This is the Chief Public Health Officer's (CPHO) third annual report on the state of public health in Canada. This report examines the state of health and well-being of Canada's seniors, including factors that positively and/ or negatively influence healthy aging such as falls and related injuries, mental health, abuse and neglect, social connectedness, healthy living, and care and services. From this examination, priority areas for action are identified where Canada can further foster optimal conditions for healthy aging.
Canada's CPHO has a legislated responsibility to report to the Minister of Health and Parliament on an annual basis through a report on the state of public health.1
Public health is defined as the organized efforts of society to keep people healthy, prevent injury, illness and premature death. It is the combination of programs, services and policies that protect and promote the health of all Canadians.2, 3
The Public Health Agency of Canada and the position of Canada's CPHO were established in September 2004 to strengthen Canada's capacity to protect and improve the health of Canadians.1, 4 In 2006, the Public Health Agency of Canada Act confirmed the Agency as a legal entity and further clarified the role of the CPHO (see Textbox 1.1 The Role of Canada's Chief Public Health Officer).1, 5
The CPHO's reports are intended to highlight specific public health issues that the CPHO has determined warrant further discussion and action in Canada, and to inform Canadians about the factors that contribute to improving our health. These reports do not represent Government of Canada policy and are not limited to reporting on federal or provincial/territorial activities. As such, they are not intended to be frameworks for policy but rather a reflection of the perspective, based on evidence, of the CPHO regarding the state of public health across the country. The reports are designed to inform Canadians of important health issues and their potential impact on health trajectories and to highlight best practices for moving forward as a society in achieving better health outcomes. Within each report, proven and promising evidence of success among various communities and countries is outlined, including programs and activities that can serve as potential models for future consideration and inspire action and collaboration among levels of government, jurisdictions, various sectors, communities, organizations and individuals.
The Chief Public Health Officer's Report on the State of Public Health in Canada, 2009: Growing Up Well – Priorities for a Healthy Future concluded that Canada, as a society, needs to ensure all Canadians have opportunities, at all stages of the lifecourse, to have, maintain and enhance good physical and mental health for as long as possible.6 This report, The Chief Public Health Officer's Report on the State of Public Health in Canada, 2010: Growing Older – Adding Life to Years, builds upon that discussion and focuses on the state of health and well-being of Canada's seniors and the importance of creating and maintaining opportunities for healthy aging throughout the lifecourse.
While this report focuses specifically on the health of seniors, it is about all Canadians. Everyone has a role to play and can benefit from opportunities for healthy aging, now and in the future.
Throughout this report the generic term 'senior' is used. While there is no consistent definition for a senior, it is based on available data, health issues and public health activities that often focus on those aged 65 years and older. It is recognized that some subpopulations have lower life expectancies due to factors influencing health and as a result may age prematurely and be considered a senior earlier than age 65. However, for the purposes of this report, the term senior will refer to this specific age group (65 years and older).7, 8 Other terms such as elderly and frail are not used in the report (unless it is language used within a program description), as these are considered to be descriptive terms.
The report also refers to 'Canadians' to denote all people who reside within the geographic boundaries of the country. In some instances, special terms are used to identify particular groups. The term 'Aboriginal' is used to refer collectively to all three constitutionally recognized groups – Indian, Inuit and Métis. Although not constitutionally recognized, the newer term 'First Nations' is used to describe both Status Indians, recognized under the federal Indian Act, and non-Status Indians. When data exists to support discussion about these distinct population groups, specific details are provided for clarity.
The following identifies the chapters contained within the report, along with a brief summary of the topics covered within each chapter.
Canada's Experience in Setting the Stage for Healthy Aging. Chapter 2 introduces the concepts of healthy aging and the lifecourse by exploring various milestones in Canada's history and highlighting successes and challenges in establishing conditions for healthy aging.
The Health and Well-being of Canadian Seniors. Chapter 3 describes the current health status of Canada's senior population from four perspectives – physical health, mental health, economic well-being and social well-being – including factors influencing their health.
Setting Conditions for Healthy Aging. Chapter 4 highlights what can be done to maintain and improve conditions for healthy aging using examples of promising and/or successful interventions, programs and policies. The examples provided have either shown evidence of success and could be applied more broadly, or are areas of promise where further work and investigation is required.
Toward Healthy Aging. Chapter 5 outlines what has been learned from earlier chapters and defines priority areas for action. Based on these priorities, recommendations and commitments to healthy aging are proposed.
The Chief Public Health Officer:
In a public health emergency, such as an outbreak or natural disaster, the Chief Public Health Officer: