5 Global Health Findings From Legatum Prosperity Index 2018

The purpose of the Legatum Prosperity Index is to be a tool for individuals around the world to see what pathways lead to a nation’s growth and development. That isn’t to say that prosperity only involves wealth; in fact, if there is one thing that the Legatum Prosperity Index proves, it is that a nation needs to balance its economic, political, judicial, and health spheres if it wants to create a strong character.

For any state to be prosperous, it needs to have created an environment where an individual can reach their full potential, and feels empowered to do so. Judging from the Index, this requires an open economy, an inclusive society, strong institutions, and empowered people who are healthy, educated and safe. In other words, when you combine all of these factors, you are more likely to see a country that is on its way to greater prosperity and well-being.

The  Legatum Prosperity Index 2018 is comprised of nine different pillars which allow you to see more thoroughly what is working and what isn’t working across the board. On that note, here are five global health findings from the Legatum Prosperity Index 2018.

What does the Health Pillar include?

As one of the nine pillars of prosperity, the Health pillar covers a country’s performance in three critical domains:

• Health Outcomes (life expectancy at birth, mortality rate, perception of health problems, feelings of joy, feelings of sadness and worry)

• Health Systems (satisfaction with healthcare, quality of sanitation facilities, the vaccination rate for diphtheria, the vaccination rate for measles)

• Disease and Risk Factors (quality-adjusted life years lost to tuberculosis, adult diabetes rate, obesity rate)

1. Singapore takes the top spot.

Out of all the countries included in the Legatum Prosperity Index, Singapore is number one in the Health pillar. After Singapore comes Luxembourg (2nd), Japan (3rd), Switzerland (4th), Qatar (5th), Austria (6th), Sweden (7th), Norway (8th), Hong Kong (9th), and the United Arab Emirates (10th).

However, when it comes to regions, Western Europe is ranked number one in Health, as well as in Governance, Personal Freedom, Safety and Security, and Natural Environment. The number two region for Health is North America, followed by Latin America & the Caribbean (3rd), Middle East & North Africa (4th), Asia-Pacific (5th), Eastern Europe (6th), and, lastly, Sub-Saharan Africa (7th). 

2. Obesity is the most widespread health issue around the world.

Despite being the number two region for Health, the countries that comprise North America (the US and Canada) still have a long way to go. While both countries improved their overall Health scores this year, they both perform poorly concerning illness and risk factors due to their obesity problems. Shockingly, 36% of the US population is obese, which is the second highest in the world behind Kuwait, and an increase from 29% a decade ago.

Additionally, Canadian citizens also suffer from a high level of obesity, with 29% of the population being considered obese, up from 23% in 2007.

This isn’t just a North American issue, either. In Germany, the prevalence of diabetes and obesity is increasing so significantly that the drop in score for the Health pillar has negated positive efforts in other pillars such as Personal Freedom and Natural Environment. Similarly, Romania and the whole region of Eastern Europe perform particularly poorly in Health due to high diabetes levels, high obesity levels, and low vaccination rates.

Furthermore, the level of obesity in the adult population rose in every Middle East & North Africa country in 2018, with the most significant increases occurring in the UAE, Algeria, and Egypt. Unfortunately, obesity is already a notable issue in this region, with significant percentages (ranging from 26% to 38%) of all the country’s populations being classed as obese – excluding Yemen at 17%.

3. Well-being in North and sub-Saharan Africa needs help.

While the MENA region comes fourth in terms of overall Health, four of the worst six countries in the region for Health are in North Africa (the other two are Iraq and Yemen). Unfortunately, in this area of the world, the majority of indicators of well-being have worsened among these countries. For example, there are far more people reporting prolonged sadness or depression in these countries compared to a decade ago.

It is vital to note that just because a country is designated a “faller” or has a low ranking doesn’t mean that all hope is lost for its future. Indeed, it means that those individuals who are currently living in the country face a lot more insecurity and far more challenges than other countries on the list, but they can also begin to work towards a path to recovery that is appropriate for their unique situation. Every country can improve its well-being and overall prosperity with the right focus, direction, and aid.

For example, in Estonia, health outcomes have risen steadily over recent years, with life expectancy now around 77 years, which is eight years higher than it was throughout the latter part of the Soviet administration. This increase in social development in Estonia has undoubtedly occurred besides its economic successes.

Another success story can be seen in Paraguay, where an investment in healthcare and education has enabled the country to move up 12 places in the Health pillar. This year, the country is ranked 47th in Health, which is far superior to its regional average. This incredible increase has come as a result of increases in vaccinations of measles (they now have a 99% vaccination rate) and a life expectancy that has increased by over 1.5 years to 73 years.

As a result of this investment and improvement in Health, individuals in Paraguay are describing higher levels of joy and lower levels of melancholy and grief. For these improvements to happen, public spending on healthcare as a percentage of GDP has risen to 7.8%.

4. Countries with poor rankings in other pillars can still focus on Health.

As seen from the obesity epidemic in some of the wealthiest countries on Earth, the Health pillar isn’t necessarily correlated with rankings in other pillars – Ethiopia is an excellent example of this.

As the largest country in East Africa, Ethiopia is ranked 137th overall and has seen minimal improvement or development over the past decade. In almost all the pillars, Ethiopia has a low ranking and continues to fall in terms of Safety and Security and Personal Freedom. That being said, the marginal improvement over the past few years in its overall prosperity score has been driven primarily by improvements in Education and Health.

For example, since 2007, Ethiopia has almost doubled its vaccination rates for both measles and diphtheria, which has had a significant impact on its Health score.

On the other hand, the Eastern European country of Ukraine is ranked 111th overall and has obtained a prosperity score that is basically the same as it was in 2007. Despite its good performance in Education, the nation doesn’t do too well in all the other pillars – particularly Governance, Safety and Security, and Health. However, there are signs of improvement when it comes to Health, as significant reforms are being initiated to improve the health and education systems.

5. Prosperity levels and well-being levels move in tandem.

One of the main takeaways from the Legatum Prosperity Index 2018 is that as global prosperity levels have risen, so have levels of well-being. Generally, it can be said that those countries who saw their overall levels of prosperity rise, also saw their well-being increase.

On the other hand, countries that saw their overall prosperity decrease, also saw their well-being decrease. Therefore, it can be seen that prosperity and well-being are intricately linked together for a nation.

That being said, within the index, it can also be seen that the divergence of well-being between rising and falling prosperity is much more significant than the divergence of GDP risers and fallers. This is why the Legatum Institute maintains the belief that in order to accurately calculate prosperity, one must find a method for obtaining the underlying economic and social well-being of a country’s people. Their thorough analysis explicates that an increase in prosperity is a more reliable predictor of an advance in well-being than an increase in GDP per capita.

For The Legatum Institute, the chosen measurement demonstrates that well-being is never an established cultural trait, or at a fixed level; instead, it varies in tandem with shifting prosperity levels. In fact, no country has a set level of well-being, nor can they feel confident in the current fixed standard. The level of well-being a nation and its people experience can advance further, or (easily) drop, or be sustained over time. It all depends on priorities and what the government chooses to focus on and dedicate money towards.

What do you think about these findings from the Legatum Prosperity Index 2018? Do you have any other insights into how countries can improve their Health pillars? Alternatively, is there something that you think is missing from this analysis? Let us know your thoughts in the comments below.