Regional disparities in Canadian adult and old-age mortality: A comparative study based on smoothed mortality ratio surfaces and age at death distributions

Abstract

This paper examines adult and old-age mortality differentials in Canada between 1930 and 2007 at the provincial level, using the Canadian Human Mortality Database and the flexible smoothing P-spline method in two-dimensions well-suited to the study of small populations. Our analysis reveals that provincial disparities in adult mortality in general, and among the elderly population in particular, are substantial in Canada. Moreover, based on the modal age at death and the standard deviation of ages at death above the mode, provincial disparities at older ages have barely reduced over time, despite the great mortality improvements in all provinces since the early 20th century. In the last few years studied, evidence of the shifting mortality regime was found among females in most Western and Central provinces, while all males were still undergoing an old-age mortality compression regime.