Manitoba ranks near the bottom of a report card on the state of Canada's health care system.

The Conference Board of Canada report, which looked at disease rates, obesity, infant mortality and bad habits such as smoking and a sedentary lifestyle, gives Manitoba a "D" grade.

Saskatchewan and Nova Scotia share the same grade.

"It's a pretty dire story when you look at the numbers," said Sheila Rao, a researcher with the Conference Board of Canada.

Where Manitoba did well was in self-reporting health and mental health issues. The province received an "A" in that category. But it got a "D-minus" in infant mortality and a "D" in the categories of premature death and death from diabetes.

Manitoba earned “C”s for life expectancy and mortality due to cancer.

The Conference Board of Canada says the poorer health of the aboriginal population may be a factor in why provinces like Manitoba and Saskatchewan received low grades

Minister of Health Sharon Blady said some of the problems are under federal jurisdiction, but the province has stepped in with its own programs, such as Healthy Baby and the Northern Healthy Food Initiative.

Blady said the programs being implemented now will start showing up in health statistics in the coming decades.

"But anybody who thinks that even 15 years of investments can overcome 250 years of colonization … it took generations to make this mess, it's going to take a long time to fix it," said Blady.

"The benefits of that, while there are some immediate benefits that are being reaped now, what we're going to see is really the long-term benefits in 10 or 15 years. Anything that involves health and health status is about a long-term investment."

Worst infant mortality rates

Manitoba has the worst ranking for infant mortality according to Rao. The numbers are high in First Nations communities because of the high occurrence of Sudden Infant Death Syndrome.

"For aboriginal populations due to smoking, smoking while pregnant, living conditions, so this all plays into the scores on these indicators," Rao said.

The report is meant to be a snap-shot of the health of Canadians, but Rao said it does make some issues very clear.

"It really is to focus on the living conditions of the aboriginal populations. Access to health care, trust issues, there are a lot of issues that come into play. And it's not a simple blanket band-aid to fix," Rao said.

The province with the best ranking in the report is Brith Columbia with an "A", followed by Ontario with a "B".

The worst rankings were in Newfoundland and Labrador and the three Northern Territories, all of which received a score of "D-minus".

When it comes to countries, Canada is in the middle of the pack, ranking eighth among 16 with an overall "B" grade.

The number one health care system in the world is in Switzerland, while the U.S. ranked last.

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