Natixis identified several reasons why the U.S. ranked the same or lower on the new index compared with last year. In the finances category, the good news is that the U.S. remained in the top 10. However, a growing proportion of retirees to working adults is increasing pressure on Social Security and Medicare funds. Rising government debt and tax pressures also led to a lower score in this category. The U.S. had the eighth-worst score for income equality, even though it ranked sixth for income per capita among all countries in the Global Reporting Initiative, an independent international standards organization. Natixis said these factors generated a lower score for the U.S. in the material well-being category. The U.S. stayed in the top 10 — at no. 10 — for health, thanks to improved insured health expenditure and by maintaining the highest score globally for per capita health spending. But it experienced a decline in life expectancy as Americans' longevity failed to keep pace with that of top-ranked Japan and other nations. The U.S. also scored lower for happiness, which evaluates the quality of retirees' current lives, lowering its quality-of-life performance. Still, the U.S. had the seventh-highest score for air quality on the index, and showed improvement in its environmental factors indicator score, though not enough to lift it out of the bottom 10 in that category. Check out the gallery to see the top 12 countries on the 2019 Global Retirement Index.
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