A. International Health Profiles
Topic Outline
- 1 International Health Rankings
- 2 Individual Country Profiles
- 3 Data: Demographic/Labor Force Characteristics
- 4 Data: Economic Characteristics
- 5 Data: Health Status/Burden of Illness
- 6 Data: Health Behavior/Lifestyle
- 7 Data: Environment
- 8 Data: Health Resources
- 9 Data: Health Utilization
- 10 Data: Health Expenditures
- 11 Data: Pharmaceuticals
- 12 Data: Health Financing/Reimbursement
- 13 Data: Social Protection
International Health Rankings
Global Health Data
- HumanProgress.org. This site does not provide summary rankings, but provides trend data on a number of indicators for all nations in the world and allows for comparisons between countries, data visualization and downloadable data. Health measures include: a) 6 measures of life expectancy; b) 4 measures of death and mortality; c) outcomes related to selected diseases (e.g., cancer, HIV/AIDS); c) a variety of measures of health care supply, including access measures related to particular conditions (e.g., pregnancy, TB); d) health spending.
Global Rankings
- World Health Organization. World Health Report 2000. This report ranks 191 health systems, concluding that the U.S. ranks 37th in the world. Its methodology has been widely criticized:
- Carl Bialik. Ill-Conceived Ranking Makes for Unhealthy Debate. Wall Street Journal, October 21, 2009.
- John Stossel. Why the U.S. Ranks Low on WHO’s Health-Care Study. RealClearPolitics.com, August 27, 2007.
- Glen Whitman. WHO’s Fooling Who? The World Health Organization’s Problematic Ranking of Health Care Systems. Cato Institute, February 28, 2008.
Rankings of Major Industrialized Countries
- Bloomberg (2018). This annual study, Most Efficient Health Care 2018, ranks 56 countries, using life expectancy, healthcare cost as percentage of GDP and healthcare cost per capita. Top 10 countries: 1. Hong Kong; 2. Singapore; 3. Spain; 4. Italy; 5. S. Korea; 6. Israel; 7. Japan; 8. Australia; 9. Taiwan; 10. United Arab Emirates.
- Commonweath Fund (July 2017). Mirror, Mirror 2017- International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care. This report assesses the performance of healthcare systems in 11 countries based on 72 indicators with the goal of ascertaining how efficient healthcare in the United States is. It classifies indicators (e.g., safety, waiting times, administrative organisation and equal access to healthcare) into 5 groups: quality, access, efficiency, equity and healthy lives. Top 10 countries: 1. UK; 2. Australia; 3. Netherlands; 4. New Zealand tied with Norway; 6. Switzerland tied with Sweden; 8. Germany; 9. Canada; 10. France.
Analysis of Global Health Performance
- Amenable Mortality (Deaths Avoidable through Health Care).
- Ellen Nolte and C. Martin McKee. Measuring The Health Of Nations: Updating An Earlier Analysis. Health Affairs January 2008 27:158-71. This study concludes the U.S. lags behind many other countries in reducing deaths amenable to health care.
- Ellen Nolte and C. Martin McKee. Web First: In Amenable Mortality—Deaths Avoidable Through Health Care—Progress In The US Lags That Of Three European Countries. Health Affairs September 2012 31:92114-2122; published ahead of print August 29, 2012, doi:10.1377/hlthaff.2011.0851. This study also concludes that U.S. progress lags behind France, Germany and UK.
- However, the amenable mortality metric likewise has been criticized:
- Johan P Mackenbach, Rasmus Hoffmann, Bernadette Khoshaba, Iris Plug, Grégoire Rey, Ragnar Westerling, Kersti Pärna, Eric Jougla, José Alfonso, Caspar Looman, Martin McKee. Research report: Using ‘amenable mortality’ as indicator of healthcare effectiveness in international comparisons: results of a validation study. J Epidemiol Community Health jech-2012-201471. Published Online First: 25 September 2012 doi:10.1136/jech-2012-201471. This study concludes “between-country differences in levels of mortality from amenable conditions should not be used for routine surveillance of healthcare performance.”
- Thomas P. Miller. Debunking Richard Cohen: How Does the U.S. Health-Care System Stack Up? National Review Online, November 15, 2010.
- Monica Desai, Ellen Nolte, Marina Karanikolos, Bernadette Khoshaba, and Martin McKee. Measuring NHS performance 1990–2009 using amenable mortality: interpret with care. Journal of the Royal Society of Medicine. September 2011 104:370—379.
- Scott Atlas (2009). 10 Surprising Facts About American Health Care. In an extensive compilation of available rankings, Hoover Institution senior fellow Scott Atlas concludes:
- Americans have better survival rates than Europeans for common cancers.
- Americans have lower cancer mortality rates than Canadians.
- Americans have better access to treatment for chronic diseases than patients in other developed countries.
- Americans have better access to preventive cancer screening than Canadians.
- Lower income Americans are in better health than comparable Canadians.
- Americans spend less time waiting for care than patients in Canada and the U.K.
- People in countries with more government control of health care are highly dissatisfied and believe reform is needed.
- Americans are more satisfied with the care they receive than Canadians.
- Americans have much better access to important new technologies like medical imaging than patients in Canada or the U.K.
- Americans are responsible for the vast majority of all health care innovations.
- Ranking America. The Health and Welfare category includes continuously updated health-related rankings from various sources.
- Docteur, Elizabeth and Robert A. Berenson. 2009. How Does the Quality of U.S. Health Care Compare Internationally? (Urban Institute, August 2009)
- An NCPA report (2009) examines the evidence on
- Are US Outcomes No Better and in Some Respects Worse Than Those of Other Nations?
- Are Low-Income Families More Disadvantaged in the US System?
- Friedman, Howard Steven. The Measure of a Nation: How To Regain America’s Competitive Edge and Boost Our Global Standing, Prometheus, 2012. The author–a statistician and health economist for the United Nations and an adjunct professor at Columbia University’s School of International and Public Affairs–compares the US’ standings on a variety of metrics concerning health, safety, education, democracy and income equality to those of 13 carefully chosen competitor nations: Australia, Belgium, Canada, France, Germany, Greece, Italy, Japan, Portugal, the Netherlands, South Korea, Spain and the UK. All of them are members of the Organization for Economic Cooperation and Development (OECD); all have populations of at least ten million, and mean GDPs per capita of at least $20,000.
- Cutler, David M., and Dan P. Ly. 2011. “The (Paper)Work of Medicine: Understanding International Medical Costs.” Journal of Economic Perspectives, 25(2): 3-25. Systematic comparison of international health spending differences.
Individual Country Profiles
- The World Factbook (CIA). Detailed profiles for all countries of the world include a section on Population showing a) age structure; b) birth and death rates; c) infant mortality rates; d) life expectancy, by sex; and e) fertility rate, all estimates for 2000.
- International Data Base (Bureau of the Census). 1-page summary demographic data profiles for 227 countries of the world include 2000 and 2025 estimates of a) birth and death rates; b) life expectancy; c) infant death rates; d) fertility rate; e) midyear population by age and sex. Profiles also include midyear population estimates, by decade from 1950-2050. Site also offers individual country population pyramids (distribution by age/sex).
- Library of Congress Country Studies (US Library of Congress). Profiles based on continuing series produced under Country Studies/Area Handbook Program, with detailed profiles of 101 countries. Each country has a section on health and welfare, including a subsection on medical care and nutrition.
- Basic Country Health Profiles for the Americas (Pan American Health Organization). Profiles based on Health Conditions in the Americas, an annual compilation (since 1954) of health situation (diseases, services, resources) at regional and country level for 48 countries in North, South and Central America.
- Basic Health Indicators (PAHO). Includes indicator dashboards for individual countries and subregions.
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OECD Reviews of Health Systems. These are in-depth studies of the health system of member countries, with a particular focus on economic issues. They assess the performance of health systems in a comparative context, identify the main challenges faced by the country health system and put forward policy options to better meet them. Reviews are initiated at the request of the country to be examined and emphasis is placed on specific issues of key policy interest. To date, OECD has prepared these 100-page analyses for Finland, Korea, Mexico Switzerland, and Turkey.
- Commonwealth Fund. International Profiles of Health Care Systems (June 2018). Provides solid 4-5 page summaries in a standardized format written by country experts for Australia, Canada, China, Denmark, England, France, Germany, India, Israel, Italy, Japan, Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, Taiwan, and the United States. It includes useful side-by-side tables on key metrics of health system performance.
Data: Demographic/Labor Force Characteristics
- International Data Base (Bureau of the Census). Downloadable data for 227 countries available for any level of aggregation selected by user for any year from 1950-2050. Regional totals and individual country breakdowns are provided: a) regional population, land area, population density; b) population by age intervals and sex (including median age); c) fertility rate; and d) vital events, including births/1,000, net migration/1,000 and population growth rate.
- World Development Indicators (World Bank). Comparative data for all countries, including a) population data (total population, 1980, 1999, 2015; average annual population growth 1980-1998, 1999-2015; age dependency ratio; percent age 65+, 1998, 2015; women age 65+/100 men, 1998, 2015); b) rural area (rural population, rural population density, land area), c) population dynamics (see list); d) reproductive health (e.g., fertility, see list); e) labor force structure (see list); f) employment by type (see list); g) unemployment (see list); h) wages and productivity (see list); i) participation in education (see list); and j) education outcomes (e.g., adult illiteracy, see list).
- HumanProgress.org. Trend data on a number of indicators for all nations in the world and allows for comparisons between countries, data visualization and downloadable data. Health measures include: a) 6 measures of life expectancy; b) 4 measures of death and mortality; and c) outcomes related to selected diseases (e.g., cancer, HIV/AIDS).
- OECD Health Data 2010 (CD-ROM order information)
Comparative data for 30 OECD countries from 1960-2008, including a) total population by gender; b) fertility rates; c) dependency ratios (e.g., children per women age 15-49); d) population age structure; e) labor force characteristics; and f) education and training.
Data: Economic Characteristics
- Penn World Tables, Version 6.1
Downloadable comparative data for most developed and underdeveloped countries in world from 1950-2000, including a) real GDP/capita; b) consumption/investment shares of GDP; c) price levels; and d) standard of living index. - World Development Indicators (World Bank)
Comparative data for all countries, including a) size of economy; b) growth of output by type; c) poverty (see list); d) distribution of income (see list); e) other extensive measures of the economy (see list); f) other extensive measures of states/markets (e.g., prices, state-owned enterprises, see list); g) extensive measures of trade (see list); and h) education inputs (see list). - OECD Health Data 2010 (CD-ROM order information)
Comparative data for 30 OECD countries from 1960-2008, including a) macroeconomic characteristics (e.g., GDP, disposable income); b) public spending & debt; c) expenditures on education; d) monetary conversion rates (exchange rates and purchasing power parity); e) income distribution (Gini levels and income by decile); and f) poverty status.
Data: Health Status/Burden of Illness
- International Data Base (Bureau of the Census)
Downloadable data for 227 countries available for any level of aggregation selected by user for any year from 1950-2050. Regional totals and individual country breakdowns are provided: a) vital events, including deaths/1,000; and b) mortality data, including infant mortality rate, total infant deaths, and life expectancy at birth. - Indicators on Health (UN)
Comparative data for all countries, including a) life expectancy at birth, by sex, 2000-2005; b) infant mortality rate, 2000-2005; and c) child mortality rates, by sex. - WHO Research Tools
Comparative data for all countries, including a) Mortality; b) Health Life Expectancy; c) Burden of Disease; and d) HIV/AIDS information. - World Development Indicators (World Bank)
Comparative data for all countries, including a) mortality (life expectancy at birth, infant mortality, under 5 mortality, child mortality by gender, adult mortality by gender); b) reproductive health (maternal mortality); and c) risk factors for health (prevalence of anemia in pregnant women, low birthweight infants, TB incidence, TB prevalence, HIV prevalance). - OECD Health Data 2010 (CD-ROM order information)
Comparative data for 30 OECD countries from 1960-2008, including mortality data on a) life expectancy and disability-free life expectancy (by sex and age); b) potential life-years lost due to selected conditions, c) mortality by 37 selected causes; and d) maternal and infant mortality; and morbidity data on a) infant health (including low birthweight, congenital anomalies)morbidity; b) self-rated health status; c) cancer incidence by sex; d) AIDS prevalence; e) dental health; f) injuries; g) absence from work due to illness; and h) direct cost of illness by major disease category.
Data: Health Behavior/Lifestyle
- World Development Indicators (World Bank)
Comparative data for all countries, including a) disease prevention (% pregnant women with tetanus vaccination, child immunization rates for DPT and measles); b) reproductive health (contraceptive prevalence rate); and c) health risk factors (prevalence of child malnutrition, consumption of iodized salt, prevalence of smoking); d) traffic and congestion (people injured.killed per 1000 vehicles). - Contraceptive Use (Bureau of Census World Population Profile: 1998)
Includes information for 227 countries on contraceptive use. - Immunizations (WHO Statistical Information System)
Comparative data for all countries, including immunization statistics. - OECD Health Data 2010 (CD-ROM order information)
Comparative data for 30 OECD countries from 1960-2008, including a) food consumption and body weight; b) alcohol consumption; c) tobacco consumption; and d) injuries in road traffic accidents and injuries in home accidents.
Data: Environment
- World Development Indicators (World Bank)
Comparative data for all countries, including a) water pollution (see list); b) air pollution (see list); c) energy emissions (see list); d) Table 3.5 Freshwater (access to safe drinking water, urban and rural populations); and e) urban environment (% with sewage connection, % with regular waste collection, % with access to potable water). - OECD Health Data 2010 (CD-ROM order information)
Comparative data for 30 OECD countries from 1960-2008, including a) total sulphur emissions; b) total nitrogen oxide emissions; and c) total carbon monoxide emissions.
Data: Health Resources
- World Development Indicators (World Bank)
Comparative data for all countries, including Table 2.14 Health Expenditures, Services and Use (physicians/1,000, hospital beds/1,000). - Health Personnel (WHO Statistical Information System)
Comparative data for all countries in 1998 (personnel/100,000), including physicians, nurses, midwives, dentists and pharmacists. - OECD Health Data 2010 (CD-ROM order information)
Comparative data for 30 OECD countries from 1960-2008, including a) inpatient beds/1,000 population; b) inpatient beds by type (acute, psychiatric, long-term care); c) medical technology; d) health employment, by type (total health, total hospital, practising MDs/1,000, female practicising MDs, general practitioners, specialists, dentists, pharmacists and certified/registered nurses; and e) medical education and training by field. - HumanProgress.org. Trend data on a number of indicators for all nations in the world and allows for comparisons between countries, data visualization and downloadable data. Includes a variety of measures of health care supply, including access measures related to particular conditions (e.g., pregnancy, TB).
Data: Health Utilization
- World Development Indicators (World Bank)
Comparative data for all countries, including Table 2.14 Health Expenditures, Services and Use (inpatient admission rate, average length of stay and outpatient visits per capita). - OECD Health Data 2010 (CD-ROM order information)
Comparative data for 30 OECD countries from 1960-2008, including a) inpatient inputs (hospital staff ratios, occupancy rates); b) inpatient utilization rates; c) discharge rates, by disease and case-mix; d) average length of stay, by disease and case-mix; e) surgical procedures by ICD-CM and case-mix; f) transplants by type; g) ambulatory visits (doctors and dentists); and h) kidney dialysis use.
Data: Health Expenditures
- World Development Indicators (World Bank)
Comparative data for all countries, including a) Table 2.14 Health Expenditures, Services and Use (total health spending as % of GDP, with separate breakdowns for public and private, health expenditures per capita in $PPP and health expenditures per capita in dollars); b) Table 4.11 Consumption in PPP (health % of household spending); c) Table 4.12 Relative Prices in PPP Terms (private consumption of health care). - HumanProgress.org. Provides trend data on a number of indicators for all nations in the world and allows for comparisons between countries, data visualization and downloadable data including on health spending.
- OECD Health Data 2010 (CD-ROM order information)
Comparative data for 30 OECD countries from 1960-2008, including a) health spending % of GDP; b) national health expenditures, by type (total, prevention/public health, health administration/insurance, and health-related functions, including health R & D); b) public national health expenditures, by type (e.g., public percent of total health expenditures, total public expenditures on health); c) national health expenditures, by service (in-patient, out-patient, ancillary/home health, pharmaceuticals/non-durables, durable medical equipment); d) expenditure by age group; e) medical price index by type of service and f) direct cost of illness by type. - How Does Health Spending in the U.S. Compare to Other Countries? Peterson-Kaiser Health System Tracker, December 7, 2018. Per-capita healthcare spending in the U.S. was $10,224 in 2017, which was 28% higher than Switzerland, the next highest spender per capita, and roughly double the comparable country average of $5,280
Data: Pharmaceuticals
- OECD Health Data 2010 (CD-ROM order information)
Comparative data for 30 OECD countries from 1960-2008, including a) pharmaceutical industry activity; b) pharmaceutical consumption by type; and c) pharmaceutical sales.
Data: Health Financing/Reimbursement
- OECD Health Data 2010 (CD-ROM order information)
Comparative data for 30 OECD countries from 1960-2008, including a) health care financing, by major source; b) flows of financing (e.g. social insurance contributions, taxes); c) medical services fees (13 services); and d) health professions incomes, by type (physicians, general practitioners; dentists; nurses; pharmacists).
Data: Social Protection
- OECD Health Data 2010 (CD-ROM order information)
Comparative data for 30 OECD countries from 1960-2008, including a) social expenditures, by type (old age benefits, disability benefits, occupational injuries, sickness benefits, unemployment benefits, health benefits, housing benefits etc.); b) health coverage by type (total, inpatient, out-patient, pharmaceutical, therapeutic appliances); and c) health cost-sharing (total, inpatient, out-patient, pharmaceutical, therapeutic appliances).