(Photo: AP)

The appeal of the U.S. as a destination for expatriates slid for the fifth consecutive year, to No. 47 out of 68 countries, dragged down by a steadily deteriorating reputation for safety and a perceived lack of affordable health care. Just five years ago, the U.S. held the fifth slot in the annual Expat Insider survey by Munich-based InterNations, a network of 3.2 million expatriates. The annual survey of more than 18,000 expats representing 178 nationalities covers everything from the cost of education and child care to family life, career prospects and perceptions of safety and political stability.

Two-thirds of expats in the U.S. view job opportunities positively, but for the first time America placed among the 15 countries deemed the least safe and secure. Just 17 percent rated the personal safety of their children as “very good,” compared with a global average of 44 percent. Expats are “afraid of gun violence,” said Malte Zeeck, a founder and co-chief executive of InterNations. Bahrain tops the list for the second year in a row. The nation got high rankings for the ease of settling in, among other things. Taiwan gained two spots to move into second place, with strong marks for job prospects and quality of life. Ecuador, where a massive earthquake in 2016 likely affected expat rankings in 2017, leapt from No. 25 to No. 3, showing improvement in just about every category.

The United Kingdom also tumbled this year, falling from No. 21 to No. 59 on the list. Expats cited a high cost of living, with 47 percent considering that a potential negative before moving. (Thirty-eight percent of U.K. expats live in London, a notoriously expensive city.) And, yes, the weather got poor marks, with just 3 percent rating it as “very good,” which affected the country’s No. 64 ranking for personal happiness.

If a new measure for digital life had not been added to the survey’s quality of life questions, the U.S. and the U.K. would have fared even worse in the overall ranking. Expats in both countries said it was easy to get unfettered high-speed digital access at home and to pay without cash, earning the U.S. the 10-highest spot on this measure and the U.K. the No. 15 rank. High marks for digital life also helped lift Israel to No. 22 in the overall ranking, up from No. 44.

Hong Kong trailed Myanmar, Russia and China with its overall ranking of 56. That’s a big decline from its standing at No. 33 last year. The special administrative enclave of China was dragged down by poor scores for work-life balance and cost of living. The average full-time work week in Hong Kong was 46.8 hours, compared with a global average of 44 hours. There were some bright spots for the Asian tiger: Seventy-nine percent of expats were positive on Hong Kong’s economy, compared with 69 percent the prior year, and the country won the top ranking on transportation infrastructure.

There were 66.2 million expatriates worldwide in 2017, according to a July research report by market researcher Finaccord. The company forecasts that the expat population will climb to 87.5 million by 2021.

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