Sun Life Canadian
Health Index
2014 Canadian Health Index Report
FPO Stock Picture(s)
Life’s brighter under the sun
Table of Contents
Introduction
1
Section 1: Five years of data
2
Section 2: The financial impact of health
5
Section 3: Mental health and stress
8
About the Sun Life Canadian Health Index
9
Introduction
The shift toward later retirement among Canadians has been well documented. Since 2008 the Sun Life Canadian Unretirement Index has been asking Canadians at what age they expect to be fully retired. The national average hit a high of 69 in 2011. And while it has been trending down since
(the average expected retirement age fell to 66 in 2013), it is reasonable to predict that early retirement will grow less common in the years ahead.
This makes sense to a lot of us. Few Canadians are required to do much heavy lifting at work, and so our concerns about
not having enough saved for retirement are easily assuaged by a plan to work longer. As life expectancies continue to
lengthen, the idea of retiring at or before 65 has begun to feel anachronistic.
But there is a catch. Our health can interrupt those plans to keep on working. Major events like a stroke, cancer diagnosis
or even a serious injury often trigger long-term absences from work. Sometimes they mean we’re unable to return to work
altogether. And coming by surprise – as they almost always do – these experiences generally present us with unforeseen
costs just as they threaten our ability to continue to earn an income.
How common an experience is this? We decided with this fifth edition of the Sun Life Canadian Health Index to ask
retirees how they planned for retirement and whether or not they experienced surprises along the way. Turns out that
nearly seven in 10 did not retire as they planned or expected. And, as we hypothesized, the most common reason for not
retiring as planned had to do with personal health. Furthermore, among those who did experience a major health event,
four in five did not get to retire on-schedule.
You’ll find more on this and other stories in this executive summary. Now in its fifth year, our study is dedicated to
understanding what Canadians think about their health and the health care system they depend on. There is good news: the
index score itself – made up of questions related to Canadians’ perception of their health, their attitudes about health and
their health-related behaviours – has been trending upwards since 2011. It’s down slightly from last year, but still up relative
to the previous three years’ results. And there is bad news: too many Canadians misunderstand how health is funded across
the country, which appears to contribute to the fact that a large number remain unprepared for health expenses.
Page 1
Section 1: Five years of data
The value of longitudinal research is of course that it helps us to understand how respondents’ attitudes
evolve over time. In some respects, the way Canadians think about their health and the health behaviours
they exhibit hasn’t changed much since we launched the Sun Life Canadian Health Index in 2010. The
beliefs and opinions we tracked in survey No. 1 are not dissimilar to those we see in survey No. 5.
That said, we have seen some movement in our key result: the health index itself.
Sun Life Canadian Health Index
68
66
65.9
64
65.4
63.3
62
60
61.3
61.2
2010
2011
58
2012
2013
2014
Source: 2014 Sun Life Canadian Health Index
After trending up steadily between 2011 and 2013, this year’s index score is down from 65.9 to 65.41. It is a marginal drop,
obviously. The result – based on a series of questions that explore how respondents feel about their health, lifestyle and
finances – is still well above our findings from the first three years of study.
On a scale of 0 to 100, three quarters (75%) of Canadians scored their overall health 75 or better. Another 21% rated their
health between 50 and 74. The numbers across the country are consistent, with the exception of Quebec where 80%
rate themselves in the top quartile.
When asked specifically about physical health, 68% of Canadians report a score between 75 and 100. Again, the stand-out here is Quebec, where 72% reported the same.
Our emotional/mental health results are a bit more positive. Slightly more than three quarters (76%) of Canadians report
in the top quartile. Quebecers are most likely to score between 75 and 100 (83% gave that score.)
The Sun Life Canadian Health Index is based on responses to six questions. Prior years’ results have been restated to facilitate methodologically sound year-over-year comparisons.
1
Page 2
Here’s
a full summary of top-quartile results: Percentage reporting top
Percentage reporting top quartile
Percentage reporting top quartile
quartile score for
score for
score for emotional/mental
overall health
physical health
health
Canada
75%
68%
76%
Atlantic Canada
76%
70%
74%
Quebec
80%
72%
83%
Ontario
71%
64%
72%
Manitoba-Saskatchewan
76%
69%
73%
Alberta
77%
69%
74%
British Columbia
75%
67%
77%
Region
Relative to last year’s results, Canadians are feeling much the same in 2014. The only statistically significant move in the
national results was on physical health. Seventy-one per cent scored themselves in the top quartile in 2013.
Regionally, there were a number of notable year-over-year moves. In Atlantic Canada, the percentage in the top quartile for
emotional/mental health fell from 78% to 74%. Top quartile results in Quebec for emotional/mental health rose from 79%
to 83%. In Ontario, 64% scored between 75 and 100 for physical health, compared to 68% a year ago. Top quartile scores
in both categories fell in Alberta: physical health fell from 74% to 69% and emotional/mental health fell from 80% to 74%.
And 67% of British Columbians rated their physical health in the top quartile, compared to 74% last year.
Six in 10 (60%) Canadians are very comfortable with their current state of health, and 69% are highly motivated to attain
and maintain a healthy lifestyle. On both measures, those are top quartile scores.
Respondents expect to live to 80, on average, according to this year’s study. That’s down from 81 in 2013.
Average life expectancy
Canada
80.2
Atlantic Canada
78.5
Quebec
80.6
Ontario
79.0
Manitoba-Saskatchewan
78.8
Alberta
81.6
British Columbia
83.2
Q: Based on everything you know today, to what age do you think you will live?
Source: 2014 Sun Life Canadian Health Index
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On a range of measures, we’re seeing just minor changes in the responses we received this year compared to the 2011 study.
Health habits have changed little since 2011
Participated in at least 30 minutes of physical
activity each day - 2011
14%
30%
Participated in at least 30 minutes of physical
activity each day - 2014
16%
28%
Had at least 7 hours of sleep a night - 2011
31%
19%
27%
17%
18%
44%
6%
11%
23%
13% 3%
Had at least 7 hours of sleep a night - 2014
22%
Eaten at least 7 servings of fruit/vegetables
a day - 2011
7%
Eaten at least 7 servings of fruit/vegetables
a day - 2014
6%
Drank at least 6-8 glasses of water each day - 2011
Felt overwhelmed by stress - 2014
Always
Usually
Smoked - 2011
Occasionally
Rarely
Never
28%
17%
6%
13%
7%
15%
30%
27%
30%
18%
31%
39%
31%
3%
8%
10%
17%
25%
36%
10% 6% 6% 5%
14%
23%
30%
33%
20%
20%
34%
24%
Drank at least 6-8 glasses of water each day - 2014
Felt overwhelmed by stress - 2011
40%
7%
8%
13%
9%
73%
Smoked - 2014
13%
7% 5% 5%
70%
Q: In the past month, how frequently have you done each of the following?
Source: 2014 Sun Life Canadian Health Index
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Section 2: The financial impact of health
Almost half of our study’s respondents (45%) report personally suffering at least one serious health
event or accident. For most of these Canadians, 61% in fact, that experience triggered a financial
impact. A quarter (25%) said it reduced or depleted their savings. Another 26% said it caused them
“some financial hardship,” with a further 16% saying they experienced “significant financial hardship.”
Financial effects of a major health event
Caused me some financial hardship
26%
Reduced/depleted my savings
25%
Increased my credit card debit
17%
Caused me significant financial hardship
16%
Caused me to borrow money from friends/family
12%
Caused me to use a personal line of credit
10%
Caused me to use some/all of my RRSPs
8%
Caused me to sell my home and downsize
4%
Caused me to remortgage my home
3%
Caused me to return to the work force from retirement
1%
No Impact
39%
Q: How has your personal experience with (serious health event or accident) impacted your personal finances, if at all?
Source: 2014 Sun Life Canadian Health Index
Not surprisingly, health can have its greatest financial impact later in life. It is in fact the most common reason Canadians are
unable to retire on the date of their choosing (even surpassing surprise retirement dates triggered by an employer decision).
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We asked retired Canadians about the circumstances surrounding their retirement. Nearly seven in ten (69%) reported they
were not able to retire as planned or expected. Almost a third (29%) retired for personal health or medical reasons.
Seven in 10 Canadians do not retire as planned
Finished my career and retired as planned/expected
31%
Retired for personal health or
medical reasons (my own)
29%
Took an optional early retirement
offer from my employer
15%
Retired for some other reason
14%
Forced to take retirement due to my employer
10%
Retired for someone else’s personal health or
medical reasons (to take care of them)
2%
69% did not retire as
planned/expected
Q: Which of the following best describes your reasons for ‘how’ you retired? Base: retired respondents.
Source: 2014 Sun Life Canadian Health Index
The truth is that poor health can cost us money in multiple ways: lost wages, medicine and other forms of therapy. And then
of course there are those often overlooked costs that come with poor health: travel to and from the doctor’s office and so
forth. Despite Canada’s justifiably celebrated universal health care system, out-of-pocket expenses are commonplace.
Last year, Canadians reported paying $1,511 out of pocket for health care expenses. Albertans spent the most ($1,765) and
Quebecers the least ($1,286).
Out-of-pocket health costs paid in the last year
Canada
$1,511
Atlantic Canada
$1,703
Quebec
$1,286
Ontario
$1,565
Manitoba-Saskatchewan
$1,567
Alberta
$1,765
British Columbia
$1,438
Q: Over the past 12 months, how much would you estimate you have personally spent on medical/health care products
and services?
Source: 2014 Sun Life Canadian Health Index
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Despite all this, a remarkable number of Canadians misunderstand the extent to which they will be required to fund their
own health care costs. Again this year, we listed a number of common health expenses and asked respondents which they
expected to pay at least some amount for out of their own pocket.
Many Canadians expect to pay nothing for health services
Prescription drugs
44%
Eye care
50%
Chiropractic services
73%
Physiotherapy
74%
Home care
76%
Hearing aids
78%
Long-term care residence
78%
Nursing home residence
79%
Hospital stay
89%
Psychiatric treatment
89%
Q: Generally speaking, which of the following medical products or services would you expect to pay at least some
amount for out of your own pocket? (Answered no.)
Source: 2014 Sun Life Canadian Health Index
For the second consecutive year, a remarkable number expect to pay nothing for prescription drugs (44%), eye care (50%) and
other common health expenses. As we reported in last year’s report, this profound disconnect suggests either Canadians have
an unrealistic level of confidence in their own health or they simply misunderstand how health care is funded.
This could explain why so many Canadians choose not to purchase health insurance. One quarter (24%) of respondents
told us they own personal health insurance. Fewer than one in five (16%) own disability insurance; 12% own critical illness
insurance; and 10% own long-term care insurance.
About one quarter (27%) say they have a written financial plan. Among those Canadians, 33% report that their plan includes
health insurance.
Nearly two thirds (61%) of respondents have group benefits provided by their employer or by their spouse’s employer.
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Section 3: Mental health and stress
One
quarter (23%) of Canadians told us they have personally experienced a mental health issue.
For many, stress continues to play an outsized role in their lives. The percentage of Canadians who reported experiencing
one or more sources of excessive or uncomfortable levels of stress rose from 72% in 2012 to 77% in 2013. This year, 76% said
the same. And again this year, the top reasons for this stress relate to finances.
The top three drivers of excessive stress are related to finances.
At least one source of excessive stress
76%
Personal or household finances
41%
Trying to maintain a budget
31%
Unexpected expenses
30%
Personal relationships
(i.e. spouse, significant other, family)
29%
My work life
25%
A health condition/personal health issues
(i.e. physical or psychological)
25%
Saving enough for my retirement
21%
Not enough time in the day
19%
Trying to maintain a healthy diet
17%
Family member health issues
16%
Government spending and cuts
14%
The state of the economy
13%
Caring for dependent children
8%
Caring for dependent adults
7%
Other
6%
Average number of stressors: 2.7
Nothing is causing me excessive/uncomfortable levels of stress at this time: 24%
Q: Some amount of stress in our day-to-day lives is normal and even good for us. But stress can also be excessive and
harmful over the long-term. Which, if any of the following areas are currently causing you to experience a level of stress you are uncomfortable with? Source: 2014 Sun Life Canadian Health Index
As we’ve found in previous years, young Canadians are most likely to be stressed out. Nine in 10 (88%) of 18 to 24 year
olds report at least one source of excessive or uncomfortable stress. Compare that to 81% of 25 to 34 year olds, 80% of
35 to 44 year olds, 79% of 45 to 54 year olds, 69% of 55 to 64 year olds and 59% of Canadians 65 and older.
Among men, 72% are experiencing at least one source of excessive stress. Eight in 10 (79%) of women say the same.
Marital status appears to be a factor too. Eight in 10 (80%) of single Canadians are experiencing excessive stress. That
compares unfavourably to 73% of married Canadians and 63% of widowed Canadians who say the same. However, 86% of
divorced Canadians are experiencing at least one source of excessive stress.
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About the Sun Life Canadian Health Index
As a leading provider of individual insurance products and group benefit plans, Sun Life Financial is
dedicated to the ongoing development of insights into the health of Canadians, and how the right
lifestyle choices can prevent or reduce the severity and the impact of illness and disease.
The Sun Life Canadian Health Index plays an important role in the development of these insights, by providing a
comprehensive snapshot of the attitudes, perceptions and behaviours of Canadians relating to their health.
About the survey
Our fifth Sun Life Canadian Health Index is based on findings of an Ipsos Reid poll conducted between June 19 and 26,
2014. A sample of 2,799 Canadians from 18 to 80 years of age from the Ipsos Canadian online panel was interviewed online.
Ipsos employed weighting to balance demographics and ensure that the sample’s composition reflected that of the adult
population according to the 2011 Census data — and to provide results intended to approximate the sample universe.
A survey with an unweighted probability sample of this size and a 100% response rate would have an estimated margin of error
of +/- 2.1 percentage points, 19 times out of 20, of what the results would have been had the entire population of adults in
Canada been polled. The margin of error will be larger within regions and for other sub-groupings of the survey population.
A note on the charts in this report: “Total” figures refer to the results of the total base (i.e. 2,799). Sub-segment figures may
not always equal the total base if all sub-segments are not included in the chart.
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For more information
For more information on the Sun Life Canadian Health Index, or any of the information presented in this paper,
please contact Corporate.Marketing.and.Communications@sunlife.com.
© Sun Life Assurance Company of Canada
GRP1799-E
Sun Life Canadian Health Index 2014