While a variety of factors contribute to the health of a country's people, the residents of developed countries tend to be healthier overall than those of developing countries, and especially the least developed countries. Developed countries offer a higher quality of life, including lower pollution rates; better infrastructure such as roads and utilities; and greater access to quality health care, strong education, good jobs, nutritious food, and safe drinking water. Unsurprisingly, these countries also often rank among the Happiest Countries in the World.
On the other hand, unhealthy countries often lack adequate access to these same benefits. Residents often lack the education required to land decent-paying jobs, which are often rare anyway. Pollution may be high, leading to health problems, illnesses, and death. Even fundamentals that many of us take for granted, such as clean water and proper roads, may be scarce. The life expectancy of the residents of these countries is often lower than average, while infant mortality is higher. These countries are clearly less healthy. This trend can be seen in the Health section of the United Nations' Human Development Index, or in other health-focused metrics, including those explored on this page.
What does "health" mean to an entire country?
In looking at the various systems for ranking national health, it quickly becomes clear that the definition of "healthy" varies from one source to the next. For example, the Bloomberg Global Health Index is a broadly-based measure that evaluates the personal health of a nation's people in a general, all-encompassing sense. By comparison, the similarly named Global Health Security Index focuses tightly on a nation's capacity to fight disease, and as such arrives at a completely different set of rankings. Both systems are measuring "health" but have their own unique interpretations of the term. Moreover, other systems may think of "health" in economic terms such as Gross Domestic Product (GDP) or in terms of national safety or some other qualification. It is important to keep these factors in mind when comparing one set of global rankings with another.
The Bloomberg Global Health Index
One metric specifically designed to measure national health is the Bloomberg Global Health Index. This metric examines many factors, including the following:
- Health risks (tobacco use, high blood pressure, obesity)
- Availability of clean water
- Average life expectancy
- Causes of death
According to the 2019 ranking, Spain's overall score of 92.75 qualified it as the healthiest country in the world. For comparison, the United States ranked 35th, with an overall score of 75. Spain boasts a life expectancy of 83.5 years, which is expected to rise to 85.8 by 2040 and be the highest in the world. Spaniards eat a Mediterranean diet filled with healthy fats and legumes, fruits and vegetables, and less red meat and processed food. Spain has the highest percentage of walkers in Europe, with 37% of people walking to work instead of driving (only 6% of Americans walk to work). Additionally, Spain’s universal healthcare program is very successful and has lowered the country's rate of preventable deaths to 45.4 preventable deaths per 100,000 inhabitants.
The Top 25 Healthiest Countries in the World (Bloomberg Global Health Index 2019):
The Global Health Security Index
In contrast to the Bloomberg index, the Global Health Security Index focuses tightly upon a nation's ability to maintain the well-being of its citizens during a pandemic or other extreme biological event. The index evaluates each country by assessing its performance in 37 different indicators, which are then combined to give each country a score between 1-100 in each of six general categories:
- Prevention — Prevention of the emergence or release of pathogens
- Detection and Reporting — Early detection and reporting for epidemics of potential international concern
- Rapid Response — Rapid response to and mitigation of the spread of an epidemic
- Health System — Sufficient and robust health system to treat the sick and protect health workers
- Compliance with International Norms — Compliance with international norms — Commitments to improving national capacity, financing plans to address gaps, and adhering to global norms
- Risk Environment — Overall risk environment and country vulnerability to biological threats.
These per-category scores are then merged into a single value: the country's overall Global Health Index (GHI) score. That GHI is compared to the GHI of other nations to rank the healthiest (and unhealthiest) countries in the world. The 2021 index was heavily impacted by the COVID-19 pandemic. In fact, the report stated that while many countries were able to develop responses to COVID-19, none thus far have taken adequate steps to prevent future pandemics.
Top 10 Healthiest Countries in the World (2021 Global Health Security Index):
- United States — 75.9
- Australia — 71.1
- Finland — 70.9
- Canada — 69.8
- Thailand — 68.2
- Slovenia — 67.8
- United Kingdom — 67.2
- Germany — 65.5
- South Korea — 65.4
- Sweden — 64.9
While the United States may not be the healthiest country in a general sense (national obesity is a particular area of concern)—and in fact, the country's COVID-19 response has drawn criticism in many circles—the U.S.A.'s massive capacity to research, communicate, and respond to a pandemic-level threat was enough to place it in the top spot. The United States ranked first in a wide range of indicators, including biosecurity, biosafety, epidemiology workforce, capacity to test and approve new countermeasures, communication with healthcare workers, and more.
The Money Index
The UK website Money offered its own healthiest places to live rankings in 2021. Compared to some of the more complex metrics available, the Money index is based on six simple (but far-reaching) factors:
- Life expectancy
- Cost to be healthy
- Air pollution
- Obesity rates
- Sunlight hours
The Top 20 Healthiest Countries in the World (Money UK Index 2021):
Healthiest and least healthy continents in the world
European countries (particularly those of Northern Europe) tend to appear near the top of most "healthiest countries" lists, establishing Europe as the healthiest continent on Earth. On the other hand, the countries of Africa typically dominate the lower spots. In fact, 27 of the bottom 30 spots on Bloomberg's 2019 list belonged to African nations. This is largely because Africa's Sub-Saharan is home to several nations that are not only the poorest countries in Africa but also the poorest in the world. Many of these countries have trouble supplying even basic needs such as clean water and adequate health care, and several are at war or engaged in armed conflict, which further complicates any attempt to improve national health.