Money can’t buy health or happiness?

Global statistics: who is wealthier, happier and healthier?

I have generally focused on OECD countries, especially Europe, USA & UK (where most readers of this blog live) and Australia (where I live), but I have also included the global highs and lows where I have the information.

Wealth

As measured by GDP per capita, the 3 richest countries are small European nations (Monaco, Liechtenstein and Luxembourg). Also in the top ten are 3 other small countries (Bermuda, Macau & Qatar) and 4 other European nations (Switzerland, Norway, Iceland & Ireland). USA is 12th and Australia 14th, and most of the remaining top 20 are European. UK is 26th. (The Economist)

GDP per capita isn’t a measure of personal income. Nevertheless, it is interesting to compare the hours worked in different countries to produce this GDP. European countries work the least hours in the OECD, and USA and Australia work about 25% longer. The table below shows that workers in Luxembourg, Norway, Switzerland and Denmark produce the most goods per hour worked, followed by USA, Australia and Germany. Whether they are are paid most per hour is another question. Workers in non-OECD countries are generally significantly worse off. (OECD)

Table: Per capita wealth, annual working hours and payment in dollars per hour for 14 selected OECD countries.

Purchasing power is another measure of a country’s wealth. Here the top 7 are smaller nations in Europe, the Middle East and Asia. Norway ranks 9th, USA 14th, Australia 22nd and UK 31st. Countries in Africa have the lowest purchasing power. (The Economist)

Wealth inequality is often measured as the ratio of the 90th percentile income and the 10th percentile, or the Gini Index, which measures the departure of incomes from complete equality across the full range. On these measures, European countries are generally the most equal in the world and the OECD, while “third world” countries, especially in Africa, are generally the most unequal. (Wikipedia, OECD)

• USA is more unequal than about 70% of countries globally and is the second most unequal in the OECD (behind Mexico).
• UK is more unequal than about 40% of the world and 4th most unequal in the OECD.
• Australian incomes are more unequal than about 35% of coutries globally and about average in the OECD.

The Economist has also ranked countries for inequality of wealth. Its list shows the most equal countries are in Eastern Europe, Central Asia and then Western Europe. The most unequal are in Africa and South and Central America. (Economist)

Poverty is a well-known and awful fact in many countries, but you might not expect it in OECD countries. It turns out that western European countries have very low levels of poverty. USA, South Korea and Israel have the highest rates of poverty in the OECD but have less poverty than 80% of countries globally. (OECD, Wikipedia)

Happiness, health & wellbeing

Several indices measure whether people are living long, happy and sustainable lives.

Life expectancy is highest (80-90 years) in western Europe, Canada, Australia and Japan & several smaller Asian nations. USA (79 years) just makes it into the top 25%. African countries generally have the lowest life expectancy (50-70 years). (WHO, Worldometer)

The United Nations World Happiness Report measures how satisfied people are with their life. The happiest 4 countries are the “Nordic” Finland, Denmark, Norway and Iceland. Next in the top ten are 4 more European countries plus Canada and New Zealand. Australia is 11th, UK 15th and USA 19th. The least happy countries are mostly in Africa and the Middle East. (Wikipedia, World Happiness Report)

The Bloomberg Healthiest Country Index is based on life expectancy, health risks (such as smoking, high blood pressure and obesity) and other health measures (such as access to clean water and sanitation, and malnutrition). The healthiest countries on this index are Spain, Italy, Iceland and Japan. Other European countries plus Australia (7th), Singapore and Israel come next. UK is 19th and USA is 34th, despite spending the most on healthcare. (World Population Review)

Indigo Wellness Index ranks 195 countries based on 10 measures: healthy life expectancy, blood pressure, blood glucose (diabetes risk), obesity, depression, happiness, alcohol use, tobacco use, inactivity (too little exercise), and government spending on healthcare. The unhealthiest countries were in Africa, small islands in the Pacific and Caribbean, and in Eastern Europe. Canada was the healthiest country, and after that the healthiest countries came from all over the world. (Business Insider, 2019)

Suicide is a symptom and one measure of mental end emotional health. Some smaller and poorer countries have high suicide rates, but others have very low rates too. Among OECD countries, Russia (3rd highest out of 183), South Korea (10th), Latvia (16th) and Belgium (22nd) have the highest suicide rates. Lowest are Israel & Mexico (147th) and Greece (157th). USA is 34th, Australia 51st and UK 109th. This data seems to indicate that, overall, suicide rates are lowest in poorer countries. (Wikipedia)

Safety and human rights

Amnesty reports on human rights across the world and in each of 159 countries. There is no simple summary of human rights globally, but I have checked the records of some key countries:(Amnesty)

• Australia was criticised for poor treatment of indigenous people and refugees and asylum seekers, and divisive attitudes to LGBTQI people.
• China was criticised for “serious threats to human rights” (there was a long list of bad practices including prison sentences on vague charges, torture, repression and other ill-treatment), and repression and worse against Hong Kong and the Uighurs.
• Norway was criticised for poor treatment of refugees and asylum seekers, and failing to provide adequate protection against violence towards women, girls and the LGBTQI community.
• The United Kingdom was criticised for restricting access to abortion in Northern Ireland (the law has since changed), the restriction of rights via counter terrorism laws and failure to address torture and other accusations against its armed forces.
• The United States was criticised for discriminatory restrictions on travel from Muslim countries, illegal treatment of detainees in Guantánamo Bay, attacks on the rights of women and girls, gun violence and the death penalty.

It is probably fair to say that few countries escaped criticism.

Gun violence kills about a quarter of a million people around the world each year. Half of all deaths occurred in six countries in the Americas (Brazil, the United States, Mexico, Venezuela, Colombia and Guatemala). Per capita, 9 of the worst 10 countries are in the Americas, and USA is tenth. European countries and Australia rank well down. However it is worth noting that the high US rate is more the result of suicide (see above) than homicide. 16 out of the top 20 countries for per capita gun homicides are in the Americas and the US is 16th. (Wikipedia, PBS)

Quality of life

Quality of life is really what we are all looking for, and in a sense sums up all the other measures. It is scored by many different variables. I have only used measures dated from 2015 to 2020. Results for the different measures are shown in the table below, followed by brief descriptions of each measure.

Table: Six ways of assessing global quality of life – top ten countries in each index.

• The OECD Better Life Index is based on 11 measures – housing, income, jobs, community, education, environment, governance, health, life satisfaction, safety and work-life balance. It is possibly the most comprehensive index. (Wikipedia, 2017)
• The New Economics Foundation Happy Planet Index measures wellbeing (how satisfied people are with their lives), life expectancy, income equality and ecological footprint in 140 countries. The index is heavily biased towards countries with small ecological footprints. (The New Economics Foundation)
• The Social Progress Imperative Social Progress Index is based on an assessment of Basic Human Needs (health care, sanitation, safety and shelter), Foundations of Wellbeing (life expectancy and access to education and technology) and Opportunity (personal rights, freedom of choice, general tolerance and access to higher education). (Social Progress Imperative, 2019)
• The Expat Insider Quality of Life Index is based on 6 factors: Leisure Options, Health & Well-Being, Safety & Security, Personal Happiness, Travel & Transportation, and Digital Life. This index seems biased towards expats and tourism. (InterNations, 2019)
• Numbeo‘s Quality of Life Index is based on 8 factors – purchasing power, safety, health, cost of living, property prices, traffic commute times, pollution and climate. (Numbeo, 2020)
• The 2020 Best Countries rankings is based on global surveys of people’s views on nine measures of quality of life – affordable, a good job market, economically stable, family friendly, income equality, politically stable, safe, well-developed public education system and well-developed public health system. (US News, 2020)

What do we learn?

Income alone is not a good measure of wealth

An assessment of wealth must include hours worked to gain an income and the cost of living essentials (housing, healthcare, food, transport, education, etc). There is a wide disparity between the working hours in different countries. Workers in western Europe are generally working shorter hours, suggesting those countries have opted for quality of life over greater wealth.

The countries where people have the greatest purchasing power are not the richest ones.

Average wealth can be a misleading indicator if there is great inequality, and/or greater poverty. Equality is better economically for the country, creates greater social cohesion and better reflects the dignity of all human life. Western European countries generally have the lowest poverty and the greatest equality of income.

Health and wealth don’t always go together

In general, wealthier countries tend to be healthier, and poorer countries tend to be less healthy, for obvious reasons. Likewise, wealthier people are more likely to live longer (Urban Institute). However, it isn’t always so. Increasing wealth can lead to obesity, binge drinking, high blood sugar, heart disease and other health problems, which reduce many countries’ life expectancy and health.

Happiness and wealth don’t always go together

The wealthier countries tend to be happier than average. But happiness varies widely in poorer countries – some are generally happy, while others are much less so (Visual Capitalist). Studies have shown that lifting people out of poverty will generally increase happiness, but after that, greater wealth has diminishing happiness returns. For wealthier countries, happiness seems to be highest with “well-functioning democracy, generous and effective social welfare benefits, low levels of crime and corruption, and satisfied citizens who feel free and trust each other and governmental institutions”. (World Happiness Report)

Wealth is bad for the planet

Wealth tends to lead to greater consumption and greater damage to the planet. The countries with the lowest ecological footprints are not among the wealthiest.

A pattern is emerging

A clear picture is emerging. Poverty is bad for health and happiness, and the global wellbeing would improve if there was greater equality of wealth. Wealthier countries can afford healthcare, education, housing and infrastructure that facilitate a good life.

But other quality of life factors moderate the value of national wealth and become more important in wealthier countries.

• Within even wealthy countries, poverty and inequality exist and reduce national wellbeing.
• Longer working hours can harm the work-life balance and increase inequality, as employers gain a greater percentage of the profits.
• Reduced access to healthcare, social welfare and education can further penalise the poorer members of a society.
• Social harmony is important, and social unrest and discrimination can adversely affect happiness.
• Higher levels of crime and corruption reduce happiness.
• Effective, just and democratic government and institutions are also important for happiness.

These factors help explain some of the data:

• Most countries in western Europe, especially Scandinavia, rate well on these quality of life factors, as do Canada, Australia and New Zealand. These nations have high levels of health and happiness.
• Some countries, though only moderately wealthy, have stable government, equality of wealth and social harmony, and so can still be happy and healthy.
• The United States is one of the wealthiest countries, but scores lower in many other important areas (inequality and poverty, lower social harmony, less access to affordable healthcare and chronic obesity), leading to lower levels of health and happiness than you might expect.
• Some of the poorest countries have high income inequality, suggesting that a richer ruling elite may be making poverty worse.

You and I can be happier

Personal happiness is only partly dependent on the country you live in and your personal income. Other factors become more important for happiness (Oxford Foundation for Knowledge Exchange).

• healthy life expectancy,
• having someone to count on,
• generosity,
• freedom to make life decisions,
• absence of corruption in business and government, and
• feeling that one’s life has a purpose

It is generally possible for us to take steps in several of these areas, and so improve our wellbeing. You can read more about this in What makes people happy, with a summary in Simple keys to a happier life.