Is the USA a First World Nation?

My husband and I have been discussing the possibility of leaving the USA, a decision that friends regularly feel the need to challenge, or at least to question. Raised on the patriotic legend that the USA is the Best Country In the World ™, they can’t conceive why we’d consider going anyplace else.

I usually just smile and laugh something to the effect of “Yep. Getting’ out of this s***hole country.” My left-leaning friends then nod empathetically. The right-leaning ones generally sputter their defense of the original “s***hole country” comment. A few attempt, with great sincerity, to explain to me why that remark can’t possibly apply to the USA. Whichever way it goes, it generally succeeds in turning their attention away from demanding that I explain my life choices to them.

But it does kinda beg the question: IS the USA a s***hole country?

During the Cold War, I joined the military – a patriotic act of faith, and of gratitude for having been born in the Best Country In The World. I saw, and appreciated my good fortune. Back then, it was easy to tell who was who.

The United States and its allies were the First World. The Soviet Union and its allies were the Second World. And everyone else was the Third World. 

Third world nations weren’t important enough to be accepted into either of the Big Clubs. They were wild, uncivilized, backward, chaotic, ruled by dictators and despots. People who lived in Third World Nations rarely had  things like electricity and indoor plumbing. The distended bellies of their starving children could be seen in TV commercials or magazines like National Geographic. In Third World Nations, girls like me often weren’t even allowed to go to school. They were married off as children, lived in poverty, died in childbirth. Sometimes, the really poor countries were even called “Fourth World” to distinguish them as the Worst of the Worst. I was clearly lucky to have been born Someplace Better Than That.

But then, the Soviet Union fell. The world order shifted, and this simplistic view of the world couldn’t keep up. Today, we identify the quality of nations by assessing their quality of life and care for their citizens.  As an American, I’ve always been taught that I am fortunate to live in a land of prosperity where I can do and be anything if I work hard enough for it. That I live in the ultimate First World Nation. But how would I even know if that weren’t true?

International bodies use several different mechanisms to measure how well countries are doing: The Human Development Index, the UN’s “Least Developed Countries” criteria, etc. But they all focus on the same general information: Economic well-being (being able to afford to live), Physical well-being (health and safety), Socio-emotional well-being (presence/absence of things like war and corrupt/abusive governments and personal freedoms/inequity), and potential to improve circumstances through things like jobs and education. So let’s take a look.

Physical Well-Being

According to the World Health Organization, globally the average life expectancy is 73 years.

US average life expectancy: 78.5

That’s good! Is it the best?

We barely make the top 40, landing behind pretty much every EU nation, as well as Turkey, Croatia, Estonia, Columbia, Peru, Kuwait, Slovenia, and Chile among others.*

Things like infant mortality take that rate down, so WHO also assesses your future if you have managed to make it to age 60.  In the USA, you can expect to live another 23 years!  (Once again, we’re barely in the Top 40.)

But living longer is only a good thing if you’re healthy enough to enjoy those years, right? So WHO also measures “Healthy Life Expectancy”.

In the US, you can expect to be a “healthy and happy” senior citizen until around the age of 66, or about ¼ of those additional 23 years. Where can you expect to be older and healthier than in the USA?

Bosnia and Herzegovina
Costa Rica
Sri Lanka

I mentioned Infant Mortality taking our overall average down – we rank 49th in the world, behind Uruguay, Serbia, Cuba, Croatia, Korea, and pretty much all of the EU. That’s apparently very regional, as the State of Massachusetts actually scores as well as a Top 30 country, while Mississippi lands around 68th place, barely ahead of Kazhakhstan.

Mothers don’t do so well, either. We’re 59th in the world for maternal mortality, with 35 women out of 1,000 dying as a result of childbirth, compared to 8 in Canada, 2 in Singapore and Australia, 18 in Iran, and 15 in Libya and China.

The US spends more than 15% of its GDP on healthcare.  There are ten other developed countries that spend more than 10% (but we’re the only one higher than 11.5%). Every one of them has higher life expectancy and lower infant mortality than the USA. Overall, our health care system is ranked 30th, behind Mexico, the United Arab Emirates, India, the Czech Republic, and Taiwan.

Economic Well-Being

Most countries use the World Bank’s method to establish the poverty level: “50% of a country’s median income.” So, since the US median income was $67,521 in 2020, the poverty level would be $33,761.  The USA, however, uses a different calculation, developed in the 1960s, and places the poverty level for a family of four at $26,246, or about 75% of the number the rest of the world uses.

As a result, the USA reports 12.3% of citizens living in poverty that year, while other estimates place it at around 17.8%, on a par with Namibia (17.4%), Iraq (18.9%), Cambodia (17.7%), and Bosnia and Herzegovina (16.9%). We come in behind Uzbekistan (14%), Vietnam (6%), Algeria (5%), Chile and Uruguay (8%), and Kazakhstan (4%)

For children in poverty, specifically, we rank fourth from the bottom of the list of developed nations, behind Mexico, Slovakia, and Latvia (but ahead of Israel, Turkey, and Chile).

Socio-Emotional Well-Being

Most of these indicators involve the state of government, so let’s start there.

Every year, the Economist Intelligence Unit compiles a “democracy index”, placing world governments on a scale from “Authoritarian Regimes” to “Full Democracies”. In 2021, the USA was listed (again) as a Flawed Democracy. Only the first 21 countries managed ‘full democracy” – we ranked 26th, behind Chile, Israel, Mauritius, Uruguay, and Costa Rica.

The rest of the government factors can be pretty much rolled up into the ‘Human Freedom Index”, which ranks based on factors including Rule of Law, Security and Safety, Freedoms (including Movement Religion, Association, Assembly, and Civil Society, Expression, Information, Trade, Identity and Relationships), Size of Government, Legal System and Property Rights, and Access to Sound Money. We did OK here, coming at 15th, somewhere in the middle of the pack for developed nations.

As for the more individual elements of well-being – we didn’t even make the Top 100 (best) for suicide rates.

There’s also the matter of income equity. (For those who think that ‘the rich getting richer’ is ‘just the way it has been throughout history’ should check out the data here. It’s not even ‘the way it is in our world today.’) Broadly, high-income countries tend to have lower inequality. Except, y’know – here in the USA, where 30% of the money flows to the top 10% of wealth-holders. And even that is a recent phenomenon.


But hey, we have a great education system, and we’re the Land of Opportunity, right?

We ranked 46th for Literacy, behind Cuba, Moldova, Croatia, Tonga, Kyrgyzstan, Turkmenistan, and Armenia, and 65th in numeracy, behind Botswana, Gabon, Suriname, and the Congo.

Congo is just above us on the list for unemployment as well, placing 80th. Our unemployment is also higher than Cameroon, Zimbabwe, Timor, Ghana, Bhutan, Guatemala, and Cuba.

When the former president made his comment about S***hole countries, he was referring to those questionably democratic, poverty-ridden, uneducated Third World Nations. If I wanted to be all dramatic, I’d follow that with “nations like ours”. But I can’t.  Because on the measures listed above, many of those nations are outperforming us.

For my friends, who don’t understand why I’d consider leaving The Best Country In The World™…

As a young soldier, I was sympathetic to the idea of “America; Love It or Leave It.”  As I matured, I came to realize that when someone you love is broken, you don’t just turn your back on them, but to try to help them back to health. And as I watch the current Congressional Hearings on the January 6th attack, I can’t help but think of the number of times people have figuratively patted me on the head as I spoke of the erosion of the Republic and my concerns that we might be headed for actual insurrection or even potential civil war. I’ve spent a lot of time trying to nurse my republic back to health – or at least get fellow citizens to take an interest in the fact that it’s ailing. Trying to convince your loved one that they need help, need to make a change is very rewarding when it works. But sometimes, you have to accept that they don’t want help, or can’t see that they need it. In those cases, all you can do is take a step back, stay out of the way of the destruction, and hope they figure it out in time to save themselves.

And that cannot happen until America looks itself in the mirror and sees not The Best Country In The World™, but the Third World Nation it has become.

* At any given time, there are around 175 recognized nations. These country names were chosen semi-randomly from the list of qualifiers.  I have focused on countries which American culture tends to assume are “inferior” to the USA in quality of life. That doesn’t mean it’s so – in fact, that’s kinda the point here, isn’t it? – and their inclusion should not be interpreted as an opinion on anything except “Americans’ conviction that their nation is somehow better despite extensive evidence to the contrary”.

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