Quick Matthew, Duong Monica, Bushnik Tracey
Health Analysis and Modelling Division, Statistics Canada.
Health Rep. 2025 Aug 20;36(8):3-15. doi: 10.25318/82-003-x202500800001-eng.
Data measuring life expectancy (LE) and health-adjusted life expectancy (HALE) in Canada are available for large geographical areas, such as provinces, territories, and health regions. However, to date, no study has analyzed LE and HALE at the municipal level.
Death and population counts from January 1, 2019, to December 31, 2020, were retrieved for 1,227 census subdivisions (CSDs) in Canada. CSDs are municipalities or areas treated as municipal equivalents by provincial and territorial governments. Functional health status was operationalized via the Health Utilities Index Mark 3 (HUI3) and obtained from the 2019 and 2020 Canadian Community Health Survey. CSD mortality rates and HUI3 scores for sex and age groups were estimated via multilevel regression models and poststratification. LE and HALE were calculated using life table methods and compared with previously published data for a subset of CSDs. The variability of LE and HALE was described using population, income, and educational characteristics.
The median CSD had estimates of LE at birth of 84.1 years for females and 79.6 years for males. The median CSD had estimates of HALE at birth of 70.8 years for females and 69.7 years for males. For both measures, the gaps between CSDs at the 95th and 5th percentiles of LE were approximately 13 years for females and 14 years for males. The differences between the model-based LE estimates and published data were typically less than one year. LE and HALE at birth were positively correlated with population size and the percentage of individuals aged 25 to 64 with a postsecondary education.
This study develops, validates, and describes the first set of LE and HALE estimates for municipalities in Canada. Municipal-level health indicators are important for research and policy focused on the health of local populations.
加拿大可获取关于大地理区域（如省份、地区和卫生区域）的预期寿命（LE）和健康调整预期寿命（HALE）的数据。然而，迄今为止，尚无研究在市级层面分析LE和HALE。
检索了加拿大1227个普查分区（CSD）在2019年1月1日至2020年12月31日期间的死亡人数和人口数。CSD是省级和地区政府视为等同于市级的行政区或区域。通过健康效用指数Mark 3（HUI3）对功能健康状况进行操作化定义，并从2019年和2020年加拿大社区健康调查中获取相关数据。通过多水平回归模型和事后分层估计CSD的性别和年龄组死亡率及HUI3得分。使用生命表方法计算LE和HALE，并与之前发表的部分CSD数据进行比较。利用人口、收入和教育特征描述LE和HALE的变异性。
CSD中位数水平的出生时预期寿命估计值为女性84.1岁，男性79.6岁。CSD中位数水平的出生时健康调整预期寿命估计值为女性70.8岁，男性69.7岁。对于这两项指标，在LE的第95百分位数和第5百分位数的CSD之间的差距，女性约为13岁，男性约为14岁。基于模型的LE估计值与已发表数据之间的差异通常小于1年。出生时的LE和HALE与人口规模以及25至64岁拥有高等教育的个体百分比呈正相关。
本研究开发、验证并描述了加拿大市级层面的第一套LE和HALE估计值。市级层面的健康指标对于关注当地居民健康的研究和政策而言非常重要。
