Chronic conditions in childhood: Prevalence

This tab presents the prevalence of diagnosed long-term conditions among children and youth aged 1 to 17 years living in the 10 Canadian provinces. All data are from the 2019 and 2023 cycles of the Canadian Health Survey on Children and Youth (CHSCY). Prevalence is presented overall, as well as by sex, age and geographic region.

The conditions covered are:

• asthma
• diabetes
• epilepsy
• anxiety disorder
• mood disorder
• eating disorder
• learning disability or disorder
• attention deficit disorder or attention deficit hyperactivity disorder (ADHD)
• autism
• fetal alcohol spectrum disorder (FASD)
• any long-term condition (includes all conditions listed here as well as “other” long-term conditions reported by the survey respondents)

On this page

• Overall prevalence of long-term conditions
• Prevalence by sex
• Prevalence by age
• Prevalence by geographic region
• Discussion
• References

Overall prevalence of long-term conditions

In 2023, 1 in 4 children and youth (over 1.6 million) had a diagnosed long-term condition. This is an increase from 23.0% in 2019 to 24.8% in 2023, or a 7.8% relative increase between the years.

Although the prevalence of most long-term conditions remained stable during that time, the exceptions were:

• decreases in asthma (7.0% to 6.4%) and learning disabilities or disorders (8.4% to 6.8%)
• increases in ADHD (6.7% to 8.4%) and autism (2.0% to 3.0%)

In 2023, among those with a long-term condition:

• 67.4% had 1 condition
• 20.9% had 2 conditions
• 11.7% had 3 or more conditions

These proportions were stable between 2019 and 2023.

The most common conditions in 2023 were:

• ADHD (8.4%)
• learning disabilities or disorders (6.8%)
• asthma (6.4%)

These conditions were also the 3 most common in 2019.

Figure 1: Prevalence of long-term conditions in 2019 and 2023 among children and youth, Canada, excluding territories

Figure 1: Notes

• E: Use estimate with caution.
• We based percentages and 95% confidence intervals (CIs) on weighted data to represent the population aged 1 to 17 years living in the 10 Canadian provinces. The 95% CI shows an estimated range of values. It’s likely to include the true value 19 times out of 20.
• We excluded territories from the 2019 results to align with the 2023 CHSCY survey coverage.
• "Any long-term condition" includes those listed in the figure and “other” long-term conditions reported by the survey respondents. For 2023, we excluded allergies from “Any long-term condition” to align with the CHSCY 2019 questionnaire and for consistency throughout this report.
• The estimates presented are crude prevalence. We also conducted analysis using age-standardization, and the estimates and patterns were comparable.
• For more details on variable definitions, refer to technical notes.

Abbreviations:

• ADHD: attention deficit hyperactivity disorder
• FASD: fetal alcohol spectrum disorder

Figure 1: Text description

Prevalence by sex

In 2023, males had a higher prevalence of any diagnosed long-term condition than females (27.7% vs. 21.8%). However, compared to males, the prevalence among females increased twice as much in 2023 relative to 2019 (by 11.2% in females vs 5.7% in males).

Compared to females, males had a higher prevalence of:

• asthma (7.6% vs. 5.1%)
• learning disabilities or disorders (8.1% vs. 5.5%)
• ADHD (10.8% vs. 5.9%)
• autism (4.3% vs. 1.5%)

Compared to males, females had a higher prevalence of:

• anxiety disorders (6.6% vs. 3.9%)
• mood disorders (3.2% vs. 1.4%)
• eating disorders (0.8% vs. 0.2%)

The 2023 patterns in prevalence by sex were the same as in 2019.

Figure 2: Prevalence of long-term conditions in among children and youth, by sex, Canada, excluding territories

Figure 2: Notes

• E: Use estimate with caution.
• We based percentages and 95% confidence intervals (CIs) on weighted data to represent the population aged 1 to 17 years living in the 10 Canadian provinces. The 95% CI shows an estimated range of values. It’s likely to include the true value 19 times out of 20.
• We excluded territories from the 2019 results to align with the 2023 CHSCY survey coverage.
• "Any long-term condition" includes those listed in the figure and “other” long-term conditions reported by the survey respondents. For 2023, we excluded allergies from “Any long-term condition” to align with the CHSCY 2019 questionnaire and for consistency throughout this report.
• The estimates presented are crude prevalence. We also conducted analysis using age-standardization, and the estimates and patterns were comparable.
• For more details on variable definitions, refer to technical notes.

Abbreviations:

• ADHD: attention deficit hyperactivity disorder
• FASD: fetal alcohol spectrum disorder

Figure 2: Text description

Prevalence by age

In 2023, the prevalence of children and youth with any diagnosed long-term condition was highest in those aged 12 to 17 years (33.3%). It was lowest in those aged 1 to 4 years (13.1%). This age pattern was the same as in 2019.

The older a child is, the more time they have to develop a long-term condition and be diagnosed. Some conditions, such as ADHD, often aren’t diagnosed until school age as some symptoms take time to develop and be recognised.^{Footnote 1} Since most long-term conditions are life-long conditions, we expect prevalence to increase with age.

Between 2019 and 2023, the prevalence of any long-term condition increased in those aged 1 to 4 years (10.9% to 13.1%) and those aged 12 to 17 years (30.9% to 33.3%). It didn’t increase in those aged 5 to 11 years. The highest prevalence of long-term conditions overall was observed in those aged 12 to 17. This group experienced an increase of 7.8% in 2023 relative to 2019. The lowest prevalence of long-term conditions overall was observed in those aged 1 to 4. However, this group experienced the largest relative increase (20.2%) over the same period.

Figure 3: Prevalence of long-term conditions in among children and youth, by age group, Canada, excluding territories

Figure 3: Notes

• E: Use estimate with caution.
• X: Estimate suppressed to meet the confidentiality requirements of the Statistics Act.
• N/A: This condition was only asked to the PMK of children and youth aged 5 to 17 years due to the diagnosis being less relevant for young children.
• We based percentages and 95% confidence intervals (CIs) on weighted data to represent the population aged 1 to 17 years living in the 10 Canadian provinces. The 95% CI shows an estimated range of values. It’s likely to include the true value 19 times out of 20.
• We excluded territories from the 2019 results to align with the 2023 CHSCY survey coverage.
• "Any long-term condition" includes those listed in the figure and “other” long-term conditions reported by the survey respondents. For 2023, we excluded allergies from “Any long-term condition” to align with the CHSCY 2019 questionnaire and for consistency throughout this report.
• For more details on variable definitions, refer to technical notes.

Abbreviations:

• ADHD: attention deficit hyperactivity disorder
• FASD: fetal alcohol spectrum disorder

Figure 3: Text description

Prevalence by geographic region

In 2023, the prevalence of any diagnosed long-term condition among children and youth varied across geographic regions. It ranged from 22.0% in Ontario to 29.6% in Quebec. Between 2019 and 2023, the prevalence of any long-term condition increased in British Columbia, the Prairies and the Atlantic provinces. Prevalence remained stable in Ontario and Quebec.

In 2023, when compared to all other geographic regions:

• the prevalence of mood disorders was lower in Quebec
• the prevalence of ADHD was higher in Quebec and lower in Ontario

The prevalence of the other long-term conditions was similar across geographic regions.

Figure 4: Prevalence of in among children and youth, by geographic region, Canada, excluding territories

Figure 4: Notes

• E: Use estimate with caution.
• X: Estimate suppressed to meet the confidentiality requirements of the Statistics Act.
• N/A: Territories not included.
• We based percentages and 95% confidence intervals (CIs) on weighted data to represent the population aged 1 to 17 years living in the 10 Canadian provinces. The 95% CI shows an estimated range of values. It’s likely to include the true value 19 times out of 20.
• We excluded territories from the 2019 results to align with the 2023 CHSCY survey coverage.
• "Any long-term condition" includes those listed in the figure and “other” long-term conditions reported by the survey respondents. For 2023, we excluded allergies from “Any long-term condition” to align with the CHSCY 2019 questionnaire and for consistency throughout this report.
• We used geographic regions instead of individuals provinces in certain cases to reduce variability of estimates and improve reportability of results.
• The estimates presented are crude prevalence. We also conducted analysis using age-standardization, and the estimates and patterns were comparable.
• For more details on variable definitions, refer to technical notes.

Abbreviations:

• ADHD: attention deficit hyperactivity disorder
• FASD: fetal alcohol spectrum disorder

Figure 4: Text description

Discussion

In 2023, 1 in 4 children and youth in Canada had a diagnosed long-term condition, a proportion that highlights a substantial need for supports and services in this population. Overall, the prevalence of a diagnosed long-term condition increased by 7.8% in 2023 relative to 2019. Many factors could potentially explain this rise, such as increased awareness and environmental and social changes (especially post-pandemic). In this report, the prevalence of 2 of the long-term conditions increased between the survey cycles, while 2 decreased (both of these changes were statistically significant). Therefore, some of these explanatory factors for change over time may be condition specific. For example, the rise observed in the prevalence of autism corresponds with broader increases reported in the literature. These reported increases are thought to result from several factors including:

• increased awareness^{Footnote 2}
• expanded diagnostic criteria^{Footnote 3}
• guidelines promoting early detection^{Footnote 4}

However, the specific factors and the extent of their contribution to this rise remain unknown.

The rise in the prevalence of ADHD also corresponds with:

• longer-term trends the Canadian literature^{Footnote 5}
• evidence suggesting an increase in ADHD symptoms globally during the COVID-19 pandemic^{Footnote 6}

However, more research is needed on the reasons for this recent increase.

As for the decrease observed in the prevalence of asthma, other studies have proposed factors such as social isolation (for example, reduced exposure to viral infections) and reduced environmental exposures (for example, lower exposure to pollen or air pollution) during the pandemic.^{Footnote 7}

The decrease in prevalence of learning disabilities or disorders in this report may deserve further investigation as longer time trends in the United States were found to be stable,^{Footnote 8} while Canadian data in people aged 15 and older between 2017 and 2022 showed an increase in prevalence.^{Footnote 9}

Although more males than females had a long-term condition, the relative change in prevalence from 2019 to 2023 was 2 times higher in females. This may reflect underdiagnosis in females in previous years, especially for conditions like ADHD and autism. These conditions have historically been more frequently identified in males.^{Footnote 5Footnote 10Footnote 11}

For age patterns, the oldest age group had a higher prevalence of long-term conditions than the younger age groups. However, the prevalence increased 2.5 times more in the 1- to 4-year-olds than the 12- to 17-year-olds. Based on surveillance data, it’s not possible to determine if this difference in the increase from 2019 to 2023 was driven by:

• earlier detection
• earlier development of childhood health challenges
• other factors specific by condition

This is an interesting finding to further investigate. Taking autism as an example, the observed increase in prevalence in the 1- to 4-year olds aligns with findings from other data sources.^{Footnote 12} It also aligns with a shift to emphasize early identification and diagnosis.^{Footnote 4} More broadly, this age pattern underscores the importance of early childhood health surveillance and support programs.

Similarly, geographic variations in the reported prevalence of long-term conditions may reflect a range of contextual factors beyond the conditions themselves or the social determinants of health. These can include differences in clinical practices by province or territory. Such factors are important to consider when interpreting survey results across geographical regions.

The 2019 to 2023 period captures the impact of the COVID-19 pandemic on childhood health. When looking at the prevalence of diagnosed long-term conditions during the pandemic, data suggest that changes in prevalence varied depending on the:

• sex
• age group
• specific condition

Future cycles of CHSCY will help monitor these changes more closely and improve understanding of groups that may be more impacted. This will help with the planning of services and supports for children and youth with long-term conditions. While surveillance evidence can’t explain why these changes are happening, it provides useful insights and can generate hypotheses for further study.

Learn more in the Determinants and outcomes tab.

For more published data on long-term conditions among children and youth:

• Autism spectrum disorder: Highlights from the 2019 Canadian health survey on children and youth
• At-a-glance FASD prevalence among children and youth: results from the 2019 Canadian Health Survey on Children and Youth
• Canadian Chronic Disease Surveillance System (data on asthma, diabetes, epilepsy, juvenile idiopathic arthritis, schizophrenia among children and youth)
  • Note: Prevalence estimates from the CHSCY, based on person most knowledgeable-reported survey data, may differ from prevalence estimates using the Canadian Chronic Disease Surveillance System (CCDSS), based on administrative health data. Differences in prevalence estimates reflect the distinct nature of the data source and methodologies used.