14. Spain

The country’s tuberculosis rate is the highest of all 15 countries, at 21.7 for every 100,000 people. Spain also has one of the highest air pollution estimates on the list. Its physician density, healthy life expectancy and infant mortality rate are average when compared with other countries on the list.

15. France

A stellar health care system and clean air landed France on the list. Working against it: the worst wastewater treatment standards of the top 15. Its tuberculosis rate–11 cases per 100,000 people, one of the highest on the list–also held it back. But there’s good news for the country’s chronically ill; France’s high physician density measurement: 3.37 per 1,000 people.