Health inclusivity index shows U.S. health equity lags behind expenditures
High spenders including the U.S. didn’t rank as highly as their expenditures might indicate.
Per capita, the United States spends more on health care than any other country in the world. But does that investment pay off in terms of health inclusivity? Not necessarily, according to a new report from Economist Impact.
The first-ever Health Inclusivity Index, released on October 11th, looked at health inclusivity amongst 40 different countries. It found that, though there was some correlation between health expenditures and health inclusivity, there was not a strong relationship between the two factors. In fact, some countries with high spending didn’t do so well on inclusivity measures. That includes the United States, which, despite being the top spender, didn’t even reach the top 10 of the countries analyzed.
The analysis looked at 37 indicators of health inclusivity amongst three domains. Those domains were Health in Society, meaning health policy; Inclusive Health Systems, meaning the strength of a country’s health care system; and People and Community Empowerment, meaning people had the tools to handle their own health care. Of those three domains, the analysis found that the final domain, People and Community Empowerment, was the most closely tied to health inclusivity.
The highest-scoring countries included the United Kingdom, Australia, France, Germany, and Sweden. Low-scorers included Algeria, Egypt, Honduras, India, and Bangladesh.
Importantly, the results were not strictly tied to GDP or health care expenditures. As the analysis pointed out, some low-GDP countries, including South Korea and Thailand, scored relatively well for health inclusivity. On the other hand, high spenders including the U.S. didn’t rank as highly as their expenditures might indicate.
David Humphreys, a Global Practice Leader in Health Policy at Economist Impact, says in a press release, “The index is ambitious in scope – linking concepts such as the social determinants of health, health in all policies, universal health coverage, cultural competency, personal agency and community empowerment. While undoubtedly there will be debate with our approach or our scores, we are confident that our transparent approach to defining and quantifying health inclusivity will enrich policy conversations and, ultimately, drive action.”
Read more: Why brokers can – and should – support health equity
Within the next two years, Economist Impact hopes to expand its index to cover 80 countries, with the ultimate goal of helping countries promote health equity.