Yesterday 24/7 Wall Street published a piece on the “Most (and Least) Healthy Countries in the World.” The rankings are based on an index that measures four variables: “life expectancy, infant mortality, maternal mortality, and incidence of tuberculosis.”

The ten healthiest countries include the usual suspects from Scandinavia (Iceland #1; Finland #2; Sweden #7; and Norway #8), as well as some that were unexpected, at least for me, (Greece #3; Poland #4; Italy #6; and Spain #9). Japan #5 and Israel #10 are the only two non-European countries on the list.

Every one of the ten least healthy countries is in sub-Saharan Africa. All are desperately poor. In Sierra Leone 1,360 mothers die in childbirth for every 100,000 live births. In the Central African Republic life expectancy is 51.4 years. In the Democratic Republic of the Congo annual GDP per capita is $810.

You may have noticed that the United States is not among the top ten, and perhaps you assumed it had just missed, coming in at number 11 or 12. Actually, it ranks 34th in the world, a downward trajectory that may indicate it isn’t just our political leadership that is making us look increasingly like a “third world” country.

You also may have noticed that many of the top ten countries were those from which the president said we’d like to get our immigrants, whereas the bottom ten seem to fall more into his “sh*thole” category. It’s understandable why he would want healthy Nordic immigrants, but you have to wonder why someone would want to emigrate here from Norway, where the annual GDP per capita is almost $73,000, or Iceland, which has the world’s lowest infant mortality rate, or even Italy, where people live, on average, almost five years longer than we do.

But hasn’t it always been that way? Aside from a few people like the Marquis de Lafayette, who never planned on settling here, most aristocrats stayed home, while “the wretched refuse of your teeming shore” came by the millions. It’s not by chance that they built the country – think what courage and initiative it takes to set off in search of a new life with no money, little education, and few prospects.

I lived for many years outside Kennett Square, Pennsylvania, “the mushroom capital of the world,” where the hard work of picking was done by immigrant laborers, most of them undocumented. They had come from Mexico and countries further south, crossed the border on foot, been crammed into vans by human smugglers known as “coyotes,” and driven thousands of miles to an unknown place, where they worked and lived under often-horrendous conditions. Those who made it eventually brought their families, and over time they created better lives for themselves and a better community for all of us who lived there. It’s an amazing story.

In 1973, La Comunidad Hispana, a grassroots, underfunded, and often-shunned organization, opened its doors to provide health care to the Spanish-speaking immigrants. It’s still there, now one of the best health agencies in the area, providing its services to anyone who walks in the door.

Which brings me back to the index of healthy/unhealthy countries. It is not only that the best ones have much bigger and richer economies, although they all do. It is also that they have invested in universal health-care systems, primarily paid for with public funds, as well as in other infrastructure developments to provide clean water, electricity, and medical research. “On a global scale,” says the report, “factors such as public policy and infrastructure have a much greater bearing on public heath than behaviors at an individual level.”

And I have to wonder, as we refuse to invest in public health, roll back both Obamacare and environmental regulations that have made huge improvements in the air we breathe and the water we drink, and confront a lethal opioid crisis, how much lower on the health index we need to fall before we take action.

Maybe we should take the billions projected for the wall and invest it in building a healthier country – because at 34th and falling, we may not need a wall to discourage immigration.