The annual Bloomberg Healthiest Country Index list is out and the good news for boquerones and expats is that we have topped the list in 2019!

In fact, if you live in Europe, you are probably better off health-wise, since six of the top 10 countries on the list are located in this continent. The list took into account 169 countries, and focused on factors such as life expectancy, obesity, penalised tobacco use, clean water, and public health care. These are the Top 10 countries and the reasons why they are the healthiest places to live.

1 – Spain

Spain has the highest life expectancy in the European Union (we live to the ripe old age of 86), and by the year 2040, we are expected to have the highest life expectancy in the world, followed by Japan, Singapore, and Switzerland. In a report entitled Spain Health System Review, the European Observatory noted that public health policy is excellent in our country, with important developments including new taxes on tobacco and alcohol, the introduction of colorectal cancer screening, and the quality of care. The report states: “Primary care remains a core element of the health system, with primary health care teams forming the basis of the SNS. Primary care is essentially supplied by public providers, specialised family doctors and staff nurses, who provide preventive services to children, women and elderly patients, and acute and chronic care. Primary care doctors are the first contact point for the system and they are the gatekeepers of the system.”

The quality of our diet has also been highlighted. The Mediterranean diet, with its dependence on healthy Omega-3 essential fatty acids, aids in the prevention of heart disease, Type 2 diabetes, and metabolic syndrome. One thing the report didn’t mention is the siesta. While many Spaniards no longer have the luxury of enjoying one of these, those who do are reaping major benefits. NASA reports that a 40-minute nap enhances performance by 34 per cent and alertness by 100 per cent… sounds like a good way to stay on the ball and to reduce your likelihood of road accidents and injuries on the job!

2 – Italy

“A baby born in Italy can expect to live to be an octogenarian. But 2,800 miles south in Sierra Leone, the average newborn will die by 52,” notes Bloomberg. The reasons for the high life expectancy in Italy are similar to those in Spain. Italians have good access to healthcare, with a good doctor-to-patient ratio, despite the struggling economy. As noted by Dr. Tom Kenyon of global relief organisation, Project Hope, “Italy has an excess of doctors” – a problem many countries in beleaguered nations could certainly put up with.

Like Spain, the Italians enjoy a diet that is rich in quality proteins, olive oil, and fruits and vegetables. It seems like the myth about Italians gorging themselves on pasta just doesn’t ring true. While pasta is consumed frequently, it is served in small amounts with olive oil, vegetables, and tomato sauce, rather than the creamy, cheesy sauces that are prevalent in nations struggling against obesity. Italians also tend to make their meals from scratch, with mealtimes being seen as a way for family to gather together and bond – in stark contrast to the essential loneliness of the ‘fast food culture’.

3 – Iceland

In addition to a good public healthcare system, Iceland boasts a long life expectancy, low rates of child mortality, and low pollution levels. The country is famed for its simple, healthy diet comprising Omega-3-rich fish like haddock and herring, milk from grass-fed, free-range cows, and healthy olive oil. Icelandic peoples also like to keep active, with activities such as ice climbing, rock climbing, mountain walks, and kayaking popular among families and youngsters alike. Iceland is home to healing hot springs, including the vividly hued Blue Lagoon in Reykjanes, the tiny white sand Nauthólsvík geothermal beach, and Landmannalaugar – ensconced on the gravel plains of the bright orange rhyolite mountains, where hot and cold flows meet and make for a natural contrast bath that promotes circulation and helps boost heart health.

4 – Japan

There are three diets that doctors and nutritionists recommend the world over: the Mediterranean, Norwegian, and Japanese diets, the latter owing to its emphasis on clean dishes, many of which are made with heart-healing fatty fish. Doctors note that people who have an Omega-3 index of less than four per cent age considerably faster than those with indexes of eight and above. The Japanese tend to be within this range. They also enjoy a plethora of fermented foods, which promote optimal gut health and are rich in Vitamin K2, which boosts immunity. Healthcare is optimal, with all citizens, expats, and foreigners who stay in Japan for over a year enjoying free healthcare.

5 – Switzerland

This tiny landlocked country is known for investing big-time in health, so much so that the World Economic Forum stated that Switzerland spends more on the health, education, and talent of its people than any other populus in the world. The Swiss spend a high percentage of their GDP on health care (around 12 per cent), but the government pays for very little of it. Costs are out-of-pocket but deductible rates are high. Citizens cover medical expenses initially, but one benefit is that they pay the same amount regardless of how old or ill they are. In general, mandatory health insurance does not exceed 10 per cent of the average salary.

The Swiss hit the nail on the head not only when it comes to physical health. In the most recent United Nations World Happiness Report, the Swiss came in sixth (after Finland, Denmark, Norway, Iceland, and the Netherlands). With so many studies revealing the powerful link between physical and mental health, happiness is definitely a value to be pursued, and the Swiss enjoy this quality thanks to strong social support, freedom from corruption, and enjoying plenty of positive effects resulting from the close connections they maintain with friends and family.

6 – Sweden

Sweden has a government-funded healthcare system which also amounts to over 12 per cent of the country’s GDP. Of course, access to medical care is just one piece of a complex puzzle that includes positive lifestyle behaviours. The Scandi diet, for instance, is low in starchy, refined carbs and high in locally sourced cold water fish and organic produce and preparation is simple and healthy. Like Icelanders, the Swedes make time for activities that boost wellness, including sauna visits. Studies have shown that taking saunas regularly reduces blood pressure and boosts heart health, as well as helping with detoxification and quelling debilitating stress. Finally, there is the Swedish love for nature and activities that celebrate it, including going for nature walks and cycling. Exercise is a big part of social interaction, and many companies encourage staff to exercise and take part in group activities. Businesses are supportive of parents; paid parental leave is generous, reduced hours are offered to families with young children, and out-of-hours care for kids is offered at a low price. Reducing stress and supporting families are indeed key factors in the mental wellness of a country.

7 – Australia

Australia is famed for its passion for healthy foods and exercise, but lawmakers are also getting it right by exerting effective tobacco control and offering equal access to health services. Dwellers down under rely on the Medicare system, which provides both primary care and emergency services to all citizens and residents. It also scores highly on environmental considerations like sanitation, access to clean water, and air quality. The Aussie government warns the people about one big problem, though – obesity. Around 63 per cent of adults are overweight or obese, and considering that one of the leading causes of death is coronary heart disease, the stats are a wake-up call to the importance of taking a nutritional cue from countries like Spain, Italy, or Japan.

8 – Singapore

Asia One predicts that healthcare in Singapore is likely to double over the next decade, which is great news for Singaporeans who are already deemed one of Asia’s healthiest populations. Smoking rates are low, diets are vegetable-rich, and health care is readily available. Singapore boasts the 10th lowest death rate due to cardiovascular disease, cancer, diabetes, or chronic respiratory disease. Moreover, only 11 per cent are obese and over the past few years, the number of people who regularly exercise has doubled.

9 – Norway

Restaurants like three-Michelin-starred sensation Maaemo have brought the beauty of simple organic Norwegian cuisine to the forefront, highlighting the inexorable link between whole foods and health. The Norwegian diet is fast becoming the subject of a multitude of nutritional studies, with foods like dark rye breads, vividly hued berries, and oily fish boasting powerful antioxidants that stave off inflammation and put an end to free radicals – the highly reactive molecules that damage DNA. Norwegians are an active bunch too, often taking long walks along lush paradises like the stunning Besseggen trail or Geirangerfjord. Alcohol and tobacco use are at enviably low levels, and health care is publicly financed, with coverage being universal and automatic for all residents. Treatment isn’t free, but there is an annual limit on how much individuals have to pay for full coverage.

10- Israel

Israelis are big on the Mediterranean diet, relying on extra virgin olive oil and walnuts almost as much as their Spanish and Italian counterparts. This phenomenon is only logical; Israel sits in the Mediterranean crescent, where diets that are rich in fish, seasonal produce, and unsaturated fats, are the norm. A recent survey conducted by an Israeli agricultural research organisation found that some 80 per cent of people ate fruits and vegetables nearly every day while a further 11 per cent enjoyed these foods two to three times a week – pretty impressive considering that in countries like the U.S., a big majority are struggling to meet their five-a-day requirements. Health care is universal in Israel, with participation in medical insurance plans being compulsory and citizens encouraged to boost their care options by choosing comprehensive policies.