Poor health outcomes in the least healthy countries are largely attributable to inadequate government services. In each of the 10 countries with the worst overall health outcomes, the share of the population with access to clean water is below the 91% worldwide average. In Somalia, fewer than one in three residents have access to clean water.
Similarly, Nigeria is the only country with the worst health outcomes in which over half the population have electricity.
Meanwhile, access to clean water and electricity is nearly universal in each of the 10 healthiest countries. Notably, each of the countries with the best health outcomes also has a publicly-funded universal health care system.
The inadequate public services in the least healthy countries are partially attributable to limited financial resources. Global economic output totalled about $16,215 per capita in 2016. GDP per capita in each of the least healthy countries is less than half the global figure. In three of the least healthy countries, GDP per capita was below $1,000.
In stark contrast, the healthiest countries tend to be wealthy. GDP per capita is higher than the global average in each of the world’s healthiest countries. In eight of the healthiest countries, GDP per capita is more than double the global figure.
The impact that public health policy, public works infrastructure, and access to utilities have on health outcomes across a population is difficult to understate. Behaviors such as excessive alcohol consumption and smoking are known to be detrimental on an individual level. Still, per-capita alcohol consumption or smoking rates are higher than average in the majority of the healthiest countries. Such unhealthy behaviors are generally less common in the least healthy countries.
Patterns in birth rates could spell trouble for many countries on both sides of this list in the coming years. Nine of the 10 least healthy countries have a faster population growth rate than the world as a whole, which could mean increased strain on already limited resources.
Meanwhile, Israel is the only country with the best health outcomes that is growing at a faster rate than the world as a whole. In four of the healthiest countries, the population is shrinking. As the population ages and fewer people are working and paying taxes in the coming years, publicly-funded health care systems could face a funding crisis.
To determine the most and least healthy countries, 24/7 Wall St. reviewed annual infant mortality rates (per 1,000 live births), maternal mortality rates (per 100,000 live births), life expectancy at birth, and the incidence of tuberculosis — a widely-used approximation of infectious diseases incidence — in 179 countries from data published by the World Bank. We normalized values using the min-max method and took the geometric mean to compare countries.
Up-to-date health measures comparable globally are often very limited. We only considered data that was available for at least 75% of the countries on our list, and we excluded countries with a population smaller than 250,000. All data is for the most recent year available.
In addition to health measures used in the ranking, we collected data on access to health services, including the number of doctors per 1,000 people. We looked at the share of a country’s population with access to clean water, clean air, and electricity — all data came from the World Bank.
We also reviewed per-capita health expenditure by public and private sources, as well as adult literacy rates, unemployment rates, population size, alcohol consumption, and smoking rates. All economic data came from the World Bank.