WASHINGTON - The gap between rich and poor remains huge, but a survey of global health finds that significantly fewer people in poorer countries say they have had to go without food or health care because they lacked the money to pay for it.

The phenomenon was evident in almost two dozen of 35 countries in which trends were available in both low-income and middle-income countries, the Kaiser/Pew Global Health Survey, released today, found. It credited improved national economic conditions since a similar survey in 2002.

The study was a joint effort of the Kaiser Family Foundation and the Pew Global Attitudes Project.

In 23 of the countries, fewer respondents reported they had not missed health care because of money. Respondents in 20 of the countries reported similar results regarding food as well.

Jordan reported the largest percentage reductions in both categories, with 23 percent fewer missing health and 30 fewer missing food. Ghana and Russia also had large reductions in both categories.

The 2007 survey covered 47 countries, in sub-Saharan Africa, Asia, Central and Eastern Europe, Latin America, the Middle East, Western Europe and the North America.

“Declines in reported deprivations notwithstanding,” the report said, speaking of the entire sample, “the gaps between rich and poor nations in reports of hunger and lack of health care remain enormous. In nearly half of the nations surveyed, at least 40 percent of the public reports that they did without health care for lack of money.”

Overall, the study found that “global health is a local phenomenon.”

Respondents in all countries of sub-Saharan Africa, for instance, consider HIV/AIDS as a “very big problem” that their governments should be dealing with. In the other regions, crime, corruption, terrorism or pollution ranked as the biggest problem

“Despite this variation, concern about health as a personal and family issue is high in most countries and across all regions,” the study said. “When asked to name, in their own words, the most important problems facing their families today, health issue rank second only to financial concerns in 33 countries (and are the number one concern in Germany and Sweden).”

On aid, the report found that people in countries that receive major amounts of aid tend more than others to say that rich nations are doing enough to help poorer ones. In Indonesia, for instance, more than half the respondents felt that way; the report speculated that was colored by the international response to the tsunami that hit Indonesia in 2004.

“Despite all the differences in views and experiences across countries,” the report said, “this survey underscores how powerfully health is experienced in people’s lives and how many see a role for their governments, and others, to do more.”

The poll involved telephone and face-to-face interviews with 45,239 people in 46 countries plus the Palestinian territories, conducted in April and May. All samples were national except for Bolivia, Brazil, China, India, Ivory Coast, Pakistan, South Africa, and Venezuela, where they were mostly or completely conducted in cities.

The numbers of people interviewed in each country varied from 500 each in Spain, Bulgaria, Ukraine and Kuwait to 3,142 in China. The margin of sampling error in each country ranged from plus or minus 2 percentage points to 4 percentage points.