Cuba's life expectancy at birth is 79.2 years (76.8 for males and 81.7 for females). This ranks Cuba 59th in the world and 5th in the Americas, behind Canada, Chile, Costa Rica and the United States. Infant mortality declined from 32 infant deaths per 1,000 live births in 1957, to 10 in 1990–95, 6.1 in 2000–2005 and 5.13 in 2009. Historically, Cuba has ranked high in numbers of medical personnel and has made significant contributions to world health since the 19th century. Today, Cuba has universal health care and despite persistent shortages of medical supplies, there is no shortage of medical personnel. Primary care is available throughout the island and infant and maternal mortality rates compare favorably with those in developed nations. That a developing nation like Cuba has health outcomes rivaling the developed world is referred to by researchers as the Cuban Health Paradox. Cuba ranks 30th on the 2019 Bloomberg Healthiest Country Index, which is the only developing country to rank that high.