Canadian adults’ functional health has declined over the past decade, largely because of deteriorating emotional health and the increasing prevalence of pain, according to a report from Statistics Canada.

Overall, the percentage of Canadian adults with very good to perfect functional health declined from 68.6% in 2015 to 56.4% in 2024. The largest decrease was among young adults aged 18-34 years.

“The decline in functional health from 2015 to 2024 is a new trend compared with what was seen before 2015. A previous report showed that from 1994 to 2015, functional health remained constant for Canadian adults under age 65 years and improved for those over age 65 years,” author Gillian Smith, a population health analyst at Statistics Canada, told Medscape News Canada.

The rate of emotional health, measured as happiness and interest in life, decreased from 78.3% in 2015 to 61.2% in 2024. Emotional health declined more than any other attribute. The percentage of adults with no pain or discomfort also decreased from 77.9% in 2015 to 72.0% in 2024.

The results of the Statistics Canada report come from the Canadian Community Health Survey, which is completed by a representative sample of some 50,000 Canadians each year. The questions on functional health focus on an individual’s level of difficulty in eight attributes, including vision, hearing, speech, cognition, dexterity, mobility, emotional health, and pain, Smith explained.

Worsening Emotional Health

Commenting on the findings for Medscape News Canada, Perry Adler, PhD, clinical psychologist and director of the teenage health unit at the Jewish General Hospital in Montreal, said that the decline in emotional health, especially among young people, is not surprising.

“There has been a significant drop in emotional health since at least 2014,” he said. Adler attributed the decline in emotional health to social media, doomscrolling, and vitriol-filled podcasts. “People are not interacting with others as much as they did for most of humanity’s history. People are all in their isolated cells of consumption of all these data. If we as humans don’t have enough social connection, we’re lonely. And loneliness leads to depression.”

The group of 18- to 34-year-olds is the most strongly affected, Adler said. “The older ones were about 17 when social media became [prevalent], and the youngest have never known a world without social media. If you spend thousands of hours a year doing mainly text-based communication, you are missing thousands of hours of face-to-face communication. You are missing facial cues and changes in vocal tone. You have less ability to communicate effectively, you are not understanding implicit explanations of what is going on, and that can lead to conflict and distancing,” said Adler. Moreover, peers’ highly curated self-presentations on social media may contribute to feelings of inadequacy, sadness, and anxiety, he added.

In his practice, Adler has witnessed a twofold increase in the prevalence of depression and anxiety disorders in people younger than 35 years, especially among those who are younger than 25 years. “In a typical week in 2000, where we would run two clinics for teenagers, maybe one or two would be suicidal. Now, almost all have suicidal thoughts,” he said.

“This new generation is the first in many generations in North America who see that they will more likely have a worse standard of living than generations before them,” Adler continued. “With the advent of AI, they’re worried about what jobs they will have. We’re hearing kids say that they have no idea what to study.”

Underneath the Numbers

The decline in functional health resulting from pain could be another adverse effect of social media, Adler suggested. “If you are spending all your time on screens, you’re not moving around, getting out in nature, or doing exercise. This affects the musculoskeletal system, which means that your body is not in as good shape as it could be, and you experience more physical discomfort. If you add anxiety and depression, this exacerbates pain.”

Kathleen Rice, PhD, associate professor of family medicine at McGill University in Montreal, agreed that young people in Canada are facing unique challenges. “They are living in a time of great uncertainty about their ability to secure the same kind of future, materially speaking, like owning a home and having a job. There’s also the bigger picture of climate change and the global political context that is shifting quite rapidly. I can only imagine how challenging it must be for them,” Rice told Medscape News Canada.

The Statistics Canada report gives an “eagle’s eye view” of trends in the nation’s functional health but lacks depth, she said. “We don’t know what is going on underneath the numbers. I would like to know more about what it is like for people with mental health struggles and what it is like for people in pain because without that knowledge, we’re not going to be able to improve systems to address the challenges they face,” Rice said.

Smith and Rice reported having no relevant financial relationships. Adler has a private practice with Perry S. J. Adler & Associates.