Canada

Sex ratio. In Canada, as elsewhere, almost 3 percent more males than females are born each year. This surplus of males continues up to about age forty-five, after which females become an increasingly large majority. By the time one gets to old age, the number of females significantly exceeds the number of males. In 2001, women constituted 57 percent of all older Canadians, and 70 percent of those past age eighty-five. These ratios are expected to remain about the same until 2026 (Statistics Canada, 1999). The reason for the changing sex ratio with age is that females experience lower death rates than males at every age. By looking at sex differences in life expectancy at birth, one can see how much advantage females have over males in longevity. Life expectancy is the average number of years that one would live under age-specific death rates existing at a particular time. Death rates around 1920 resulted in women's life expectancy exceeding men's by two years (61 versus 59). By 1970 the gender gap in life expectancy had grown to seven years (76 versus 69). In recent decades the gender gap has declined a little, and in 1996 was below six (81.4 versus 75.7) (Statistics Canada, 1999). The imbalanced sex ratio in later life caused by differential mortality has implications for gender differences in aging.

Marital status. The excess number of older women compared to men means that chances of being married in old age differ by sex. While almost 75 percent of older men are married, only 41 percent of older women are married. Correspondingly, almost half of older women are widowed as compared to 13 percent of older men. This difference is even more dramatic among those age eighty-five and over, where just over half of men, but less than 10 percent of women, are married, and twice as many women as men are widowed (80 percent versus 39 percent). Given the sex differences in marital status, it is not surprising that more older women than men live alone (38 percent versus 16 percent). Among those aged eighty-five plus, the gap between women and men living alone is even greater (58 percent versus 29 percent) (Statistics Canada, 1999).

Living arrangements. Most older Canadians (93 percent) live in private households, but as cohorts age, an increasing proportion is cared for in institutions. The proportion living in institutions in 1996 increased from only 3 percent for those aged sixty-five to seventy-four to 34 percent of the population over age eighty-five. Within the oldest-old population, women, who are more likely to be widowed and have more functional limitations than men, are more likely than men to be institutionalized (38 percent versus 24 percent) (Statistics Canada, 1999). The disproportionate number of women among the older population and their greater likelihood of being institutionalized result in 70 percent of all long-term care residents being women.

Immigrant status. As a country that is largely the result of immigration, the ethnic and linguistic diversity in Canada is substantial. The original settlers were predominantly from England, Scotland, France, Ireland, and Wales, but were joined by immigrant families from Germany, Ukraine, Poland, Russia, and China in the nineteenth century. The heaviest immigration to Canada, relative to the nonimmigrant population, occurred between 1906 and 1915, and immigrants in this period tended to be young adult males. This pattern of immigration had important implications for the age and sex structure of the aging population during the latter part of the twentieth century. Even as recently as 1996, a remarkable 27 percent of all Canadians past age sixty-five were foreign born. Toward the end of the twentieth century, the largest number of immigrants came from Asia and Latin America (more than half of the immigrants since 1980 have come from Asia) (Statistics Canada, 1999). This new immigration pattern suggests that in the future there will be even greater ethnic variation in the older population than there is today. One result of the immigration history is that it creates an important difference between the languages and cultures of many seniors and those of the persons who are delivering services to seniors.

Labor force participation. Over the twentieth century the labor force participation rate declined continuously as retirement became institutionalized. This pattern continued in the late twentieth century as the proportion of those over age sixty-five still in the labor force declined from 11 percent in 1981 to 6 percent in 1998. Not surprisingly, a higher proportion of older men than women was in the labor force in 1998 (10 percent versus 3 percent). The distribution of employed older persons across occupational categories was fairly uniform: 21 percent employed in farming, 17 percent in professions, 15 percent in sales, 12 percent in both services and managerial occupations, and the remaining in clerical, manufacturing, construction, and transportation. Of course participation in the labor force is not the only way for older people to make productive contributions to Canadian society. About 23 percent of seniors participate in formal volunteer roles, and a majority (58 percent) report that they provide informal assistance to others outside their own homes. Slightly more women than men contribute in this way. As retirement has become nearly universal among people over age sixty-five, the most notable change in the labor force age structure since the mid-1970s has been the marked decrease in participation by those age fifty-five to sixty-four. Among men in what was once considered a preretirement age category, labor force participation declined from 74 percent in 1976 to 56 percent in 1998. Over this same time period, women ages fifty-five to sixty-four slightly increased their level of involvement in the labor force (from 30 percent to 36 percent). It is noteworthy that 22 percent of women, but only 2 percent of men, over age sixty-five never participated in the paid labor force (Statistics Canada, 1999).

Poverty and economic status. The proportion of older people in Canada with incomes below what Statistics Canada labels the "low income" cutoff declined from 34 percent in 1980 to 20 percent in 1998. This is the same as the percent of children with low incomes, and slightly higher than the percent of nonold adults. Within the older population, women are twice as likely as men to have low incomes (27 percent v 13 percent), and more than half (53 percent) of unattached older women have low incomes. Provincial variations in average income are substantial, with territories and provinces in the Atlantic region having lowest average incomes, and seniors living in Ontario, Alberta, and British Columbia having average incomes about $5,000 above the Canadian average. The primary source of income for seniors is Old Age Security, which provides 29 percent of all income received by people over age sixty-five. Other sources are employment-based pensions (21 percent), Canada and Quebec Pension Plan benefits (21 percent), investments (17 percent), and employment (8 percent). There is a variety of programs in most provinces that supplement the incomes of seniors in need. Another indicator of economic well-being is home ownership. A majority of senior families (84 percent), and almost half of unattached seniors, own their own homes (Statistics Canada, 1999). Some provinces contribute to the rent of low-income seniors through a variety of programs, and some provide support services to enable older people to remain in their own homes after developing functional limitations.

Health status. Less than one-fourth of older Canadians report their general health is only "fair" or "poor", and 40 percent report that it is "excellent" or "very good." The remainder (38 percent) report good health. Nevertheless, 82 percent of those aged sixty-five and over reported having at least one long-term chronic condition. Regarding more serious conditions, 28 percent report being limited in at least some activities because of a chronic health conditions. Among seniors between ages sixty-five and seventy-four, slightly more men than women report some limitation (23 percent versus 21 percent), but past age eighty-five women are more likely than men to report limitations (54 percent versus 42 percent). By far the most commonly reported chronic condition among both men and women is arthritis, which increases with advancing age; 53 percent of those aged eighty-five and over have this problem. Heart disease also increases throughout the later years of life to a peak of 22 percent at age eighty-five, but high blood pressure peaks between ages seventy-five and eighty-four at 35 percent. Another significant chronic disease, diabetes, remains almost constant at about 11 percent through later life (Statistics Canada, 1999).

Health care. The public health care insurance system in Canada contributes to the sense of well-being and financial security of all Canadians, especially of older Canadians. The national system includes all medically necessary treatment as legislated by the Canada Health Act. However, the degree to which long-term care (home care and facility care) is provided or covered varies substantially from province to province. While most provinces cover prescription drugs and vision care for seniors, the existence and amount of copayment vary across the provinces. All provinces have policies and service delivery programs to meet long-term care needs. The most comprehensive programs with lowest copayment requirements are in Manitoba and Quebec, and the least comprehensive and most costly to the consumer are in Alberta, Ontario, and Nova Scotia.