The USA can keep its hoard of Olympic medals. Australia has thrashed the superpower in a far more significant world ranking.
Australia is among the top 10 healthiest countries in the world, according to the most comprehensive analysis of burden of disease and living standards to date.
Taking out 10th place among 188 countries, Australia was just four points behind top-ranked Iceland when benchmarked against 33 health-related indicators linked to the UN’s sustainable development goals.
The US trailed in 28th place with an SGD index of 75 compared with Australia’s 81, according to the Global Burden of Disease Studypublished in The Lancet.
A suite of perfect scores buoyed Australia’s performance, including top marks for indicators associated with war, malnutrition, water access, sanitation and malaria.
But its result was dragged down by lower scores for suicide, alcohol, smoking, overweight, HIV, violence and disaster (defined as the death rate due to exposure to forces of nature per 100,000 population).
The US’s comparatively poor performance will come as a surprise to many, considering its socio-economic heft, wrote the research coalition of more than 1870 international researchers who analysed the performance of countries between 1990 and 2015.
The superpower’s lacklustre scores for maternal mortality alcohol consumption, childhood overweight, and deaths due to interpersonal violence, self-harm, and unintentional poisoning compared to other higher income countries dragged down its overall ranking.
East Timor was the biggest success story, winning the title of most improved and rocketing up the rankings to 122nd place.
Dead last was the Central African Republic, with a total SDG index score of 20. War-torn Afghanistan came in 180th place, and Syria fell to 117th, still scoring better than Russia in 119th place. China came was 92nd, and Papua New Guinea 155th.
Overall, the most pronounced progress internationally was among the universal health coverage indicators, largely thanks to anti-retroviral therapies and widespread use of insecticide-treated nets in malaria-endemic countries since the early 2000s.
And while there were also substantial improvements in childhood stunting caused by malnutrition, childhood overweight rates had worsened considerably over the past 15 years.
“Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient,” the researchers said.
The SDG targets have been a source of intense debate, with critics arguing they were too vague, unrealistic, poorly measured, or missing key indicators – for instance, banning forced labour or mental health improvements.
The SDG agenda replaced the Millenium Development Goal framework, which expired in 2015.
The scores routinely inform decisions concerning which countries may be most deserving of aid funding, as well as national and international policy and strategies.
“The difficulties of measurement are also further compounded by persistent problems of data availability, quality and comparability across a host of indicators” as the researchers work to pull together a daunting tangle of national data sets, survey results and pharmaceutical records.
The latest analysis was a step towards a more cohesive approach to understanding the interaction between SDGs, targets and indicators by comparing the relationship between education, income and fertility, the authors said.
It also raised questions about the impact of other drivers on health and living standards across the globe.
The authors urged governments, donors, and global development institutions to use the results to “enhance accountability through open and transparent review and action”.