The Least Healthy Countries
> Life expectancy: 60.8
> Infant mortality rate (per 1,000 live births): 52.8
> Health expenditure per capita: $46
> GDP per capita: $875
Still recovering from a bloody and destructive civil war in the 1990s, Liberia today lacks many of the infrastructural elements necessary for good public health. Less than 10% of the population has access to electricity, and roughly one in every four residents lacks access to sanitized water. Such poor access to basic necessities likely heavily contributes to Liberia’s poor health outcomes, which are some of the worst on the planet. The infant mortality rate in Liberia, at 53 deaths for every 1,000 births, is one of the highest of any country. While the maternal mortality rate in many advanced countries is less than five maternal deaths per 100,000 live births, in Liberia an average of 725 women die per 100,000 births — nearly the highest rate of any country.
9. South Africa
> Life expectancy: 57.2
> Infant mortality rate (per 1,000 live births): 33.6
> Health expenditure per capita: $570
> GDP per capita: $13,209
Tuberculosis, a potentially deadly disease primarily affecting young adults — common in impoverished countries — is a major problem in South Africa. There are 834 new incidents of tuberculosis for every 100,000 people annually, the highest TB rate of any country considered.
The country also faces a serious HIV problem. Nearly one in every five South Africans between the ages of 15 and 49 are HIV positive, one of the highest such shares in the world. A lack of education surrounding the disease may be partially to blame. The country’s president, Jacob Zuma, famously claimed he once showered after having sex with an HIV positive woman to reduce the likelihood of being infected.
8. Cote d’Ivoire
> Life expectancy: 51.6
> Infant mortality rate (per 1,000 live births): 66.6
> Health expenditure per capita: $88
> GDP per capita: $3,359
While there was relative peace in Ivory Coast for several decades after the country gained independence from France in 1960, a military rebellion in 2002 ignited a period of violence and instability that left thousands dead and much of the nation’s infrastructure in disrepair. Just 56% of the Ivory Coast population today has access to electricity, and nearly one in five residents lack access to sanitized water. The average life expectancy at birth in the country of just 52 years is nearly the lowest in the world and 27 years less than the U.S. life expectancy of about 79 years.
> Life expectancy: 55.0
> Infant mortality rate (per 1,000 live births): 56.7
> Health expenditure per capita: $42
> GDP per capita: $1,192
Many Mozambicans lack access to basic infrastructure that people in healthier countries take for granted. Only about half of the country’s population has access to clean water, and only 20% have access to electricity. Such access is even scarcer in the country’s rural areas. Lack of access to modern amenities likely contributes the country’s low 55 year life expectancy.
Like many unhealthy countries, health spending in Mozambique is relatively low. Combined annual public and private health care expenditure amounts to only about $42 per capita. In comparison, annual U.S. health care spending tops $9,400. Low investment in health care is partially the consequence of weak economic conditions. The country’s official unemployment rate of 22.6% is among the worst in the world.
> Life expectancy: 55.2
> Infant mortality rate (per 1,000 live births): 60.3
> Health expenditure per capita: $37
> GDP per capita: $1,511
Childbirth is far riskier for both mothers and infants in Guinea-Bissau than it is in most other countries. Infants are over 10 times more likely to die within the first year of life in the West African nation than in the United States. Similarly, the maternal mortality rate during childbirth is nearly 40 times the U.S. rate.
Progress, as measured by health outcomes, is likely hindered by inadequate infrastructure and education. For example, slightly more than half of the population of 1.8 million lives in rural areas, many of whom lack basic amenities. Only 60.3% of the country’s rural residents have access to clean water, and 21.5% have access to electricity.