Bottom of the pile for South Africa on world’s list of healthiest nations

Written on 02/25/2019
Linda van Tilburg

Mauritius came out as the healthiest Sub-Saharan African nation with regards to health and South Africa literally fell off the list.

London — It seems that a Mediterranean diet consisting of olive oil, loads of vegetables, fish and moderates amount of meat is the way to go if you want to improve a country’s health as Spain has pushed Italy off the top spot as the world’s healthiest nation. The Bloomberg Healthiest Country Index ranked 169 economies according to variables such as life expectancy, clean water and sanitation and gave penalties for tobacco use and obesity. The news for Sub-Saharan Africa is not good, the region “accounted for 27 out of the 30 unhealthiest nations in the ranking.” This was just above Afghanistan and Yemen, two country’s with protracted civil wars. Mauritius came out as the wealthiest Sub-Saharan African nation and South Africa literally fell off the list. – Linda van Tilburg

By Lee Miller and Wei Lu

(Bloomberg) – Maybe it’s something in the gazpacho or paella, as Spain just surpassed Italy to become the world’s healthiest country.

That’s according to the 2019 edition of the Bloomberg Healthiest Country Index, which ranks 169 economies according to factors that contribute to overall health. Spain placed sixth in the previous gauge, published in 2017.

Four additional European nations were among the top 10 in 2019: Iceland (third place), Switzerland (fifth), Sweden (sixth) and Norway (ninth). Japan was the healthiest Asian nation, jumping three places from the 2017 survey into fourth and replacing Singapore, which dropped to eighth. Australia and Israel rounded out the top 10 at seventh and 10th place.

healthiest countries

The index grades nations based on variables including life expectancy while imposing penalties on risks such as tobacco use and obesity. It also takes into consideration environmental factors including access to clean water and sanitation.

Spain has the highest life expectancy at birth among European Union nations, and trails only Japan and Switzerland globally, United Nations data show. Spain by 2040 is forecast to have the highest lifespan, at almost 86 years, followed by Japan, Singapore and Switzerland, according to the University of Washington’s Institute for Health Metrics and Evaluation.

“Primary care is essentially provided by public providers, specialised family doctors and staff nurses, who provide preventive services to children, women and elderly patients, and acute and chronic care,” according to the European Observatory on Health Systems and Policies 2018 review of Spain, noting a decline the past decade in cardiovascular diseases and deaths from cancer.

Eating habits

Researchers say eating habits may provide clues to health levels enjoyed by Spain and Italy, as a “Mediterranean diet, supplemented with extra-virgin olive oil or nuts, had a lower rate of major cardiovascular events than those assigned to a reduced-fat diet,” according to a study led by the University of Navarra Medical School.

Meanwhile in North America, Canada’s 16th-place ranking far surpassed the US and Mexico, both of which dropped slightly to 35th and 53rd. Life expectancy in the US has been trending lower due to deaths from drug overdoses and suicides.

Cuba placed five spots above the US, making it the only nation not classified as “high income” by the World Bank to be ranked that high. One reason for the island nation’s success may be its emphasis on preventative care over the US focus on diagnosing and treating illness, the American Bar Association Health Law Section said in a report last year after visiting Cuba.

South Korea improved seven spots to 17th while China, home to 1.4bn people, rose three places to 52nd. Life expectancy in China is on track to surpass the US by 2040, according to the Institute for Health Metrics and Evaluation.

Sub-Saharan economies accounted for 27 of the 30 unhealthiest nations in the ranking. Haiti, Afghanistan and Yemen were the others. Mauritius was the healthiest in Sub-Sahara, placing 74th globally as it had the lowest death rate by communicable diseases in a region still marred by infectious mortality.


  • Bloomberg evaluated health variables and risks ranging from those of behavioural nature to environmental characteristics.
  • Final index only included nations with at least 0.3m population and sufficient data.
  • 169 WHO states met the criteria to be included.