Avoidable Mortality of the Two Main Linguistic Communities in Québec
This report examines the avoidable mortality rates of Québec's two main linguistic groups, francophones and anglophones, over four periods: 1990−1994, 1995−1999, 2000−2004, and 2005−2007. The analysis was performed for Québec as a whole and for three specific areas: the Montréal census metropolitan area (CMA), all of Québec's other census metropolitan areas (Gatineau, Québec City, Sherbrooke, Trois-Rivières, and Saguenay), and the rest of Québec, i.e., non-metropolitan areas, or non-CMA.
Avoidable mortality refers to deaths occurring before age 75 due to causes that are known to be preventable. It is considered as an indicator of the quality of health services and public health interventions. Given advances in knowledge about the causes of disease and the means of treatment, we should ideally see a decrease in avoidable deaths, regardless of where people live or to what linguistic group they belong. We used the classification method developed by Tobias and Jackson (2001), which identifies the potential of primary, secondary, or tertiary care to reduce mortality for 62 different causes of death.
Avoidable death rates for Québec anglophones and francophones generally decreased between 1990−1994 and 2005−2007, with a few exceptions.
The avoidable mortality rate for lung cancer in anglophone women in Québec as a whole and in the Montréal CMA remained unchanged for 18 years. In the other CMAs and nonmetropolitan areas, the rate seems to have increased, but it is impossible to confirm this statistically. However, the avoidable mortality rate for lung cancer in francophone women increased significantly throughout Québec.
The avoidable mortality rate for colorectal cancer decreased significantly for francophone men and women in 18 years. This decline however has not been observed among anglophones while the trend of rates is stagnated.
Other major causes of avoidable mortality, such as ischemic heart disease and breast cancer (in women), decreased considerably in both groups across Québec during the period studied, although the decreases were not always significant for the anglophone population.
Anglophones often had lower avoidable mortality rates than francophones in 1990−1994. The more rapid decrease for the latter group brought mortality rates for the two linguistic groups closer together and sometimes eliminated differences that were significant at the beginning of the period studied.
Anglophone men and women in Québec still had significantly lower rates of lung cancer, suicide, intentional injuries, traffic accidents, and chronic obstructive pulmonary disease in 2005−2007.
Reduced mortality in francophone men eliminated the difference in favor of anglophone men that had existed in 1990−1994 with respect to ischemic heart disease, colorectal cancer, and cerebrovascular disease.
There were no significant differences between women in the two linguistic groups for colorectal cancer, cerebrovascular disease, and breast cancer rates throughout the entire period studied. The difference in favour of anglophones that existed for the ischemic heart disease has disappeared.