.8	7.5	3.5
Notes: Stroke, diabetes, high blood pressure, asthma, heart disease (ever diagnosed) and cancer (ever diagnosed) are reported for Canadians aged 12 and older; arthritis is reported for Canadians aged 15 and older; chronic obstructive pulmonary disease (COPD) is reported for Canadians aged 35 and older; and overweight and obesity are reported for Canadians aged 18 and older. For asthma and COPD, 2020 data are used. Estimates for Canada exclude the territories. Stroke, heart disease, cancer and diabetes percentages for 18- to 34-year-olds should be interpreted with caution. Stroke and COPD percentages for 35- to 49-year-olds should be interpreted with caution. Sources: Statistics Canada, Canadian Community Health Survey, 2020 and 2021.

Data table for Chart 3.1



Data table for chart 3.1
Table summary
This table displays the results of Data table for chart 3.1 Overweight, Obesity, Arthritis, High blood pressure, Asthma, Cancer, Diabetes, Heart disease, COPD and Stroke, calculated using percent units of measure (appearing as column headers).

	Overweight	Obesity	Arthritis	High blood pressure	Asthma	Cancer	Diabetes	Heart disease	COPD	Stroke
	percent
Q1 (lowest)	32.7	29.1	23.8	20.8	9.0	8.9	10.0	8.7	6.5	2.2
Q2	35.5	29.1	21.4	20.1	8.9	8.4	8.7	8.2	4.5	1.4
Q3	36.3	29.5	18.3	16.5	8.6	7.6	6.8	5.5	3.3	0.8
Q4	36.1	29.6	17.4	16.7	9.0	6.2	6.2	5.0	3.6	0.7
Q5 (highest)	37.0	28.8	16.5	14.7	8.0	6.7	4.9	4.9	1.7	0.6
Notes: Stroke, diabetes, high blood pressure, asthma, heart disease (ever diagnosed) and cancer (ever diagnosed) are reported for Canadians aged 12 and older; arthritis is reported for Canadians aged 15 and older; chronic obstructive pulmonary disease (COPD) is reported for Canadians aged 35 and older. For asthma and COPD, 2020 data are used. Estimates for Canada exclude the territories. Stroke percentages for the fourth and fifth quintiles (Q4 and Q5) should be interpreted with caution. Sources: Statistics Canada, Canadian Community Health Survey, 2020 and 2021.

Data table for Chart 3.2



Data table for chart 3.2
Table summary
This table displays the results of Data table for chart 3.2 Overweight, Obesity, Arthritis, High blood pressure, Asthma, Cancer, Diabetes, Heart disease, COPD and Stroke, calculated using percent units of measure (appearing as column headers).

	Overweight	Obesity	Arthritis	High blood pressure	Asthma	Cancer	Diabetes	Heart disease	COPD	Stroke
	percent
First Nations people living off reserve	26.2	45.3	21.2	14.3	13.1	5.0	9.5	6.5	5.1	1.0
Métis	27.6	45.2	19.8	17.0	17.4	7.1	8.5	8.4	5.4	1.6
Non-Indigenous people	35.8	28.9	19.5	17.9	8.5	7.6	7.3	6.5	3.9	1.1
Notes: Stroke, diabetes, high blood pressure, asthma, heart disease (ever diagnosed) and cancer (ever diagnosed) are reported for Canadians aged 12 and older; arthritis is reported for Canadians aged 15 and older; COPD is reported for Canadians aged 35 and older; and overweight and obesity are reported for Canadians aged 18 and older. For asthma and COPD, 2020 data are used. Estimates for Canada exclude the territories. Percentages for stroke, COPD and cancer for First Nations people living off reserve and Métis should be interpreted with caution. Percentages for heart disease and diabetes for Métis should be interpreted with caution. Data are too unreliable to be published for Inuit; because the Canadian Community Health Survey includes only Inuit living in the provinces, much of the Inuit population is not captured. Sources: Statistics Canada, Canadian Community Health Survey, 2020 and 2021.

Cancer

Did you know?

About two in five Canadians (43%) are expected to be diagnosed with cancer in their lifetime.^{Note 39}

Despite major advancements in cancer treatment and survival over the past few decades, cancer has remained the leading cause of death in Canada since 2006, responsible for just over one-quarter of all deaths in 2020 (26.6%). Overall cancer incidence rates have declined, but the number of cases and deaths continues to increase, mainly because of population growth and aging.^{Note 40}

In 2021, 7.6% of Canadians aged 12 and older reported ever having been diagnosed with cancer (Table 3.0), and the reported prevalence of ever having been diagnosed with cancer was highest among those aged 65 and older (Chart 3.0).

Cancer incidence

Cancer incidence over time

Overall cancer incidence, or the number of new cases of cancer, has been declining in Canada.^{Note 39} Age-standardized incidence rates (ASIRs) for all cancers combined and both sexes declined on average by 2.7% annually from 2016 to 2020.^{Note 41}

Chart 3.3 shows ASIRs from 1984 to 2022 for the most common cancer types: lung, colorectal, prostate, and breast. Combined, these four types of cancer represent almost half (46%) of all cancers that were projected in Canada in 2022.^{Note 40}

The lung cancer incidence rate among males has declined significantly, but for females, the projected ASIR for 2022 was 43% higher than the rate in 1984 (Chart 3.3). The incidence rate of breast cancer among females increased into the mid-1990s and has fluctuated throughout the last 20 years (Chart 3.3). The prostate cancer incidence rate increased among males in the early 1990s but has remained relatively stable since 2014 (Chart 3.3). Colorectal cancer incidence rates among males and females have declined since the early 2000s (Chart 3.3).

Data table for Chart 3.3



Data table for chart 3.3
Table summary
This table displays the results of Data table for chart 3.3 Lung (males), Colorectal (males), Prostate (males), Lung (females), Colorectal (females) and Breast (females), calculated using age-standardized incidence rate per 100,000 units of measure (appearing as column headers).

	Lung (males)	Colorectal (males)	Prostate (males)	Lung (females)	Colorectal (females)	Breast (females)
	age-standardized incidence rate per 100,000
1984	117.8	84.8	109.3	40.1	64.3	116.3
1985	115.0	86.6	115.5	41.6	66.0	120.1
1986	116.9	83.6	117.4	42.6	61.6	114.5
1987	115.2	84.5	122.6	44.8	61.1	117.9
1988	116.0	83.7	124.5	46.8	60.5	129.1
1989	113.2	83.0	126.4	46.8	59.2	126.6
1990	112.4	82.7	137.8	48.0	58.6	127.2
1991	109.2	81.2	157.5	48.7	58.5	133.9
1992	109.5	83.3	174.3	51.7	56.5	134.8
1993	107.9	80.0	192.4	52.5	56.6	130.3
1994	101.8	81.5	174.9	50.9	55.1	129.4
1995	101.2	79.6	153.6	53.1	54.7	129.1
1996	98.7	77.5	156.1	54.3	53.6	128.9
1997	94.5	78.3	166.0	54.2	53.9	134.9
1998	95.4	81.0	165.7	56.6	56.6	133.0
1999	95.3	81.4	172.3	55.7	55.8	136.5
2000	90.0	82.7	177.9	57.3	56.9	129.9
2001	89.3	81.9	190.8	57.0	56.3	128.8
2002	86.8	80.1	176.3	57.0	55.5	133.3
2003	84.6	78.2	167.4	56.4	54.2	125.0
2004	84.1	80.2	171.3	57.6	54.6	125.4
2005	83.6	80.2	171.9	59.9	54.7	126.7
2006	82.4	79.2	180.4	59.9	53.6	126.0
2007	82.2	79.7	180.5	59.8	53.8	126.8
2008	78.9	80.3	164.5	60.0	53.5	123.9
2009	79.4	77.6	159.5	59.8	53.0	126.9
2010	80.3	76.4	157.2	60.9	53.6	131.1
2011	77.2	77.3	161.1	60.4	52.7	131.5
2012	78.5	74.9	139.3	62.2	52.6	126.9
2013	74.7	74.5	123.4	61.4	51.6	126.7
2014	74.9	73.7	117.6	62.9	51.5	127.9
2015	72.2	73.0	115.8	60.9	50.3	127.3
2016	69.3	67.7	120.9	59.7	47.5	128.6
2017	69.2	64.7	123.4	60.1	46.1	126.9
2018	64.6	62.9	124.5	59.0	45.0	129.3
2019	65.4	65.0	119.5	58.8	46.2	128.5
2020	64.0	64.0	118.9	58.3	45.7	128.6
2021	62.5	63.2	118.4	57.7	45.2	128.8
2022	61.0	62.3	117.8	57.2	44.6	129.0
Notes: Rates were age standardized to the 2011 Canadian standard population. Shading indicates projected data from 2019 to 2022. Source: Darren R. Brenner, Abbey Poirier, Ryan R. Woods, Larry F. Ellison, Jean-Michel Billette, Alain A. Demers, Shary Xinyu Zhang, Chunhe Yao, Christian Finley, Natalie Fitzgerald, Nathalie Saint-Jacques, Lorraine Shack, Donna Turner, Elizabeth Holmes. Projected estimates of cancer in Canada in 2022. CMAJ May 2022, 194 (17) E601-E607; DOI: 10.1503/cmaj.212097.

Incidence of the most common cancer types

In 2022, lung cancer was projected to be the most frequently diagnosed cancer in Canada, followed by breast, prostate, and colorectal cancers (Table 3.1).  The ASIR for all cancers combined in 2022 was projected to be 15% higher among males than females (Table 3.1). ASIRs for all cancers were projected to be lowest in Western Canada and higher in Eastern Canada.^{Note 40}

Cancer mortality

An estimated 85,100 Canadians died of cancer in 2022. Lung cancer was projected to be the leading cause of cancer deaths, accounting for 24.3% of all cancer deaths, followed by colorectal (11.0%), pancreatic (6.7%), and breast (6.5%) cancers.  Colorectal and lung cancer mortality has decreased by 3.4 and 3.8 percentage points, respectively, since the mid-2010s.^{Note 42}

The age-standardized mortality rate (ASMR) is defined as the number of deaths per 100,000 population and removes the effects of differences in the age structure of populations among areas and over time.^{Note 43} The ASMR for all cancers combined in 2022 was projected to be 34% higher among males than females (Table 3.1). Aside from breast cancer, males are expected to have higher mortality rates for all other non-female-specific types of cancer (Table 3.1). Like incidence, ASMRs are lower in Western and Central Canada and generally higher in the East.^{Note 42}



Mental health disorders

Mental illness is characterized by changes in an individual’s thinking, mood or behaviour and is usually associated with significant distress or impaired functioning in social, occupational, and other activities.^{Note 44} There are several types of mental illness: mood disorders, anxiety disorders, schizophrenia and related disorders, personality disorders, substance-related disorders (e.g., alcohol abuse or dependence), and eating disorders. This report focuses on anxiety disorders, such as phobia, obsessive-compulsive disorder, or a panic disorder, and mood disorders, including major depression, bipolar disorder, mania, or dysthymia (chronic form of depression).

In 2021, over 3.4 million Canadians aged 12 and older (10.4%) reported having been diagnosed with an anxiety disorder, and over 3.1 million (9.6%) reported having a mood disorder (Chart 3.4). The prevalence of anxiety and mood disorders has increased by 2.6 and 1.7 percentage points, respectively, since 2015 and was higher in Ontario, Saskatchewan and the Atlantic provinces (except Prince Edward Island), compared with the rest of Canada (Chart 3.4). Females of all age groups reported more anxiety and mood disorders than males of all ages in 2021.

Data table for Chart 3.4



Data table for chart 3.4
Table summary
This table displays the results of Data table for chart 3.4 Anxiety and Mood disorder, calculated using percent units of measure (appearing as column headers).

	Anxiety	Mood disorder
	percent
Canada	10.4	9.6
N.L.	14.4	11.5
P.E.I.	11.8	11.2
N.S.	14.8	12.2
N.B.	15.1	12.4
Que.	8.5	6.0
Ont.	11.3	10.5
Man.	10.0	9.7
Sask.	11.0	11.3
Alta.	9.8	10.8
B.C.	9.7	10.6
Y.T.	8.7	8.7
N.W.T.	7.9	7.6
Nvt.	9.3	8.9
Notes: Provincial data are from the 2021 Canadian Community Health Survey (CCHS), and provinces are compared with the 2021 estimate for the rest of Canada, which excludes the province being compared and the territories (shown). Territorial data are from the 2017 and 2018 CCHS, and territories are compared with the 2017 and 2018 estimate for the rest of Canada, which excludes the territory being compared (not shown). Data for the Northwest Territories and Nunavut should be interpreted with caution. Sources: Statistics Canada, Canadian Community Health Survey (CCHS), 2021, Table 13-10-0096-01 Health characteristics, annual estimates; and CCHS, 2017 and 2018, Table 13-10-0113-01 Health characteristics, two-year period estimates.

In 2021, a higher proportion of First Nations people living off reserve (20.4%) and Métis (19.7%) reported having anxiety compared with non-Indigenous people (10.1%). Similarly, a higher proportion of First Nations people living off reserve (19.0%) and Métis (19.6%) reported having mood disorders compared with non-Indigenous people (9.6%). A larger proportion of people in the lowest income quintile reported having anxiety (13.9%) and mood disorders (14.4%), compared with those in the highest income quintile (9.7% and 8.5%, respectively).

Did you know?

According to the Canadian Survey on Disability, in 2017, over 2 million Canadians aged 15 and older (7%) had a mental health-related disability, meaning they experienced limitations in daily activities because of an emotional, psychological, or mental health condition. Among youth, women (11%) were twice as likely as men (5%) to have a mental health-related disability.^{Note 45}

Multimorbidity

One in 12 Canadians (8.3%) had multimorbidity, defined as having three or more chronic conditions (arthritis, high blood pressure, diabetes, cancer [ever diagnosed], heart disease [ever diagnosed], stroke, mood disorders, and anxiety).

Multimorbidity was highest among females aged 65 and older (23.8%) compared with other age and sex groups (Chart 3.5).

Data table for Chart 3.5



Data table for chart 3.5
Table summary
This table displays the results of Data table for chart 3.5. The information is grouped by Age group (years) (appearing as row headers), Males and Females, calculated using percent units of measure (appearing as column headers).

Age group (years)
	percent
18 to 34	1.1	1.9
35 to 49	2.7	4.6
50 to 64	8.6	10.3
65 and older	22.8	23.8
Notes: Multimorbidity is defined as having three or more of the selected chronic conditions: arthritis, high blood pressure, diabetes, cancer (ever diagnosed), heart disease (ever diagnosed), stroke, mood disorders and anxiety. Estimates for the 18- to 34-year-old group should be interpreted with caution. Source: Statistics Canada, Canadian Community Health Survey, 2021.

Canadians in the lowest income quintile had a higher prevalence of multimorbidity (Chart 3.6), and the onset of multimorbidity is likely to be significantly earlier for this group.^{Note 46}

Data table for Chart 3.6



Data table for chart 3.6
Table summary
This table displays the results of Data table for chart 3.6 Multimorbidity, calculated using percent units of measure (appearing as column headers).

	Multimorbidity
	percent
Quintile 1 (lowest)	13.1
Quintile 2	9.9
Quintile 3	6.9
Quintile 4	6.1
Quintile 5 (highest)	5.4
Note: Multimorbidity is defined as having three or more of the selected chronic conditions: arthritis, high blood pressure, diabetes, cancer (ever diagnosed), heart disease (ever diagnosed), stroke, mood disorders and anxiety. Source: Statistics Canada, Canadian Community Health Survey, 2021.

Attention deficit hyperactivity disorder and autism

In 2019, 5.3% of children and youth aged 1 to 17 were reported as having attention deficit hyperactivity disorder (ADHD), and 2.0% were reported as having autism.^{Note 3} A higher proportion of males were reported as having ADHD, compared with females (7.4% and 3.0%, respectively).^{Note 3} Similarly, three times as many males as females were reported as having autism (3.1% and 0.8%, respectively).^{Note 3}

4.0 Mortality

Key findings

• The crude mortality rate increased from 708.7 per 100,000 population in 2000 to 808.5 per 100,000 in 2020.
• The top 4 leading causes of death in Canada in 2020 were cancer, heart disease, COVID-19 and accidental deaths.

Within the last 20 years, the crude mortality rate (a measure of the number of deaths per 100,000 individuals in the population) increased from 708.7 per 100,000 population in 2000 to 808.5 per 100,000 population in 2020 (Chart 4.0). In 2020, the year in which the COVID-19 pandemic reached Canada, there was a 7.7% increase in deaths from 2019 (Chart 4.0). Mortality rates across all years are higher among males than females (Chart 4.0).

Data table for Chart 4.0



Data table for chart 4.0
Table summary
This table displays the results of Data table for chart 4.0 Males and Females, calculated using rate per 100,000 population units of measure (appearing as column headers).

	Males	Females
	rate per 100,000 population
2000	733.5	684.4
2001	727.0	684.7
2002	729.2	697.0
2003	732.9	696.2
2004	723.2	694.4
2005	725.2	700.0
2006	712.1	685.3
2007	726.9	702.0
2008	729.0	703.6
2009	719.3	694.6
2010	712.7	694.4
2011	714.6	697.8
2012	721.2	698.1
2013	728.3	707.4
2014	742.0	714.9
2015	751.0	724.6
2016	754.9	719.0
2017	784.6	740.4
2018	792.8	750.7
2019	784.1	735.2
2020	842.6	774.9
Source: Statistics Canada, Table 13-10-0392-01 Deaths and age-specific mortality rates, by selected grouped causes.

Leading causes of death

In 2020, there were 307,205 deaths in Canada.^{Note 29} The four leading causes of death were cancer, heart disease, COVID-19 and accidental deaths (Table 4.0), with males accounting for a higher proportion of the mortality rate in all categories.^{Note 29}



Did you know?

Mortality patterns of Black adults are different than those of White adults.^{Note 47} Integrated census and mortality data enabled the first-ever study to estimate differences in the mortality of Black adults on a national scale for a variety of causes of death.^{Note 47} Compared with White adults, Black adults had an increased risk of dying for some causes of death, such as HIV/AIDS and specific cancers, after accounting for many social determinants of health, including region of birth, income and educational attainment.^{Note 47}