First Joint Survey of Health in Canada and the United States Shows Both Countries Report High Level of Health

For Immediate Release: June 2, 2004

Contact: NCHS/CDC Public Affairs, (301) 458-4800

The Joint Canada-United States Survey of Health (JCUSH) [PDF – 496 KB]

The overwhelming majority of Americans and Canadians rate their health as good, very good or excellent, but there are differences in key risk factors and patterns of health care in the two countries, according to the first joint U.S.-Canadian health survey released today by the Centers for Disease Control and Prevention (CDC) within the U.S. Department of Health and Human Services. Overall, Americans were more likely than Canadians to report that they were very satisfied with health care (53 percent compared to 44 percent), but findings for uninsured Americans accounted for significant differences between the countries in a number of categories.

The Joint Canada/U.S. Survey of Health, conducted by Statistics Canada and CDC’s National Center for Health Statistics, covered measures of health status, risk factors, health disparities, access to health care, and quality of and satisfaction with health care services. Because the survey contacted a representative sample of adults in each country and asked for exactly the same information in the same manner in a one-time telephone interview, this survey achieves a degree of comparability never before attained.

In the survey, people were asked to rate their health from poor to excellent, and 85 percent of Americans and 88 percent of Canadians reported that they were in good, very good or excellent health. Americans were slightly more likely than Canadians to rate their health as excellent (26 percent compared to 24 percent). This was particularly true for senior citizens; almost twice as many Americans 65 and over (15 percent compared to 8 percent) reported they were in excellent health. Americans were also slightly more likely to indicate that their health was only poor or fair (15 percent compared to 12 percent). Among low-income respondents, 31 percent of Americans said they were in fair or poor health, compared with 23 percent of low income Canadians.

The survey looked at measures of physical and mental health. Overall, 25 percent of Americans and 24 percent of Canadians reported some level of mobility limitation (problems with walking, standing or climbing). More Americans, particularly American women (7 percent compared to 4 percent), report highly severe mobility limitations. Approximately 8 percent of adults and 10 percent of women in both countries had experienced a major depressive episode in the past year.

Two key risk factors – smoking and obesity – were examined. Canadians were more likely than Americans to be current daily smokers (19 percent compared to 17 percent) and this difference was more pronounced among older women. However, a significantly higher proportion of Americans than Canadians are obese, primarily because among U.S. women the rate of obesity is nearly twice that of Canadian women. In both countries, those with the lowest incomes report poorer health and higher rates of severe mobility limitations as well as higher levels of smoking and obesity.

Since the health systems and the role of public and private insurance differ in each country, another important aspect of the report compares access to health care and people’s satisfaction with the health care they receive. Americans were more likely to report that the quality of their health care services in general was excellent compared with Canadians (42 percent compared to 39 percent.) Among uninsured American respondents, 28 percent said the quality of the health care services they received was “excellent,” 44 percent “good,” and 28 percent “fair” or “poor.” When asked about their satisfaction with health care services in general, 53 percent of Americans and 44 percent of Canadians said they were “very satisfied,” while 37 percent of Americans and 43 percent of Canadians said they were “somewhat satisfied.” Among uninsured Americans, 39 percent were “very satisfied” with the services they received, and 40 percent were “somewhat satisfied.”

Unmet medical needs during the past 12 months were reported by 13 percent of Americans and 11 percent of Canadians. Among those with an unmet need, Americans were more likely to identify cost as the primary barrier to health care (53 percent of unmet needs cases), while Canadians cited waiting for care as the primary barrier (32 percent of cases). Among the 11 percent of American respondents who were uninsured, four out of every ten reported an unmet medical need. Likewise, only 43 percent of the uninsured respondents said they had a regular medical doctor, compared with 80 percent of total American respondents and 85 percent of Canadian respondents.

The overall pattern of the use of prescription medicine was similar in the two countries, with use higher among those 65 years of age and older and among women. However, there was higher prescription drug use among Americans aged 45-64 than Canadians in this same age group.

The Joint Canada/US Survey of Health was conducted from November 2002 through March 2003 with a representative sample of civilian, non-institutionalized population of adults 18 and over; the sample size was approximately 3500 Canadians and 5200 Americans. For more information about the survey and a copy of the report check the Joint Canada/US Survey of Health website.