Why Norway is one of the 'world's healthiest countries'

In a recent ranking that compared the 'world's healthiest countries', Norway was placed fourth, with Japan, South-Korea, and Finland taking the top three highest ranked spots on the list.

The analysis ranked the healthiest OECD countries around the world, looking at various factors including life expectancy, prevalence of smoking, alcohol consumption, adult obesity and vaccination rates.

An overall weighted score was then created and each country was ranked. The scores are based on WHO and OECD data.

The data on Norway used in the study includes the following:

• Life expectancy at birth - 82.8 years old
• Prevalence of current tobacco smoking - 18.4 percent
• Prevalence of obesity among adults - 23.1 percent
• Vaccination rates – 96 percent
• Prevalence of insufficient physical activity among adults - 31.7 percent
• Population using at least basic drinking water services – 100 percent
• Overall score - 75.88

The ranking is one of a number that are produced annually which seek to compare the health records of different countries.

Norway and Norwegian cities usually perform well on lists of this kind, although there are some exceptions.

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“A number of rankings have been made of which countries it is best to live in, and in the current ranking, Norway comes in fourth place. Lifestyle factors such as smoking, physical activity and alcohol consumption, life expectancy and organisational or structural conditions have been included, and Norway generally scores well on all these factors when compared with other countries,” says Haakon E. Meyer, a professor in Chronic Diseases and Ageing and senior medical officer with the Norwegian Institute of Public Health (NIPH), the national health authority.

But do the rankings reflect public health in Norway in practice?

“Yes, I think the ranking reflects reality. I see the figures are taken from respected and well-known sources (WHO and OECD), and I have seen similar figures elsewhere and over several years,” says Jon Buestad, chief advisor for health and welfare with Lindesnes Municipality.

“It is known in health and political circles that Norway scores high on such rankings and has done so at least since the 1980s-1990s. How high the country scores depends somewhat on which indicators are emphasised,” Buestad noted.

In comments provided to The Local, both senior medical professionals said the ranking is reflective of reality but pointed out that health can be measured in different ways. 

“However, making an accurate ranking is challenging, and the result is affected by which factors are emphasized. Therefore, one often sees that Norway comes out a little different in different rankings, but generally Norway comes out well,” Meyer said.

Buestad also said a country's overall health can be measured in many different ways.

“I do not think it is wrong, but… you can measure (comparisons of national public health) in many ways. Japan has a very high score for suicide, it is not included here,” he notes as an example.

Another popular national comparison for which Nordic countries are known for their high scores is happiness, most famously in the World Happiness Report. Norway was last top of this ranking in 2017 and placed fifth in 2020.

“Otherwise, there is another measurement that has been popular in the Nordic countries, it measures self-experienced happiness: Happiness Index. Here, Japan is further down, while, for example, the USA is higher. The Nordic countries are repeatedly ranked highly, for some years Norway was in first place (in the 1990s),” Buestad said. 

What factors ensure Norway is always near the top of these lists?

“Life expectancy and infant mortality are generally considered to be the two most important indicators, and here Norway and the Nordic countries score highly,” Buestad explains.

“Why do we score high? The common explanation is related to our welfare model with a social and health ‘safety net’,” he adds.

Examples of the safety net include public health services for all, an average high level of education and low unemployment.

“Statistically, people have better health the better education they have, and if they have a secure job,” Buestad says.

But while Norway appears to constantly rank high on these types of lists, it is not certain to always be the case in the future.

We are gradually beginning to notice some of the disadvantages of high prosperity and wealth, Buestad said.

“Life expectancy rose for many years in Norway, while now the increase has stopped. Some of the explanation can perhaps be found in the indicator morbid obesity, which has increased quite a bit in recent years. We also drink more now than before,” he said.

“The negative development in these areas is probably due to the fact that general prosperity has become so high, people have more money and on average we work fewer hours than before, we have more time and money to eat and relax,” he added.