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Open Access Research article

Avoidable mortality across Canada from 1975 to 1999

Paul D James123, Doug G Manuel13* and Yang Mao24

Author Affiliations

1 Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, Toronto, Canada

2 The Department of Epidemiology and Community Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Canada

3 The Department of Public Health Sciences, Faculty of Medicine, University of Toronto, 155 College Street, Toronto, Canada

4 Surveillance and Risk Assessment Division, Centre for Chronic Disease Prevention and Control, Population and Public Health Branch, Health Canada, Tunney's Pasture, Ottawa, Canada

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BMC Public Health 2006, 6:137  doi:10.1186/1471-2458-6-137

Published: 23 May 2006



The concept of 'avoidable' mortality (AM) has been proposed as a performance measure of health care systems. In this study we examined mortality in five geographic regions of Canada from 1975 to 1999 for previously defined avoidable disease groups that are amenable to medical care and public health. These trends were compared to mortality from other causes.


National and regional age-standardized mortality rates for ages less than 65 years were estimated for avoidable and other causes of death for consecutive periods (1975–1979, 1980–1985, 1985–1989, 1990–1994, and 1995–1999). The proportion of all-cause mortality attributable to avoidable causes was also determined.


From 1975–1979 to 1995–1999, the AM decrease (46.9%) was more pronounced compared to mortality from other causes (24.9%). There were persistent regional AM differences, with consistently lower AM in Ontario and British Columbia compared to the Atlantic, Quebec, and Prairies regions. This trend was not apparent when mortality from other causes was examined. Injuries, ischaemic heart disease, and lung cancer strongly influenced the overall AM trends.


The regional differences in mortality for ages less than 65 years was attributable to causes of death amenable to medical care and public health, especially from causes responsive to public health.