(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.
For the Bloomberg 2019 Healthiest Country Index full data set, click HERE
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, specialized 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.
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.
Cuba placed five spots above the U.S., 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 U.S. focus on diagnosing and treating illness, the American Bar Association Health Law Section said in a report last year after vising Cuba.
South Korea improved seven spots to 17th while China, home to 1.4 billion people, rose three places to 52nd. Life expectancy in China is on track to surpass the U.S. 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 behavioral nature to environmental characteristics. Final index only included nations with at least 0.3 million population and sufficient data. 169 WHO states met the criteria to be included.
To access the Bloomberg 2019 Healthiest Country Index data set for all nations, click HERE.