A few surprises to come out of Bloomberg’s Healthiest Countries report this year.

Great news for those of you who dig olive oil, rice, and octopus. Not so much if you’re into calzone or spaghetti bolognese. Oh, and if Chipotle is your go-to meal source, beware–the U.S. and Mexico dropped a few spots this year to rank 35th and 53rd respectively.

These are the world's healthiest countries:

1. Spain

2. Italy

3. Iceland

4. Japan

5. Switzerland

35. U.S.https://t.co/EZmH07r93S — Bloomberg (@business) February 25, 2019

How Do You Identify the Healthiest Countries?

The Bloomberg index takes into account several factors that contribute to the overall health and wellbeing of a person. These include alcohol and tobacco ingestion, access to healthcare, a tendency toward obesity, access to clean water and sanitation.

If you had called Spain the healthiest country in the world a few years back, someone would have belly-laughed in your face. The cafes and bars that line the streets of Spanish towns and cities were clogged with smoke.

Old men with wizened faces downed shots of liquor with their morning coffee. And the word ‘vegetarian’ evoked bewildered looks comparable only to that of bringing up bitcoin with aging relatives.

Well, Spain has certainly cleaned up its act since then. However, its position as number one comes as a slight surprise. Anyone who’s experienced the local culture recently will know that the Spanish tendency for cold cerveza, sangria, and the occasional cigarette is still deeply ingrained. As well as coffees with a little ‘pick me up’ in the morning.

The sidewalks also continue to be a minefield of dog shit that causes unwitting tourists to sidestep into the street, provoking accidents. But still, the excellent healthcare system seems to make all that better.

Pulling the Spanish up into the number one slot according to the European Observatory on Health Systems and Policies 2018 is its healthcare system. And one has to admit, it’s rather good.

Primary care is essentially provided by public providers, specialized family doctors and staff nurses, who provide preventive services to children, women and elderly patients, and acute and chronic care.

This is almost unthinkable in the U.S. where some 3.2 million people have no access to health insurance.

Cuba Is Healthier than the U.S.A

You may think of the Cubans as still suffering from years of the U.S. economic, commercial, and financial embargo. But, according to the survey, the island economy is 30th place on the list–a full five slots above the United States. Cuba, in fact, is the only ‘non-high-income’ nation to be ranked so highly.

It seems that the main reason for this isn’t diet, since basic supplies are often scarce. However, in Cuba, they also have exceptional healthcare. Their system focuses more on preventative care than treatment.

Moreover, this year, life expectancy rates in the USA have been trending down as a result of deaths from suicides and drug overdoses. Trump clearly has a long way to go before he makes America better.

Bringing Up the Rear

Unsurprisingly, perhaps, Haiti, Yemen, and Afghanistan hold the lowest spots in the healthiest countries list. Low life expectations, poor healthcare and lack of access to clean drinking water are the main culprits for this.

Move to Spain, would you: Spain is the world’s healthiest country, according to the 2019 Bloomberg Healthiest Countries Index. — Egils Rupeks (@RupeksEgils) February 25, 2019

So, if you had any doubt about where to take your next vacation or maybe spend your retirement, it looks as if you’d be well placed in the Mediterranean. Sipping on sangria, downing liquor shots, and living several years longer for it.