Life Satisfaction in Canadians With Cardiovascular Disease: A 20-year Repeated Cross-Sectional Analysis on Racial Disparities by Time and Region

Background Racialized Canadians face inequities in cardiovascular disease (CVD) burden and care, but evidence on quality-of-life measures such as life satisfaction is limited. We estimated the association between racialized status and life satisfaction among adults with CVD, examined four secondary quality-of-life outcomes, and assessed variation by survey cycle, province/territory, and immigrant status. Methods We pooled ten Canadian Community Health Survey cycles (2003-2022) including adults with self-reported heart disease or stroke. Life satisfaction and secondary outcomes (perceived health, mental health, life stress, community belonging) were each analysed as a binary (favourable vs. unfavourable) outcome. Survey-weighted logistic regression accounted for age, sex, survey cycle, and provinces/territories (Model 1), with additional adjustment for income and education (Model 2). We also examined whether life satisfaction estimates differed over time, across provinces/territories, and by immigrant status. Results Among 88,043 adults with CVD, 5,482 (6.2%) were racialized. Life satisfaction was 77.8% vs 83.4% in racialized vs non-racialized respondents (Model 1 adjusted odds ratio [aOR] 0.77, 95% CI 0.73-0.82; Model 2 aOR 0.75, 95% CI 0.71-0.79). Racialized respondents had lower adjusted odds of good perceived health, mental health, and belonging (all p<0.001). The adjusted life-satisfaction gap narrowed from -11.0 percentage points in 2003 to near convergence by 2021-2022, with geographic heterogeneity. The exploratory immigrant-status interaction was not statistically significant (β = −0.083, 95% CI −0.223 to 0.068; p=0.303). Conclusions Among adults with CVD, racialized respondents had lower odds of life satisfaction. Equity efforts in cardiovascular care—including supportive, psychosocial, and palliative care—should address quality-of-life disparities.