Canada used to be the greatest country in the world. It can be again. But, according to every independent review, we are not any more.
It was a great source of national pride when Canada had the highest score in 1994 on the United Nations Human Development Index. Remarkably, Canada had the highest score for the next six years as well. Every citizen was beaming. Even the prime minister at the time, Jean Chrétien, regularly remarked about our international standing.
Last year, Canada did not even rank among the top 10 nations.
That said, there are some limitations to the UN ranking system. First, it narrowly focuses on life expectancy, educational status and gross national income. Second, recent modifications to how the system evaluates maximum income — from discounting to logarithmic discounting — have been criticized.
Last week, the Social Progress Index for 2014 was released. Most will agree that the SPI is a significant upgrade from the HDI. The progress index is the sum of three main dimensions — basic human needs, foundations of well-being and opportunity. Each of the three dimensions has four components, and those in turn have 54 subcategories. For example, within the dimension of basic human needs, there is the component of medical care, and within that are subcategories such as maternal mortality and child mortality rates.
A unique advantage of the SPI is that it monitors actual and objective outcomes, and not simply process indicators such as how much money is spent on an activity, how many workers are involved or how many procedures are performed.
In this index, Canada ranked seventh. What is perhaps most surprising is where our nation had significant limitations.
For example, in the dimension of foundations of well-being, Canada is ranked 17th after countries such as Estonia, Slovenia, Slovakia and Costa Rica. In the subcategories, Canada is ranked 12th in life expectancy, 12th in death rates from noncommunicable diseases, 99th in levels of obesity and 81st in suicides.
In the dimension of basic human needs, Canada ranks 11th. However, we score poorly in areas such as maternal mortality rate, where we were 29th, and child mortality, where the country ranked 28th. The child mortality rate in Canada is 130 per cent higher than the top nation, Iceland. Within the same dimension, Canada ranks ninth in the rate of stillbirths and 20th in food deficit.
Perhaps more surprisingly, our country ranks 21st in medical care, behind countries such as Slovenia. Even in access to clean water and sanitation, it ranks 35th, trailing the likes of Slovenia, Lebanon, Bulgaria, Uruguay, Kuwait, Malaysia, Mauritius and Egypt. In case this sounds too incredible, we only need to look at how the federal government does not ensure access to clean water on First Nations reserves.
An encouraging aspect of the Social Progress Index is its conclusion that money alone will not fix complex problems. It requires good public policy. For example, New Zealand, with the highest overall score, had a per capita GDP of $25,857 while Canada, with a relatively poor showing in seventh place, had a GDP per capita of $35,936. The United States, with a GDP per capita of $45,336, had an overall ranking of 16th.
So how did New Zealand do it? In a case study at the end of the report, the authors note that the country’s high level of success was due to public policies that encourage an egalitarian outlook, a progressive approach in recognizing indigenous rights including self-determination, a strong education system and a tradition of welfare provision.
To fund these priorities, New Zealand spends much less money than similar countries do on medical care.
The most extreme example is the U.S. It spends almost double what other developed countries spend on health care, but ranks only 24th in basic medical care, 36th in child mortality, 38th in maternal mortality, 29th in life expectancy and so on. In plain language, it is obvious that the main determinants of health fall outside of the health-care sector.
Canada is not the greatest country in the world any more. It used to be, and can be again. It all depends on whether we are willing to adopt evidence-based policies.
Mark Lemstra is a columnist for the Saskatoon StarPhoenix.
