It ranks 180 countries on 24 performance indicators across 10 issue categories, all of which center around environmental health and ecosystem vitality. At the top of the list is Switzerland, followed by France, Denmark, Malta, and Sweden. At the bottom of the list is India, Bangladesh, Burundi, the Democratic Republic of the Congo, and Nepal. The United States placed 27th in this list, scoring well with regards to sanitation and air quality but very poorly in deforestation and greenhouse gas emissions.