The UK has topped a list of 40 countries for its approach to inclusivity in healthcare, closely followed by Australia, France and Germany.

The Health Inclusivity Index, commissioned by OTC medicines company Haleon and carried out by researchers at Economist Impact, assessed the extent to which policies, systems and cultures “give everyone in society the chance to optimise their health”. 

It used 37 indicators, including the public’s ability to participate in policy decisions, workforce infrastructure and training, the availability of health information, and the extent to which health systems prioritise vulnerable population groups.

The UK scored 90.8 out of a possible 100, with Australia scoring 90 and France scoring 87.1. Bangladesh, Algeria and Egypt had the lowest scores of the 40 countries the researchers looked at.

“The index demonstrates the levers governments, policymakers and others can use to address health inequity and promote inclusion, particularly for vulnerable and marginalised people and communities,” said Haleon.

It found that countries with higher inclusivity scores tended to score higher on healthy life expectancy and that countries with higher GDP per capita “tend to be more inclusive,” although countries’ “health and wealth expenditure do not guarantee greater inclusivity in health,” said Haleon.

And while universal health coverage was found to be necessary for a country to obtain a high score, it was “not sufficient to ensure inclusivity”.

Out of all the metrics used in the index, ‘community empowerment’ – where health literacy programmes, community outreach and other initiatives are used to promote a proactive approach to looking after one’s own health – was especially predictive of a high overall score on inclusivity. 

The use of multidisciplinary teams including pharmacists, nurses, social workers and other professionals may help overcome some of the “multiple challenges people face when trying to manage their health,” said the researchers.

Haleon CEO Brian McNamara said: “Everyone should have the opportunity to live in good health, but millions of people continue to face barriers. The inaugural Health Inclusivity Index highlights the barriers which lead to the vulnerable and marginalised being held back from and less included in opportunities for better everyday health.

“Raising awareness and creating a global benchmark are vital first steps in addressing health inequity, but this is just the start. We are also collaborating with industry, government, academia and other healthcare stakeholders to improve health inclusivity.”

David Napier, a UCL professor of medical anthropology and one of the principal advisors on the index, said it “rightly recognises the fact that health is largely made or lost outside the formal health sector”. 

He added: “I believe that the indicators on People and Community Empowerment will emerge as the most important part of the Index.

“It is here that even cash-strapped countries can make progress, for empowering individuals and communities to manage their own health provides people with options that they may not otherwise have thought of or considered feasible.”