Health Report

The Alberta Paradox

Brian Bergman October 23 2000
Health Report

The Alberta Paradox

Brian Bergman October 23 2000

The Alberta Paradox

Health Report

Cover

Brian Bergman

Sitting at the epicentre of an economic boom, Alberta’s two largest cities are, in many ways, the envy of the nation. Unemployment is low, incomes are high and residents are, for the most part, well-educated. If superior socio-economic status usually translates into a healthy population—and the experts agree that it does—Edmontonians and Calgarians should, it would seem, be among the leaders in the Macleans Health Report survey. But that is not the case. While Edmonton and Calgary fare considerably better across a range of health indicators than several other major centres—including Montreal and Halifax—their health profiles are no match for those from large chunks of British Columbia’s Lower Mainland and the affluent regions around Toronto.

So what gives? There are few definitive explanations, but Alberta healthcare experts offer some informed speculation. Possible factors include everything from stress in the workplace and smoking habits to the spectre of urban poverty in the midst of affluence. But behind it all is a hint of bafflement as to why the Alberta cities did not do better in the survey. “It’s a fascinating question,” says University of Alberta health-care economist Richard Plain. “But it is also likely a pretty tough nut to crack.”

Plain offers a couple of theories. Edmonton and Calgary, being the two largest health regions in a relatively sparsely populated province, act as a magnet for people from outlying communities. The sick and elderly, he explains, tend to move into

The wealthy, bustling province posts so-so health results

the cities as their health deteriorates. A concurrent development is that Alberta’s more affluent—and more robust—retirees often head to the West Coast for their sunset years. “It could be,” says Plain, “that relatively healthier people are moving out of the Prairies and into Vancouver and Victoria.”

Gerry Predy, the Edmonton region’s medical officer of health, says one factor that may be affecting the area’s overall results is a significant low-income population—many of I them aboriginal people—in the city’s inner I core. Babies born in that part of the city are far i more likely to have a low birth weight, which, ; in turn, drives up the rates of infant mortality 12 and other health complications. Predy also points out that, although Alberta is enjoying its latest boom cycle now, unemployment levels were higher through much of the 1980s and 1990s. “The rates of disease and mortality may not reflect the current economic situation,” he says, “but what went on before.” Others cite the prevalence of smoking as a likely culprit. The latest Health Canada statistics show that, among those aged 15 and older, 27 per cent of Albertans are smokers, compared with 24 per cent in Ontario and 20 per cent in British Columbia, where the healthier survey results appear. “Those provinces have been really aggressive in promoting smoke-free environments,” says Kabir Jivraj, senior vice-president and chief medical officer for the Calgary health region. “We’ve been a bit behind on that.”

A clash of cultures may also be behind some of the differences, says Art Quinney, past chairman of the Canadian Fitness and Lifestyle Research Institute. “Vancouver has a reputation as a laid-back kind of city that values free time,” notes Quinney, who currently serves as an associate vice-president at the University of Alberta. “Calgary and Edmonton are much more focused on entrepreneurship and a hard-nosed work ethic.” Then again, could it be as simple as diet? Albertans are famously fond of their tasty, homegrown beef. But as Predy, among others, point out, beef is much leaner than it used to be and the fat content in most people’s diet comes from processed foods, french fries and the like. On the other hand, recent surveys do show that the average Albertan eats less than the recommended amounts of fruits and vegetables. “This is pure speculation, but people in Vancouver and Toronto tend to have greater access to fresh produce than people in Calgary or Edmonton,” says University of Calgary nursing professor Lorraine Watson. “Could that be part of it?”

It seems as good a theory as any.