Death and dying abroad: The Canadian experience

Background:The objective was to examine the characteristics of internationa l travelers from Canada, who have died while abroad, and to review the heal th protection and promotion strategies for prevention of adverse health out comes associated with travel, which may have prevented these deaths. Method:An EpiInfo 6 program was created to analyse all of the Consular repo rts received in 1995 via the Secure Integrated Global Network, which provid es communications and computerization services to the Department of Foreign Affairs and International Trade, Canada. The Consular Management and Opera tions System was designed to support the delivery of consular services by t he Department, and to link Headquarters in Ottawa with missions in other co untries, through case management files, including a "Death Abroad" file. Th e type of data collected included personal demographics (age, gender), date , country, and cause of death. Results: In 1995, consular services received 309 reports of Canadians dying abroad. Two hundred and twenty deaths were males (71.2%), and 69 were fema les (22.3%). The average age (56 years) and median age (43 years) were simi lar for males and females (age range 0.3-86 years). Recorded causes of deat h were: natural (62.1%), accidents (24.9%), murder (7.8%), and suicide (5.2 %). Cardiovascular disease and trauma were the two most commonly specified causes of death. Conclusions: At least 36% of the deaths occurring in Canadian travelers wou ld be considered preventable. Pretravel medical interventions for travelers with known preexisting medical problems, may have prevented many more deat hs. International travelers need to be aware of the health risks associated with travel. Access to appropriate health risk assessment, prior to exposu re, in many cases, would have prevented death abroad.