But 12th-place ranking lags behind
nations with more aggressive programs
MARGARET PHILP
A Canadian born last year can expect to live 72 healthy years before sickness and injury start taking their toll, a statistic that ranks Canada 12th in the world according to a new life-expectancy measure from the World Health Organization.
For the first time, the WHO is ranking countries according to the number of healthy years its citizens can expect to live, a step beyond the usual life-expectancy estimates that measure average lifetimes in nations around the world.
And while total life expectancy in Canada, at 78 years, ranks seventh among the 191 countries measured by the WHO, when it comes to the number of years a Canadian infant can expect to live free of disease or disability, Canada slips to 12th place.
Healthy as Canadians tend to be, says report co-author Alan Lopez, head of WHO's Epidemiology and Burden of Disease team, some of the countries such as Australia and Sweden that rank ahead of it have mounted more rigorous public-health campaigns around smoking, drinking and driving, and HIV infection.
"Canada is doing quite well," he said in an interview from the WHO headquarters in Geneva. "It's right up there at the top. But it comes down [in health expectancy] a little bit because there tends to be a little more prevalence of ill health in Canada. It's the same diseases that are killing Canadians that are also causing ill health."
Top of the health heap was Japan, where a traditional low-fat diet and low incidence of smoking have held rates of heart disease and cancer in check. A baby born in 1999 in Japan can expect to live 74.5 years, although the WHO report notes that fatty foods such as red meat are creeping into the Japanese diet and smoking is a growing trend.
While about 7 per cent of the Japanese lifespan is spent ill or disabled, Canadians can expect to lose nearly 9 per cent of their days to ill health or injury.
At the bottom of the pack sits battle-torn Sierra Leone, where AIDS and civil war are wreaking havoc on the population and a baby born in that country can expect to live only 26 healthy years.
Indeed, the 10 lowest-ranked countries are all located in sub-Saharan Africa, where the AIDS epidemic has slashed lifespans during the past decade. The life expectancy for a baby girl born there has plunged to 46 from 51 years in just 10 years.
"Healthy life expectancy in some southern African countries is dropping back to levels we haven't seen in advanced countries since medieval times," Mr. Lopez said.
Eliminating the impact of the AIDS epidemic, he said, would add about 14 years of robust health to the life expectancies of people living in African countries such as Namibia, Botswana, and Zimbabwe.
The health-expectancy ranking is calculated by measuring total life expectancy and subtracting years of ill health weighted according to the severity of the sickness.
In the view of WHO officials, the measurement is superior to that of life expectancy, because it rates the job that health-care systems are doing not only in preventing death, but in prolonging health.
"We would expect this will force people in policy in Canada to think, 'We're not doing quite so well after all. What can we do to reduce disability and morbidity?' " Mr. Lopez said. "We hope this type of measure will incite that kind of debate."
One of the most striking findings of the health-expectancy ranking was the dismal showing of the United States, the most prosperous nation on the planet, landing behind 23 other countries with an expectancy of 70 healthy years for a baby born last year.
The enormous gulf between rich and poor in U.S. society was clear in the findings, which showed the bottom 5 per cent of the population on the health-expectancy scale -- predominantly native Americans, rural blacks and inner-city poor -- can count on about 55 years of good health. "If they were a country," Mr. Lopez said, "it would rank at 130th, similar to Bolivia and India."
"At the other end of the extreme, there are levels of [health expectancy] far in excess of what we've recorded for Japan, probably in the mid-eighties," he said.
"The gap between rich and poor in the States is more marked -- is more extreme -- than in countries like Canada and Australia, which is why we're seeing the U.S. where it is."
THE LONG AND SHORT OF LONGEVITY
BOTTOM 15 NATIONS
FEELING FINE
The Globe and Mail - Monday, June 5, 2000
Estimates of age before sickness and injury take their toll, 1997 and 1999:
TOP 15 NATIONS
Male
Female
Total
Japan
71.9
77.2
74.5
Australia
70.8
75.5
73.2
France
69.3
76.9
73.1
Sweden
71.2
74.9
73.0
Spain
69.8
75.7
72.8
Italy
70.0
7504
72.7
Greece
70.5
74.6
72.5
Switzerland
69.5
75.5
72.5
Monaco
68.5
76.3
72.4
Andorra
69.3
75.2
72.3
San Marino
69.5
75.0
72.3
Canada
70.0
74.0
72.0
Netherlands
69.6
74.4
72.0
U.K.
69.7
73.7
72.0
Norway
68.8
74.6
71.7
Male
Female
Total
Namibia
35.8
35.4
35.6
Burkina Faso
35.3
35.7
35.5
Burundi
34.6
34.6
34.6
Mozambique
33.7
35.1
34.4
Liberia
33.8
34.2
34.0
Ethiopia
33.5
33.5
33.5
Mali
32.6
33.5
33.1
Zimbabwe
33.4
32.4
32.9
Rwanda
32.9
32.7
32.8
Uganda
32.9
32.5
32.7
Botswana
32.3
32.2
32.3
Zambia
30.0
30.7
30.3
Malawi
29.3
29.4
29.4
Niger
28.1
30.1
29.1
Sierra Leone
25.8
26.0
25.9
Estimates of age before sickness and injury take their toll. How Canada compares to the top and bottom three nations:
Japan
74.5
Australia
73.2
France
73.1
CANADA
72.0
Malawi
29.4
Niger
29.1
Sierra Leone
25.9
Estimates for 1997 and 1999
Source: WHO
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