Healthcare is a universal necessity that will always be needed. However, readily accessible and high-quality care is unfortunately not attainable to everyone. Globally, significant disparities remain due to social, economic, and environmental disadvantages. The National Library of Medicine states, “This can be measured by observing differences in incidence, prevalence, mortality, burden of disease, and other adverse health conditions.”  Other factors, such as location, affordability, and quality, impact health outcomes. According to the National Library of Medicine, race, ethnicity, gender, location, sexual orientation, and disability status are all impactful factors. It is essential to recognize which systems are most effective and successful. By observing diverse global statistics, we can compare how different countries and regions perform and identify the key aspects driving inequity. 

Many European countries such as the UK, France, Germany, Norway, and Switzerland have shown well-performing healthcare statistics, similar to Asian countries like Japan, China, and South Korea. In fact, according to the Health Index Score, as of 2023, Singapore had the highest ranking score: 86.9. The Global Health Index, which assesses and benchmarks health security and quality, categorizes countries into five tiers based on their ability to handle disease outbreaks. The tiers are: Tier 1 = 0-20, Tier 2 = 20.1-40, Tier 3 = 40.1-60, Tier 4 = 60.1-80, Tier 5 = 80.1-100. The higher the number, the better the health industry performs. Contributors to high ranks are affordability, efforts to innovate and expand medical knowledge, and preventative care. Europe focuses on universal coverage, public health benefits, and modernized infrastructure and technology. These countries also have strong governments that support their citizens and strive for high standards to be met. The mortality rate often indicates how effective a country’s healthcare system is. According to AMN Healthcare, “Infant mortality rate is an estimate of the number of infant deaths for every 1,000 births.” The following countries have the lowest rates of infant mortality: “Monaco with 1.91 deaths per 1,000 births, Luxembourg with 2 deaths per 1,000 births, Finland with 2 deaths per 1,000 births, Japan with 2.17 deaths per 1,000 births, Norway with 2.49 deaths per 1,000 births, Singapore with 2.61 deaths per 1,000 births, Sweden with 2.64 deaths per 1,000 births, and Iceland with 3.18 per 1,000 births.” All the above data is sourced from AMN Healthcare.

IOM, or “Institute of Medicine,” names six factors for improving healthcare—safe, effective, patient-centered, timely, efficient, and equitable care. Europe and Asia are consistently high performers in this industry. Not only is it affordable, but it is readily available and of good quality. Spending extreme amounts on healthcare isn’t necessarily the answer either, though. For example, according to the Peter G. Peterson Foundation, the United States has one of the world’s highest healthcare costs. “In 2022, U.S. healthcare spending reached $4.5 trillion, which averages $13,493 per person. By comparison, the average cost of healthcare per person in other wealthy countries is less than half as much.” However, according to The Commonwealth Fund, the US has the worst healthcare outcomes compared to other high-income countries. It is the only high-income country without universal health coverage. “The US spends three to four times more on healthcare than South Korea, New Zealand, and Japan.” This is evidence that high spending does not equate to effectiveness and efficiency. The US also has high infant and maternal death rates, suicide rates, and obesity rates that are over double the OECD (Organization for economic co-operation and development) average.”

Nevertheless, the USA is far from having the world’s worst healthcare. The poorest performing countries are Madagascar, with a Health Index score of 22.2; Haiti, with a score of 20.8; The Republic of Congo, with a score of 18.8; The lowest scores were Equatorial Guinea, at a score of 11; and the Democratic Republic of Congo, at 11.3. According to Africa Renewal, “Low-income countries experience poor availability of essential medicines in health facilities, substandard-quality treatments, frequent stock-outs and suboptimal prescription and use of medicines,” Africa has an inefficient sector supply system that causes medications to be often too expensive or simply unavailable. Additional issues are “poor transportation systems, a lack of storage facilities for pharmaceutical products, and a weak manufacturing capacity.” Malaria is a significant issue for many of these countries in Africa. According to Center for Disease Control and Prevention, “In 2020, malaria caused an estimated 241 million clinical episodes and 627,000 deaths. An estimated 95% of deaths in 2020 were in the African Region.”

Although African countries are improving, they are still far behind the rest of the world regarding economic and health prosperity.  So, what makes such a difference in quality and accessibility? Many people in lower-income countries do not have access to vaccines, high-quality treatment, or maternal care. This results in high death rates, a shorter life expectancy, and poverty. There is also often a lack of modern infrastructure, such as hospitals, offices, medical supplies, and high-tech equipment that can treat and prevent disease. 

Racial disparities also affect the type of healthcare patients receive, regardless of the country. For instance, “Native Americans and Alaska Natives have an infant mortality rate that is 60 percent higher than the rate for their white counterparts,” according to the National Library of Medicine. “In 2013, infants born to African American mothers experienced the highest rates of infant mortality (11.11 infant deaths per 1,000 births)” Another exciting statistic on obesity is that “from 2011 to 2014, Hispanic children and adolescents ages 2 to 19 had the highest prevalence of obesity in the United States (21.9 percent), and Asians had the lowest (8.6 percent.” Furthermore, “African Americans were 30 percent more likely than whites to die prematurely from heart disease in 2010, and African American men are twice as likely as whites to die prematurely from stroke.” Homicide-related deaths are the highest for African American men, and the suicide rate is highest for male American Indians/Alaska Natives. “Overall, mortality rates for Native Americans are almost 50 percent higher than that of their white counterparts.” These statistical disparities hardly scratch the surface when it comes to the total amount of inequality in health outcomes due to race.

Income can greatly impact the type of care received as well. This is especially prevalent in the United States because of the extremely high costs. Often, those in middle to lower income brackets will “skip needed medical care and have problems paying medical bills,” according to The Commonwealth Fund. This also applies to mental health care, and it is no surprise that more than 1 in 5 US adults live with a mental illness, as reported by the Centers for Disease Control. With the cost of treatments being so high, it is challenging for many Americans to obtain the treatment they need or to have any incentive to do so when they believe their money is better spent elsewhere.    

Ultimately, healthcare inequity is a globally comparable issue. Many different approaches are taken, but it is clear, based on the statistics, that specific systems lead to better outcomes. The data shows cost issues in the United States and Africa’s struggles with governmental issues and prioritizing health infrastructure. On a different scale, gender, race, and income significantly affect healthcare received, regardless of the country. Low cost, proper education, and waste prevention are key factors in maintaining a high-status healthcare system. Asia has outperformed much of the world in this sector, but it is undeniable that Europe is not far behind.  This issue is multifaceted and requires significant policy implementation and intervention to ensure equitable access to everyone worldwide.