Canada and the United States, while similar in many ways, differ somewhat in age structures, life expectancies, policies relevant to an ageing population, and the challenges they face with future ageing. Canada is the older and longest-lived. Both countries have made changes in their healthcare systems to provide access to healthcare across their populations. Socioeconomic differences in the ageing process are an issue in both of these countries. In this chapter, we first outline the demographic conditions relevant to the ageing population in these countries, then examine health issues relevant to the ageing population including a number of dimensions of health and healthcare. We then lay out specific socioeconomic and cultural challenges related to an ageing population in each country and how these are likely to be dealt with in the future.