Where on earth is the best place to die? This week, the Economist Intelligence Unit tried to answer that question with its second Quality of Death report, which ranked 80 countries on palliative care and end-of-life support. Here’s a look at the best, the worst, and why Canada couldn’t crack the Top 10.

Surprise standout — Mongolia

It’s no surprise that the highest-ranked countries are also among the richest. What is surprising, however, is Mongolia’s ranking of 28th — just after Chile and beating out Costa Rica — especially given that 15 years ago, the country didn’t have a single hospice or government policy for palliative care.

So what happened? According to the report, Odontuya Davaasuren happened, a passionate doctor who led the charge on everything from doctor training and increasing drug access to building a national program for palliative care. “She’s a brilliant teacher, leader and visionary,” Stephen Connor, senior fellow at the Worldwide Hospice Palliative Care Alliance, said in the report.

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Trouble spot — China

In China, there is no national strategy for palliative care, which the vast majority of terminally-ill patients are unlikely to receive, according to the report. This is alarming, especially given the sheer size of China’s population and how rapidly it’s aging (by 2050, an estimated 30 per cent of people will be over 60).

The hurdles are many: medical schools rarely teach about palliative care and addiction fears are preventing opiates from reaching people who need them for end-of-life pain relief. But in a Confucian society that preaches filial piety, perhaps the biggest obstacle is cultural. “The biggest challenge is to change people’s minds, to let them know that society can take good care of their parents in the late stages of illness and help them die with dignity,” said Dr. Li Wei, founder of Beijing’s Songtang Hospice, in the report.

O Canada, where art thou?

Canada was edged out of the Top 10 this year, ranking 11th. (The first Quality of Death report, published in 2010, had Canada tied for 9th with the United States, but because it used a different methodology it can’t be directly compared with this latest one). While Canada remains a top global performer, the rankings suggest that one’s dying days are better spent in New Zealand or Taiwan.

Two weaknesses pushed Canada down the list, according to Sharon Baxter, executive director with the Canadian Hospice Palliative Care Association. One is that Canada still lacks a strong national strategy. The other, surprisingly, is in the category of affordability, where Canada ranked 22nd. “Even though Canada professes to be a publicly-funded system, a lot of the care in the last year or two of life is provided while you’re still at home,” Baxter said. “Our health care system, besides hospital care, doesn’t really cover a lot of that. So what you (see) coming out of the pockets of Canadians is actually increasing.”