Health of Canadians
Health outcomes

1.0 Health status

Key findings

• The share of Canadian adults reporting very good or excellent perceived health declined from 61.3% in 2020 to 52.2% in 2023.
• The decrease in perceived health since 2021 was especially prominent among those aged 65 and older (a 9.4 percentage point reduction from 2021 to 2023).
• Unlike perceived health, which declined with age, perceived mental health improved with age and was highest among those aged 65 and older.
• A lower proportion of adults living in the Atlantic provinces (except for Newfoundland and Labrador) reported very good or excellent perceived health and mental health compared with Canada overall (excluding the territories).
• In 2023, larger shares of all racialized groups reported very good or excellent perceived health and mental health than their non-racialized counterparts.
• Perceived health and mental health varied across population subgroups in 2023 and were lower among women (vs. men), the lowest-income households (vs. the highest) and those with a self-reported disability (vs. those without disabilities).
• Life expectancy increased for the first time in three years in 2023 but remained below levels observed before the COVID-19 pandemic.

Perceived health refers to an individual’s overall health assessment, whether self-reported or provided by a proxy. It is measured on a scale from excellent to poor. The measure aligns with the World Health Organization’s definition of health as complete physical, mental and social well-being. This report focuses on those who reported “very good” or “excellent” perceived health.

Perceived health

For each year from 2015 to 2020, roughly 60% of Canadian adults reported their perceived health as very good or excellent. This percentage then declined from 61.3% in 2020 to 58.8% in 2021 and subsequently decreased again to 53.8% in 2022 and to 52.2% in 2023 (Chart 1.0). The decline in very good or excellent perceived health since 2021 has been especially prominent among those aged 65 and older (9.4 percentage point reduction from 2020 to 2023). Perceived health also fell with increasing age, from 62.1% of 18- to 34-year-olds reporting very good or excellent health to 40.5% of those aged 65 and older, in 2023.

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 2021, 2022, 2023, Percent, 95% Conifidence Interval, Percent, 95% Conifidence Interval, Percent and 95% Conifidence Interval, calculated using from, to, from, to, from and to units of measure (appearing as column headers).

	2021			2022			2023
	Percent	95% Conifidence Interval		Percent	95% Conifidence Interval		Percent	95% Conifidence Interval
		from	to		from	to		from	to
Note: Territorial data are not included in annual estimates. Sources: Statistics Canada, Canadian Community Health Survey, 2021 to 2023; Table 13-10-0905-01  Health indicator statistics, annual estimates.
Total, 18 and older	58.8	58.0	59.6	53.8	53.1	54.5	52.2	51.4	52.9
18 to 34	66.1	64.3	67.9	62.4	60.7	64.0	62.1	60.4	63.8
35 to 49	61.3	59.7	63.0	58.0	56.6	59.4	54.8	53.4	56.3
50 to 64	56.0	54.4	57.6	50.9	49.5	52.2	49.3	47.9	50.6
65 and older	49.9	48.7	51.2	42.3	41.3	43.3	40.5	39.6	41.4

Patterns of perceived health varied throughout Canada (Chart 1.1). In 2023, a lower proportion of adults in the Atlantic provinces (except Newfoundland and Labrador) reported very good or excellent perceived health (ranging from 41.9% in New Brunswick to 46.7% in Nova Scotia) compared with Canada overall, excluding the territories (52.2%). In contrast, higher proportions of adults living in Quebec (55.7%) and Alberta (54.4%) reported very good or excellent perceived health, compared with Canada overall (excluding the territories). In 2022, when territorial data were available, a lower proportion of adults living in the Northwest Territories (45.6%) and Nunavut (45.5%) reported very good or excellent health compared with all of Canada (53.8%).

Did you know?

According to the 2022 Indigenous Peoples Survey (IPS), four in five Indigenous children aged 1 to 14 (80.1%), excluding those living on reserve, had very good or excellent health (78.6% of First Nations children living off reserve, 82.0% of Métis children and 77.3% of Inuit children).^{Note 26}

From 2021 to 2022, very good or excellent perceived health declined similarly among men (from 58.9% to 55.6%) and women (from 58.6% to 52.0%), and it further decreased in 2023 (to 53.9% for men and 50.5% for women). Gender differences in perceived health were largest among 35- to 49-year-olds; the proportion of women reporting very good or excellent health was 6 percentage points lower than that of men in 2023. In the same year, the share of people reporting very good or excellent perceived health was 20 percentage points lower among adults aged 18 to 34 whose reported sexual orientation is lesbian, gay, bisexual or another orientation that is not heterosexual (LGB+) than among their heterosexual counterparts.

Perceived health rose with increasing income quintiles. In 2023, a greater proportion of adults living in households in the highest income quintile (60.9%) reported very good or excellent perceived health compared with those in the lowest household income quintile (42.8%), an 18 percentage point difference. The same trend has been found since 2015. In recent years, there was an 18 percentage point difference in 2022 and a 20 percentage point difference in 2021.

In 2023, immigrants (51.2%) and non-immigrants (51.9%) did not differ in reporting very good or excellent health, consistent with the findings observed in 2021 and 2022. However, there are disparities in immigrants’ perceived health when examined by period of immigration. For example, 61.1% of immigrants who were admitted to Canada in the last 10 years reported very good or excellent health, compared with 47.4% of immigrants who were admitted to Canada more than 10 years ago.

Among racialized groups, the share of people with very good or excellent perceived health was higher among the South Asian (56.3%), Filipino (58.7%), Latin American (61.2%) and Japanese (67.4%; this figure should be used with caution) groups, compared with the non-racialized population (51.7%).

In 2023, the percentage of people reporting very good or excellent perceived health was nearly three times lower among those with a self-identified disability (19.5%) than among those without a disability (56.4%).

Perceived mental health

Did you know?

The life changes that occur during the transition to adolescence and young adulthood can contribute to lower levels of self-rated mental health for some youth.^{Note 29} At the same time, the COVID-19 pandemic had a big effect on the lives of many Canadians, especially children and youth. School closures and physical distancing measures implemented during critical periods of social development may have been particularly impactful.

The longitudinal component of the 2023 Canadian Health Survey on Children and Youth (CHSCY) followed up with individuals who participated in the 2019 survey to see how their physical and mental health had changed over the past four years. Findings indicate that among the 88% of youth aged 12 to 17 who rated their mental health as good, very good or excellent in 2019, about one in five (21%) reported a decline to fair or poor by 2023. This type of decrease in perceived mental health was more common among older teenagers (aged 15 to 17), who were making the transition to young adulthood during the pandemic.

A consistent decline in the proportion of Canadians aged 18 and older reporting very good or excellent mental health was observed, from 68.2% in 2018 to 54.8% in 2022. However, this percentage remained relatively stable in 2023 (53.8%), except for 35- to 49-year-olds, among whom it continued to decline (from 52.9% in 2022 to 50.6% in 2023). Unlike perceived health, which decreased with age, perceived mental health increased with age; the share of people reporting very good or excellent mental health was highest among those aged 65 and older (62.2% in 2023).

Across all age groups, a lower proportion of women rated their mental health as very good or excellent compared with men in 2021, 2022 and 2023. Gender differences in mental health were largest between women and men aged 18 to 34 (the share of women in this age group reporting very good or excellent mental health was 12 percentage points lower than that of men in 2023). In 2023, compared with heterosexual men (58.7%) and women (51.9%), a lower percentage of LGB+ men (39.3%) and women (23.2%) reported very good or excellent perceived mental health.

Did you know?

Mental health is an integral component of health and well-being with documented disparities among Indigenous people, especially younger people.^{Note 30} These disparities exist in the context of complex factors, including intergenerational trauma rooted in harmful colonial policies.^{Note 31} The 2022 IPS explored the mental health of Indigenous children aged 14 and younger as reported by a parent.^{Note 26} Most children had very good or excellent mental health: 67.7% of off-reserve First Nations children, 69.9% of Métis children and 72.3% of Inuit children. According to the CHSCY, the corresponding percentage for non-Indigenous children of the same age was 86.0%.

For those aged 15 and older, the 2022 IPS found that 34.5% of First Nations people living off reserve, 39.6% of Métis and 37.6% of Inuit reported very good or excellent mental health^{Note 32}. When asked whether their mental health had worsened during the pandemic, 39.0% of First Nations people living off reserve, 39.5% of Métis and 25.8% of Inuit aged 15 and older reported much or somewhat worse mental health. First Nations, Métis and Inuit women were more likely than men to report that their mental health had worsened during the pandemic.

Patterns of perceived mental health varied among adults across Canada in 2023. Like perceived health, a lower proportion of adults living in the Atlantic provinces (except for Newfoundland and Labrador) rated their mental health as very good or excellent than in Canada overall, excluding the territories (Chart 1.1). Every year from 2021 to 2023, lower proportions of adults in Ontario, Saskatchewan and British Columbia reported very good or excellent mental health, compared with Canada overall (excluding the territories). In contrast, a higher proportion of adults in Quebec reported very good or excellent mental health each year, compared with Canada overall (excluding the territories). From 2021 to 2023, reports of very good or excellent mental health were 3 to 5 percentage points higher among rural Canadians compared with their counterparts in population centres.

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 Perceived health, Perceived mental health, Percent, 95% Confidence Interval, Percent and 95% Confidence Interval, calculated using from, to, from and to units of measure (appearing as column headers).

	Perceived health			Perceived mental health
	Percent	95% Confidence Interval		Percent	95% Confidence Interval
		from	to		from	to
Note: Estimates for Canada exclude the territories. Sources: Statistics Canada, Canadian Community Health Survey, 2022 and 2023; Table 13-10-0905-01 Health characteristics, annual estimates.
Canada	52.2	51.4	52.9	53.8	53.1	54.5
N.L.	48.7	45.1	52.3	53.3	49.6	56.9
P.E.I.	44.9	39.2	50.7	45.2	39.3	51.2
N.S.	46.7	44.0	49.4	47.6	44.8	50.4
N.B.	41.9	38.7	45.1	47.6	44.2	50.9
Que.	55.7	54.3	57.2	64.5	63.1	66.0
Ont.	51.5	50.2	52.8	50.9	49.5	52.2
Man.	52.5	49.9	55.1	52.9	50.1	55.7
Sask.	50.7	47.6	53.8	50.3	47.4	53.2
Alta.	54.4	52.6	56.2	52.5	50.7	54.4
B.C.	49.7	48.0	51.4	49.1	47.4	50.9
Y.T.	51.1	47.0	55.2	47.1	42.7	51.4
N.W.T.	45.6	40.7	50.4	41.4	36.1	46.7
Nvt.	45.5	39.6	51.3	44.8	37.9	51.7

In 2023, a greater proportion of adults living in households in the highest income quintile (57.1%) reported very good or excellent mental health compared with those in the lowest household income quintile (50.9%). The same trend was found in 2022, but the gap appeared to be closing in 2023 (10% difference between the highest and lowest income quintiles in 2022 vs. 6% difference in 2023).

From 2021 to 2023, a higher proportion of immigrants reported very good or excellent mental health than non-immigrants (Chart 1.2). In 2023, 58.2% of immigrants reported very good or excellent mental health, compared with 51.7% of non-immigrants. Proportionally fewer immigrants who were admitted to Canada more than 10 years ago reported very good or excellent mental health (57.4%), compared with those who were admitted more recently (62.8%) (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 2021, 2022, 2023, Percent, 95% Conifidence Interval, Percent, 95% Conifidence Interval, Percent and 95% Conifidence Interval, calculated using from, to, from, to, from and to units of measure (appearing as column headers).

	2021			2022			2023
	Percent	95% Conifidence Interval		Percent	95% Conifidence Interval		Percent	95% Conifidence Interval
		from	to		from	to		from	to
Notes: Notes: Territorial data are not included in annual estimates. Immigrants include people who are, or who have ever been, landed immigrants or permanent residents. They have been granted the right to live in Canada permanently by immigration authorities. Immigrants who have obtained Canadian citizenship by naturalization are included in this category. Immigrants who were admitted to Canada in the last 10 years include people who first obtained landed immigrant or permanent resident status on the survey date or in the 10 years before. In 2022, for example, this category includes people who obtained landed immigrant status from 2012 to 2022. Immigrants who were admitted to Canada more than 10 years ago include people who first obtained landed immigrant or permanent resident status more than 10 years prior to the survey date. In 2022, for example, this category includes people who obtained landed immigrant status in 2011 or before. Non-immigrants include people who are Canadian citizens by birth. Sources: Statistics Canada, Canadian Community Health Survey, 2021 to 2023; Table 13-10-0880-01 Health indicators by visible minority and selected sociodemographic characteristics: Canada excluding territories, annual estimates.
Immigrants	62.7	60.8	64.6	59.3	57.7	60.9	58.2	56.8	59.7
Immigrants who were admitted to Canada more than 10 years ago	60.8	58.4	63.2	58.1	56.3	60.0	57.4	55.6	59.1
Immigrants who were admitted to Canada in the last 10 years	67.0	63.5	70.6	64.1	60.7	67.3	62.8	59.4	66.0
Non-immigrants	57.4	56.5	58.3	52.6	51.8	53.3	51.7	50.9	52.6

Perceived mental health varied across racialized groups. Despite declines in very good or excellent mental health for most groups from 2021 to 2022, a higher proportion of Filipino (66.3%), Black (63.3%), Latin American (60.6%) and South Asian (59.9%) people reported very good or excellent mental health in 2023 compared with the non-racialized population (52.8%).

In 2023, a lower proportion of Canadians aged 18 and older with a self-identified disability (31.8%) reported very good or excellent mental health compared with those without disabilities (56.4%).

Did you know?

The intersections of gender and other sociodemographic characteristics significantly influence mental health outcomes. According to a study using data from two cycles of the Canadian Community Health Survey (2019 annual data and data from September to December 2020), about 2.6 million women and girls, or approximately 16%, had three or more intersecting characteristics, such as low income, unemployment, immigrant status, Indigenous identity, racialized group membership, LGB+ sexual orientation and disability.^{Note 33} When multiple characteristics intersected, poor mental health outcomes for diverse groups of women and girls became more pronounced. For example, compared with women and girls who did not report having any of these characteristics, those with one characteristic were two times more likely to report fair or poor perceived mental health, while those with two characteristics were two and a half times more likely and those with three or more characteristics were almost three times more likely.

Some characteristics increased this risk even more. Notably, women and girls with a disability were 7.8 times more likely to report having fair or poor mental health, compared with those without any intersecting characteristics, while those identifying as LGB+ were 5.6 times more likely and those with an Indigenous identity were 3.6 times more likely.

Note: Non-binary people were not redistributed into the women and men categories in this study.

Life expectancy at birth

Changes in life expectancy at birth in Canada stem from various factors. Life expectancy rises when there are fewer deaths overall or when deaths occur at older ages, or both.^{Note 34} Conversely, it declines when there are more deaths, when deaths happen at younger ages, or through a combination of these factors.

Did you know?

By decomposing the differences in life expectancy by cause of death, it is possible to identify some of the potential causes driving the recent change in life expectancy in Canada. In 2022, the increase in deaths among younger age groups can be attributed in part to deaths under investigation by a coroner or medical examiner, which are typically unintentional injuries (e.g., substance-related toxicity deaths), suicides and homicides.

Such deaths are classified as “other ill-defined and unspecified causes of mortality” until a final cause of death is determined.

Following three years of continuous decline, life expectancy at birth in Canada rose from 81.3 years in 2022 to 81.7 years in 2023, marking an increase of 0.4 years.^{Note 34Note 35} Despite the gain, life expectancy was still 0.5 years lower than in 2019, before the pandemic (82.2 years). The rise was more pronounced for males (0.5 years) than for females (0.4 years), with life expectancy reaching 79.5 years for males and 83.9 years for females.

Did you know?

The vital statistics databases that are used to create the life expectancy indicator do not include information about the Indigenous identity of individuals. To generate estimates specifically for the Indigenous population, a research study used linkages between the long-form census questionnaire and the Canadian Vital Statistics – Death database.^{Note 27} The study found that from 2016 to 2019, life expectancy at birth was lower among First Nations people with Indian Status (75.4 years), Métis (81.7 years) and Inuit (71.6 years) compared with the non-Indigenous population (85.6 years). Life expectancy was higher among females than males for all groups.

In 2023, notable increases in life expectancy at birth were seen in Ontario, Quebec, British Columbia, Alberta, Nova Scotia and New Brunswick.^{Note 34Note 35}

Did you know?

There are wide variations in life expectancy across various subnational geographic areas. However, little is known about these variations at very detailed levels of geographic disaggregation in Canada. A recent study on life expectancy expanded the boundaries for such analyses by focusing on variations across the smallest possible geographic areas (census tracts), for people living in metropolitan areas.^{Note 36} It found that life expectancy can differ by up to two decades across census tracts in the largest Canadian cities. The strength of associations with socioeconomic factors varied significantly, specifically in Canada’s largest cities. This suggests that municipal factors, as well as provincial and federal factors, play a role.

2.0 Sexual and reproductive health

Key findings

• The crude birth rate declined from 9.7 live births per 1,000 population in 2021 to 8.8 in 2023 across all provinces and territories.
• The total fertility rate in Canada declined from 1.44 children per female aged 15 to 49 in 2021 to 1.26 in 2023.
• Stillbirth rates increased from 8.6 per 1,000 total births in 2021 to 8.8 in 2023, corresponding to 3,106 stillbirths in 2023. Rates varied across the country, from 3.3 per 1,000 total births in Manitoba to 28.5 in the Northwest Territories.
• While the infant mortality rate in Canada declined from 5.3 per 1,000 live births in 2000 to 4.6 in 2023, it remains higher than in other countries of the Organisation for Economic Co-operation and Development.
• In 2023, the maternal mortality rate increased to 11.65 per 100,000 live births, a high for the period since comparable statistics have been available.

Crude birth rate

In 2023, there were 351,477 live births in Canada (excluding Yukon)—a decrease from 351,679 in 2022 and 370,155 in 2021.^{Note 37} The crude birth rate in Canada is defined as the number of live births per 1,000 population. As previously reported, the crude birth rate was 9.7 in 2021 and has declined further since then (9.0 in 2022 and 8.8 in 2023).^{Note 38}

The crude birth rate was lower in 2023 than in 2019 across all provinces and territories. In 2023, Newfoundland and Labrador (5.9 live births per 1,000 population) and Nova Scotia (6.9) had the lowest crude birth rates, while Nunavut (19.5) had the highest.

Fertility rate

The total fertility rate (an estimate of the average number of live births a female can be expected to have in her lifetime, based on the age-specific fertility rates of a given year) declined to 1.44 children per female aged 15 to 49 in 2021, and it continued to decrease in 2022 (1.33) and 2023 (1.26). Since the total fertility rate required to maintain a population is 2.1 children per female, the Canadian population will mainly rely on international migration for continued growth.

At the provincial and territorial level, Nunavut had the highest total fertility rate in 2023 (2.48 children per female), making it the only jurisdiction with a fertility rate above the population replacement rate. British Columbia and Yukon had the lowest rates, at 1.00 and 1.01 children per female, respectively.

The age-specific fertility rate is the number of live births per 1,000 females in a specific age group. From 2021 to 2023, age-specific fertility rates declined among females in all age groups below 45, with the largest decrease seen for those aged 25 to 29, from 81.1 live births per 1,000 females in 2019 to 64.3 in 2023. Those aged 45 to 49 saw a small increase from 0.8 live births per 1,000 females in 2019 to 0.9 in 2023.

Stillbirths

A stillbirth is the death of a fetus at or after 20 weeks of pregnancy or weighing 500 grams or more.^{Note 39} Stillbirths increased from 8.6 per 1,000 total births in 2021 to 8.7 in 2023, corresponding to 3,106 stillbirths in 2023.^{Note 40} The rate ranged from 3.3 per 1,000 total births in Manitoba to 28.5 in the Northwest Territories. Risk factors associated with stillbirths include maternal weight, smoking and age.^{Note 41}

The rate of stillbirths in multiple deliveries is much higher than that in single deliveries. In Canada, the rate of stillbirths was 8.4 per 1,000 births for single deliveries and 19.4 for multiple deliveries in 2023.^{Note 40} The largest difference was in British Columbia, where the stillbirth rate was 14.3 per 1,000 births for single deliveries and 42.3 for multiple deliveries.

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 2023, neonatal mortality accounted for 73.5% of all infant deaths in Canada.^{Note 42}

The top five causes of neonatal mortality have remained consistent since 2018: congenital malformations; disorders related to short gestation and low birth weight; complications of pregnancy; complications of the placenta, cord and membrane; and intrauterine hypoxia and birth asphyxia.^{Note 43} 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 44} 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.

While the infant mortality rate in Canada declined from 5.3 per 1,000 live births in 2000 to 4.6 in 2023, it remains higher than in other countries of the Organisation for Economic Co-operation and Development.^{Note 42Note 45}

Did you know?

Indigenous identity is not captured on birth records. Linking Canadian Birth Census Cohort data and Census of Population records enables infant mortality rates to be calculated for Indigenous and non-Indigenous populations.

A national study found that from 2014 to 2016, the infant mortality rate of the total Indigenous population (7.7 per 1,000 live births) was higher than that of the non-Indigenous population (4.2) by a factor of approximately 1.8.^{Note 27} From 2014 to 2016, the infant mortality rate was twice as high among First Nations people with Indian Status living on reserve (10.0 per 1,000 live births; this figure should be used with caution) and three times as high among Inuit (13.5; this figure should be used with caution), compared with the non-Indigenous population (4.2).

Maternal mortality

Maternal mortality rates are critical measures of maternal health. Maternal mortality rates reflect shifts in the demographics of the childbearing population in Canada and associated risk factors, including advanced maternal age, prevalence of medical comorbidities, and a growing refugee and immigrant population.^{Note 46}

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 one year after delivery or the end of the pregnancy.

As previously reported, the maternal mortality rate showed an overall upward trend from 2000 (3.05 per 100,000 live births) to 2020 (9.15).^{Note 47} In more recent years, it fluctuated downwards to 8.16 per 100,000 live births in 2021 and 7.96 in 2022. However, in 2023, the maternal mortality rate increased to 11.65 per 100,000 live births, a high for the period since comparable statistics have been available.

Maternal mortality during pregnancy or within 42 days of delivery or the end of the pregnancy dropped from 8.04 per 100,000 live births in 2020 to 6.26 in 2022. However, in 2023, it increased to 9.38 deaths per 100,000 live births. Mortality from 42 days to one year after delivery or the end of the pregnancy rose from 1.39 per 100,000 live births in 2020 to 2.84 in 2023.

Spotlight on sex education and information

Sex education

According to waves 12 and 13 of the Canadian Social Survey, in 2024, over 7 in 10 women (71.6%) and men (71.8%) aged 15 and older reported that they received sex education during their time in elementary or high school.

More than three in five people aged 15 to 24 who indicated that they received sex education during their time in elementary or high school (62.0%) reported that it was “very helpful” or “helpful” (as opposed to “unhelpful” or “very unhelpful”) in terms of preparing them for a healthy life.

Sources of sexual and reproductive health information

When asked where they typically get information about sexual and reproductive health, over half (50.4%) of people aged 15 and older cited health care providers as a source of information (Chart 2.0). This was followed by the media (34.2%), friends (17.9%) and family (16.5%). More than one in five people (22.1%) reported that they do not get information about sexual and reproductive health from any source.

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 Percent and 95% confidence interval, calculated using from and to units of measure (appearing as column headers).

	Percent	95% confidence interval
		from	to
Notes: Territorial data are not included in annual estimates. Respondents could select more than one answer. As a result, the total is greater than 100%. Source: Statistics Canada, Canadian Social Survey, 2024.
Health care providers	50.4	49.5	51.2
Media	34.2	33.4	35
Friends	17.9	17.2	18.6
Family	16.5	15.8	17.2
Sexual partners	13.8	13.2	14.4
Telephone hotlines, live chats or self-help groups	1.5	1.3	1.7
Other sources	5.2	4.8	5.6
I do not get information from any source	22.1	21.5	22.8

While one in two people reported getting information about sexual and reproductive health from health care providers, a larger share of younger people (i.e., those aged 15 to 34) than their older counterparts also reported getting information from the media, friends, family and sexual partners. For example, the proportion of 15- to 34-year-olds who reported getting information from the media (49.9%) was almost double that observed among those aged 35 and older (26.8%).

Information needed to make healthy decisions about sexual and reproductive health

Most women (91.3%) and men (92.5%) reported that they were very confident (54.5% of women and 56.1% of men) or somewhat confident (36.8% of women and 36.4% of men) that they have the information they need to make healthy decisions about their sexual and reproductive health. People aged 15 to 24 (41.5%) were proportionally the least likely to report being very confident in this regard (Chart 2.1).

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 Percent and 95% confidence interval, calculated using from and to units of measure (appearing as column headers).

	Percent	95% confidence interval
		from	to
Note: Territorial data are not included in annual estimates. Source: Statistics Canada, Canadian Social Survey, 2024.
15 to 24
Very confident	41.5	38.7	44.4
Somewhat confident	48.2	45.3	51.1
Not very confident	8.3	6.8	10.1
Not confident at all	2.0	1.4	3.0
25 to 34
Very confident	51.4	48.8	53.9
Somewhat confident	41.3	38.9	43.8
Not very confident	5.7	4.6	7.0
Not confident at all	1.6	1.1	2.4
35 to 44
Very confident	57.4	55.2	59.5
Somewhat confident	35.9	33.8	38.0
Not very confident	4.7	3.9	5.6
Not confident at all	2.0	1.4	2.9
45 to 54
Very confident	61.4	59.3	63.4
Somewhat confident	32.5	30.6	34.5
Not very confident	4.4	3.7	5.3
Not confident at all	1.7	1.3	2.2
55 to 64
Very confident	60.7	58.8	62.5
Somewhat confident	32.5	30.8	34.3
Not very confident	4.2	3.5	5.1
Not confident at all	2.6	1.9	3.4
65 and older
Very confident	58.5	57.0	59.9
Somewhat confident	30.9	29.6	32.2
Not very confident	5.3	4.6	6.0
Not confident at all	5.4	4.7	6.1

3.0 Chronic diseases

Key findings

• In 2023, almost half of Canadian adults had one or more selected chronic diseases (46.1%). Some of the most common were arthritis (20.6%) and high blood pressure (19.9%).
• Chronic disease risk factors such as overweight (35.5%) and obesity (30.2%) were also prevalent.
• The prevalence of most chronic diseases has been stable since 2021, but that of mental health conditions has grown:
• The share of people reporting diagnosed anxiety disorders increased from 10.3% in 2021 to 14.8% in 2022.
• The proportion of those reporting diagnosed mood disorders also rose, from 10.0% in 2021 to 11.7% in 2022 and 13.0% in 2023.
• The prevalence of both conditions was higher among people whose reported sexual orientation is lesbian, gay, bisexual or another orientation that is not heterosexual and among younger people.
• The prevalence of most selected chronic diseases (high blood pressure, heart disease, stroke, diabetes, arthritis and cancer) increased with age.
• Proportionally more adults in rural areas than in population centres had high blood pressure, heart disease, diabetes, obesity and arthritis.
• A higher proportion of Canadians in the lowest income quintile reported high blood pressure, heart disease, stroke, diabetes, obesity, arthritis, anxiety and mood disorders, compared with those in the highest quintile.
• Proportionally more non-immigrants than immigrants experienced heart disease, obesity, arthritis, anxiety and mood disorders.
• A greater share of non-racialized individuals had high blood pressure, heart disease, obesity, arthritis, anxiety and mood disorders, compared with most racialized groups.
• The proportion of adults with disabilities reporting high blood pressure, heart disease, stroke, diabetes, obesity, arthritis and mood disorders was higher than that of individuals without disabilities.
• Almost half (45%) of Canadians were projected to be diagnosed with cancer in their lifetime.
• While age-standardized incidence and mortality rates for all cancers combined were projected to decrease from previous years, they remained 13% and 37% higher, respectively, for males than females.
• The lung cancer mortality rate remained higher among males, but females were expected to have a higher incidence rate in 2024 than males. 

Chronic diseases 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, diet and physical inactivity.

Prevalence of one or more selected chronic diseases

The prevalence of having one or more selected chronic diseases has increased over the last eight years (Chart 3.0), from 41.2% of Canadians aged 18 and older in 2015 to 46.1% in 2023 (over 14 million people). The chronic diseases considered in this trend analysis are arthritis, high blood pressure, diabetes, cancer (ever diagnosed), heart disease (ever diagnosed), stroke and mood disorders.

Data table for Chart 3.0

Data table for chart 3.0 Table summary
The information is grouped by   (appearing as row headers), Percent and 95% Confidence Interval, calculated using from and to units of measure (appearing as column headers).

	Percent	95% Confidence Interval
		from	to
Notes: Estimates for Canada exclude the territories. The chart shows Canadians aged 18 years and older who reported one or more of the following chronic diseases: arthritis, high blood pressure, diabetes, cancer (ever diagnosed), heart disease (ever diagnosed), stroke and mood disorders. In the previous report, anxiety was included among these conditions. However, because of content changes in the 2023 Canadian Community Health Survey, anxiety data are based on only five provinces, and anxiety was therefore excluded from "one or more selected chronic diseases.” Sources: Statistics Canada, Canadian Community Health Survey, 2015 to 2023.
2015	41.2	40.5	41.9
2016	43.0	42.4	43.6
2017	42.4	41.8	43.0
2018	42.7	42.1	43.4
2019	43.5	42.8	44.2
2020	42.9	42.1	43.7
2021	44.5	43.8	45.2
2022	45.3	44.7	45.9
2023	46.1	45.5	46.8

The prevalence of having one or more chronic diseases varied across Canada. In 2023, it was higher in the Atlantic provinces (59.0% in Newfoundland and Labrador, 55.8% in Prince Edward Island, 54.2% in Nova Scotia, and 55.0% in New Brunswick) and Manitoba (49.4%) compared with Canada overall (excluding the territories). In contrast, a lower proportion of adults in Quebec reported having a chronic disease (43.1%). In 2022, the prevalence of having a chronic disease was lower in Nunavut (36.7%) than in Canada overall (45.3%). A higher proportion of rural Canadians reported having at least one chronic disease compared with those living in population centres (52.2% in rural areas vs. 45.0% in population centres in 2023).

In 2023, the prevalence of reporting one or more chronic diseases also differed by sociodemographic characteristics. For example, prevalence was higher among females (48.9%) than males (43.3%) and among adults aged 65 and older (79.6%) compared with those aged 18 to 34 (21.0%). The same year, a greater share of Canadians with a disability (76.7%) reported having one or more chronic diseases, compared with those without disabilities (42.2%).

A larger proportion of non-immigrants (49.0%) reported having at least one chronic disease in 2023 compared with immigrants (41.5%). Among immigrants, a higher percentage of those who were admitted to Canada more than 10 years ago (49.6%) reported having a chronic disease, compared with more recent immigrants (21.5%). Additionally, in 2023, the prevalence of having one or more chronic diseases was higher among the non-racialized population (51.0%) than among all racialized groups.

Cardiovascular disease

Cardiovascular disease is a general term describing diseases that affect blood vessels or the heart. Cardiovascular disease risk can be reduced by eating healthy, doing adequate physical activity and limiting substance use.^{Note 48} 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 49} Risk factors for high blood pressure include sedentary behaviours, obesity and high sodium consumption.^{Note 50}

In 2023, 19.9% of Canadians aged 18 and older reported having high blood pressure (Table 3.0). While a slight increase occurred from 2020 to 2021 (from 18.3% to 19.1%) and from 2021 to 2022 (to 20.2%), there were no changes in 2023 (19.9%) (Chart 3.1). However, the prevalence of high blood pressure increased with age consistently from 2015 to 2023. In 2023, the prevalence of high blood pressure ranged from 2.7% among Canadians aged 18 to 34 to 45.0% among those aged 65 and older.

A higher prevalence of high blood pressure was seen in the Atlantic provinces (25.0% to 27.5%) and Saskatchewan (22.5%), and a lower prevalence was observed in Quebec (18.4%), Alberta (18.4%) and British Columbia (18.0%), compared with all of Canada, excluding the territories (Table 3.0).

Data table for Chart 3.1

Data table for chart 3.1 Table summary
The information is grouped by   (appearing as row headers), Overweight, Obesity, Arthritis, High blood pressure, Diabetes and Heart disease , calculated using percent units of measure (appearing as column headers).

	Overweight	Obesity	Arthritis	High blood pressure	Diabetes	Heart disease
	percent
Notes: Estimates for Canada exclude the territories. The question on heart disease changed across Canadian Community Health Survey cycles. From 2015 to 2017, the question was "Do you have heart disease?" (referring to a current diagnosis only). From 2018 to 2021, the question "Did you ever have heart disease?" (lifetime diagnosis) was added. From 2022 to 2023, the wording was changed to "Have you ever had a heart attack?" instead of heart disease. Body mass index is derived by dividing the respondent's self-reported body weight (in kilograms) by their height (in metres) squared. This excludes pregnant females and people shorter than 3 feet or taller than 6 feet 11 inches. A correction factor is applied to adjust for underestimates in weight and overestimates in height. According to the World Health Organization and Health Canada guidelines, the index for body weight classification for the population aged 18 and older is 25.00 to 29.99 for overweight; 30.00 to 34.99 for obese, class I; 35.00 to 39.99 for obese, class II; and 40.00 or greater for obese, class III. Obesity classes are grouped for the purposes of this analysis. Sources: Statistics Canada, Canadian Community Health Survey, 2015 to 2023.
2015	35.8	26.1	21.2	18.2	7.4	4.7
2016	35.8	26.5	21.4	19.0	7.5	5.1
2017	36.0	26.9	20.0	19.1	7.8	5.0
2018	36.3	26.8	19.6	18.4	7.6	6.3
2019	35.8	27.7	20.5	18.9	8.4	6.4
2020	35.6	28.2	19.9	18.3	7.6	6.7
2021	35.5	29.2	20.2	19.1	7.9	6.9
2022	34.7	30.0	20.6	20.2	8.4	6.3
2023	35.5	30.2	20.6	19.9	8.0	6.3

From 2015 to 2023, rural Canadians consistently had a prevalence of high blood pressure 3 to 6 percentage points higher than those living in population centres (22.1% vs. 19.4% in 2023, Chart 3.2).

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, Diabetes, Heart disease , Stroke, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent and 95% Confidence Interval, calculated using from, to, from, to, from, to, from, to, from, to, from, to, from and to units of measure (appearing as column headers).

	Overweight			Obesity			Arthritis			High blood pressure			Diabetes			Heart disease			Stroke
	Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval
		from	to		from	to		from	to		from	to		from	to		from	to		from	to
Notes: Territorial data are not included in annual estimates. A population centre has a population of at least 1,000 and a population density of 400 persons or more per square kilometre, based on population counts from the current Census of Population. All areas outside population centres are classified as rural areas. Body mass index is derived by dividing the respondent's self-reported body weight (in kilograms) by their height (in metres) squared. This excludes pregnant females and people shorter than 3 feet or taller than 6 feet 11 inches. A correction factor is applied to adjust for underestimates in weight and overestimates in height. According to the World Health Organization and Health Canada guidelines, the index for body weight classification for the population aged 18 and older is 25.00 to 29.99 for overweight; 30.00 to 34.99 for obese, class I; 35.00 to 39.99 for obese, class II; and 40.00 or greater for obese, class III. Obesity classes are grouped for the purposes of this analysis. Source: Statistics Canada, Canadian Community Health Survey, 2023.
Population centre	35.8	35.0	36.5	29.0	28.3	29.7	19.5	19.0	20.0	19.4	18.9	19.9	7.8	7.5	8.1	6.0	5.7	6.3	1.1	1.0	1.3
Rural area	34.3	33.0	35.6	36.7	35.3	38.1	26.2	25.0	27.3	22.1	21.1	23.2	9.1	8.4	9.8	7.7	7.1	8.3	1.6	1.3	2.0

A greater proportion of Canadians aged 18 and older in the lowest income quintile (23.2%) reported having high blood pressure compared with those in the highest quintile (16.9%) in 2023. The same trend has been seen since 2015. In addition, a higher prevalence of high blood pressure was found among those who reported having a disability (32.0%) compared with those who did not (18.2%) in 2023 (Chart 3.3).

Data table for Chart 3.3

Data table for chart 3.4 Table summary
This table displays the results of Data table for chart 3.4 Overweight, Obesity, Arthritis, High blood pressure, Diabetes, Heart disease , Stroke, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent and 95% Confidence Interval, calculated using from, to, from, to, from, to, from, to, from, to, from, to, from and to units of measure (appearing as column headers).

	Overweight			Obesity			Arthritis			High blood pressure			Diabetes			Heart disease			Stroke
	Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval
		from	to		from	to		from	to		from	to		from	to		from	to		from	to
Notes: Territorial data are not included in annual estimates. Body mass index is derived by dividing the respondent's self-reported body weight (in kilograms) by their height (in metres) squared. This excludes pregnant females and people shorter than 3 feet or taller than 6 feet 11 inches. A correction factor is applied to adjust for underestimates in weight and overestimates in height. According to the World Health Organization and Health Canada guidelines, the index for body weight classification for the population aged 18 and older is 25.00 to 29.99 for overweight; 30.00 to 34.99 for obese, class I; 35.00 to 39.99 for obese, class II; and 40.00 or greater for obese, class III. Obesity classes are grouped for the purposes of this analysis. Source: Statistics Canada, Canadian Community Health Survey, 2023.
Self-reported disability	30.6	28.7	32.5	40.1	38.2	42.0	41.9	40.0	43.8	32.0	30.3	33.7	16.6	15.3	17.9	14.1	13.0	15.3	4.6	3.8	5.4
No self-reported disability	36.1	35.4	36.9	29.1	28.4	29.8	18.0	17.5	18.4	18.2	17.8	18.7	6.9	6.5	7.2	5.2	4.9	5.4	0.7	0.6	0.8

High blood pressure also varied among other subpopulations. Immigrants who were admitted to Canada more than 10 years ago had over double the prevalence of high blood pressure (26.0%) compared with more recent immigrants (10.0%) (Chart 3.4).

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 Overweight, Obesity, Arthritis, High blood pressure, Diabetes, Heart disease , Stroke, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent and 95% Confidence Interval, calculated using from, to, from, to, from, to, from, to, from, to, from, to, from and to units of measure (appearing as column headers).

	Overweight			Obesity			Arthritis			High blood pressure			Diabetes			Heart disease			Stroke
	Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval
		from	to		from	to		from	to		from	to		from	to		from	to		from	to
Notes: Territorial data are not included in annual estimates. Body mass index is derived by dividing the respondent's self-reported body weight (in kilograms) by their height (in metres) squared. This excludes pregnant females and people shorter than 3 feet or taller than 6 feet 11 inches. A correction factor is applied to adjust for underestimates in weight and overestimates in height. According to the World Health Organization and Health Canada guidelines, the index for body weight classification for the population aged 18 and older is 25.00 to 29.99 for overweight; 30.00 to 34.99 for obese, class I; 35.00 to 39.99 for obese, class II; and 40.00 or greater for obese, class III. Obesity classes are grouped for the purposes of this analysis. Immigrants include people who are, or who have ever been, landed immigrants or permanent residents. They have been granted the right to live in Canada permanently by immigration authorities. Immigrants who have obtained Canadian citizenship by naturalization are included in this category. Immigrants who were admitted to Canada in the last 10 years include people who first obtained landed immigrant or permanent resident status on the survey date or in the 10 years before. In 2022, for example, this category includes people who obtained landed immigrant status from 2012 to 2022. Immigrants who were admitted to Canada more than 10 years ago include people who first obtained landed immigrant or permanent resident status more than 10 years prior to the survey date. In 2022, for example, this category includes people who obtained landed immigrant status in 2011 or before. Non-immigrants include people who are Canadian citizens by birth. Source: Statistics Canada, Canadian Community Health Survey, 2023.
Immigrants	38.1	36.6	39.6	23.6	22.2	24.9	16.8	15.7	17.8	21.4	20.3	22.6	9.1	8.4	9.9	5.6	5.0	6.1	1.3	1.1	1.6
Immigrants who were admitted to Canada more than 10 years ago	37.7	35.8	39.5	23.7	22.1	25.4	21.6	20.1	23.1	26.0	24.5	27.4	11.3	10.3	12.2	7.3	6.5	8.0	1.6	1.2	1.9
Immigrants who were admitted to Canada in the last 10 years	39.3	36.1	42.5	22.7	19.7	25.7	4.5	3.4	5.7	10.2	8.2	12.2	4.4	3.0	5.8	1.3	0.7	2.0	0.5	0.1	0.8
Non-immigrants	34.5	33.8	35.3	33.3	32.5	34.0	22.7	22.1	23.3	19.7	19.3	20.2	7.8	7.5	8.1	6.7	6.4	7.0	1.2	1.1	1.3

Table 3.1 shows a lower prevalence of high blood pressure across most racialized groups compared with the non-racialized population in 2023.

Heart disease

Heart disease remained the second leading cause of death in Canada, accounting for 57,890 deaths in 2023. In 2022 and 2023, 6.3% of Canadians aged 18 and older reported having ever been diagnosed with heart disease or having had a heart attack (Table 3.0). This percentage has remained relatively stable since 2018 (6.3%) (Chart 3.1). Heart disease was more prevalent among males; in 2023, 7.9% of males reported having heart disease, compared with 4.7% of females. Sex differences in heart disease were observed across most age groups, and these differences widened with age. For example, in 2023, heart disease was 1 percentage point more prevalent in males aged 35 to 49 than females in the same age group but nearly 9 percentage points more prevalent in males aged 65 and older than their female counterparts.

Across the provinces, in 2023, people in Newfoundland and Labrador (8.4%), Nova Scotia (8.7%), and Saskatchewan (7.5%) had a higher prevalence of heart disease compared with Canada overall, excluding the territories (6.3%). Meanwhile, people in Ontario (5.9%) and Alberta (5.1%) had a lower prevalence of heart disease (Table 3.0). In 2022, the prevalence of heart disease was lower in Yukon (3.9%) and the Northwest Territories (3.8%) compared with Canada (6.3%). A higher proportion of rural Canadians (7.7%) reported having heart disease than their counterparts in population centres (6.0%) in 2023 (Chart 3.2). The same trend has been observed consistently since 2018.

The prevalence of heart disease also varied by sociodemographic factors. In 2023, 8.8% of Canadians in the lowest household income quintile reported having heart disease, compared with 5.1% in the highest quintile. This trend has been consistent since 2018. Immigrants had a lower prevalence of heart disease than non-immigrants from 2020 to 2023, but this trend was not consistent before 2020. In 2023, those who were admitted to Canada more than 10 years ago (7.3%) had a higher prevalence of heart disease than recent immigrants (1.3%) (Chart 3.4). Additionally, most racialized groups had a lower prevalence of heart disease compared with the non-racialized population in 2023 (Table 3.1). The same year, those who reported having a disability (14.1%) had a higher prevalence of heart disease than those who did not (5.2%) (Chart 3.3). In addition, bisexual and pansexual Canadian adults (2.8%) had a lower prevalence of heart disease than heterosexual adults (6.3%).

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. Stroke was in the top five leading causes of death in Canada from 2019 to 2023, accounting for 13,833 deaths in 2023.

No changes in stroke prevalence have been observed since 2015—1.2% of Canadian adults reported suffering from the effects of a stroke in 2023 (Chart 3.1). Stroke prevalence was higher among 50- to 64-year-olds (1.1%) and those aged 65 and older (3.4%), compared with those aged 18 to 34 (0.2%) in 2023. Prevalence also varied by income and disability status. In 2023, 2.1% of Canadians in the lowest household income quintile reported having had a stroke, compared with 0.7% of those in the highest quintile, and 4.6% of people with a disability reported having had a stroke, compared with 0.7% of those without disabilities (Chart 3.3). Some racialized groups had a lower prevalence of stroke than the non-racialized population in 2023 (Table 3.1).

Endocrine and metabolic disorders

Diabetes

Diabetes is a chronic disease that occurs when the body is unable to produce enough insulin or properly use it.^{Note 51} Diabetes can lead to many complications, including cardiovascular disease, vision loss or blindness, kidney failure, nerve damage, problems with pregnancy, oral disease, and depression.

In 2023, 8.0% of Canadians aged 18 and older reported having type 1, type 2 or gestational diabetes (Table 3.0). This percentage had increased from 2018 (7.6%) to 2019 (8.4%) but declined in 2020 (7.6%) and has been stable since (Chart 3.1). Like other chronic diseases, the prevalence of diabetes increased with age. In 2023, it was lowest among 18- to 34-year-olds (1.4%) and highest among adults aged 65 and older (17.6%). Males (9.0%) had a higher prevalence of diabetes than females (7.1%) in 2023. A similar trend was found in 2021 and 2022, with the prevalence of diabetes being around 2 percentage points higher in males. Sex differences in the prevalence of diabetes were observed at older ages (50 and older), and they widened with age. For example, in 2023, the prevalence of diabetes was 2.7 percentage points higher in males aged 50 to 64 but 5.7 percentage points higher in males aged 65 and older, compared with their female counterparts.

Across the provinces, people in Newfoundland and Labrador (11.1%) and Nova Scotia (10.5%) had a higher prevalence of diabetes, and those in British Columbia had a lower prevalence (6.8%), compared with Canada overall, excluding the territories, in 2023 (8.0%) (Table 3.0). A similar trend was seen in 2021 and 2022. In 2022, Yukon also had a lower prevalence of diabetes (5.7%) compared with Canada overall (8.4%). The prevalence of diabetes was similar in rural areas and population centres from 2015 until a difference emerged in 2022 and 2023. In these years, a higher percentage of Canadians living in rural regions reported having diabetes compared with those in population centres (9.1% vs. 7.8% in 2023, Chart 3.2).

The prevalence of diabetes also varied across different population groups of Canadians. In 2023, 10.1% of Canadians in the lowest household income quintile reported having diabetes, compared with 6.3% in the highest quintile. A similar trend has been seen since 2015. Diabetes prevalence was also much higher among those with a disability (16.6%) than among those without disabilities (6.9%) in 2023 (Chart 3.3). In the same year, 9.1% of immigrants had diabetes, compared with 7.8% of non-immigrants (Chart 3.4). From 2021 to 2023, immigrants who were admitted to Canada more than 10 years ago had a 7 to 8 percentage point higher prevalence of diabetes than more recent immigrants. Compared with the non-racialized population (8.0%), South Asian people had a higher prevalence of diabetes (10.8%), whereas Chinese (6.3%), Latin American (5.5%), Japanese (4.0%), Korean (2.9%) and West Asian (2.8%) people had a lower prevalence (Table 3.1).

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 disease.

Body mass index (BMI), calculated by dividing the respondent’s body weight (in kilograms) by their height (in metres) squared, is a method of classifying body weight according to health risk. According to the World Health Organization and Health Canada guidelines, having a BMI of 25.00 to 29.99 (classified as overweight) is associated with an increased health risk, and having a BMI of 30.00 or greater (classified as obese) is associated with a high health risk. A correction factor is applied to adjust for underestimates in weight and overestimates in height.^{Note 52}

In 2023, 35.5% of Canadian adults were classified as overweight and 30.2% had obesity (Table 3.0). The proportion of adults with overweight or obesity has remained stable since 2015 (Chart 3.1). In each year since 2015, the proportion of males who were overweight was higher than that of females. In 2023, 40.0% of males were classified as overweight, compared with 31.0% of females. Sex differences in overweight were largest among those aged 35 to 49 (12.3 percentage points higher in males). Although a greater proportion of males than females were classified as having obesity from 2015 to 2018, no sex differences in obesity were observed from 2019 to 2023.

Several provinces (all the Atlantic provinces, Manitoba and Saskatchewan) had a higher obesity prevalence than Canada overall, excluding the territories (Table 3.0). Notably, in Newfoundland and Labrador and New Brunswick, 41.1% of adults had obesity in 2023, compared with 30.2% in Canada overall, excluding the territories. Meanwhile, British Columbia had a lower percentage of adults classified as having obesity (24.3%) compared with Canada overall, excluding the territories, and a similar trend has been observed since 2015. In 2023, obesity prevalence was higher among adults in rural areas (36.7%) than among those living in population centres (29.0%) (Chart 3.2). A similar trend has been found since 2015.

The prevalence of overweight and obesity differed based on sociodemographic characteristics, often showing contrasting patterns. For instance, in 2023, individuals who reported having a disability had a lower prevalence of overweight (30.6%) than those without disabilities (36.1%). However, the prevalence of obesity was higher among those with a disability (40.1%) than among those without disabilities (29.1%) (Chart 3.3).

In 2023, a greater proportion of Canadians aged 18 and older in the highest income quintile were classified as overweight (37.8%), compared with those in the lowest quintile (33.3%). The same trend has been found since 2015. In contrast, obesity was more prevalent among those in the lowest quintile (30.1%), compared with those in the highest (27.1%) in 2023.

Since 2021, a higher proportion of immigrants have been classified as overweight, compared with non-immigrants (2 to 4 percentage points higher for immigrants). In contrast, obesity has been more prevalent among non-immigrants than immigrants since 2015. In 2023, 23.6% of immigrants were classified as having obesity, compared with 33.3% of non-immigrants (Chart 3.4).

Obesity prevalence was lower among some racialized groups compared with the non-racialized population in 2023 (Table 3.1). A higher proportion of South Asian (40.8%) and Black (41.4%) Canadians were classified as overweight in 2023 compared with non-racialized Canadians (35.2%). A similar trend was found for South Asian people in 2021 and 2022.

Musculoskeletal disorders

Arthritis

Arthritis is associated with mobility limitations and dependency in activities of daily living.^{Note 53} The prevalence of arthritis has remained stable since 2019 (Chart 3.1). In 2023, 20.6% of Canadian adults reported having arthritis (Table 3.0). Unlike other chronic diseases where the prevalence is higher among males, in 2023, the prevalence of arthritis was higher among females (24.4%) than males (16.7%), across all age groups. Like other chronic diseases, the prevalence of arthritis increased with age, ranging from 2.3% among 18- to 34-year-olds to 46.0% among those aged 65 and older in 2023. Arthritis prevalence was 16 percentage points higher among females aged 65 and older (53.5%) than among males in the same age group (37.6%).

The prevalence of arthritis varied across the provinces in 2023. People in all the Atlantic provinces and Manitoba had a higher prevalence of arthritis than those in Canada overall (excluding the territories), while Quebec was the only province where people had a lower prevalence of arthritis (18.1%) (Table 3.0). In 2022, the proportion of people with arthritis in the Northwest Territories (17.0%) and Nunavut (10.5%) was lower compared with Canada overall (20.6%). Arthritis prevalence was higher among adults in rural areas (26.2%) than among those living in population centres (19.5%) (Chart 3.2). A similar trend was found in 2021 and 2022.

Arthritis prevalence was higher among those who reported having a disability (41.9%) compared with those who did not (18%) (Chart 3.3). Like most other chronic diseases, a greater proportion of those in the lowest household income quintile reported having arthritis (25.4%) compared with those in the highest quintile (18.2%) in 2023. A similar trend has been observed since 2015.

Arthritis has remained more prevalent among non-immigrants than immigrants since 2015. In 2023, 16.8% of immigrants reported having arthritis, compared with 22.7% of non-immigrants (Chart 3.4). Among immigrants, 21.6% of those who were admitted more than 10 years ago reported having arthritis in 2023, compared with 4.5% of more recent immigrants. Similar trends were observed in 2021 and 2022. A lower proportion of people in all racialized groups reported having arthritis compared with the non-racialized population in 2023 (Table 3.1). Similar trends have been seen since 2015.

Did you know?

According to the 2022 Indigenous Peoples Survey, the most prevalent chronic diseases among First Nations people living off reserve, Métis and Inuit were arthritis, high blood pressure and asthma.

Table 3.1-2
Prevalence of common chronic diseases among First Nations people living off reserve, Métis and Inuit aged 15 and older, Canada, 2022 Table summary
This table displays the results of Prevalence of common chronic diseases among First Nations people living off reserve, Métis and Inuit aged 15 and older, Canada, 2022 , calculated using (appearing as column headers).

	Arthritis	High blood pressure	Asthma	Cancer	Diabetes	Heart disease	Chronic bronchitis, emphysema and COPD	Bowel disorders
Note: COPD = chronic obstructive pulmonary disease. Source: Statistics Canada, Indigenous Peoples Survey, 2022.
First Nations people living off reserve	22.9	19.6	16.3	5.8	10.6	5.6	5.0	11.2
Métis	24.1	20.6	15.3	7.2	9.4	6.0	5.5	12.5
Inuit	15.5	15.4	11.3	4.0	5.5	4.5	4.3	6.1

Arthritis, bowel disorders and cancer were more prevalent among First Nations, Métis and Inuit women compared with men. Similarly, asthma prevalence was higher among First Nations and Métis women than men. In contrast, diabetes was more common among Métis men than women. For First Nations people and Métis, heart disease and high blood pressure were more prevalent among men than women, and this trend was also observed for high blood pressure among Métis.

Cancer

Did you know?

An estimated 45% of Canadians are expected to be diagnosed with cancer in their lifetime.^{Note 54}

Cancer is not one disease, but a collection of over 100 distinct diseases that are complex and influenced by many factors, including genetics, lifestyle and the environment. As the leading cause of premature death (i.e., death before age 75) in Canada, cancer has a large impact on the health of Canadians and the Canadian health care system. The potential years of life lost (i.e., the number of years of potential life not lived) because of premature mortality from cancer from 2018 to 2020 reached approximately 1.3 million years.

Because of the time needed to gather and verify data, cancer statistics inevitably lag several years behind the present.^{Note 55} Short-term projections are calculated by extrapolating from historical trends into the future through statistical models. These estimates of incidence and mortality offer an up-to-date view of cancer’s impact in Canada that is crucial for planning resources, conducting research and guiding cancer control programs.

In Canada, 247,100 new cancer cases were projected to be diagnosed in 2024. Lung cancer was projected to remain the most diagnosed cancer, with 32,100 new cases expected in 2024, followed by breast (30,800 cases), prostate (27,900 cases) and colorectal (25,200 cases) cancers. Combined, these four cancer types made up 47% of all new cancer cases expected in 2024.

In 2024, 88,100 people in Canada were expected to die of cancer. Lung cancer was projected to remain the most common cause of cancer death, with an expected 20,700 deaths in 2024, followed by colorectal (9,400 deaths), pancreas (6,100 deaths), breast (5,500 deaths) and prostate (5,000 deaths) cancers. Combined, these five cancers were expected to account for more than half (53%) of all cancer deaths in Canada in 2024.

Age-standardized incidence rates (ASIRs) and age-standardized mortality rates (ASMRs) per 100,000 people are presented in Table 3.2. Although the total ASIR and ASMR were projected to decrease from previous years for both males and females, the ASIR for all cancers combined was projected to be 13% higher among males than females in 2024. The ASMR for all cancers combined was projected to be 37% higher among males than females.

Incidence and mortality rates over time for selected cancers

ASIRs (Chart 3.5) and ASMRs (Chart 3.6) are shown from 1984 to 2024 for selected common cancers. In the past, lung cancer incidence and mortality rates were higher among males than females, but this difference has recently been shrinking. While the lung cancer mortality rate remained higher among males than females, females were expected to have a higher incidence rate in 2024 than males. Incidence and mortality rates of colorectal cancer have been steadily decreasing for both males and females.

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 Male, Female, Lung, Colorectal, Prostate, Lung, Colorectal and Breast, calculated using age-standardized incidence rate per 100,000 population units of measure (appearing as column headers).

	Male			Female
	Lung	Colorectal	Prostate	Lung	Colorectal	Breast
	age-standardized incidence rate per 100,000 population
Notes: Rates were age standardized to the 2011 Canadian standard population. Shading indicates projected data from 2020 to 2024 for incidence and from 2021 to 2024 for mortality. Rates include Quebec. Source: Brenner DR, Gillis J, Demers AA, et al. Projected estimates of cancer in Canada in 2024. CMAJ 2024. DOI: https://doi.org/10.1503/cmaj.240095.
1984	128.3	85.5	109.7	39.2	64.5	116.8
1985	123.4	87.6	115.5	40.9	66.4	119.0
1986	127.4	85.4	117.2	41.8	63.6	114.3
1987	125.7	85.5	121.0	44.0	62.8	117.4
1988	126.1	85.0	122.2	45.7	60.8	126.2
1989	123.3	83.1	123.3	46.1	59.8	124.2
1990	122.5	83.0	133.2	47.9	60.0	124.0
1991	120.1	82.9	149.9	49.4	58.4	130.0
1992	122.1	88.4	167.2	53.2	60.7	132.1
1993	123.1	84.5	186.3	54.5	60.1	129.0
1994	116.9	85.5	171.7	53.3	59.3	128.8
1995	114.4	83.0	149.6	54.7	57.4	128.6
1996	111.4	81.5	146.8	56.4	55.8	128.7
1997	107.7	81.0	154.2	56.2	55.9	133.6
1998	109.2	84.0	154.0	58.3	58.7	135.2
1999	107.9	84.8	159.8	58.2	57.7	137.8
2000	102.9	87.0	166.6	60.0	58.8	133.2
2001	103.2	85.8	177.4	60.0	57.9	131.1
2002	99.8	84.8	165.5	60.7	57.2	134.1
2003	97.2	82.1	161.9	60.9	56.3	127.5
2004	96.9	83.6	165.2	61.7	57.2	127.5
2005	95.2	83.3	164.4	63.3	56.5	127.8
2006	93.2	82.4	170.1	63.8	55.1	127.5
2007	92.6	82.4	169.8	64.0	55.6	128.1
2008	90.1	82.7	156.2	64.8	55.1	125.4
2009	88.9	80.6	153.7	65.0	54.7	127.9
2010	91.8	81.1	154.5	67.4	56.1	134.2
2011	88.4	80.5	163.5	67.0	55.4	134.6
2012	87.8	78.3	146.7	68.9	55.4	130.5
2013	82.1	76.7	127.9	66.6	53.6	130.9
2014	84.0	76.6	122.4	69.0	53.2	131.7
2015	80.8	76.8	120.0	66.9	52.0	131.3
2016	77.7	71.4	124.2	66.8	49.6	133.1
2017	78.4	68.2	127.6	67.6	48.8	130.0
2018	73.5	67.6	126.5	66.5	47.9	132.6
2019	71.9	66.3	120.6	65.2	47.2	133.3
2020	70.7	66.9	121.9	65.9	46.9	132.6
2021	68.9	65.9	121.3	65.6	46.3	132.8
2022	67.1	64.9	120.9	65.4	45.6	132.9
2023	65.3	63.9	120.3	65.1	44.9	133.0
2024	63.4	63.0	119.7	64.9	44.2	133.1

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 Male, Female, Lung, Colorectal, Prostate, Lung, Colorectal and Breast, calculated using age-standardized mortality rate per 100,000 population units of measure (appearing as column headers).

	Male			Female
	Lung	Colorectal	Prostate	Lung	Colorectal	Breast
	age-standardized mortality rate per 100,000 population
Notes: Rates were age standardized to the 2011 Canadian standard population. Shading indicates projected data from 2020 to 2024 for incidence and from 2021 to 2024 for mortality. Rates include Quebec. Source: Brenner DR, Gillis J, Demers AA, et al. Projected estimates of cancer in Canada in 2024. CMAJ 2024. DOI: https://doi.org/10.1503/cmaj.240095.
1984	106.6	44.6	39.4	29.5	32.9	41.2
1985	104.2	46.0	41.4	31.5	32.8	42.4
1986	105.0	43.5	42.1	31.9	32.2	42.7
1987	104.5	44.1	41.9	33.7	31.6	41.6
1988	108.4	44.5	44.2	35.5	31.3	41.7
1989	107.8	44.1	42.8	35.8	29.4	41.7
1990	105.7	42.1	42.8	36.4	29.4	41.6
1991	105.1	41.6	44.9	39.0	28.6	40.1
1992	103.5	42.9	44.8	39.2	28.1	40.6
1993	103.8	40.8	44.9	41.8	28.0	39.0
1994	100.3	41.6	44.6	42.2	27.6	40.1
1995	97.6	41.2	45.1	41.3	27.3	38.5
1996	97.2	40.6	42.6	44.4	27.1	38.7
1997	93.3	39.4	41.9	42.8	25.9	36.9
1998	93.6	39.9	40.9	45.5	26.7	35.7
1999	93.9	39.1	39.5	46.2	25.8	34.0
2000	85.9	39.4	39.5	45.6	25.2	33.9
2001	86.6	37.4	39.6	45.4	24.6	33.8
2002	86.6	38.2	37.3	46.8	24.4	33.0
2003	84.1	36.8	36.0	46.8	23.7	32.8
2004	81.0	37.0	35.2	48.0	23.9	31.3
2005	80.2	36.6	32.9	47.5	23.3	30.7
2006	77.6	34.5	31.6	48.8	21.9	29.1
2007	76.8	33.9	31.2	48.2	22.8	29.6
2008	73.9	34.2	30.6	48.3	22.0	28.3
2009	73.5	32.7	29.8	48.1	21.1	27.5
2010	71.0	31.4	29.6	48.2	20.8	27.0
2011	69.1	31.8	27.6	46.7	20.9	26.3
2012	67.9	30.8	26.6	46.8	19.8	25.8
2013	63.9	30.1	27.1	46.7	20.2	25.2
2014	64.9	29.9	27.4	46.5	20.0	25.3
2015	61.5	28.6	25.6	45.4	18.9	24.9
2016	58.4	28.3	26.0	44.9	19.1	25.0
2017	57.5	27.3	25.5	43.3	17.9	24.6
2018	54.8	26.3	24.4	41.6	17.0	23.7
2019	52.3	26.0	24.5	39.5	16.9	23.2
2020	49.2	24.3	24.1	38.5	16.4	22.5
2021	50.9	25.0	23.7	38.7	16.4	22.8
2022	49.5	24.5	23.4	37.8	16.0	22.4
2023	48.2	24.2	23.0	36.9	15.7	22.1
2024	46.8	23.7	22.7	35.9	15.3	21.8

4.0 Mental health

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 7} As with chronic physical health conditions, mental disorders can affect quality of life and can require ongoing management. 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), eating disorders, and dementia. This report focuses on self-reported anxiety disorders, such as phobia, a panic disorder or generalized anxiety disorder, and mood disorders, including major depression, bipolar disorder, mania or dysthymia (chronic form of depression), that have lasted six months or more and have been diagnosed by a health care provider.

Anxiety disorders

A higher percentage of Canadian adults reported having a diagnosed anxiety disorder in 2022 (14.8%) than in 2021 (10.3%), and this share has been steadily increasing since 2015 (7.8%). In 2022, a higher proportion of women (19.1%) reported having been diagnosed with anxiety than men (10.5%), and this difference was observed across all age groups. A greater proportion of 18- to 34-year-olds (20.2%) reported having an anxiety disorder than older age groups in 2022. As observed in 2021, anxiety disorder prevalence in 2022 was twice as high among gay or lesbian adults (26.4%) and more than three times as high among bisexual or pansexual adults (46.0%) as among heterosexual adults (13.5%). Across all age groups except for those aged 60 and older, the prevalence of anxiety was higher among adults whose reported sexual orientation is lesbian, gay, bisexual or another orientation that is not heterosexual (LGB+) compared with their heterosexual counterparts (Chart 4.0).^{Note 15}

Anxiety disorders were more common among Canadians in the lowest household income quintile (18.8%) than the highest (11.0%). Proportionally fewer immigrants (9.0%) reported having an anxiety disorder in 2022 compared with non-immigrants (17.2%), and this 8 percentage point difference remained consistent from 2021. Among immigrants, a greater proportion of those who were admitted to Canada more than 10 years ago reported an anxiety disorder diagnosis (9.7%) than more recent immigrants (6.8%) in 2022. Overall, the prevalence of anxiety was higher among non-racialized Canadians than among most racialized groups in 2022.

Did you know?

The 2022 Mental Health and Access to Care Survey (MHACS) used a modified version of the World Health Organization’s Composite International Diagnostic Interview to classify people with selected mood, anxiety or substance use disorders based on their reports of various symptoms and experiences. This differs from the Canadian Community Health Survey, which asks respondents whether they have a mental health condition that was diagnosed by a health professional.

A study using MHACS data found that the prevalence of mood, anxiety and substance use disorders was generally lower among South Asian, Chinese, Filipino and Black people in Canada than among non-racialized, non-Indigenous people. There were some variations in the magnitude of the differences depending on the type of disorder.^{Note 56}

Mood disorders

In 2023, 13.0% of Canadian adults reported having been diagnosed with a mood disorder (e.g., major depression, bipolar disorder or mania), an increase from 2022 (11.7%) and 2021 (10.0%), as part of a trend seen since 2015. A higher proportion of women (20.4%) reported having a mood disorder than men (12.0%) in 2023. In the same year, there was a higher prevalence of mood disorders among 18- to 34-year-olds (16.1%) than all older age groups. Compared with the 11.6% of heterosexual adults who reported having a mood disorder in 2023, the prevalence of mood disorders was twice as high among gay or lesbian adults (21.2%) and almost four times as high among bisexual or pansexual adults (41.4%). This trend has remained consistent since 2015. Across all age groups, mood disorders were more prevalent among LGB+ people than their heterosexual counterparts (Chart 4.0).^{Note 15}

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 Anxiety, Mood disorders, Heterosexual, LGB+, Heterosexual, LGB+, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent and 95% Confidence Interval, calculated using from, to, from, to, from, to, from, to and percent units of measure (appearing as column headers).

	Anxiety						Mood disorders
	Heterosexual			LGB+			Heterosexual			LGB+
	Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval
		from	to		from	to		from	to		from	to
	percent
Notes: Territorial data are not included in annual estimates. Anxiety includes self-reported diagnoses of phobia, a panic disorder or generalized anxiety disorder. The 2022 Canadian Community Health Survey excluded obsessive-compulsive disorder from anxiety disorders. Mood disorders include self-reported diagnoses of major depression, bipolar disorder, mania or dysthymia (chronic form of depression). LGB+ includes people whose reported sexual orientation is lesbian, gay, bisexual or another sexual orientation that is not heterosexual. Estimates of sexual orientation are based on a survey question that includes four response categories: heterosexual, homosexual, bisexual and a write-in category to specify a sexual orientation. Write-in responses of "pansexual" are included in the bisexual category. Write-in responses that specify another sexual orientation that is not heterosexual are included in the LGB+ total. Sources: Statistics Canada, Canadian Community Health Survey, 2022 and 2023.
Total, 18 years and over	13.5	13.0	14.0	38.6	35.2	42.1	11.6	11.2	12.1	34.6	31.6	37.7
18 to 34 years	16.8	15.5	18.0	46.5	41.4	51.6	12.4	11.3	13.6	41.1	36.5	45.8
35 to 49 years	14.4	13.5	15.4	37.7	31.5	43.8	12.8	11.8	13.8	28.9	24.2	33.6
50 to 64 years	13.5	12.6	14.4	22.6	15.1	30.1	12.9	12.0	13.8	21.9	16.5	27.3
65 years and older	8.9	8.3	9.5	11.7	7.5	15.8	8.2	7.7	8.8	17.7	11.5	23.9

Did you know?

A study using 2022 MHACS data found that 2SLGBTQ+ people aged 15 to 24 were 2.6 times more likely than their cisgender heterosexual peers to have met the diagnostic criteria for a mental health or substance use disorder and 4.8 times more likely to have considered suicide in the past year.^{Note 57}

The prevalence of mood disorders varies across the country. Fewer adults in Quebec reported having a mood disorder (9.4%) compared with the Canadian average excluding the territories (13.0%) in 2023, similar to the trend seen since 2019. Conversely, in 2023, a higher percentage of adults in Newfoundland and Labrador (17.4%), New Brunswick (16.8%), Nova Scotia (16.3%), and Alberta (15.0%) reported having a mood disorder, compared with Canada overall (excluding the territories). In 2022, a higher share of adults in Yukon reported having a mood disorder (17.2%) compared with the national average (11.7%).

In 2023, a greater proportion of adults in the lowest household income quintile reported having a mood disorder (17.1%) than in the highest quintile (10.9%). Immigrants had a lower prevalence of mood disorders than non-immigrants in 2021 (5.0% vs. 11.9%), 2022 (8.1% vs. 13.2%) and 2023 (8.4% vs. 15.0%). However, among immigrants, a larger percentage of those who were admitted to Canada more than 10 years ago (8.8%) reported having a mood disorder than immigrants who were admitted in the last 10 years (6.6%). Additionally, in 2023, a greater proportion of non-racialized Canadians reported having a mood disorder compared with most racialized groups. In the same year, mood disorder prevalence was three times as high among Canadians with a disability (35.4%) compared with Canadians without a disability (10.3%).

Did you know?

According to the 2022 Indigenous Peoples Survey, over one-quarter of First Nations people living off reserve (28.0%) and Métis (26.3%) and just under one-fifth of Inuit (18.3%) aged 15 and older reported having been diagnosed with an anxiety disorder. Similar proportions were found for those reporting mood disorders: 26.0% among First Nations people living off reserve, 23.4% among Métis and 18.0% among Inuit.

The prevalence of mood and anxiety disorders was higher among First Nations, Métis and Inuit women than men. Among First Nations people living off reserve, anxiety disorder prevalence was higher among those in low income (35.7%) than those not in low income (25.6%). The same pattern was seen among Métis (35.5% vs. 24.6%, respectively). Similar findings were observed for mood disorders, with a higher prevalence among those in low income than those not in low income: 31.7% compared with 24.2%, respectively, for First Nations people living off reserve and 33.0% compared with 21.7%, respectively, for Métis.

Note: Low income refers to the income situation of a person in relation to the low-income measure, after tax. People with after-tax income, less COVID-19 benefits, that is below this low-income line are in low income.

5.0 Oral health

Key findings

The 2023 to 2024 Canadian Oral Health Survey (COHS) found the following:

• Three in four Canadians aged 12 and older (72.3%) reported having visited an oral health professional in the past year.
• Two-thirds (65.5%) of Canadians aged 12 and older had dental insurance.
• Proportionally more Canadians with insurance (80.8%) than without (56.0%) reported having visited an oral health professional in the previous year.
• Proportionally fewer adults aged 65 to 79 (38.0%) and 80 and older (25.1%) reported having dental insurance compared with younger age groups.
• Approximately 7 in 10 Canadians (70.5%) brushed their teeth or dentures at least two times a day, and 3 in 10 (30.0%) flossed at least five times a week.
• Just over one in four Canadians (26.4%) had mouth problems “sometimes or often” in the past 12 months, including having persistent or ongoing mouth pain (21.6%) or avoiding eating certain foods (15.6%).
• Moreover, 4.4% of Canadians aged 18 and older reported having no natural teeth (edentulism). The share was higher among those who had last visited an oral health professional one year ago or more (10.0%), compared with those who had visited in the past year (1.8%).
• A higher percentage of people with a disability than people without disabilities reported edentulism (11.3% vs. 3.5%) and mouth problems (46.2% vs. 23.8%).

Oral health has been referred to as the gateway or window to perceived health and is considered to contribute to general well-being, on top of the mere absence of disease. Daily activities like eating, talking, smiling and creative contributions to society are determinants of an individual’s well-being.^{Note 58}

Did you know?

The COHS is the first-ever national survey dedicated to oral health in Canada, collecting voluntary information directly from Canadians on their oral health. The survey was developed to address key oral health data gaps and help inform new federal investments in dental care, including the Canadian Dental Care Plan.

The target population for the COHS consists of Canadian households with adults aged 18 and older, as well as all household members aged 17 and younger, living in private dwellings. Cycle 1 was conducted from November 2023 to March 2024.

The survey covers several key aspects of oral health, including individuals’ ability to pay for oral health care, experiences with the oral health care system, challenges finding oral health services, self-reported oral health and care needs.

Dental visits

Routine dental visits play an important role in maintaining oral health. The Canadian Dental Association suggests that a dental visit every six months is adequate for most people; however, the frequency of visits is based on an individual’s needs and risk of oral diseases.^{Note 59}

According to the COHS, approximately three in four Canadians aged 12 and older (72.3%) reported during the period from November 2023 to March 2024 that they had visited an oral health professional in the past year. This was down from 74.7% in 2018 but up from 65.4% in 2022, when compared with results from the Canadian Community Health Survey (CCHS).

The prevalence of dental visits in the past year varied across the provinces. Proportionally fewer Canadians (of all ages) living in New Brunswick (65.0%), Newfoundland and Labrador (68.7%), Quebec (69.0%), Manitoba (69.3%), and Saskatchewan (70.4%) reported having visited an oral health professional in the past year, compared with those in Ontario (74.5%). A higher proportion of Canadians living in population centres (72.9%) reported a visit, compared with those living in rural areas (67.0%).

Having had a dental visit in the past year varied by gender and across age groups in the 2023 to 2024 COHS (Chart 5.0). Compared with adults aged 18 to 34 (67.5%), proportionally more adults aged 35 to 49 (74.6%) and 50 to 64 (76.7%) had visited a dentist in the past year. The prevalence of having had a visit was highest among children aged 6 to 11 (88.6%) and youth aged 12 to 17 (87.6%), and lower among children younger than 6 (51.8%) and adults aged 80 and older (55.1%). Overall, the prevalence of dental visits varied by gender, with proportionally more women (73.8%) than men (70.6%) reporting having visited an oral health professional in the past year.

Did you know?

According to the 2021 Survey on Access to Health Care and Pharmaceuticals During the Pandemic, many Canadians aged 18 and older living in the provinces had difficulties accessing health care services or avoided non-emergency dental treatments during the pandemic because of fear of exposure to COVID-19. This led to the postponement of routine visits and examinations.^{Note 60}

Dental insurance

Having dental insurance is a crucial predictor of oral health care access and use, independent of income and sociodemographic factors.^{Note 61Note 62Note 63} The 2023 to 2024 COHS revealed that just under two-thirds (63.5%) of Canadians aged 12 and older had dental insurance, a little below the pre-pandemic level (64.6% in the 2018 CCHS) but up from 2022 (60.7% in the 2022 CCHS).^{Note 64}

The majority of Canadians of all ages with dental coverage in 2023 and 2024 had private insurance (61.6%), meaning they had a plan paid by an employer, a personally purchased plan, or a plan through a college or university. Meanwhile, 3.0% reported being covered exclusively by a public plan (i.e., a government-paid plan), and 31.0% reported having no dental insurance.

The 2023 to 2024 COHS showed that a higher percentage of Canadians with private or public dental insurance (80.8%) reported having visited an oral health professional in the previous year than those without insurance (56.0%).

Dental insurance coverage varied across the provinces. Compared with people in Ontario (66.9%), proportionally more Canadians living in Alberta (77.0%), Saskatchewan (76.1%) and Manitoba (72.1%) and proportionally fewer people living in Quebec (52.9%) reported having dental insurance. A higher percentage of those living in population centres (66.8%) reported having dental insurance compared with those living in rural areas (56.3%).

Proportionally more children aged 0 to 5 (82.7%) and 6 to 11 (78.8%), youth aged 12 to 17 (76.9%), and adults aged 35 to 49 (75.3%) had dental insurance, compared with younger adults aged 18 to 34 (67.3%) (Chart 5.0). In contrast, proportionally fewer adults aged 65 to 79 (38.0%) and 80 and older (25.1%) reported having dental insurance, compared with younger age groups.

Did you know?

Using data from the 2019 and 2020 Canadian Health Survey on Seniors, researchers found that among seniors who had not visited a dental professional in three years, 56.3% deemed it unnecessary and 30.8% identified cost as the major barrier.^{Note 62} After sociodemographic characteristics were controlled for, insured seniors were over two times more likely to have had a dental visit in the past 12 months (adjusted odds ratio [OR]: 2.27; 95% confidence interval [CI]: 2.03 to 2.54) and were less likely to avoid dental visits because of cost (OR: 0.18; 95% CI: 0.12 to 0.28), compared with their uninsured counterparts.

Similarly, the 2019 Canadian Health Survey on Children and Youth found that children and youth with dental insurance were nearly three times more likely (OR: 2.94; 95% CI: 2.60 to 3.33) to have visited a dental professional in the past 12 months than uninsured children and youth.^{Note 63} Having dental insurance (OR: 0.19; 95% CI: 0.16 to 0.21) was protective against barriers to seeing a dental professional because of cost.

Data table for Chart 5.0

Data table for chart 5.0 Table summary
This table displays the results of Data table for chart 5.0 Dental visit in the past 12 months, Dental insurance, Percent, 95% Confidence Interval, Percent and 95% Confidence Interval, calculated using from, to, from and to units of measure (appearing as column headers).

	Dental visit in the past 12 months			Dental insurance
	Percent	95% Confidence Interval		Percent	95% Confidence Interval
		from	to		from	to
Notes: Estimates exclude those living in the territories. Dental visits include visits to any oral health professional, including dentists, denturists, dental hygienists and any other dental specialists. Dental insurance is defined as respondents having all or part of their dental expenses covered by any insurance plan or government program. Private insurance includes plans through an employer (including those partially paid or sponsored by an employer), private plans (including personally purchased plans), and plans through colleges and universities. Public insurance includes government-paid plans (e.g., children's or seniors' dental programs; the Régie de l'assurance maladie du Québec; and the Non-Insured Health Benefits program for First Nations people and Inuit, which includes individuals living on and off reserves). Source: Statistics Canada, Canadian Oral Health Survey, 2023 to 2024.
Total, all ages	72.2	70.9	73.5	65.6	64.2	66.9
0 to 5	51.8	47.8	55.8	82.7	79.0	85.9
6 to 11	88.6	86.2	90.6	78.8	75.3	82.0
12 to 17	87.6	85.1	89.7	76.9	73.7	79.9
18 to 34	67.5	63.3	71.4	67.3	63.2	71.3
35 to 49	74.6	72.1	77.0	75.3	72.8	77.6
50 to 64	76.7	74.6	78.7	70.1	67.8	72.3
65 to 79	69.5	67.6	71.2	38.0	36.1	40.0
80 and older	55.1	51.6	58.5	25.1	22.3	28.2

Oral health behaviours

Good oral hygiene, including regular brushing and flossing, can help prevent tooth decay and inflammation in the gums.^{Note 65} According to the 2023 to 2024 COHS, approximately 7 in 10 Canadians of all ages (70.5%) brushed their teeth or dentures at least two times a day, and 3 in 10 (30.0%) flossed at least five times a week. A larger share of women reported brushing at least two times a day (76.2%) and flossing at least five times a week (34.1%), compared with men (64.6% and 25.8%, respectively).

Mouth problems

Mouth problems can have a significant impact on people’s daily lives by decreasing their quality of life.^{Note 58} Being in a prolonged state of oral pain can cause functional and psychological problems. Furthermore, avoiding certain foods because of pain or other mouth problems can result in lower food intake overall, leading to weight loss, insomnia, irritability and low self-esteem. Mouth problems can also result in time and productivity losses at school or in the workplace.^{Note 66}

According to the 2023 to 2024 COHS, just over one in four Canadians of all ages (26.4%) had mouth problems “sometimes or often” in the past 12 months, including having persistent or ongoing mouth pain (21.6%) or avoiding eating certain foods (15.6%).^{Note 65}

Mouth problems were more prevalent among women (29.0%) than men (23.8%) and among those aged 65 to 79 (35.3%) than those aged 18 to 34 (26.3%).^{Note 65} Proportionally fewer children aged 0 to 5 (9.4%) and 6 to 11 (15.3%) and youth aged 12 to 17 (15.3%) had mouth problems sometimes or often, compared with adults aged 18 to 34.

A higher percentage of people with a disability (46.2%) reported having mouth problems, compared with people without disabilities (23.8%) (Chart 5.1).

Edentulism

The loss of all natural teeth (also known as toothlessness or edentulism) can lead to changes in eating patterns, nutrient deficiency, involuntary weight loss and speech difficulty.^{Note 67} It also increases the risk of chronic diseases such as cardiovascular disease and diabetes, significantly affecting overall health and well-being if left uncorrected.

Overall, the 2023 to 2024 COHS found that 4.4% of Canadians aged 18 and older had lost all their natural teeth.^{Note 65} Edentulism was more common among those who had last visited a dentist one year ago or more (10.0%), compared with those who had visited in the past year (1.8%). Toothlessness increased with age. A higher percentage of adults aged 65 to 79 (10.7%) and 80 and older (24.6%) reported edentulism, compared with those aged 18 to 34 (1.6%).

Edentulism varied across the provinces. Proportionally more adults in Quebec (8.3%), New Brunswick (6.6%), Saskatchewan (5.6%), Nova Scotia (5.4%), and Newfoundland and Labrador (5.3%) reported toothlessness, compared with those in Ontario (2.9%).^{Note 65} Edentulism was also more prevalent in rural areas (8.3%) than in population centres (3.9%).

A higher percentage of people with a disability (11.3%) reported edentulism, compared with those without disabilities (3.5%). Most notably, for older adults aged 65 to 79, edentulism was nearly 7 percentage points higher among those with a disability (16.1%) than those without disabilities (9.5%).

Data table for Chart 5.1

Data table for chart 5.1 Table summary
This table displays the results of Data table for chart 5.1 Mouth problems in the past 12 months, No natural teeth, Percent, 95% Confidence Interval, Percent and 95% Confidence Interval, calculated using from, to, from and to units of measure (appearing as column headers).

	Mouth problems in the past 12 months			No natural teeth
	Percent	95% Confidence Interval		Percent	95% Confidence Interval
		from	to		from	to
Notes: Estimates exclude those living in the territories. People with mouth problems in the past 12 months include those who reported having persistent or ongoing mouth pain or avoiding eating certain foods. People with disabilities, as defined by the Canadian Survey on Disability, are people with long-term difficulties or conditions, such as vision, hearing, mobility, flexibility, dexterity, pain, learning, developmental, memory or mental health impairments, that limit their daily activities inside or outside the home, including at school, at work or in the community in general. Source: Statistics Canada, Canadian Oral Health Survey, 2023 to 2024.
Total population	26.4	25.2	27.6	4.4	4.0	4.9
People with disabilities	46.2	42.4	50.1	11.3	9.4	13.6
People without disabilities	23.8	22.6	25.1	3.5	3.1	3.9

Spotlight on Indigenous children’s oral health

Dental services are especially important to prevent tooth decay that can lead to pain and infection in children and adversely impact speech and self-image. Indigenous children experience oral health inequity linked to accessibility, availability and affordability barriers, and programs are seeking to eliminate disparities.^{Note 68}

According to a study using the 2022 Indigenous Peoples Survey (IPS), a similar percentage of Indigenous children aged 1 to 5 (86.2% of First Nations children living off reserve, 87.7% of Métis children and 75.2% of Inuit children) had visited a dental professional in the past 12 months for a check-up or cleaning, compared with their older counterparts aged 6 to 14 (86.1% of First Nations children living off reserve, 89.2% of Métis children and 80.0% of Inuit children) (Chart 5.2).^{Note 26} However, having visited a professional in the past year for toothaches, tooth decay or cavities was more prevalent among older First Nations children living off reserve and Métis children, compared with their younger counterparts.

Data table for Chart 5.2

Data table for chart 5.2 Table summary
This table displays the results of Data table for chart 5.2 First Nations living off reserve, Métis, Inuit, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent and 95% Confidence Interval, calculated using from, to, from, to, from and to units of measure (appearing as column headers).

	First Nations living off reserve			Métis			Inuit
	Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval
		from	to		from	to		from	to
Notes: The question about visiting a dental professional in the past 12 months was asked of those who had ever seen a dental professional. Error bars represent 95% confidence intervals. Source: Statistics Canada, Indigenous Peoples Survey, 2022.
Children aged 1 to 5
Past 12 months, seen a dental professional for a check up or cleaning	86.2	84.0	88.2	87.7	84.9	90.1	75.2	69.1	80.4
Past 12 months, seen a dental professional for toothaches, tooth decay or cavitie	35.7	32.6	38.9	23.5	20.4	27.0	50.9	44.4	57.3
Children aged 6 to 14
Past 12 months, seen a dental professional for a check up or cleaning	86.1	84.0	87.9	89.2	86.9	91.1	80.0	75.4	83.8
Past 12 months, seen a dental professional for toothaches, tooth decay or cavitie	42.8	40.1	45.5	41.5	38.5	44.6	46.5	41.0	52.2

Chart 5.3 shows that 23.7% of First Nations children living off reserve, 11.9% of Métis children and 42.2% of Inuit children aged 1 to 5 were affected by early childhood cavities.^{Note 26} A higher proportion of First Nations children living off reserve (36.5%) and Métis children (28.2%) aged 6 to 14 were affected by early childhood cavities than their younger counterparts aged 1 to 5.

Data table for Chart 5.3

Data table for chart 5.3 Table summary
This table displays the results of Data table for chart 5.3 Children 1 to 5, Children 6 to 14, Child’s teeth affected by early childhood cavities, Child’s teeth treated for early childhood cavities, Child’s teeth affected by early childhood cavities, Child’s teeth treated for early childhood cavities, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent, 95% Confidence Interval, Percent and 95% Confidence Interval, calculated using from, to, from, to, from, to, from and to units of measure (appearing as column headers).

	Children 1 to 5						Children 6 to 14
	Child’s teeth affected by early childhood cavities			Child’s teeth treated for early childhood cavities			Child’s teeth affected by early childhood cavities			Child’s teeth treated for early childhood cavities
	Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval		Percent	95% Confidence Interval
		from	to		from	to		from	to		from	to
Note: Error bars represent 95% confidence intervals. The person most knowledgeable about the respondent was asked “Have the child’s teeth been affected by (or treated for) early childhood cavities?” Early childhood cavities are commonly known as early childhood caries. This is a chronic condition that occurs in children under the age of 6, where one of more of the primary teeth are decayed, missing or have filled teeth surfaces. Bottle tooth decay is an example of early childhood caries. Source: Statistics Canada, Indigenous Peoples Survey, 2022.
First Nations living off reserve	23.7	21.4	26.0	20.2	18.2	22.4	36.5	34.0	39.2	43.1	40.5	45.7
Métis	11.9	10.0	14.2	11.9	9.9	14.2	28.2	25.6	31.1	35.1	32.3	38.0
Inuit	42.2	37.6	46.9	29.8	25.5	34.5	40.2	34.6	46.1	46.7	41.1	52.3

The 2022 IPS showed that 15.6% of Inuit children aged 1 to 14 needed dental care in the past 12 months but did not receive it, with higher unmet dental care needs among Inuit children living in Inuit Nunangat (20.3%) than among those living outside Inuit Nunangat (4.2%). Meanwhile, 6.1% of First Nations children living off reserve and 5.5% of Métis children had unmet dental care needs. Cost, lack of availability at the time required or in the area, and COVID-19 were the top reasons given for unmet dental care needs among parents of Indigenous children aged 14 and younger.

According to the 2022 IPS, during their most recent visit to a dental care professional, most First Nations children living off reserve (57.0%) and Inuit children (82.1%) used government programs, including the Non-Insured Health Benefits (NIHB) program, to cover dental care costs. Since Métis are not eligible for the NIHB program, the proportion of Métis children who used a government program to pay for dental visits was much lower (21.6%). The majority of Métis children (70.2%) had private insurance, whereas less than half of First Nations children living off reserve (43.4%) and fewer Inuit children (18.6%) had private insurance. Less than one-quarter (21.5%) of First Nations children living off reserve, 32.5% of Métis children and 8.9% of Inuit children paid for dental care out of pocket.

6.0 Infectious diseases

Infectious diseases are caused by pathogenic microorganisms, such as bacteria, viruses, parasites or fungi. These diseases can spread from the environment or be transmitted directly or indirectly from one person to another, resulting in illness. Factors associated with infectious diseases are varied and include sanitation and water supply, environmental and climate change, education, agriculture, trade, tourism, transport, industrial development, and housing.^{Note 69} This report focuses specifically on COVID-19 infections.

Key findings

• As of June 2023, about two in three Canadian adults said they had had at least one confirmed or suspected case of COVID-19 (64.4%). Many had been infected more than once since the pandemic started.
• Higher shares of some racialized groups reported multiple COVID-19 infections, with Black Canadians being the most affected.
• About 3.5 million Canadian adults reported having long-term symptoms after a COVID-19 infection (11.7%). Of these, 2.1 million were still dealing with symptoms as of June 2023 (6.8%), and nearly half said their symptoms had not improved over time (49.7%).
• More than one in five Canadians with long-term symptoms who were in school or working had missed days of school or work (22.3%), averaging 24 days missed.
• About 40% of people with long-term symptoms faced difficulties accessing the health care they needed.

COVID-19 infection rates

According to a study using data from the Canadian COVID-19 Antibody and Health Survey, the percentage of Canadian adults who had tested positive for COVID-19 or suspected an infection increased from 38.7% in the summer of 2022 to 64.4% by June 2023.^{Note 70} By this time, 44.6% of Canadians had experienced one infection, 14.4% had had two infections and 5.4% had had three or more infections.

Did you know?

These numbers likely underestimate the true number of infections, as people are not always aware they have been infected. According to Cycle 2 of the Canadian COVID-19 Antibody and Health Survey, nearly half of Canadians who had antibodies from a previous infection had not tested positive or suspected they had been infected.^{Note 71}

Proportionally fewer adults aged 65 and older (2.3%; this figure should be used with caution) reported having had three or more infections, compared with those aged 18 to 34 (6.7%) and 35 to 49 (8.2%) (Chart 6.0).^{Note 70} A higher proportion of females than males reported having had a previous COVID-19 infection, but equal shares of both sexes reported having had multiple infections.

Data table for Chart 6.0

Data table for chart 6.0 Table summary
This table displays the results of Data table for chart 6.0 Three or more infections, Two infections, One infection, No infections, Percent, 95% confidence intervals, Percent, 95% confidence intervals, Percent, 95% confidence intervals, Percent and 95% confidence intervals, calculated using from, to, from, to, from, to, from and to units of measure (appearing as column headers).

	Three or more infections			Two infections			One infection			No infections
	Percent	95% confidence intervals		Percent	95% confidence intervals		Percent	95% confidence intervals		Percent	95% confidence intervals
		from	to		from	to		from	to		from	to
Notes: Some estimates do not add up because of rounding. The estimate for three or more infections among those aged 65 and older needs to be interpreted with caution. Source: Statistics Canada, Canadian COVID-19 Antibody and Health Survey Follow-up Questionnaire, 2023.
18 to 34	6.7	5.0	9.1	18.0	14.8	21.7	46.4	42.0	50.9	28.8	24.9	33.2
35 to 49	8.2	6.2	10.8	19.6	16.9	22.7	46.0	42.3	49.7	26.2	23.0	29.7
50 to 64	4.0	3.0	5.4	12.2	10.3	14.3	45.9	42.8	49.1	37.9	34.7	41.2
65 and older	2.3	1.6	3.3	6.9	5.6	8.5	39.6	36.8	42.4	51.2	48.2	54.2

Reinfection reporting also differed across racialized groups. Proportionally more Black Canadians (30.3%) reported having had multiple infections than Canadians with Latin American (21.7%), Chinese (18.3%), Filipino (17.9%), Arab (12.1%) and West Asian (9.1%) backgrounds.^{Note 70}

Did you know?

Indigenous people found innovative solutions to safeguard those at risk of severe COVID-19 infection, prevent the spread of the virus and curb social isolation, while ensuring continued cultural engagement.^{Note 72Note 73Note 74} These efforts faced challenges from a history of long-standing structural inequalities, such as overcrowded homes, a lack of access to clean water, insufficient medical facilities to house those with infections, health care and Internet access barriers, and the heavy burden of various chronic diseases.^{Note 72Note 75} To support efforts, government and service agencies ensured access to personal protective equipment and vaccines, prioritizing Indigenous communities.^{Note 76} Despite these efforts, Indigenous people experienced higher rates of infection (including severe infection), hospitalization, intensive care admission and mortality compared with non-Indigenous people.^{Note 77Note 78}

Long-term COVID-19 symptoms

As of June 2023, 19.0% of Canadian adults who had been infected with COVID-19 reported experiencing symptoms lasting three or more months after the infection.^{Note 70} This represented 11.7% of the total adult population, or 3.5 million Canadians, in the 10 provinces. The burden was significant: 6.8% of all Canadian adults, or 2.1 million people, continued to experience these long-term symptoms. The most frequently reported symptoms were fatigue (65.5%), brain fog (39.0%) and shortness of breath (28.0%).

Some Canadians were at greater risk of experiencing long-term COVID-19 symptoms. The proportion of adults with a disability reporting such symptoms was higher than that of adults without disabilities (26.8% vs. 18.3%). Similarly, proportionally more adults with one or more chronic diseases before the pandemic reported long-term COVID-19 symptoms than those without chronic diseases (24.7% vs. 14.0%).

Among Canadians still experiencing COVID-19 symptoms, about 70.0% reported having symptoms every day or almost every day at their worst. Additionally, 21.7% said they were often or always limited in their daily activities by these symptoms. Overall, 49.7% of those with ongoing symptoms reported no improvement over time.

Chart 6.1 shows that proportionally fewer females reported a resolution of their long-term symptoms (33.0%), compared with males (53.1%), and females also tended to experience their symptoms for a longer duration.

Data table for Chart 6.1

Data table for chart 6.1 Table summary
The information is grouped by Long-term symptom duration (appearing as row headers), Males, Females, Percent, 95% confidence intervals, Percent and 95% confidence intervals, calculated using from, to, from and to units of measure (appearing as column headers).

Long-term symptom duration	Males			Females
	Percent	95% confidence intervals		Percent	95% confidence intervals
		from	to		from	to
Note: Some estimates do not add up because of rounding. Source: Statistics Canada, Canadian COVID-19 Antibody and Health Survey Follow-up Questionnaire, 2023.
Less than six months	51.8	43.1	60.3	36.0	30.3	42.1
Six months to less than one year	25.0	19.0	32.1	33.2	27.7	39.3
One year or longer	23.3	17.1	30.8	30.8	25.6	36.6

Impact on school and work attendance

Long-term symptoms of COVID-19 affected many Canadians’ livelihoods and education.^{Note 70} Among Canadian adults who ever experienced long-term symptoms and were employed or attending school, 22.3% missed days. On average, they missed 24 days of school or work, translating to 600,000 Canadians missing a total of about 14.5 million days.

Among employed adults with long-term COVID-19 symptoms, 5.3% applied for disability benefits or workers’ compensation because of their symptoms, and 93.8% of those who applied received benefits or compensation. The most common industries for working Canadians with long-term symptoms were health care and social assistance (17.5%); professional, scientific and technical services (17.1%); and educational services (10.3%).

As of June 2023, approximately 100,000 Canadian adults had been unable to return to work or school because of their COVID-19 symptoms.

Challenges in accessing health care

As of June 2023, 46.9% of Canadian adults who reported experiencing long-term COVID-19 symptoms also stated that they had consulted a health care provider about those symptoms.^{Note 70} Family doctors and nurse practitioners were the primary points of contact, with 82.8% of those who sought health care consulting one of these professionals. Other frequently consulted health care services for long-term symptoms included specialist medical doctors (20.0%), pharmacists (18.7%) and emergency departments (17.0%). On average, those who sought health care for long-term symptoms consulted two different services.

According to the Canadian COVID-19 Antibody and Health Survey Follow-up Questionnaire, 39.7% of those who consulted a health care provider reported at least one difficulty accessing services. Of the 800,000 Canadians who faced difficulties, one in five did not receive the needed service because of these challenges. The most common problems were long waits between booking and receiving care (49.4%), appointment cancellations or delays because of the pandemic (39.6%), and trouble getting referrals (35.2%). Consulting a health care professional does not always ensure adequate treatment. In fact, 66.4% of those with long-term COVID-19 symptoms felt they did not receive sufficient treatment, service or support. Among the Canadian adults needing health care for their long-term symptoms, 12.5% reported receiving comprehensive treatment. Meanwhile, 5.7% of those still experiencing symptoms as of June 2023 had received a post-COVID-19 condition diagnosis.

Did you know?

It is well documented that Indigenous children face greater risk for serious respiratory conditions tied to the social determinants of health, including living in overcrowded homes that have poor ventilation and need major repairs.^{Note 79Note 80} According to the 2022 Indigenous Peoples Survey, 7.1% of First Nations children living off reserve, 8.3% of Métis children and 6.5% of Inuit children aged 1 to 14 had been diagnosed with a respiratory infection such as tuberculosis, pneumonia, respiratory syncytial virus or bronchiolitis in the past 12 months.^{Note 26} Respiratory infections were more common among younger Indigenous children aged 1 to 5 (12.7%) than older children aged 6 to 14 (5.2%), excluding those living on reserve. Preventing, diagnosing and treating lung conditions are important for the immediate and long-term health of children.

7.0 Mortality

The previous version of Health of Canadians presented crude mortality rates from 2000 to 2020. While these are accurate for yearly death incidence, they are not ideal for year-to-year comparisons.^{Note 81} In this report, age-standardized mortality rates (ASMRs) are presented (standardized to the 2021 Canadian population). ASMRs remove the effects of differences in the age structure of a population, allowing for better comparisons over time.

Key findings

• The ASMR (for all causes of death) generally declined from 2000 to 2019 but increased sharply in 2020, the year in which the COVID-19 pandemic reached Canada. From 2020 to 2021 the ASMR decreased but has fluctuated since.
• Cancer and heart disease remained the two leading causes of death in Canada, accounting for 43.7% of deaths in 2023.
• The number of COVID-19 deaths increased from 14,617 in 2021 to 19,906 in 2022, the highest number recorded since the beginning of the pandemic, but dropped by 60% in 2023 to 7,963 deaths.

Age-standardized mortality rates

The ASMR generally declined from 2000 (1,033.7 deaths per 100,000 population) to 2019 (786.3) (Chart 7.0).^{Note 82} However, in 2020, the year in which the COVID-19 pandemic reached Canada, there was a spike in the ASMR (829.6 deaths per 100,000 population). From 2020 to 2021 the ASMR decreased (819.1 deaths per 100,000 population), but it has fluctuated since.

From 2000 to 2023, the ASMR was consistently higher among males than females (Chart 7.0).

Data table for Chart 7.0

Data table for chart 7.0
Table summary
This table displays the results of Data table for chart 7.0 Females, Males and Both sexes, calculated using age-standardized mortality rate per 100,000 population units of measure (appearing as column headers).

	Both sexes	Males	Females
	age-standardized mortality rate per 100,000 population
Source: Statistics Canada, Table 13-10-0932-01  Deaths and mortality rate (age standardization using 2021 population), by selected grouped causes.
2000	1033.7	1304.7	844.8
2001	1012.6	1273.7	830.7
2002	1002.7	1252.8	828.2
2003	985.3	1229.0	813.1
2004	960.9	1190.2	797.4
2005	947.6	1169.2	788.9
2006	908.4	1120.2	756.4
2007	910.4	1117.7	758.8
2008	897.3	1102.8	748.4
2009	871.1	1067.5	727.5
2010	850.7	1036.9	713.2
2011	837.0	1016.4	703.0
2012	821.7	997.8	689.5
2013	817.2	986.0	688.5
2014	815.1	982.6	685.7
2015	812.9	974.3	687.4
2016	798.0	956.5	673.5
2017	808.8	972.2	679.4
2018	808.8	966.9	681.7
2019	786.3	942.6	660.8
2020	829.6	1000.0	691.8
2021	819.1	993.0	676.5
2022	857.6	1033.7	714.5
2023	807.6	964.5	678.0

Leading causes of death

In Canada, cancer and heart disease remained the leading causes of death, together accounting for 43.7% of deaths in 2023, up from 42.4% in 2022.

Other prominent causes of death in 2023 included accidents (unintentional injuries), cerebrovascular disease (stroke), chronic lower respiratory diseases, COVID-19, diabetes mellitus, influenza and pneumonia, Alzheimer’s disease, and chronic liver disease and cirrhosis (Table 7.0). In total, these 10 causes (including cancer and heart disease) accounted for 221,147 deaths, or 67.8% of all deaths.

COVID-19-related deaths rose from 14,617 in 2021 to 19,906 in 2022, marking the highest toll since the start of the pandemic. However, in 2023, COVID-19 deaths decreased by 60% (7,963 deaths). Still, COVID-19 continued to disproportionately affect older individuals in 2023. Approximately 7 in 10 COVID-19 deaths (69%) were of people aged 80 and older, while one-quarter of deaths were of those aged 65 to 79.

Deaths from influenza and pneumonia also saw an increase, rising from 4,139 in 2021 to 6,363 in 2023. Deaths from these illnesses had reached an all-time low in 2021, largely because of public health measures aimed at reducing COVID-19 transmission.

Did you know?

A recent study found that the COVID-19 ASMR was 4.5 times higher among First Nations people than non-Indigenous people.^{Note 28} COVID-19 mortality rates were five times higher among First Nations females and two times higher among Métis females compared with their non-Indigenous counterparts. A higher proportion of COVID-19 deaths were among First Nations people and Métis with three or more comorbidities. Further analysis of various social determinants of health associated with COVID-19 mortality found that unsuitable and inadequate housing and lower income were risk factors for COVID-19 mortality among First Nations people and Métis in private dwellings.