region has resulted in a brain drain, with many citizens migrating to other parts of the world for employment. The job market in Kerala is forcing many to relocate to other places. Human Development Index The United Nations developed the Human Development Index (HDI) in 1990 as a composite statistic used to rank countries by level of "human development" and separate developed (high development), developing (middle development), and underdeveloped (low development) countries. The HDI is used in the United Nations Development Programme's annual Human Development Reports and is composed from data on life expectancy, education and per-capita GDP (as an indicator of Standard of living) collected at the national level using a formula. This index, which has become one of the most influential and widely used indices to compare human development across countries, gave the Kerala model international recognition since Kerala has consistently had scores comparable to developed countries since the HDI's inception. In 2021, Kerala again tops the HDI among the Indian states with a score of 0.782, according to the Global Data Lab. Public health History Kerala's improved public health relative to other Indian states and countries with similar economic circumstances is founded on a long history of successful health-focused policies. One of the first key strategies Kerala implemented was making vaccinations mandatory for public servants, prisoners, and students in 1879 prior to Kerala becoming a state, when it was composed of autonomous territories. Moreover, the efforts of missionaries in setting up hospitals and schools in underserved areas increased access to health and education services. Though class and caste divisions were rigid and oppressive, a rise in subnationalism in the 1890s resulted in the development of a shared identity across class and caste groups and support for public welfare. Simultaneously, the growth in agriculture and trade in Kerala also stimulated government investment in transportation infrastructure. Thus, leaders in Kerala began increasing spending on health, education, and public transportation, establishing progressive social policies. By the 1950s, Kerala had a significantly higher life expectancy than neighboring states as well as the highest literacy rate in India. Once Kerala became a state in 1956, public scrutiny of schools and health care facilities continued to increase, along with residents' literacy and awareness of the necessity of access health services. Gradually, health and education became top priorities, which was unique to Kerala according to a local public health researcher. The state's high minimum