When it comes to differences between Canada and the U.S., there is one area at least where we can claim bragging rights: Canadians have the edge when it comes to life expectancy and health-related quality of life.
"Canadians live longer and healthier than Americans," said U.S. health economist David Feeny, lead author of a newly published analysis of a joint Canada-U.S. population health survey. "Mortality rates are lower in Canada and the health related quality of life -- the quality of those years -- is higher in Canada than in the United States."
In fact, the analysis of the 2002-2003 data shows that a 19-year-old in Canada, for instance, can expect to enjoy 2.7 years more of "perfect health" than an American the same age, said Feeny, an investigator at the Kaiser Permanente Center for Health Research.
While populations north and south of the border share many similarities, including standards of living, Feeny said there are two distinct potential explanations for the gap in life expectancy and quality of life: access to health care and the prevalence of poverty.
"One obvious (reason) is universal 'prenatal to grave' health care in Canada," said Feeny, a dual-citizen who worked at Hamilton's McMaster University and the University of Alberta in Edmonton for more than 30 years.
"There's substantial evidence particularly in the U.S. that not having health insurance, controlling for other things that affect your health, is unhealthy," he said Wednesday from Portland.
"Another explanation is lower rates of poverty. There's a systematic relationship in virtually all countries between income and health. The higher rates of poverty in the United States confounded by the lack of access to health care result in lower quality of life and higher (premature) mortality."
The authors say the findings, published online in BioMed Central's open access journal Population Health Metrics, "have implications for health care and social policy in the United States."
Indeed, reform of the health care system has been front and centre since U.S. President Barack Obama entered the White House more than a year ago. After months of often acrimonious bipartisan debate, Congress recently passed a much watered-down health reform bill that will offer some relief to more than 30 million Americans who have no health insurance.
Robert Evans, a health economist at the Centre for Health Services and Policy Research at the University of British Columbia, said the almost three years of extra "perfect health" enjoyed by Canadians compared to Americans is a substantial amount.
"They are probably right about the health-care system playing a role in this," he said. But there are many socioeconomic factors that may contribute to differences in life-expectancy and quality of life, including a higher prevalence of violence and unhealthier, poorer immigrant populations south of the border.
"We don't really know how to parse out the differences between Canada and the U.S. into better access to health care and less brutalizing social environment for some parts of the population," he said from Vancouver.
"So it's not clear to me that the adoption of a Canadian-style system, even if they could do it" would make a difference, said Evans, noting that eliminating third-party private insurers from the U.S. health-care mix would present a monumental challenge.
"Is Obama-care going to cure it? No. You're on the start of a long road down there. It's in the right direction, it will certainly help some people a lot, but ... is the U.S. health status disadvantage going to disappear in the next four or five years? I would bet against it."
And while Canadians may feel good that they outrank their American cousins on some health indicators, Feeny cautioned against feeling smug.
"Life expectancy in Canada is high by international standards, but certainly not the highest," he said. "I think it's one of those typically Canadian mixed messages."
