In my recent article for the BMJ (British Medical Journal) (https://www.bmj.com/content/385/bmj.q1229), I raised the alarm about the sheer rate of death in Canada. While there has been coverage of specific causes of death, such as COVID and the opioid crisis, what has gone almost unnoticed is that this is adding up to a historically high overall rate of death. Life expectancy has dropped year-over-year for the past three years — the first real drop since World War II.
There was some very thoughtful commentary from readers on X (formerly Twitter) about the reasons for the high death rate. Because some of the increase is not accounted for by COVID and opioids. No one has the answers (certainly not me!), but the questions are good ones.
First, did the lack of health care during the pandemic lead to deaths because serious problems like heart disease and cancer went undetected and undiagnosed?
Or is the overall lack of access to health care the issue? The latest estimate is that 6 million Canadians do not have regular access to primary care (https://www.cbc.ca/news/politics/meet-the-canadians-without-a-family-doctor-1.7116475). Many more complain that they can’t get in to see a doctor when they’re sick.
Are the long-term effects of COVID on heart disease, diabetes and kidney disease to blame? These don’t get picked up in statistics on deaths due to COVID. And these major causes of death are increasing.
How many of the deaths are due to climate change? Several recent studies have shown that deaths continue long after a serious weather event such as fire, floods or heatwaves. So deaths due to climate change are underestimated if we look only at deaths that are directly related.
https://hms.harvard.edu/news/climate-change-fueled-weather-events-linked-worsened-heart-health
https://www.nature.com/articles/s41586-024-07945-5
Tara Moriarty at the University of Toronto spoke to me about trying to get good statistics on mortality in order to broach some of these questions. There are issues with the statistics, mainly related to differences among provincial systems in classifying and recording cause of death, as well as long lag times to report on a national level. Moriarty made the very good point that we can’t take action to prevent or address causes of death if we don’t even have the data to understand them.
In the meantime, the burden on society and even at the individual level is huge. I have lost many friends and family members since the pandemic started, and many of my surviving friends are in the same situation. I would say that most Canadians are experiencing some level of grief at any given time. Most deaths involve high costs to the health care system; some involve social service costs. Both of these systems are overburdened as it is.
We need a renewed full-court press to prevent and treat opioid addiction and to keep up high rates of COVID vaccination. We need much better warning and intervention systems for climate catastrophes. We need to see these as life preservers. To extend the metaphor, we can’t let Canadians go down in a sinking ship.
Carolyn Brown 