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Mental & Physical Health202511 min read

How Healthy You Feel Depends on Where You Live

Demographic variation in self-rated physical health across 22 countries: findings from the Global Flourishing Study

Notable finding

People in some developing nations feel healthier than Westerners.

By
Bradshaw, Matt et al.
Participants
202,898
Countries
22
Journal
BMC Global and Public Health
DOI
10.1186/s44263-025-00141-1
Chat with paper
Chat with paper
§1

Key Takeaways

01

Surprisingly, people in some developing, non-Western countries like Indonesia and Nigeria reported higher average physical health than people in many economically developed nations like Japan and the UK.

02

While self-rated health generally declines with age, this trend is not universal, as some countries show higher health ratings among both the youngest and oldest adults.

03

Demographic factors such as employment status, education level, and religious service attendance are meaningfully associated with self-rated physical health across many different countries.

§2

Why It Matters

Improving a nation’s health means looking beyond economic growth to the cultural and social factors that help people feel well.

This research matters because it challenges the assumption that economic wealth automatically translates into better personal health. For public health officials and policymakers, understanding that people in wealthy nations may feel less healthy points to potential gaps in healthcare access, work-life balance, or social support. It also highlights the need to pay closer attention to developing countries, where people report feeling relatively healthy despite fewer economic resources. The findings reveal that personal factors like age, gender, and employment interact with health in complex ways that differ by country. This means health interventions cannot simply be copied from one nation to another. They must be tailored to local cultural and social contexts. As future waves of this study track changes over time, this baseline data will help researchers and global organizations identify what actually helps people feel healthier and more resilient, no matter where they live.

This research matters because it challenges the assumption that economic wealth automatically translates into better personal health. For public health officials and policymakers, understanding that people in wealthy nations may feel less healthy points to potential gaps in healthcare access, work-life balance, or social support. It also highlights the need to pay closer attention to developing countries, where people report feeling relatively healthy despite fewer economic resources. The findings reveal that personal factors like age, gender, and employment interact with health in complex ways that differ by country. This means health interventions cannot simply be copied from one nation to another. They must be tailored to local cultural and social contexts. As future waves of this study track changes over time, this baseline data will help researchers and global organizations identify what actually helps people feel healthier and more resilient, no matter where they live.

Improving a nation’s health means looking beyond economic growth to the cultural and social factors that help people feel well.

§3

The Story

When you ask people around the world to rate their physical health on a scale from 0 to 10, the answers might surprise you. A massive new study surveyed over 200,000 people across 22 countries to understand how self-rated physical health varies. The findings reveal a striking pattern: three of the four highest health scores came from developing, non-Western countries—Indonesia, Nigeria, and Kenya.

People in some of the world's wealthiest nations report feeling less physically healthy than those in several developing countries.

Meanwhile, the five lowest scores were all in economically developed nations: Germany, Australia, Sweden, the UK, and Japan. Japan had the lowest average score at 5. 97, while Indonesia topped the list at 8. 29.

This suggests that having a wealthy nation does not automatically mean its people feel healthier. The study also looked at how health ratings differ across age, gender, and other personal traits. On average, younger people tended to rate their health higher than older people. Men tended to report slightly better health than women. People who were employed or students generally felt healthier than those who were retired or unemployed.

And interestingly, people who attended religious services more often tended to report higher health scores. However, these patterns were not universal. The way age, gender, or education related to health differed a lot depending on the country. For example, in the United States, older adults actually reported some of the highest health scores, which is unusual compared to most other countries. In Japan, women rated their health higher than men, the opposite of the general trend. These differences suggest that local culture, context, and life circumstances matter a great deal when it comes to how people perceive their own health.

Figure
+2.3 points
Global Health Perception Gap

On a 10-point scale, average self-rated health in Indonesia was 2.3 points higher than in Japan, highlighting a wide variation in health perceptions across countries.

Figure
2.2x
Health Inequality Difference

The Gini coefficient, a measure of inequality, was 2.2 times higher in India than in Indonesia, indicating that self-rated health was much more unequally distributed among the population in India.

Figure
+8.5%
Religion and Reported Health

Globally, individuals who attended religious services more than once a week reported an average physical health score 8.5% higher than those who never attended.

Figure
-1.2 points
Age-Related Health Decline

On average across 22 countries, self-rated physical health was 1.2 points lower for adults aged 80 or older compared to those aged 18-24.

Figures
+2.3 points
Global Health Perception Gap

On a 10-point scale, average self-rated health in Indonesia was 2.3 points higher than in Japan, highlighting a wide variation in health perceptions across countries.

2.2x
Health Inequality Difference

The Gini coefficient, a measure of inequality, was 2.2 times higher in India than in Indonesia, indicating that self-rated health was much more unequally distributed among the population in India.

+8.5%
Religion and Reported Health

Globally, individuals who attended religious services more than once a week reported an average physical health score 8.5% higher than those who never attended.

-1.2 points
Age-Related Health Decline

On average across 22 countries, self-rated physical health was 1.2 points lower for adults aged 80 or older compared to those aged 18-24.

§4

Reader Questions

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Research Details
& Citation

Chat with this paper
Published
2025
Journal
BMC Global and Public Health
Participants
202,898
Countries
22
Cite this paper
Bradshaw, M., Kent, B. V., Levin, J., Wortham, J. S., Pertel, N. L., VanderWeele, T. J., & Johnson, B. R. (2025). Demographic variation in self-rated physical health across 22 countries: findings from the Global Flourishing Study. BMC Global and Public Health, 3(1). https://doi.org/10.1186/s44263-025-00141-1
Tags
physical-healthagegendereducationemploymentreligion-spirituality
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