“Iceland, Japan, Switzerland round out top five; U.S. is 35th – Health index looks at life expectancy, environmental factors…The index grades nations based on variables including life expectancy while imposing penalties on risks such as tobacco use and obesity. It also takes into consideration environmental factors including access to clean water and sanitation. Spain has the highest life expectancy at birth among European Union nations, and trails only Japan and Switzerland globally, United Nations data show. Spain by 2040 is forecast to have the highest lifespan, at almost 86 years, followed by Japan, Singapore and Switzerland, according to the University of Washington’s Institute for Health Metrics and Evaluation.

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,” according to the European Observatory on Health Systems and Policies 2018 review of Spain, noting a decline the past decade in cardiovascular diseases and deaths from cancer…”