Canada lags behind peers in doctors per capita, but average in physician visits

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TORONTO — Canada lags well behind all but the United States among 11 of the wealthiest nations when it comes to the number of doctors per capita, a new report indicates.

The analysis by the Commonwealth Fund, a health-care advocacy group, finds Canadians have 2.7 practising physicians per 1,000 people, compared with 2.6 for the U.S. Norway has the most at 4.8.

At the same time, Canadians are average in terms of their physician visits per year, according to the report.

"(This) suggests that our physicians are working quite hard in meeting needs," Livio Di Matteo, a health economist at Lakehead University, said of the report. "We also have higher than average hospital stays combined with a lower than average per capita number of hospital beds — which is a factor in current issues in hospital overcrowding."

The report indicates that Canadians, at 82 years, are slightly above average when it comes to life expectancy. The Swiss can expect to live 83.6 years, while Americans — with a life expectancy of 78.6 years — are at the bottom of the pack despite spending the most on health care.

"Canadians should be proud our health-care system outperforms the U.S., but we still have a long way to go," said Dr. Michael Rachlis, with the Dalla Lana School of Public Health at the University of Toronto. "We shouldn't just be satisfied in the middle of the pack."

In line with other countries, Canada has made strides when it comes to avoidable deaths — those from health conditions such as diabetes, high blood pressure or some cancers that could be prevented if the patient has access to quality health care.

While 109 such deaths per 100,000 Canadians were recorded in 2000, the rate had plunged to 72 by 2015. The United States had the highest rate of avoidable deaths at 112 per 100,000 in 2016.

The U.S. also had the highest suicide rate, with 13.9 people per 100,000 people killing themselves in 2016. France's rate was slightly lower, while Canada — at 11.8 suicides per 100,000 — had the fourth-highest rate among the 11 rich countries. The U.K., at just 7.3, had by far the lowest suicide rate.

"Elevated suicide rates may indicate a high burden of mental illness; socioeconomic variables are also a factor," the report states. "The U.S. has seen an uptick in 'deaths of despair' in recent years, which include suicides and deaths related to substance use, including overdoses."

Canadians are also more likely than others in developed countries to be obese, with a little more than a quarter of the population reporting a body-mass index of 30 or higher. While that's much lower than the rate of obese Americans (40 per cent), it's also more than double the rate in Switzerland, Norway and Sweden.

"Issues that contribute to obesity include unhealthy living environments, less-regulated food and agriculture industries, and socioeconomic and behavioural factors," the report says.

The New York-based Commonwealth Fund is a think tank that describes its mission as promoting a high-performing health-care system for everyone.

This report by The Canadian Press was first published on Jan. 30, 2020.

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