WASHINGTON — We don’t know when we’re going to go, but barring an accident on vacation we probably know what country it’s going to happen in. And a new study ranks the best nations to die in.
The Economist’s second Quality of Death Index lists 80 countries in order of the quality and availability of palliative care. The United Kingdom comes out on top, with Australia and New Zealand coming second and third, respectively. The United States comes in ninth, the main negative being the high cost of care.
The countries were ranked in five categories:
- the general palliative and health care framework;
- the availability and training of health care professionals in end-of-life issues;
- the affordability of palliative care and the availability of public funding to help pay for it;
- the involvement of patients with health care professionals and the availability of opioids;
- the public awareness and availability of volunteers regarding palliative care.
The UK also came in atop the first Quality of Death Index, issued in 2010.
The worst country to die in? Iraq.
Not surprisingly, the report says, “in general, income levels are a strong indicator of the availability and quality of palliative care, with wealthy countries clustered at the top.”
Conversely, “many developing countries are still unable to provide basic pain management due to limitations in staff and basic infrastructure.”
Still, the report says, some low-income countries rank surprisingly highly: Panama (31) is making palliative care part of primary care; hospice care is growing in Mongolia (28), and painkillers are much more available in Uganda (35). Conversely, despite its economic growth, China comes in 71st.
The report says that there are more people over 65 in the world than under five, so the health needs of an aging population have never been more important.
“This is something that arguably will affect every single person and yet we invest almost nothing in trying to work out how to do it better,” Katherine Sleeman, a lecturer at King’s College London, says in the report.
