September 29, 2016 — Canada has made substantial improvements in population health over the last 50 years, but compared with peer countries, its relative position remains unchanged. According to the latest report from the Canadian Institute for Health Information (CIHI), between 1960 and 2010, Canada's potential years of life lost (PYLL) decreased from 9,113 PYLL per 100,000 population to 3,113 per 100,000 population. Despite this 66% improvement for Canada, a number of other peer countries have made accelerated improvements, while Canada maintained an average performance over time.

In Canada's International Health System Performance Over 50 Years: Examining Potential Years of Life Lost, PYLL is defined as a measure of premature mortality that provides an estimate of the additional time a person would have lived had he or she not died before age 70. In other words, a person who dies at age 50 would have lost 20 years of potential life. The PYLL for a given country represents the total years of potential life lost within the population in each year. This study compares Canada's PYLL performance with that of 17 other high-income Organisation for Economic Co-operation and Development (OECD) countries over 50 years.

"In terms of health system performance on the international stage, this report shows that Canada has room for improvement and can learn from peer countries, such as Australia," says Jean Harvey, CIHI's Director, Canadian Population Health Initiative. "Strategies within and beyond health care — such as social policy, education, health promotion and disease prevention — should be analyzed to learn how they may be applied to the Canadian context."

Canadian women falling behind on PYLL

According to CIHI's report, Canadian women (compared with women in peer countries) have lost ground on this measure since the 1990s and are falling behind the international average. In 2010, Canadian women lost 2,385 potential years of life per 100,000 — 315 more than Australia, and 589 more than Japan, a consistent top-performing country for women. When examining PYLL for specific diseases, Canadian women were close to the international average for lung cancer in the 1960s. Over the 50-year study period, Canadian women fell behind on lung cancer while other peer countries improved. This means that in 2010, Canadian women lost more years of potential life from lung cancer than women in most of the other countries studied.

The picture is different for Canadian men, who have consistently performed ahead of the international average relative to men in other countries since the 1990s. In 2010, Canadian men lost 3,836 potential years of life per 100,000 population — 204 more than Australian men, and 763 more than men in Sweden, a consistent top-performing country for men.

"These findings are consistent with other CIHI studies which have indicated that Canadian women don't fare as well for lung cancer as women in other OECD countries," says Deborah Cohen, Senior Researcher, Canadian Population Health Initiative. "By identifying where Canada lags behind the international average for premature mortality due to specific diseases, we may better focus our efforts to improve the health of Canadians."

Canada's performance varies across diseases and conditions

When examining specific diseases and conditions, Canada performs very well for some and not as well for others. The study shows that Canada does very well for PYLL from stroke for both men and women. Over the study period, Canada experienced a decrease of more than 80% in PYLL — improving from 332 PYLL per 100,000 population in 1960 to 60 PYLL per 100,000 in 2010.

Canada also experienced a reduction of almost 85% in PYLL due to heart disease over the 50 years studied, decreasing from 1,471 PYLL per 100,000 population in 1960 to 230 PYLL per 100,000 in 2010. Despite this, Canada still sits behind the international average.

When looking at all cancers, Canada experienced a reduction of more than 40% in PYLL over the 50 years studied, and Canadian men have performed well, relative to other men, but Canadian women have lagged behind relative to other women internationally.

For more international comparisons and information on the 17 high-income OECD countries studied, an interactive web-based companion product is available on Use this tool to compare leading causes of PYLL caused by cancer, heart disease, stroke, and external causes such as falls, traffic accidents, accidental poisonings and intentional self-harm.