Canada gets low marks for opioid deaths, access to health care in OECD report

Health

Canada performs better than average on three-quarters of health status indicators, including life expectancy and preventable deaths from lung cancer, heart attacks and strokes, according to a new report comparing 38 high-income countries.

Higher marks for life expectancy, smoking and preventable deaths

Amina Zafar · CBC News

· Posted: Nov 07, 2023 6:12 PM EST | Last Updated: November 8, 2023

A nurse tends to a patient at the Bluewater Health Hospital in Sarnia, Ont., in 2022. (Chris Young/The Canadian Press) Canada does better than average on three-quarters of health status indicators, including life expectancy and preventable deaths from lung cancer, heart attacks and strokes, according to a new report comparing 38 high-income countries.

But it performs comparatively worse on factors including opioid deaths and access to care, according to the report released Tuesday by the Organization for Economic Co-operation and Development (OECD).

“Amid the increasing demand for services as a result of the combined effect of population aging and unhealthy lifestyles, health systems need to facilitate better and timelier access to affordable health care, while addressing the lingering after-effects of COVID-19 on mental and physical health,” said OECD Secretary-General Mathias Cormann. 

Canada also scored well on measures including:

Smoking prevalence (8.7 per cent compared with OECD average of 16). Fruit and vegetable consumption (five or more servings per day). Appropriately low prescribing of antibiotics.  Delivering urgent surgery for hip fractures within two days. Jason Sutherland, a professor in the Centre for Health Services and Policy Research at the University of British Columbia, called the report a useful snapshot of where Canada is doing well and where there are problems. 

“It gives us a second to sort of pause and think about what we’re trying to achieve with their public spending and health care,” Sutherland said.

Compared to the OECD average, Canada’s problems include:

Diabetes being slightly more prevalent. Opioid deaths. Satisfaction with the availability of quality health care. Dr. Peter Cram, chair of the department of medicine at the University of Texas Medical Branch, spent eight years practising and conducting research in Toronto.

Cram says the report offers a high-level view of health care in Canada.

“How do you address poverty?” Cram said from Rotterdam, the Netherlands. “If you can fix poverty, you have a Nobel Prize coming your way because that’s something that all countries struggle with.”

Cram says the affordability of social assistance programs and improving access to doctors in disadvantaged neighbourhoods are common concerns for most countries in the report. 

Overall, Canada’s health system is comparatively, “middle of the pack,” said Sara Allin, an associate professor of health policy at University of Toronto.

Generally, Canada relies more than other countries on private insurance coverage from employers or paying out of pocket. These include for dental care, many prescription medications and mental health care.

WATCH | Strain of training more family physicians:

Plan to add extra year to family doctor training gets push back There is growing opposition to a plan that would add one year of residency to family doctor training in Canada. Critics say it’s not worth the time — particularly when family doctors are in such short supply.

“Not everyone can afford to pay out of pocket for the things that we charge for in Canada that we don’t see in other countries,” said Allin.

While it may be cold comfort to Canadians, many other countries also struggle with access to care and wait times, she said.

“Workforce is a top priority for health system strengthening,” in Canada, Allin said. “For every dollar we spend, about 70 cents is going to [the] workforce.”

The report also says Canada has fewer practising physicians, at 2.8 per 1,000 people, compared with the OECD average of 3.7 per 1,000.

To improve, Allin said, Canada needs to complement doctors and nurses working in primary and acute care, recognize the challenges of hiring, recruiting and retaining them in rural, remote and Indigenous communities and create supportive workplaces.

ABOUT THE AUTHOR

Amina Zafar covers medical sciences and health topics, including infectious diseases, for CBC News. She holds an undergraduate degree in environmental science and a master’s in journalism.

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