Health of Canadians
Determinants of health

Key findings

• Canada’s population is growing and aging. From 2016 to 2021, the population of Canada increased by 5.2%, and by 2068, more than one in four people will be aged 65 and older.^{Note 73} A growing older population means increased health issues and demands on the health care system.
• Data on gender diversity were reported for the first time in the 2021 Census. Most people in Canada aged 15 and older were cisgender (99.7%), and 1 in 300 people was transgender or non-binary (0.3%). Stigma, prejudice, and discrimination experienced by transgender and non-binary people have been found to affect health status.
• One-quarter (23.0%) of the Canadian population were immigrants in 2021.^{Note 74} Immigrants tend be healthier than non-immigrants, but as they spend more time in Canada, their health deteriorates.
• Racialized groups made up just over one-quarter (26.6%) of the total population in 2021. Experiences of racial discrimination are connected to worse mental and physical health.
• Indigenous people make up approximately 5.0% of the Canadian population.^{Note 75} The various impacts of colonization, subsequent intergenerational trauma and systemic inequities related to social determinants, and discrimination have all played an important role in negatively affecting the health of Indigenous people.^{Note 76}

12.0 Influence of Canada’s demographics on health

The size and age distribution of the Canadian population has an impact on the overall health of the population and the demand for health care services. From 2016 to 2021, Canada’s population increased by 5.2%, reaching an estimated 36,991,981 people.^{Note 77} The mean age of the population was 41.9 years and varied across the provinces and territories, ranging from 28.3 years in Nunavut to 45.5 years in Newfoundland and Labrador.^{Note 78} The Canadian population is growing and aging and is expected to reach close to 57 million in 2068, with more than one in four people aged 65 and older. The number of people aged 85 and older is expected to triple to roughly 3.2 million.^{Note 73}

13.0 Social determinants of health

Education, employment, and income, among other factors, determine people’s position in society and their ability to live a healthier and longer life. Additionally, experiences of discrimination, racism, and historical trauma are important determinants of health for certain groups, such as LGBTQ2+ people (people who are lesbian, gay, bisexual, transgender, queer or Two-Spirit, or who use other terms related to gender or sexual diversity), those with disabilities, immigrants, Indigenous populations, and racialized groups.

Education, employment and income

Canada’s population is highly educated, with 67.1% of Canadians aged 25 to 64 having a postsecondary certificate, diploma or degree, according to the 2021 Census, an increase from 60.7% in 2006.^{Note 79} Education is one of the main drivers of stable employment, financial security, and social success, which are associated with higher levels of self-reported health and lower levels of morbidity and mortality.^{Note 80}

Unemployment is strongly related to poorer quality of life and increased anxiety and depression.^{Note 81} Since 1976, the unemployment rate for Canadians older than 25 has fluctuated, reaching a high of 10.2% in 1993 and a record low of 4.5% in 2022.^{Note 82}

Did you know?

The unemployment rate for Canadians older than 25 increased from 4.8% in 2019 to 8.0% in 2020 mainly because of the COVID-19 pandemic.^{Note 82}

Considerable research has shown that health status improves with each step up the income and social hierarchy. Median after-tax household income provides an indication of net take-home income per household and is the middle point between the highest and lowest incomes.

Adjusted for inflation, median income expressed in 2020 constant dollars increased by 9.8% from $66,500 in 2015 to $73,000 in 2020.^{Note 83} In 2020, the Northwest Territories ($109,000) and Nunavut ($104,000) had the highest median household incomes in Canada (Chart 13.0).

Data table for Chart 13.0



Data table for chart 13.0
Table summary
This table displays the results of Data table for chart 13.0. The information is grouped by   (appearing as row headers), median after-tax household total income (dollars) (appearing as column headers).

	median after-tax household total income (dollars)
Canada	73,000
N.L.	63,200
P.E.I.	64,000
N.S.	62,400
N.B.	62,000
Que.	63,200
Ont.	79,500
Man.	69,000
Sask.	73,000
Alta.	83,000
B.C.	76,000
Y.T.	88,000
N.W.T.	109,000
Nvt.	104,000
Note: The horizontal line at 73,000 represents Canada. Source: Statistics Canada, Table 98-10-0057-01 Household income statistics by household type: Canada, provinces and territories, census divisions and census subdivisions.

Did you know?

Lower-income households are more likely to be food insecure.84 Over the last several years, the percentage of people living in food-insecure households has continued to rise. In 2021, approximately 16% of all households in Canada experienced some food insecurity. This represents almost 6 million Canadians, including 1.4 million (or one in five) children and youth younger than 18.^{Note 84}

Sex at birth, gender, and sexual orientation

Sex at birth and gender refer to two different, but interrelated, concepts, both of which are associated with health. Sex at birth refers to sex assigned at birth based on a person’s reproductive system and other physical characteristics. Gender refers to an individual’s personal and social identity as a man, woman, or non-binary person. In 2021, according to the census, most of the population aged 15 and older were cisgender, people whose gender corresponds to their sex at birth (99.7%). Additionally, 0.3% of Canadians aged 15 and older, or 1 in 300 people, were transgender (people whose gender does not correspond to their sex assigned at birth) or non-binary (people who are not exclusively a man or a woman).^{Note 85}

Sexual orientation refers to how a person describes their sexuality. In the 2021 Canadian Community Health Survey, most of the Canadian population reported their sexual orientation as heterosexual (95.2%), while 1.8% of the population reported being gay or lesbian and 2.7% reported being bisexual or pansexual.

Social stresses, including stigma, prejudice, and discrimination, experienced by those who do not identify as cisgender or heterosexual have been found to affect health status.^{Note 86}

Did you know?

The 2021 Census of Population collected data on gender for the first time, making Canada the first country to publish data on gender from a national census.^{Note 85}

Disability

Disability is tied to the social determinants of health, as poverty can lead to disability and disability can lead to poverty. Chronically poor people are often at risk of ill health and injuries, which may lead to disability.^{Note 87} People with disabilities tend to have lower participation in the workforce and subsequently lower personal income, compared with those without disabilities.^{Note 87} In 2017, the Canadian Survey on Disability reported that approximately one in five Canadians aged 15 and older (6.2 million people) had one or more disabilities that limited their daily activities.^{Note 45} Furthermore, approximately 4 in 10 Canadians with a reported disability (43%) had a severe or very severe disability.^{Note 45} Those aged 15 to 64 with more severe disabilities who reported living alone or being lone parents experienced the highest rates of poverty, which is a determinant of poor health.^{Note 45}

Immigrant status

In 2021, just under one in four Canadians (23.0%) was an immigrant, and 3.5% of immigrants were considered recent immigrants (they obtained landed immigrant or permanent resident status within the last five years).^{Note 74} From 2016 to 2021, just over 1.3 million new immigrants settled permanently in Canada.^{Note 74} The proportion of immigrants was 1.3 times higher in Ontario (29.6%) and 1.2 times higher in British Columbia (28.5%) compared with the rest of Canada.^{Note 88}

Did you know?

Immigrants tend to have better health than the Canadian-born population; this is called the healthy immigrant effect.^{Note 89} For example, compared with Canadian-born individuals or established immigrants of the same age, recent immigrants report better mental health and lower prevalence of multiple chronic conditions, even after controlling for factors like physical activity and diet.^{Note 89}

The healthy immigrant effect tends to be strongest in the first three years after arrival.^{Note 89Note 90} This can be partly attributed to the way immigrants are selected (medical screening, favoured skills and economic class), but immigrant health has been shown to deteriorate over time, both mentally and physically.^{Note 89Note 90} Time since migration is a risk factor for heart disease, cancer, diabetes, and even suicidal ideation.^{Note 91}

Indigenous populations

In 2021, 5.0% of the population in Canada were Indigenous people, up from 4.6% in 2016.^{Note 75} First Nations people accounted for over half (58.0%) of the Indigenous population, while just over one-third (34.5%) were Métis and 3.9% were Inuit.^{Note 75} Indigenous people made up a large share of the total population in the territories, accounting for over four-fifths (85.8%) of the population of Nunavut, almost half (49.6%) in the Northwest Territories and over one-fifth (22.3%) in Yukon.^{Note 75} Provincially, the population of Manitoba had the highest share of Indigenous people (18.1%), followed by Saskatchewan (17.0%), Newfoundland and Labrador (9.3%), and Alberta (6.8%).^{Note 75}

Indigenous populations continue to grow much faster than the national average, increasing by 9.4% from 2016 to 2021 (vs. 5.3% growth for the non-Indigenous population).^{Note 75} Large urban centres accounted for 12.5% of the increase in the Indigenous population (801,045 people) from 2016 to 2021.^{Note 75}

Did you know?

Nearly one in three First Nations people living off reserve and Métis reported deterioration in their overall health during the pandemic versus one in five among non-Indigenous people.^{Note 92}

Racialized populations

Racism is being increasingly recognized as an important driver of inequitable health outcomes for some racialized Canadians.^{Note 93} There is growing evidence of the negative effects of chronic stress and experiences of discrimination and trauma on mental and physical health. In this report, data on racialized groups are based on the “visible minority” variable. The Employment Equity Act defines visible minorities as “persons, other than Aboriginal peoples, who are non-Caucasian in race or non-white in colour.” The racialized population includes the following groups: South Asian, Chinese, Black, Filipino, Latin American, Arab, Southeast Asian, West Asian, Korean and Japanese.

Immigration continues to be the main driver of population growth for each racialized group, and 69.3% of the immigrant population in 2021 were racialized (vs. 11.4% for non-immigrants).^{Note 94} In 2021, the three largest racialized groups, representing 16.1% (up from 13.6% in 2016) of Canada’s total population, were the South Asian (7.1%), Chinese (4.7%) and Black (4.3%) groups (Chart 13.1). The composition of racialized groups varies across the country: Ontario’s largest racialized groups were the South Asian (10.8%), Chinese (5.8%) and Black (5.5%) groups, while the Black (5.1%) and Arab (3.4%) groups were the largest ones in Quebec.^{Note 94} The Atlantic provinces generally have smaller populations of racialized groups. However, from 2016 to 2021, more recent immigrants settled in the Atlantic provinces, increasing the size of their South Asian, Black and Filipino populations.^{Note 94}

Data table for Chart 13.1



Data table for chart 13.1
Table summary
This table displays the results of Data table for chart 13.1 percentage of total population (appearing as column headers).

	percentage of total population
South Asian	7.1
Chinese	4.7
Black	4.3
Filipino	2.6
Latin American	1.6
Arab	1.9
Southeast Asian	1.1
West Asian	1.0
Korean	0.6
Japanese	0.3
Racialized population, n.i.e.	0.5
Multiple racialized groups	0.9
Notes: “Racialized population, n.i.e.” means “not included elsewhere.” This category includes people who provided responses that are classified as racialized but that cannot be classified with a specific group listed above (for example, “Guyanese,” “Pacific Islander,” “Polynesian,” “Tibetan” and “West Indian”). Indigenous respondents were removed from the “non-racialized” category. Source: Statistics Canada. Table 98-10-0308-01 Visible minority by immigrant status and period of immigration: Canada, provinces and territories, census metropolitan areas and census agglomerations with parts.