Heart disease remains one of the top health concerns for Canada, due to the increasing obesity and hypertension cases in the country. Different regions and population groups in Canada disproportionately bear its burden. It impacts the Canadian healthcare system negatively. Consequently, Canada has implemented various strategies, such as educating its population on the importance of physical exercises, food habits, and other lifestyle challenges to tackle heart disease. While these strategies should lead to a decline in heart disease rates, the failure to address inequalities in the Canadian population could make it challenging to reduce heart disease mortality rates. This essay will provide epidemiological evidence of heart disease in Canada and discuss its impact on the healthcare system. First, the essay will provide epidemiological data focusing on the incidence and prevalence of heart disease and compare trends in the United States. Second, the essay will discuss community-based strategies Canada uses to prevent and manage heart disease. Lastly, the essay will discuss the impact of heart disease on the Canadian healthcare system.
Epidemiological Data
Different regions bear a disproportionate burden of heart disease in Canada. According to Orzel et al. (2021), Labrador and Newfoundland in Atlantic Canada have the highest heart disease cases and mortality rates. This trend could be attributed to low physical activity rates in Atlantic Canada, which lead to poor heart disease outcomes (Orzel et al., 2021). Statistics indicate that Newfoundland records about 274.3 deaths per 100,000 population per year, which is Canada’s highest heart disease mortality rate (Orzel et al., 2021). Nova Scotia has the second-highest mortality rate at 261 deaths per 100,000 (Orzel et al., 2021). New Brunswick and Prince Edward Island also have high heart disease mortality rates of 246.5 deaths per 100,000 and 255.1 deaths per 100,000, respectively (Orzel et al., 2021). The Canadian average heart disease mortality rate for the same period was 192.6 deaths per 100,000 people (Orzel et al., 2021). Therefore, some areas in Canada bear a greater burden of heart disease than others.
Additionally, heart disease affects certain population groups in Canada more than the rest. First Nations are the most affected population group with the highest heart disease rates and deaths. According to Anand et al. (2019), First Nations have the highest rates of chronic diseases and the lowest life expectancy in Canada. Anand et al. (2019) pointed out that the age-standardized heart disease mortality rate was 30% higher for this population group and 76% higher for its women than non-Indigenous people. The high rate of chronic diseases, including heart disease, can be attributed to sociopolitical factors affecting Indigenous people’s health. The current health status of the Indigenous people in Canada can be attributed to the effect of European colonization. According to Anand et al. (2019), colonists dismantled the educational, cultural, economic, health, and sociopolitical practices and structures of Canada’s First Nations people. The impact of the destroyed structures and practices explains why many First Nations people have no access to health care systems. Indigenous communities with low socioeconomic advantages, low education attainment, low trust among members, and low socio-support bear the highest burden of heart disease in Canada.
Many people suffering from heart disease in these communities rarely get the right treatment. Many cannot afford to buy prescriptions to manage heart disease events (Anand et al., 2019). First Nations communities also have difficulties accessing primary health care, which leaves them untreated and contributes to the high mortality rates attributed to heart disease (Anand et al., 2019). Besides, heart disease affects the First Nations men in Canada more than women (Anand et al., 2019). Gender and age are risk factors since older men at 40 and above are more likely to suffer heart disease that their younger counterparts. Anand et al. (2019) also noted that women who received high social support reported low heart disease cases. The findings suggest Canada could lower heart disease rates in its First Nations communities if it provided them with the necessary social support.
Trends for the Past 10 to 15 Years
Canada’s heart disease events and mortality rates have increased significantly over the last fifteen years. This trend can be attributed to changes in several significant risk factors such as obesity, hypertension, smoking, and diabetes. Dai et al. (2021) observed that only smoking had a downward trend, while the other significant factors showed an upward trend. Although smoking rates have decreased over the last fifteen years, the other major risk factors have increased. Dai et al. (2021) observed that the prevalence of obesity, diabetes, and hypertension increased significantly from 2005 to 2016. Cases of hypertension increased significantly among men over 40 but slightly reduced among women aged 40 to 79 (Dai et al., 2021). The increasing cases of various conditions that are risk factors contribute significantly to the high heart disease cases in Canada.
Additionally, the increasing smoking and obesity cases can account for the high heart disease rates in some parts of the country. According to Dai et al. (2021), the prevalence of obesity, during the same period, increased among women and men over 20. Dai et al. (2021) observed that the prevalence of obesity had increased faster within a decade than in previous years of Canadian history. In contrast, smoking prevalence decreased among men aged 20 to 59, over 80, and women in all age groups (Dai et al., 2021). From 2005 to 2016, the smoking rate in the country reduced from 22.1% to 17.8% (Dai et al., 2021). While smoking may have reduced in most Canadian regions, Dai et al. (2021) observed that it increased in a few regions, including Nunavut and Campbellton. The prevalence of smoking rates in the country shows an uneven distribution. Nunavut has the highest smoking rate of 62.4% compared to Richmond Health Service Deliver Area’s 11% (Dai et al., 2021). These trends have significantly impacted heart disease rates in Canada over the same period.
Comparison with the United States
Heart disease trends in Canada differ slightly to those in the United States. Hernández et al. (2021) pointed out that the U.S.A. has a higher prevalence of heart disease, higher mortality rates, and lower life expectancy than Canada. However, various factors lower the risk of heart disease in both countries. Anand et al. (2019) and Hernández et al. (2021) noted high education and income in both nations contributed to decreased heart disease rates. Smoking also increases the risk of heart disease in Canada and the United States. Therefore, a decline in smoking in the two countries contributed significantly to reducing heart disease events.
While the mortality trends have somehow stabilized in both nations, the burden of heart disease remains high. According to Ritchey et al. (2020), the United States has not realized any change in heart disease mortality rates since 2011. In 2017, one person in the United States died of heart disease every minute (Ritchey et al., 2020). Furthermore, the increasing prevalence of diabetes and obesity in the United States is a major barrier to decreasing heart disease mortality and events (Ritchey et al., 2020). Just as in Canada, the prevalence of obesity in the United States is remarkably high. About 40% of the people who died of heart disease from 2015 to 2016 aged 20-74 were obese (Ritchey et al., 2020). Similarly, American adults aged 35 to 64 were physically inactive (Orzel et al., 2021). Many Americans within this age bracket had less than ten minutes of physical exercise (Ritchey et al., 2020). Such findings indicate that trends in heart disease in the two countries are almost similar.
Community-Based Strategies
Canada has adopted various strategies to promote a greater understanding of how changing lifestyle behaviors can prevent heart disease. Consequently, various entities in the country have been focusing on enhancing awareness of how modifiable disease-specific risk factors lead to heart disease and what Canadian residents should do to lower their risk of getting the disease (Orzel et al., 2021). Examples of major initiatives that Canada has implemented to prevent heart disease include the Canadian Hypertension Education Program and the Cardiovascular Health Awareness Program (Dai et al., 2021). Various bodies are sensitizing Canadian communities on the importance of having the right food habits (Sebastian et al., 2022). The country can lower the prevalence and incidence of heart disease by ensuring its population knows lifestyle factors that increase the risk of getting this disease and what they should do to stay healthy.
Additionally, educating people on the importance of physically active living can help the country prevent heart disease. Orzel et al. (2021) pointed out that low physical activity levels were a well-known risk factor for heart disease. Low physical activity levels among various Canadian population groups contribute significantly to high heart disease rates (Sebastian et al., 2022). For example, Sebastian et al. (2022) noted that South Asian immigrants in Canada rarely engaged in physical activity, which explains why this group has some of the highest heart disease events in the country. Such findings suggest that Canada should sensitize groups with inactive lifestyles on the importance of engaging in physical exercises.
South Asian immigrants in Canada have been resistant to diet and lifestyle changes because they want to maintain their culture. Consequently, educating them on changing their food habits and becoming physically active without altering other aspects of their culture is beneficial in preventing heart disease (Sebastian et al., 2022). At the same time, a significant percentage of the Canadian population has responded positively to calls to get physically active to prevent heart disease. According to Orzel et al. (2021), a survey capturing 96% of the country’s population revealed that in 2017, 29% of adults in Canada met physical activity guidelines of over 150 minutes per week in more than ten-minute bouts. Accelerometer data in Canada provided an objective measurement compared to self-reports, which indicated 40% of the country’s population met physical activity guidelines (Orzel et al., 2021). Statistics indicate younger men below 40 years were more physically active than women (Orzel et al., 2021). Furthermore, healthy-weight individuals were more physically active than obese and overweight people (Orzel et al., 2021). Such statistics suggest that Canada should target inactive population groups and encourage them to start doing physical exercises to lower the risk of heart disease.
Access to healthcare services is another strategy Canada uses to address heart diseases. Canada strives to ensure all its residents can access healthcare services to facilitate routine screening (Sebastian et al., 2022). The country can deal with heart diseases better if it identifies the people at great risk in time. Furthermore, access to healthcare services is helping Canada to care for Chronic medical conditions, such as high cholesterol and type II diabetes mellitus (Sebastian et al., 2022). Treating these conditions lowers the risk of cardiovascular diseases. Roussel et al. (2018) and Dai et al. (2021) noted there was sufficient evidence to show that managing major risk factors reduced heart disease events and mortality. One of the challenges affecting access to healthcare amongst immigrants in Canada has been high health insurance rates (Sebastian et al., 2022). The Canadian government can lower heart disease cases in the country by ensuring everyone can access healthcare facilities for screening and treating related health conditions.
Canada can improve access to healthcare systems by addressing socioeconomic inequalities. Dai et al. (2021) stated that persistent socio-economic inequalities in smoking, diabetes and hypertension have affected heart disease rates across the country over the past decade. They also noted that although Canada had implemented various strategies to prevent and manage heart disease and its major risk factors, prevention policies failed to improve socioeconomic disparities. Some prevention policies could exacerbate inequalities, thus making it difficult for the country to address heart disease effectively. Dai et al. (2021) recommended that future policies focus on socially disadvantaged groups to help reduce heart disease statistics in Canada. For example, appropriate policies could target having more health facilities in marginalized areas or building more recreational facilities in rural areas. According to Allana et al. (2021), about 19% of Canada’s population lives in rural areas where they experience various problems trying to access health care. Therefore, such measures would ensure vulnerable communities in Canada can get healthcare services and improve their physical activity, which is important for preventing heart disease events.
Direct and Indirect Impacts on the Canadian Health Care
Heart disease impacts Canadian health care directly and indirectly. Starting with direct effects, heart disease kills many people in Canada every year. According to Lang et al. (2018) and Dai et al. (2021), heart disease is the country’s second-highest cause of death. Some of the Canadian regions report hundreds of deaths per 100,000 population every year (Orzel et al., 2021). Besides, treating the disease in Canadian health facilities is a direct cost that the health care system must bear. According to Boisclair et al. (2018), heart disease claimed Canada’s highest direct health costs in 2008, with the country incurring 12 billion Canadian dollars in direct health costs for heart disease. From 2013 to 2014, heart failure and attacks were some of the leading reasons for hospitalization in Canada (Boisclair et al., 2018). Hospitalized people with heart failure spent the longest time in the hospital, averaging about 9.2 days (Boisclair et al., 2018). Individuals with heart attacks spend about 5.2 days in hospitals (Boisclair et al., 2018). The time patients spend in hospitals after suffering heart attacks or failures shows heart disease directly imposes a heavy burden on Canada’s healthcare systems.
Lastly, heart disease has indirectly imposed a great burden on the Canadian healthcare system. Canada incurs huge costs trying to prevent or manage heart diseases and related conditions. Dai et al. (2021) explained that Canada spent huge sums of money preventing and managing obesity. Besides increasing the probability of heart disease, obesity also affects two other related conditions that are major factors for heart disease. Consequently, Canada spends a lot of resources helping its citizens to change their lifestyles to reduce their risk for obesity and other risk factors. For example, the country has had to construct recreational facilities and sponsor expensive campaigns to encourage people to start living a physically active lifestyle. Due to the ongoing inequalities, the government will have to consider constructing more recreational facilities in rural areas to tackle the increasing heart disease rates in these areas (Allana et al., 2021). Such expenditure is an example of indirect cost since the government will most likely channel it through a different ministry. Therefore, Canada incurs huge indirect costs in preventing and managing risk conditions like obesity and diabetes since they impact heart disease trends in the country.
Conclusion
While Canada has implemented various strategies to address heart disease challenges, its burden will remain high unless it eliminates disparities in its population. Examples of the measures it has implemented include educating its population on the importance of physical exercises and encouraging its citizens to quit smoking. In spite of these initiatives, many Canadian residents are continuing to suffer from and die of heart diseases. This could be because Canada has not achieved remarkable results in its efforts to lower obesity rates. The high mortality rates are direct impacts, while indirect effects include the increasing costs of preventing and managing various risk factors. Lastly, this study shows Canada’s immigrants, First Nations, and people in rural areas cannot access the same facilities that could help them reduce heart disease rates and related conditions. Therefore, Canada should ensure all its residents have access to health care and fitness facilities to reduce the cost of heart disease.
References
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