Your Postal Code Shouldn’t Determine Your COPD Care. In Canada, It Still Does.

Lung Health Foundation’s new Canadian COPD Performance Index finds significant shortfalls in COPD care across the country, driven by missing data, workforce shortages and no national strategy. Here’s where your region stands.

TORONTO, Oct. 05, 2026 (GLOBE NEWSWIRE) -- Your lungs don’t know what province you live in. Canada’s healthcare system does, especially when it comes to chronic obstructive pulmonary disease (COPD).

That’s the headline finding of the Canadian COPD Performance Index, a first-of-its-kind report released today by Lung Health Foundation (LHF), and made possible in part by a grant from the Speak Up for COPD Coalition. Built by a national working group of clinicians, researchers and people living with COPD, the Index is the first of its kind to lay every province and territory side by side – comparing them on population health, patient experience, workforce capacity, cost of care and health equity.

The topline message is clear: there are significant gaps in COPD care across Canada, and where you live may shape the care you receive. The Index shows where those gaps are, and where provinces and territories can learn from one another.

“COPD is one of the most common, most costly, and most under-prioritized chronic diseases in Canada,” says Dr. Somkene Igboanugo, Director, Programs & Person-Centered Care at Lung Health Foundation. “We constantly hear from people living with COPD about the gaps they run into in their own care. What most don’t see is how much that care varies from one part of the country to another. This Index puts real data behind both.”

More than two million Canadians live with COPD. It is the second-leading cause of hospitalization in the country, accounting for 76,968 hospital stays in 2024 alone, averaging 7.3 days each. That burden is felt across the entire health system, in hospital beds and costs that affect every Canadian, with or without COPD. People living with COPD die at more than twice the rate of people who don’t have it. And, on the global stage, Canada ranks a middling 17^th out of the 45 countries measured by the Global COPD Index, despite having a publicly funded healthcare system that, in theory, should put Canada near the top.

In practice, however, the Index shows that COPD care falls short across the country and varies widely along provincial and territorial lines. These gaps are specific to COPD, not simply a reflection of broader pressures on the healthcare system, and there is still no national COPD strategy to close them.

A Tale of 10 Provinces and Three Territories

Here’s where it gets complicated – and where the Index does something no one else has done. Instead of naming a single “best” or “worst” place for COPD care, it breaks performance into pieces because this is what the data supports. A region can lead the country in one respect and lag poorly in another, and even the leading scores leave significant room for improvement.

Canadian COPD Performance Index Highlights:

• New Brunswick has the highest concentration of respiratory therapists in Canada (53.5 per 100,000 -- well above the national rate of 30.2) and a lower-than-average cost per COPD hospitalization. It also has the highest smoking rate in the country (17.2%, vs. 11.7% nationally) and no dedicated COPD strategy -- and it is the only province missing from Canada's national chronic disease tracking. Hence, its COPD prevalence, new cases and death rates are unknown.
• Ontario leads the provinces in primary care access, with the lowest share of residents without a regular provider (11.5%, vs. 17% nationally). It also has Canada’s most comprehensive publicly published COPD quality standard, updated in 2023, fewer new COPD cases than the national rate, and a team-based model through its Primary Care Asthma and COPD Program. There is still room to grow. The share of residents living with COPD sits slightly above average (9.7% vs. 9.5%), the family doctor and respiratory therapist rates remain below national levels (107.3 vs. 119.1 and 23.4 vs. 30.2 per 100,000, respectively), and – like most of the country – Ontario lacks a formal, province-wide COPD strategy.
• Alberta has a below-average number of people living with COPD (9.1%, vs. 9.5% nationally) and is one of only two provinces with a dedicated COPD strategy. Its COPD hospitalization costs, though, run above the national average: $8,652 per patient hospitalized for COPD, compared with $8,202 nationally.
• Prince Edward Island, as of 2024, reports the lowest rate of primary care access in the country -- nearly four in 10 Islanders (38.3%) don't have a regular provider, more than double the national rate (17%). In addition, COPD accounts for a larger share of the Island’s hospital stays (2.9%) than the national figure (2.5%).
• Nunavut carries the country's highest COPD prevalence (20.5%, more than double the national rate) and its highest COPD hospitalization rate, while also reporting the lowest density of respiratory therapists of anywhere in Canada. It also has the fewest family doctors per capita (48.6 per 100,000, vs. 119.1 nationally), no identifiable pulmonary rehabilitation program and no established COPD care pathway.
• Across the country, the gaps are shared. Pulmonary rehabilitation -- an evidence-based program shown to reduce hospital use for people with COPD -- is concentrated in urban hospitals, where limited capacity, referral requirements and waitlists can delay access; none of the three territories has an identifiable program. There is no public data on how many people can access spirometry, the breathing test used to diagnose COPD, or how long they wait for it. And Canada counted just 823 respirologists in 2019, the most recent figure available, with none reported in the Northwest Territories.
  
  

“There is no simple ranking here, as healthcare access and services vary,” says Dr. Shirley Quach, Registered Respiratory Therapist and Co-Chair of the project’s national working group. “A province can have excellent primary care access and may still be missing a COPD strategy. A territory can have a strong workforce on paper and still be hours away from a specialist. We built this Index report so Canadians understand how different factors may influence care and access within their communities.”

The Data Canada Doesn’t Have is a Finding, Too

According to national working group Co-Chair Dr. Andrea Gershon, Senior Scientist and Staff Respirologist, Division of Respirology at Sunnybrook Health Sciences Centre and University of Toronto, the Index makes two things undeniable. “There is significant room for improvement of COPD care in Canada, and where you live can shape the COPD care you receive. There are opportunities for provinces and territories to learn from each other and improve outcomes nationwide.”

Dr. Gershon stresses that primary care is the front line. “Most people living with COPD are cared for by their family doctor or primary care team, yet roughly one in six Canadian adults (17%) has no regular primary care provider -- a gap that can mean delayed or missed diagnosis, sicker patients and higher healthcare costs.”

She also points to a gap that runs through every region: the data itself. “Across Canada, we lack basic information about the experiences of people living with COPD, including whether they receive the supportive and palliative care they need. We can’t fix what we don’t measure. Better data isn’t a luxury; it’s where better COPD care begins.”

A COPD Patient’s Perspective

Glenn Kitchener, a Torontonian who lives with COPD and served on the COPD Performance Index Working Group: “I am fortunate to live in a large urban center where my medical needs are well addressed by doctors who are top in their fields. The numbers certainly show that some provinces, territories and regions of this country have inadequate services when it comes to treating people with COPD. We have a lot of hard work ahead for ourselves.”

What Comes Next

The Lung Health Foundation is calling on federal, provincial and territorial leaders to use the Index as a starting point for a coordinated national strategy, one that doesn’t ask Canadians to get lucky with their postal code to breathe a little easier.

“COPD care in Canada is fragmented,” adds Dr. Igboanugo. “This report gives policymakers, clinicians, and advocates the evidence to change that. We’re not just pointing out gaps; we’re pointing the way forward.”

For the full Canadian COPD Performance Index, including detailed data for every province and territory, visit the Lung Health Foundation’s Insight Hub.

About Lung Health Foundation

The Lung Health Foundation, formerly the Ontario Lung Association, has been working to improve the lung health of Canadians for more than 100 years. As the national leader in lung health, the organization supports and empowers individuals living with lung disease through community programs, research, education, and advocacy. Its work helps build a healthier future for Canadians affected by lung conditions and their caregivers.

Follow LHF on social media: Instagram: @lunghealthfoundation; Facebook: lunghealthfoundation; X (formerly Twitter): @LungHealthFdn.

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