MOSCOW - Although the World Health Organization (WHO) has been monitoring the state of health in various countries for the past 60 years, it has never explicitly compared countries with one another. So Bloomberg news, using WHO data as well as other data from the World Bank and the United Nations, put together a rating of the healthiest countries. 

The comparisons were based on complex criteria - the first one was called “general health level,” which included life expectancy, mortality rates in different age brackets and many other demographic questions. The second criteria had to do primarily with risk factors - the percentage of people who drink and smoke as well as the number of people with high blood pressure or high cholesterol. 

The unexpected number one was Singapore, followed by Italy, Australia and Switzerland. The first 20 countries at the top of the list were also all countries with a generally high standard of living. 

“It’s logical, that at the top of the list you would have countries with a developed economy,” said Vladimir Shkolnikov, one of the editorial directors of the WTO Russia bulletin. “But it is interesting to notice that, for example, Norway is in 18th place and Israel is in 6th, although Norway is richer. For the population’s health, the government’s social orientation is the most important thing. For example, in Germany it is impossible to imagine having to raise money for a child with leukemia or another serious illness - if someone’s life is in danger, the government will take care of its citizens.” 

Russia wound up in the rankings behind many of its neighbors, winding up at 97th place out of 145 countries. Among the former Soviet countries, Russia managed to outstrip only Ukraine, Kyrghizistan, Turkmenistan and Kazakhstan. Experts were unanimous in saying that the biggest challenges for health in Russia are limited access to health care, heavy drinking, smoking, unhealthy eating and a sedentary lifestyle. 

“This is not at all to say that Russia is a doomed territory,” Shkolnikov said. “If you take the right measures, then you can see a real increase in life expectancy, and an increase in health among the population - for example, the results of the 1985 campaign against alcohol consumption. More recently, starting in 2004, mortality rates in Russia have been decreasing. In the past year there was a decrease in the number of deaths from heart disease and strokes. Russians started seriously controlling blood pressure, and the quality of drugs and medical care increased. So there are positive changes.” 

On the other hand, experts can’t help but be wary of the government’s commitment to health. The budget for 2013 proposes an 8.7 percent reduction in health expenditures in comparison with 2012, and there are even more cuts planned for 2014-2015. Still, health care professionals do note that it is ultimately up to each individual Russian citizen to choose between a generally more active lifestyle or sticking with the same old bad habits.

Elsewhere in the comparative study, a notable disregard for social protections put the United States in 33rd place. Although the country spends the most money on healthcare in the world (17 percent of GDP), tens of millions of Americans don’t have enough money to buy medical insurance.

In terms of general health, the United States came in behind Costa Rica (24th place) and Cuba (28th). Americans often go to Costa Rica for medical procedures - the procedures in the Latin American country are done at an international level, but are much more affordable then in the United States. Cubans have access to universal and free health care, and have an active lifestyle.