Health deficiencies in Cape Breton County, Nova Scotia, Canada, 1950-1995

Cape Breton County contains one of the most polluted areas in North America and is socioeconomically depressed. We evaluated mortality patterns in thi s area over the past 5 decades, focusing on life expectancy and life loss. Life loss refers to the difference in life expectancy of Cape Breton County residents and all Canadians, and was further broken down into disease-spec ific components using cause-eliminated life table methods. We observed lags in health of 20 to 25 years for residents of Cape Breton County. Life expe ctancy in some municipalities of Cape Breton County is reduced by more than 5 years. Life loss for these residents is greater than that of any single cause of death for Canadians. Life loss among Cape Breton County women is p rimarily attributable to cancer, and, among men, to cardiovascular diseases . Life loss from cancer is higher in the steel producing communities; where as life loss from respiratory diseases and lung cancer is higher in the coa l mining communities, These (and other) decompositions of life loss disclos e patterns in health deficiencies that give rise to etiologic hypotheses an d provide clues and directions for prevention and interventions.