Mortality

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Canadian Vital Statistics recorded 230,100 deaths in 2005, up 1.6% compared to the number recorded the previous year (226,600). The number of deaths recorded in 2005 was the highest since the Vital Statistics Registry was established in 1921 (table A-3.1).

The overall number of deaths is expected to increase from year to year (figure 3.1) because of the combined effect of two factors: population growth and aging. On the one hand, population growth increases the number of deaths, despite the fact that Canada’s mortality rate is decreasing. On the other hand, increasingly large generations are reaching old age with its higher mortality rates, which is also leading to more deaths in the population.

Figure 3.1
Deaths in Canada, 1926 to 2005

Between 2004 and 2005, the number of deaths increased in all Canadian provinces with the exceptions of Prince Edward Island, New Brunswick and Manitoba (table A-3.1). Since these three provinces and the territories have fewer inhabitants, the number of deaths recorded in these areas is more subject to yearly fluctuations. However, these often minor yearly fluctuations do not alter the general upward trend seen in these provinces and the territories and throughout Canada over the last several decades.

The differences in the number of deaths by age recorded in 2004 and 2005 are presented in figure 3.2. Nearly three quarters (2,600) of the additional 3,500 deaths recorded in 2005 compared to 2004 occurred to individuals 85 years or older. This aging of the population explains in large part the upward trend in the number of deaths in Canada. In 2005, the death distribution pattern—the specific age at which there was the greatest number of deaths—was 82 years for men and 85 years for women. This also shows that most deaths today occur at advanced ages.

There was a slight increase in the number of infant (less than 1 year of age) deaths between 2004 and 2005. This increase is largely attributable to the increased number of births in Canada during the same period. A little more than 5,000 more births were recorded by the Vital Statistics Registry in 2005 compared to the previous year.

The aging of the various generations that comprise Canada’s population explains several other trends observed in figure 3.2. The progressive replacement of people in a given age group by people from larger or smaller generations will be accompanied by an increase or decrease in the population of this age group, and consequently, in the number of deaths that occurs. As a result, from 2004 to 2005, the number of deaths decreased among 65 to 79 year olds (smaller generations born between 1925 and 1939), 35 to 39 year olds (smaller generations following the baby boom) and 1 to 4 year olds (drop in births at the beginning of the 2000s). Conversely, the number of deaths between the ages of 40 and 64 years increased as a consequence of the large generations of baby boomers currently at those ages.

Figure 3.2
Variation in the number of deaths by age between 2004 and 2005, Canada

By relating the deaths that have occurred at each age to the population at risk of dying, it is possible to calculate the probability of dying at any age. Figure 3.3 shows that men were at a higher risk of dying than women at all ages, in 2005. This is particularly true for 15 to 35 year olds where most deaths are due to external causes—suicides and traffic accidents for the most part—which are much more likely to involve men.

Figure 3.3
Probabilities of dying by age and sex, Canada, 2005

People between the ages of 5 and 15 have the lowest probability of death; in 2005, a 5 year old was more than 99.9% likely to reach 15 years of age providing the mortality conditions to which the child was subject remained the same as those recorded in 2005. In fact, it is likely that this child would enjoy potential reductions in mortality in the coming years, further reducing the child’s risk of death.

Starting at 30 years of age, the risk of death increases exponentially for men and women alike, reaching odds of one in ten at around age 85. The probability of a 65-year-old man reaching 80 years of age was 62% in 2005. The probability decreased to 42%—less than one chance in two—if the age was extended to 85. The equivalent probabilities were 75% and 58% for women.

Infant Mortality

Both men and women are in their late fifties before their probability of death exceeds that of 0 to 1 year olds. For this reason and because it is often a good indicator of a country’s health development, infant mortality is of particular interest.

Infant mortality in Canada has been relatively stable since the mid 1990s totalling 5.4 deaths per 1,000 births in 2005. Mortality was slightly lower for girls (5.0 per 1,000) than boys (5.8 per 1,000). Sweden and Japan currently have the lowest infant mortality rate at less than 3.0 per 1,000. These international comparisons suggest that there is still room to improve the infant mortality rate in Canada (table A-3.2).

The stagnation of the infant mortality rate observed in Canada over the last fifteen years or so may be due to the increase in high-risk pregnancies that occurred during this period. The chapter on fertility in this report indicates a significant increase in the fertility rates of women 30 and over, ages at which higher risk pregnancies are more common.

The infant mortality rate varies from province to province. In 2005, it was about 4.0 per 1,000 in the Maritime Provinces, Quebec and British Columbia. It was much higher in the Prairie Provinces, especially in Saskatchewan where it was 8.3 per 1,000, the same as in Nunavut. Although it is difficult to positively identify the factors responsible for these regional variations, the presence of larger Aboriginal populations in these regions could explain part of these differences. It also bears mentioning that in the case of isolated regions such as Nunavut, and the three territories in general, the harshness of the climate, the living conditions and access to health care, which is sometimes more difficult than in metropolitan areas, are also factors that may explain what are often higher infant mortality rates. 

The risk of death is highest during the first week of life (early neonatal mortality). Approximately 75% of infant mortality observed in Canada occurs in the first week of a newborn’s life and the early neonatal mortality rate is 4.0 per 1,000. After the first seven days, the newborn mortality rate decreases significantly, underscoring the fact that future progress on infant mortality will come primarily from gains in the area of endogenous health problems, those present at birth such as congenital malformations (figure 3.4).

Figure 3.4
Infant mortality rate, neo-natal and early neo-natal, Canada, 1926 to 2005

Life Expectancy

Canadian men’s life expectancy at birth has been increasing at a rate of 0.3 year per year since the early 2000s and for Canadian women it has been increasing by 0.2 year per year, which means the discrepancy observed between the two genders is decreasing. In 2005, men had a 78.0 years life expectancy while women were expected to live 82.7 years, a mere 4.7 years difference, the lowest since the end of World War II (table A-3.3).

In 2004, the average life expectancy for both genders broke the 80-year threshold in Canada. It was 80.4 years in 2005.

In 2005, only a few countries did better than Canada in the area of average longevity: Japan (82 years), Iceland (81 years), Sweden (81 years) and Switzerland (81 years). Inhabitants of France, Australia, Italy, Norway and Spain had life expectancies similar to that of Canada. In the United States, life expectancy reached 78.0 years in 2005. Inhabitants of some countries, such as Africa, were still expected to live less than 40 years in 2005.

Only three years separate the province with the shortest life expectancy, Newfoundland and Labrador (78.2 years), from the one with the longest, British Columbia (81.2 years). Prior to the early 1960s, this difference regularly reached at least five years, with Quebec usually having the shortest life expectancy at birth and Saskatchewan the longest.

Apart from British Columbia, three provinces stand apart with a life expectancy greater than 80 years: Alberta (80.3 years), Quebec (80.4 years) and Ontario (80.7 years). In all these regions, a large proportion of the residents live in urban areas that offer easier access to heath care and services.

Life expectancy in the three territories (76.3 years in 2005) is usually shorter than in the Canadian provinces, a situation linked not only to the particular climate and living conditions in these areas, but also to the presence of greater numbers of Aboriginal communities. Aboriginal people, especially the Inuit, have a shorter life expectancy than other Canadians; a recent study showed that life expectancy in areas where the Inuit usually live was less than 68 years in 2001.¹

Life expectancy after the age of 65 continued to increase, reaching an average of 19.6 years in 2005 in Canada. Women had a greater life expectancy (21.1 years) than men (17.9 years): a 3.2-year discrepancy. The total discrepancy between men and women’s life expectancy at birth was 4.7 years; nearly 70% of this difference was related to mortality after the age of 65. This can be attributed to the consequences of the various diseases that still affect men and women today. Women are more often affected by degenerative diseases (osteoporosis, arthritis, etc.) than men, who are more subject to cardiovascular diseases, which are often more deadly over the short term.

Mortality among the very elderly also improved, for men and women alike. For both genders, life expectancy at age 90 was about five years in 2005; it was only about three years in 1951.

Causes of Death in 2004

Causes of death were not available for 2005 when this report was published; therefore this section analyzes only causes of death for 2004.

For the first time, in 2004 the mortality rate relating to tumours and cancers (213.3 per 100,000) among men was slightly greater than for diseases of the circulatory system (212.2 per 100,000). In both cases, mortality associated with these diseases declined between 2003 and 2004, a downward trend that began several decades ago. However, mortality due to diseases of the circulatory system is decreasing more rapidly, which explains why, in 2004, tumours and cancers became the primary causes of death in men in Canada (table A-3.4).

Among women, diseases of the circulatory system remained the main cause of death with a rate of 214.7 per 100,000. This rate, similar to that of men, remained significantly higher than the mortality rate relating to tumours and cancers (192.8 per 100,000). However, mortality caused by diseases of the circulatory system has also been declining among women for several decades; in the coming years, this type of mortality may fall below the rate for tumours and cancers, which has continued to hover around 195 per 100,000 since 1981.

Between 2003 and 2004, the mortality rate for men and women alike relating to ischemic cardiac disease and cerebrovascular disease continued its uninterrupted downward trend, which began in 1981.

Finally, although progressing at different rates, mortality associated with malignant tumours of the respiratory tract continued to decrease among men and increase among women. Generations of women who smoked in greater numbers since they were young are now reaching old age, which has certainly contributed to the increase in mortality caused by malignant tumours of the respiratory tract observed since 1981. If the current trend continues, mortality due to malignant tumours of the respiratory tract may soon exceed mortality associated with cerebrovascular disease among women.

HIV-related Deaths

Among men, HIV-related deaths decreased between 2003 and 2004, reaching 345 deaths, the lowest number since 1991, with the exception of 2002. Despite this decrease, HIV continued to claim the lives of more Canadian men than women, with only 75 deaths reported among women in 2004. However, this represented a small increase over the preceding year. The lower number of HIV-related deaths among women causes greater annual fluctuations, making it difficult to establish clear trends for HIV-related deaths for this population (table A-3.5).

Table A-3.1
Total deaths and infant deaths, Canada, provinces and territories, 1981 to 2005

Table A-3.2
Infant mortality rate, Canada, provinces and territories, 1981 to 2005

Table A-3.3
Life expectancy at different ages, Canada, 1981 to 2005

Table A-3.4
Mortality rates according to some causes of death and sex, Canada, 1981 to 2004

Table A-3.5
Deaths due to HIV by broad age groups and sex, Canada, 1991 to 2004

Note

1. Wilkins, R., S. Uppal, P. Finès, S. Senécal, E. Guimond and R. Dion. 2008. “Life expectancy in the Inuit-inhabited areas of Canada, 1989 to 2003”. Health Reports. Statistics Canada Catalogue number 82-003-X. Number 19. Volume 1. pp 1 to 14.