How borders are drawn and enforced has far-reaching consequences, whether we live on either side of them or halfway across the world.

While Italy’s economy is currently on shaky ground, the country has come out on top in a new ranking of the worlds healthiest countries by Bloomberg.

The Bloomberg Global Health Index ranks Italy, Iceland, Switzerland, Singapore and Australia as the countries with the healthiest populations, in that order. The ranking takes into account metrics such as mortality, life expectancy, the number of people with elevated levels of blood pressure, blood glucose, and cholesterol, as well as the prevalence of obesity, alcoholism, and childhood malnutrition in the country.

Italy far outpaces Canada (#17) and the UK (#23). Meanwhile, the US comes in at #34, behind Cuba, Lebanon, and Costa Rica.

Much credit must go to the Italian healthcare system, which was established in 1978 and offers free universal access to healthcare. The country’s approach to primary health care has proven efficient, the rates of avoidable hospitalization in the country are amongst the lowest in the OECD, and the medical workforce provides a high level of care, while the country spends less per capita on healthcare than its neighbors.

And while the fast-food versions of the Italian food contribute to American obesity, the traditional Mediterranean diet—rich in fresh vegetables, olive oil, pasta and fish—helps Italians live well into their Eighties (pdf).

Italy’s achievement is even more remarkable given that the Italian economy has been struggling recently (paywall). Almost 40% of the country’s youth is unemployed and the country’s overall unemployment rate was 11.9%, according to the latest government statistics (pdf). In February, the European Commission said that Italy’s record public debt represented “a major source of vulnerability” (paywall) and urged the country to take steps to clamp down on it.

The desperation of young people in the country is apparent in a photo series by Italian photographer Michele Borzoni. Pictures of scores of young Italians taking exams in gymnasiums, concert halls, and sporting arenas across the country are evidence of the fierce competition for government jobs.