Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
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<strong>Health</strong> systems in transition <strong>Canada</strong> 137<br />
treated (at least until a certain age), amenable mortality seeks to capture the<br />
extent to which the health system has, or has not, been effective at avoiding<br />
death (Nolte & McKee, 2004, 2008). This methodology is based on a host of<br />
mortality indicators that are then aggregated in a single amenable mortality<br />
scale.<br />
Table 7.3<br />
Amenable mortality rates and rank in <strong>Canada</strong> and selected OECD countries <strong>for</strong><br />
last available year<br />
Amenable mortality<br />
rate (age-standardized<br />
Last available year avoidable deaths per<br />
of data 100 000 population)<br />
Rank among<br />
31 OECD countries<br />
Annual rate of change<br />
in amenable mortality<br />
from 1997 to last<br />
available year (%)<br />
Australia 2004 68 7 – 5.1<br />
<strong>Canada</strong> 2004 74 11 – 3.4<br />
France 2006 59 1 – 2.8<br />
Sweden 2006 68 5 – 3.3<br />
United Kingdom 2007 86 19 – 5.2<br />
United States 2005 103 24 – 1.7<br />
Source: Gay et al. (2011).<br />
Table 7.3 highlights the results of <strong>Canada</strong> and its comparators based on a<br />
larger study of 31 OECD countries in which age-standardized avoidable<br />
mortality ranged from a low of 59 to a high of 200 deaths per 100 000<br />
population (Gay et al., 2011). While <strong>Canada</strong>’s amenable mortality rate was at<br />
the low end, it did not rank as high as France (in first position), Sweden and<br />
Australia. On the other hand, <strong>Canada</strong> per<strong>for</strong>med considerably better than the<br />
United Kingdom and the United States. In addition, the annual rate of decline<br />
in amenable mortality, although substantially slower than the rates in Australia<br />
and the United Kingdom, was modestly higher than the rates of decline in<br />
Sweden and France, and double the rate in the United States.<br />
These results are consistent with a Canadian case study comparing the<br />
progress made (as measured by rates of decline in amenable mortality in the<br />
poorest neighbourhoods relative to the richest neighbourhoods) in 25 years<br />
following the introduction of universal medicare. While medicare has had an<br />
enormous impact on reducing the amenable mortality gap between poor and<br />
rich, this reduction in the disparity gap is due almost entirely to improving<br />
access to medical care as opposed to other types of health intervention. When<br />
examining amenable mortality in terms of public health interventions, there was<br />
little change over the same period, thus emphasizing the unrealized potential<br />
of public health policies, programmes and interventions (James et al., 2007).