Canada's global position in life expectancy: a longitudinal comparison with the healthiest countries in the world.

OBJECTIVE To assess the global position of Canadian life expectancy and to determine the areas of greatest negative impact on life expectancy. METHODS Using retrospective data on life expectancy at birth (LE(0) and age-standardized mortality rates, Canada was compared with 13 other countries with the longest LE(0). Linear regression models were used to produce trends and projections of LE(0) until 2010. RESULTS Canadian women and men currently rank 8th and 5th, respectively, in LE(0) among the 14 nations. Canada has one of the smallest annual LE(0) improvement rates among the countries studied. Canadian women progressed significantly slower than nine countries and Canadian men progressed slower than five. Women are improving at only half the rate of men due to narrowing gaps in most mortality risks--mostly for cardiovascular diseases, lung cancer and injury. These trends lowered projected LE(0) ranks of Canadians, especially for women, for 2010. CONCLUSION LE(0) of Canadians is slipping relative to most of the other 13 countries, and more so for women than men. This phenomenon is explained by historically higher mortality rates from ischemic heart disease, cancer and respiratory system disease for all Canadians, coupled with recently lower improvement rates in most mortality risks for Canadian women and in cancers and diabetes for Canadian men. Improving the health and wellness of Canadians, particularly women, demands a priority focus on enhanced chronic disease detection and management as well as strategies to reduce obesity and tobacco use by addressing the determinants of these behavioural risk factors.