Ontario is in the middle of one of its biggest health emergencies ever, but it is going on under the radar, and we have no plan to deal with it. Our life expectancy dived in 2020 and five years later we have not got back up to pre-COVID-19 levels. There is no provincial plan focused on getting life expectancy back to where it should be.
Some will argue that we do not have all the information to develop a comprehensive plan. But that is not an excuse. There is evidence to guide the urgent action that we need now to deal with this health emergency.
Life expectancy is a key indicator of the health of a nation. Life expectancy in Canada had been increasing for 40 years, peaking in 2019. At that time, Canadians could expect to live 82.2 years. Our life expectancy at birth dipped in 2020 to 81.6 years and had only crawled back to 81.7 years in 2023, which is the last year for which Statistics Canada has posted comprehensive data.
Canada slipped to 19th in the world in life expectancy in the latest United Nations report.
The obvious reason for the dip in life expectancy is the COVID-19 pandemic. But that is not the whole story. By 2023, COVID-19 deaths were the lowest they had been since 2020, and still, our life expectancy had not increased significantly. Federally, Statistics Canada points to increasing deaths from cancer as well as the highest ever number of deaths from accidental drug poisoning as possible contributary factors to our continued lower life expectancy.
More locally, Wellesley Institute research has shown that in Ontario, people living in smaller towns, racialized populations and non-permanent residents are among the groups whose life expectancy has decreased the most in recent years. While this research supports the role of COVID-19 in that dip, it also points to an increased proportion of deaths linked to mental health and neurocognitive illnesses such as dementia.
The evidence shows that the foundations of a plan to improve life expectancy must include continued work to protect people from COVID-19, greater efforts to decrease deaths from drug overdose and cancer, and focused work on mental health and neurocognitive diseases targeted at equity-deserving groups. There must also be a specific focus on small towns and rural areas.
In Ontario, the current big focus in health is to attach 100 per cent of people to primary care. This is vital. But simply focusing on attachment may not be enough to improve life expectancy. Primary care would need to impact the causes of our decreased longevity. This could be done by promoting vaccination, increasing early detection and treatment of cancer and promoting better care and support for mental health problems and neurocognitive illnesses. However, supporting evidence-based strategies for decreasing drug overdoses and action on the social factors that lead to health inequities would round out an initial plan.
There is a least a five-year difference in life expectancy between rich and poor in Ontario, as well as notable differences between women and men and between racialized and non-racialized groups. Infectious diseases, chronic diseases, cancers and mental health issues are more prevalent in low-income, racialized and rural populations. All the statistics point to the importance of social and economic factors in health. A comprehensive plan to increase life expectancy must include public health and policy interventions such as increasing access to healthy housing, dealing with food insecurity, increasing incomes and fighting discrimination. There must also be strategies to promote fairness in access to health and social services and outcomes of care.
There is enough data for us to build an initial plan to raise our longevity. Sure, we need more information, but there is so much we already know that could help everyone live long and prosper.