I agree, and would add „lifestyle“ to the relevant factors. Cuba has a lot more „communal“ life. Eating alone, as but one example, just doesn’t happen. Even som

I agree, and would add „lifestyle“ to the relevant factors. Cuba has a lot more „communal“ life. Eating alone, as but one example, just doesn’t happen. Even something like watching TV is more of a group activity. Even if the cause of that is an inability to afford your own TV, chances are it could have an impact on psychological well-being. Physical activity is also far higher. Again, this may be a result of relative poverty. But walking or taking public transport to work just happens to also be healthy. Interestingly, these are factors somewhat shared across Cuba, Spain and Italy, even though there is no similar economic pressure in those countries. On the other side of the divide, I live in Germany. We have universal insurance that is functionally equivalent to government-run healthcare (I, and everyone else, can visit a GP any time without paying). Yet outcomes here, and in Britain and Canada, are closer to the US.