A study projects millions more Ontarians will live with major illnesses, putting health care at risk
The Projected Patterns of Illness in Ontario study reveals that millions more Ontarians will be living with chronic illnesses by 2040.
This report, published by the University of Toronto’s Dalla Lana School of Public Health in collaboration with the Ontario Hospital Association (OHA), highlights a major increase in the prevalence of chronic diseases and the significant challenges it will pose for Ontario’s health care system over the next two decades.
The findings indicate that 3.1 million adults will be living with major illnesses in Ontario by 2040, up from 1.8 million in 2020. Additionally, the study projects that one in four adults over the age of 30 will require significant hospital care for major illnesses by 2040, compared to one in eight in 2002.
The report combines demographic projections based on age and sex with historical trends in chronic disease to model the future burden on the population.
The study finds that the rise in chronic diseases, particularly those associated with aging, such as osteoarthritis, diabetes, and cancer, will significantly strain Ontario’s health care services.
As the population ages, multimorbidity—the presence of two or more chronic conditions in a person—will also increase. This will contribute to the rising demand for health services, as individuals with multimorbidity often require more complex and costly care.
Adalsteinn Brown, dean of the Dalla Lana School of Public Health and co-author of the study, said that planning for sustainable and equitable health care requires projections of future chronic disease rates.
According to Brown, their projections suggest more Ontarians will be living with major illness, highlighting the need for new solutions, including efforts in chronic disease prevention and management.
The study emphasizes that as life expectancy in Canada continues to rise, reaching 81.5 years as of 2020-2022, the aging population will drive the increase in chronic illnesses.
Structural and social determinants of health, along with growing chronic disease risk factors, also play a significant role in these projections.
Anthony Dale, president and CEO of the Ontario Hospital Association, underscored the urgent need for innovation in Ontario’s health care system in response to the findings. “As we look to the future, it's clear that Ontario's reached a turning point,” said Dale.
“Ontario's health system is already grappling with rapid population growth, increasingly complex health needs, and intense pressures on existing capacity. These findings confirm that maintaining the status quo is not an option.”
The report advocates for a focus on prevention, early detection, and the effective treatment of chronic diseases. It also highlights the importance of expanding services that support seniors, such as home and community care, primary care, and supportive housing.
These measures are essential to preserving hospital and long-term care capacity for individuals with the most complex needs.
Dale also pointed to the potential benefits of new technological innovations in health care, stating that “Over the past several decades it is biomedical and technological innovation that has driven clinical improvements, cost savings and improved access to care in hospital settings.”
He emphasized the importance of integrating technologies like artificial intelligence, gene therapy, and personalized medicine to address the growing demand for health services.
The study presents a detailed look at the demographic trends contributing to the rise in chronic illness. Ontario’s population is expected to grow by 36 percent over the next 20 years, with the largest growth occurring in those aged 65 and older.
By 2040, the number of people aged 65 or older is projected to increase from 2.6 million to 4.2 million, an expansion of over 60 percent. This aging population, coupled with the rising prevalence of chronic illnesses, will place immense pressure on the health care system.
According to the study, the number of people living with chronic illnesses in Ontario has already nearly doubled in the past 20 years, from approximately 960,000 in 2002 to 1.8 million in 2020. This trend is expected to continue, with 3.1 million Ontarians projected to be living with major illnesses by 2040.
In the working-age population (ages 30-64), the proportion of people with major illnesses is expected to increase from 5.7 percent in 2002 and 9.2 percent in 2020 to over 10 percent in 2040.
The study also anticipates a significant rise in the number of Ontarians living with some form of illness. By 2040, an additional 5.1 million people are expected to be living with an illness, up from 3.9 million in 2020.
Some conditions, such as dementia, hearing loss, and osteoarthritis, which are typically associated with aging, are expected to experience particularly large growth in the number of cases.
The findings call for immediate action in developing long-term health care strategies to manage the growing demand for services, particularly those focused on chronic disease prevention and management.
Ontario’s health care system must adapt to meet the needs of its rapidly aging and expanding population, while ensuring that individuals with the most complex health care needs receive adequate care.
