America leads the world when it comes to access to higher education. But when it comes to health, environmental protection, and fighting discrimination, it trails many other developed countries, according to the Social Progress Imperative, a U.S.-based nonprofit.

The results of the group’s annual survey, which ranks nations based on 50 metrics, call to mind other reviews of national well-being, such as the World Happiness Report released in March, which was led by Norway, Denmark, and Iceland, or September’s Lancet study on sustainable development. In that one, Iceland, Singapore, Sweden, and the U.S. took spots 1, 2, 3, and 28—respectively. 

The Social Progress Index released this week is compiled from social and environmental data that come as close as possible to revealing how people live. “We want to measure a country’s health and wellness achieved, not how much effort is expended, nor how much the country spends on healthcare,” the report states. Scandinavia walked away with the top four of 128 slots. Denmark scored the highest. America came in at 18. 

The U.S. may be underperforming, but so is the rest of the world. American progress, like that of other rich nations, has stalled for four years running. Based on overall world GDP, humanity as a whole could be doing a much more efficient job taking care of itself. Tough graders, these social-progress folks.

Of course it’s easy enough to dismiss or belittle these occasional reports, each with their unique methodologies and almost identical conclusions. Another approach, however, would be to look at them all together and conclude that they represent “mounting evidence.” In that case, Houston (and Dallas, New Orleans, Tulsa, St. Louis, Baltimore, Chicago, and New York), we have a problem.

SPI produces the report in part to help city, state, and national policymakers diagnose and (ideally) address their most pressing challenges. The group’s chief executive, Michael Green, said America “is failing to address basic human needs, equip citizens to improve their quality of life, protect the environment, and provide opportunity for everyone to make personal choices and reach their full potential.” 

As a result, the U.S. is ranked as a second-tier nation within the multilevel structure of the Social Progress Index 2017 report, which comes complete with interactive graphics. Second-tier countries demonstrate “high social progress” on core issues, such as nutrition, water, and sanitation. However, they lag the first-tier, “very high social progress” nations when it comes to social unity and civic issues. That more or less reflects the U.S. performance. (There are six tiers in the study.)

Its lowest marks come in the categories of “tolerance and inclusion” and “health and wellness.”

Since 2014, as discrimination in America rises based on race, religion, sexual identity, and national origin, U.S. scores in the “tolerance and inclusion” category fell, according to the study. 

The authors note that wealth is no guarantee to first-tier access. Even among nations with similar GDP, “countries achieve widely divergent levels of social progress.” It’s true a little bit of economic growth goes a long way toward improving lives, but those gains taper off at more mature stages of development.