University of Ottawa.
Virginia Commonwealth University.
Health Rep. 2024 Aug 21;35(8):3-13. doi: 10.25318/82-003-x202400800001-eng.
An extensive literature documents substantial variations in life expectancy (LE) between countries and at various levels of subnational geography. These variations in LE are significantly correlated with socioeconomic covariates, though no analyses have been produced at the finest feasible census tract (CT) level of geographic disaggregation in Canada or designed to compare Canada with the United States.
Abridged life tables for each CT where robust estimates were feasible were estimated comparably with U.S. data. Cross-tabulations and graphical visualizations are used to explore patterns of LE across Canada, for Canada's 15 largest cities, and for the 6 largest U.S. cities.
LE varies by as much as two decades across CTs in both countries' largest cities. There are notable differences in the strength of associations with socioeconomic status (SES) factors across Canada's largest cities, though these associations with income-poverty rates are noticeably weaker for Canada's largest cities than for the United States' largest cities.
Small area geographic variations in LE signal major health inequalities. The association of CT-level LE with SES factors supports and extends similar findings across many studies. The variability in these associations within Canada and compared with those in the United States reinforces the importance for population health of better understanding differences in social structures and public policies not only at the national and provincial or state levels, but also within municipalities to better inform interventions to ameliorate health inequalities.
大量文献记录了国家间和国家内不同次国家地理区域的预期寿命（LE）存在显著差异。这些 LE 差异与社会经济协变量显著相关，尽管在加拿大或旨在与美国进行比较的最可行的普查区（CT）地理细分级别上尚未进行任何分析。
对于可行的每个 CT，都估计了简化生命表，与美国数据进行了可比的比较。交叉表和图形可视化用于探索加拿大、加拿大 15 个最大城市以及美国 6 个最大城市的 LE 模式。
在这两个国家最大城市的 CT 中，LE 差异高达二十年。尽管加拿大最大城市的收入贫困率与 SES 因素的关联明显较弱，但加拿大最大城市与 SES 因素的关联强度存在明显差异。
LE 的小区域地理差异表明存在重大健康不平等。CT 层面 LE 与 SES 因素的关联支持并扩展了许多研究中的类似发现。加拿大内部和与美国相比这些关联的可变性，加强了不仅在国家和省或州一级，而且在市政当局内部更好地理解社会结构和公共政策差异的重要性，以更好地为减轻健康不平等的干预措施提供信息。
