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New study finds access to health care in U.S. worse than Libya, Bosnia, and Romania

For Release Wednesday, September 4, 2013

WASHINGTON, September 4, 2013 – A review of health systems around the world found it is easier to get adequate medical care in Libya, Bosnia, and Romania than it is in the United States, according to a report released by World Vision on Wednesday. This gap between the “health rich” and “health poor” is contributing to the deaths of thousands of children every day.

The Killer Gap: A Global Index of Health Inequality for Children (PDF) assesses 176 countries around the world according to the size of the gap between those who have access to good health care and those who don’t. The United States is ranked a surprising 46th on the global index, ranking below lower-income countries like Libya (21st), Bosnia (36th) and Romania (25th).

“The fact that the U.S. is ranked lower than many lower-income countries on the index proves that a country’s wealth does not guarantee its people access to good health care and quality health,” said Lisa O’Shea, World Vision’s Campaign Director for Child Health Now. “It’s a horrifying reality that in today’s world, when we have the knowledge, resources and tools to provide everyone with quality maternal, newborn and child health, we still fall so short.”

The following health outcome indicators were used to rank countries in the report:

  • Health Inequality-adjusted Human Development Index representing a national average of human development achievements in three areas: health (life expectancy), education and income.

  • Financing for health: Out-of-pocket expenditure as a percentage of total health expenditure

  • Health outcome: Adolescent Fertility Rate

  • Coverage of health services: Density of physicians and density of nursing and midwifery staff

The ten countries with the smallest gaps, according to World Vision’s index, are (in order from smallest to widest gap) France, Denmark, Norway, Luxembourg, Finland, Germany, Sweden, Slovenia, Cuba and Switzerland. The ten countries with the largest gaps are Chad, Sierra Leone, Guinea, Mali, Equatorial Guinea, Niger, the Democratic Republic of Congo, Afghanistan, Cameroon and Cote d’Ivoire. Seven of the ten countries with the greatest health gaps are among the poorest countries in the world, but Equatorial Guinea, Cote d’Ivoire and Cameroon are middle income.

“Over the past 20 years, we’ve made a lot of progress – the number of children under the age of five dying every year has fallen dramatically. But it’s still too high – 19,000 every day – and this report looks at one reason why this is,” said O’Shea. “In achieving this and tackling global poverty and poor health, governments and organizations have reached those who are easiest to get to, but in many cases this has meant a devastating increase in the gap between the health rich and poor, with the most vulnerable children bearing the brunt.”

With two years until the deadline for the Millennium Development Goals, World Vision is using the report to urge governments to finish the job and leaders to take every step possible to close the health gap in their countries and to achieve Millennium Development Goals 4 and 5, tackling child and maternal health.


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