The good news is that medical and public-health advances have brought about dramatic improvements in life expectancy over the last decades. The bad news, a new federal report indicates, is that much of that gained time is lived under the burden of serious illness.
The average Canadian will spend more than a decade of his or her life dealing with diseases such as diabetes, high blood pressure or cancer, concludes the Public Health Agency of Canada in a report that underlines the downside of surviving longer.
While women live on average to almost 84 years, for instance, their average healthy, disease-free longevity is just 72 years, according to the analysis, billed as the first of its kind in this country.
It is no secret that chronic disease affects people’s quality of life, but such calculations provide a graphic illustration of the impact, and should help drive changes in health policy and individual lifestyles, said Susan Bondy, a University of Toronto epidemiology professor.
“We’re living longer, but not necessarily living better,” said Prof. Bondy, who was not involved in the study. “We have turned things that used to be fatal into chronic disorders.… We do have better life expectancy, but it has not been matched in terms of quality of life or absence of disability in those later years.”
Average lifetimes have climbed steadily in the last century, from 61 for Canadian women in 1920 to 66 in 1940, and 79 in 1980, according to Statistics Canada.
The agency bills the report on “health-adjusted life expectancy” as the first in a series of such studies, and a baseline to measure progress in future.
“We know that Canadians are not just interested in living longer – they want to live longer in good health,” Sylwia Krzyszton, an agency spokeswoman, said in an emailed response to questions.
The analysis already shows a surprising difference between men and women. While female Canadians live on average almost four years longer than men, they live a significantly smaller portion of those lives in good health.
The report also computes how three chronic diseases affect total life expectancy. Strikingly, the agency researchers concluded that the average, total longevity from birth for a woman who develops cancer is 27 years, a “huge” difference from the overall population, and never quantified before.
They also calculate the bump to overall life expectancy if death from cancer was suddenly eliminated as a danger; such a health watershed would add 3.4 years for the average woman and 3.7 for the average man.
High blood pressure and type-two diabetes have less impact than cancer on overall lifetimes, but a bigger effect on disease-free longevity, the report found. A woman with diabetes will live a healthy life of just 62 years on average, the report found.
The researchers came up with their “health-adjusted” life figures by essentially subtracting the years of ill health – derived from various statistical databases – from overall life expectancy.
The results underline that the health-care system must not just “mop up” acute disease, then abandon the patient to chronic illness, said Prof. Bondy. Instead of simply saving the life of someone who has a heart attack, for instance, the system should also provide rehabilitation and other care afterward to ensure the patient lives the rest of his life in better shape, she said.
Actually applying such an approach to daily health care is more of a challenge, though, said Prof. Bondy.