According to a major international analysis published in The Lancet Public Health, Canada ranks among the top three nations globally for its widening gap between overall life expectancy and healthy life expectancy. The study, drawing on findings from the Global Burden of Disease Study 2023, reveals that while populations are living longer, health gains are failing to keep pace with longevity, creating a nearly 14-year morbidity gap in Canada.
### Canada’s 14-Year Morbidity Gap
The 2023 data places Canada’s morbidity gap—the difference between how long people live and how many of those years are spent in good health—at 13.7 years. According to findings highlighted by the Association pour la santé publique du Québec (ASPQ), Canada trails only the United States at 14 years and Australia at 13.9 years among 204 countries and territories evaluated.
This divide has widened significantly over the past three decades. In 1990, the Canadian gap stood at 11.4 years, representing a 20.3 percent increase in unhealthy years by 2023. Researchers emphasize that this expansion is not confined to the final stages of life but accumulates progressively throughout adulthood.
Non-fatal chronic conditions and disabilities drive the bulk of this burden. Globally, musculoskeletal disorders, mental health conditions, sensory organ diseases, and unintentional injuries accounted for 57.4 percent of years lived in poor health in 2023.
“We have managed to add years to life, but we are not succeeding at the same rate in keeping our population healthy,” says Thomas Bastien, executive director of the ASPQ. “In Canada, the gap now reaches nearly 14 years and has widened by more than two years since 1990. Our next collective challenge is clear: to ensure that our longevity gains also become health gains.”
### A Public Health Warning for Quebec
The national trend mirrors pressing local health statistics in Quebec. Data from 2023–2024 shows that 57 percent of Quebecers aged 65 and older live with at least two chronic diseases, while 37 percent manage three or more. Among residents aged 75 and older, multimorbidity affects more than 70 percent of the population.
Demographic shifts will intensify these pressures. Projections from the Institut de la statistique du Québec indicate that adults aged 65 and older will make up one-quarter of the province’s population by 2031. Public health advocates warn that an expanding population living with multiple chronic conditions will strain home-support networks, increase demands on caregivers, accelerate the loss of personal autonomy, and challenge public finances.
The ASPQ argues that healthy life expectancy must become a core metric in public policy, evaluated alongside traditional benchmarks like healthcare access and network performance.
“Living longer is an achievement. But our collective ambition must now be to live longer in good health,” Bastien notes. “The next government of Quebec will have the choice: continue to intervene mainly when disease is established or act much earlier to reduce its onset, delay its consequences, and preserve autonomy.”
### Policy Proposals Ahead of the Election
Ahead of upcoming provincial elections, these health metrics align with platforms advanced by regional coalitions. The Coalition québécoise pour la réduction de la maladie, representing more than 65 organizations, advocates for increased investments in prevention, standardized health outcome tracking, and cross-government strategies to reduce illness burdens.
Similarly, the Coalition québécoise pour vieillir en santé calls for prioritizing healthy aging and accelerating the transition toward home-based care. Their proposals include establishing a national home-care allowance program to support individuals experiencing loss of autonomy.
“The Lancet data shows us that longevity can no longer be our only indicator of success,” Bastien concludes. “As elections approach, the parties must also tell us how they plan to allow Quebecers to live more years in health. Every year of healthy life gained is a win for individuals, for our healthcare system, and for Quebec.”
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