As of 2015[update], Kerala has a Human Development Index (HDI) of 0.770, which is in the "high" category, ranking it first in the country.[68] It was 0.790 in 2007–08[69] and it had a consumption-based HDI of 0.920, which is better than that of many developed countries.[69] Comparatively higher spending by the government on primary level education, health care and the elimination of poverty from the 19th century onwards has helped the state maintain an exceptionally high HDI;[70][71] the report was prepared by the central government's Institute of Applied Manpower Research.[72][73] However, the Human Development Report 2005, prepared by Centre for Development Studies envisages a virtuous phase of inclusive development for the state since the advancement in human development had already started aiding the economic development of the state.[70] Kerala is also widely regarded as the cleanest and healthiest state in India.[74]