An excerpt from The Case for Canada—By the Numbers

Much of the debate about Canada and the United States begins with opinions and ends with slogans. This book takes a different approach. It starts with the evidence.

One of the simplest questions we can ask is this: Which country is doing a better job of helping its people live long, healthy lives?

The Evidence

We’ll start with the most basic indicator of all, life expectancy.

In Canada, life expectancy at birth in 2023 was 84.2 years. In the United States, that number was 80.9 years.[1]

HALE—healthy life expectancy—is the expected length of the relatively healthy period of a life. In 2021, the latest year for which stats are published on the WHO website, HALE in Canada was 69.8 years. In the United States, that number was 63.9 years[2]. 

So, what do these most basic of measures of population health say? The answer is pretty simple. Canadians live longer than Americans. And Canadians are healthy for a longer period than Americans. This isn’t an opinion. This is an observation based on the data. That said, we haven’t examined the reason for this yet. We’ve merely made an observation.

If we dig a bit deeper into the numbers, we’ll find that infant mortality in Canada is 4.1 deaths per thousand live births[3]. In the United States that number is 5.1 deaths per thousand live births. In Canada, our maternal mortality rate is 11.1 women per 100,000 live births. In the United States, that number is 21 deaths per 100,000 live births.[4]

And what do these measures of public health say? Pregnancy is a lower risk condition in Canada than it is in the United States, and pregnancy is more likely to result in a healthy birth in Canada. Again, this isn’t an opinion. It’s an observation, based on the data. And again, we haven’t specifically looked for an explanation yet. We’ve merely made another observation.

In Canada, in 2021, there were 113 deaths from preventable cause per 100,000 people. In the United States, that number was 238.[5] In Canada, death by treatable causes accounted for 58 deaths per 100,000 people. In the United States, that number was 98.[6]

We’re beginning to see a picture emerge. Canadians are less likely to die from avoidable or medically treatable causes than Americans. And again, we haven’t specifically looked for an explanation yet. We’ve merely made another observation.

So, let’s look at the observations:

• Canadians are living longer.
• Canadians are healthy longer.
• Canadian women are less likely to die during childbirth.
• Canadian babies and young children are less likely to die.
• Canadians are less likely to die by preventable causes.
• Canadians are less likely to die by treatable illnesses.

So, why is that? Why does the data say that Canadians live longer? What are the arguments?

 

[1] CIA World FactBook 2023 estimates

[2] World Health Organization – GHO Indicators Healthy Life Expectancy at Birth

[3] CIA World FactBook

[4] CIA World FactBook

[5] OECD Health at a Glance 2023

[6] OECD Health at a Glance 2023

Editor's Note

This excerpt presents the evidence. It shows the measurable differences in health outcomes between Canada and the United States.

The full chapter in The Case for Canada—By the Numbers examines the factors that may contribute to these differences, including healthcare systems, public policy, lifestyle, and other structural characteristics of the two countries. Throughout the book, this same evidence-first approach is applied to a wide range of comparisons, allowing readers to evaluate the data before considering the explanations.