Relative Intelligence · Health Care Equity
How State Street Health Care Select Sector SPDR ETF (XLV) compares with the whole market and its popular alternatives
Built by QuantCommons' quantitative engine, this page is about relative opportunity, not data on XLV alone. It places XLV (State Street Health Care Select Sector SPDR ETF) against 20+ popular alternatives, its neighboring categories and the entire market of over 10,000 U.S.-listed stocks and ETFs, and surfaces what has done better on consistent outperformance, return for the risk taken, behavior in real market crashes and diversification. The result is a clearer view of where XLV stands in the market, and of the alternatives worth a closer look.
Period covered: XLV's full trading record, from December 1998 through September 2026. All returns include reinvested dividends. Data as of October 20, 2026.
Data as of October 20, 2026. Full tables and charts read best on a larger screen.
On this page12 sections
Key findings
- What you're buyingXLV is a healthcare bet first: 99% of assets, versus 10% in the S&P 500. At a glance ↓
- Right nowOver the past 6 months, XLV rose 23.0% against 9.1% for the S&P 500 and 11.2% for the Nasdaq 100. Its similar funds were far apart over the past 6 months, from IHF (iShares U.S. Healthcare Providers ETF, up 32.6%) to XBI (State Street SPDR S&P Biotech ETF, up 11.3%). Consistency ↓
- Fund or market?XLV rose 13.4% over the past 3 months while the S&P 500 rose 3.9%. Its similar funds did not move as one over the past 3 months: BBH (VanEck Biotech ETF) rose 23.0%, while XBI (State Street SPDR S&P Biotech ETF) rose 1.5%.
- Long termXLV turned $10,000 into $30,200 over the past decade, against $42,100 in the S&P 500. Even so, over the past decade, only PTH (Invesco Dorsey Wright Healthcare Momentum ETF) of its similar funds outpaced XLV. Growth of $10,000 ↓
- In a crashXLV fell less than the S&P 500 in six of seven sell-offs, but the 2015 China and oil sell-off broke the pattern: it fell 15.9%, more than the S&P 500's 12.8%. Crash tests ↓
- DiversificationAgainst the S&P 500, XLV has a correlation of 0.58 over 5 years, less closely than 79% of ETFs with at least $100 million in assets. Next to an index fund it is some diversification, but not a hedge. When the S&P 500 had a down month, XLV usually fell with it (19 of 22 months). By year ↓
- Better options
- Popular alternatives
- VIG (Vanguard Dividend Appreciation ETF) earned more than XLV with less volatility over the past 5 years: 10.4% a year at 14.1% volatility, against 8.4% a year at 15.2%.
- Nearby categories and themes
- VTV (Vanguard Morningstar Value ETF, US large-cap value) and SCHD (Schwab U.S. Dividend Equity ETF, US dividend equity) earned more than XLV with less volatility over the past 5 years. VTV returned 12.1% a year at 13.7% volatility, against 8.4% a year at 15.2%.
- Whole market
- Few investments have done better on both counts: only 69 of the 3,633 stocks and funds worth at least $500 million earned more than XLV with less volatility over the past 5 years, among them VTV (Vanguard Morningstar Value ETF), VIG (Vanguard Dividend Appreciation ETF) and SCHD (Schwab U.S. Dividend Equity ETF).
How much would $10,000 in XLV have grown?
This chart tracks a hypothetical $10,000 investment in XLV over the past 25 years, with dividends reinvested, alongside the same amount in the S&P 500, investments that ended ahead of XLV over the same span and XLV's popular alternatives, among those that traded for the entire period. A second view covers the past 5 years, the period the better options further down the page are judged on. It shows not only where each investment ended up but also how smooth or uneven the path was.
Note: The chart covers the past 25 years rather than XLV's full 27 years, because most of its popular alternatives have not traded that long.
- $10,000 invested in XLV at the end of September 2001 would have grown to $107,068 by September 2026, less than the $114,557 it would have become in SPY, an S&P 500 fund.
- Six of the eight other investments on the chart ended ahead of XLV, and AAPL finished highest, at $14,356,990.
Choose a period
From the end of September 2001 to the end of September 2026. The scale is logarithmic, so equal steps up the chart are equal percentage gains. Hover over a fund in the key to pick out its line. 624 of the 1,326 stocks and funds worth at least $500 million that traded the whole period ended ahead of XLV; the chart shows 5, closest alternatives first. The other 3 lines are popular alternatives, shown for context.
- AAPL$14M+143,470% total · +33.7% a year
- NVDA$11M+109,423% total · +32.3% a year
- MSFT$328,610+3,186% total · +15.0% a year
- XLK$273,782+2,638% total · +14.2% a year
- BBH$185,014+1,750% total · +12.4% a year
- TRV$158,381+1,484% total · +11.7% a year
- SPY (S&P 500)$114,557+1,046% total · +10.2% a year
- XLV$107,068+971% total · +9.9% a year
- IBB$88,678+787% total · +9.1% a year
- PPH$37,610+276% total · +5.4% a year
From the end of September 2021 to the end of September 2026. Hover over a fund in the key to pick out its line. 1,677 of the 3,628 stocks and funds worth at least $500 million that traded the whole period ended ahead of XLV; the chart shows 5, closest alternatives first. The other 3 lines are popular alternatives, shown for context.
- XLK$27,207+172% total · +22.2% a year
- SPY (S&P 500)$19,000+90.0% total · +13.7% a year
- VTV$17,967+79.7% total · +12.4% a year
- IHE$17,918+79.2% total · +12.4% a year
- PJP$16,782+67.8% total · +10.9% a year
- VIG$16,653+66.5% total · +10.7% a year
- PPH$16,589+65.9% total · +10.7% a year
- SCHD$15,708+57.1% total · +9.5% a year
- XLV$14,351+43.5% total · +7.5% a year
- PTH$11,674+16.7% total · +3.1% a year
XLV at a glance
This section summarizes the key facts about the fund, its returns over periods from one to ten years and the risk it has carried, with dividends reinvested throughout. These figures serve as the baseline for every comparison that follows.
- XLV is trading within 1% of its all-time high.
- XLV's deepest decline since it began trading in 1998 was 39.2%, from December 2007 to March 2009. It took 25 months from the low to climb back to its old high.
- Over 27 full calendar years, XLV's best was 2013, when it returned 41.4%, and its worst was 2008, when it lost 23.3%. It lost money in six of those years.
The fund
- Issuer
- SPDR
- Began trading
- December 1998
- Expense ratio
- 0.08%per year
- Assets
- $46B
- Category
- Healthcare
Returns
- Past 1 year
- +26.3%total return
- Past 3 years
- +47.6%+13.9% a year
- Past 5 years
- +49.3%+8.4% a year
- Past 10 years
- +202%+11.7% a year
- Best calendar year
- +41.4%2013
- Worst calendar year
- −23.3%2008
- Losing years
- 6 of 27full calendar years
Risk
- Volatility
- 15.3%typical yearly swing, 5 years
- Sharpe ratio
- 0.60return per unit of risk, 5 years
- Worst decline ever
- −39.2%Dec 2007 to Mar 2009
- From its all-time high
- At its highwithin 1%
XLV against the whole market
Where XLV ranks among every stock and fund, and what across the market has done better.
How does XLV rank among all ETFs?
This section ranks XLV on return, volatility, risk-adjusted return and worst decline against every ETF worth at least $100 million with enough history. Where the comparisons with its popular alternatives show how XLV stacks up against its peers, these rankings show where it stands in the market as a whole.
- XLV's 1-year return ranks in the top 10% of the 2,485 ETFs with at least $100 million in assets with 1 year of history.
Ranked against U.S.-listed ETFs with at least $100M in assets that have enough history for each measure, so the count changes from row to row; smaller ETFs and leveraged funds are left out. Lower volatility and smaller declines rank higher.
| Measure | XLV | Rank | Standing |
|---|---|---|---|
| 1-year return | +26.3% | 239 of 2,485 | top 10% |
| 3-year return | +47.6% | 1,207 of 1,949 | bottom 39% |
| 5-year return | +49.3% | 688 of 1,560 | top 44% |
| 10-year return | +202% | 282 of 958 | top 29% |
| Volatility, 5 years | 15.3% | 638 of 1,560 | top 41% |
| Sharpe ratio, 5 years | 0.60 | 712 of 1,560 | top 46% |
| Worst decline, past 10 years | −28.4% | 177 of 951 | top 19% |
What has beaten XLV on both return and risk?
Each dot is an investment, placed by how much it earned a year over the past 5 years (higher is better) and how much its price swung, its volatility (further left is calmer). XLV sits where the dashed lines cross. Anything in the green box above and to the left earned more than XLV with smaller swings, a better trade-off over this period on both counts. Past results are no promise, but a name in the box is worth a closer look.
- 69 ETFs worth at least $500 million sit in the green region: each earned more than XLV over the past 5 years with smaller price swings. That is 2% of the 3,633 screened. Few investments beat it on both counts.
- Among those with at least half XLV's swings, LVHI has the best return for its risk: 17.0% a year at 11.1% volatility, 27% less than XLV's 15.2%, and a Sharpe ratio (return above cash per unit of volatility) of 1.48 against 0.60 for XLV.
- Among XLV's popular alternatives, VIG is in the region. VIG earned 10.4% a year against 8.4% a year for XLV, at 14.1% volatility, 7% less than XLV's 15.2%.
Annual return is the annualized total return with dividends reinvested, and volatility the annualized swing in daily prices, both over 5 years. Labeled dots are the strongest picks from the table below and the names called out above, colored by how close they sit to XLV; faint dots are 27 more of the 69 in the green region (the strongest, one per fund family). 3,633 stocks and funds worth at least $500 million were screened. Hover over a dot for its figures.
- Popular alternatives
- Same and neighboring categories, and shared themes
- The whole market
- Others in the green region
Is there a better investment than XLV?
Investments that beat XLV over the past 5 years on return, volatility, drawdowns, consistency, crash losses or fees, from its popular alternatives out to the whole market.
- Among XLV's popular alternatives, VIG earned more than XLV with less volatility over the past 5 years: 10.4% a year at 14.1% volatility, against 8.4% a year at 15.2%.
- Looking beyond its popular alternatives, VTV (US large-cap value) and SCHD (US dividend equity) earned more than XLV with less volatility over the past 5 years. VTV returned 12.1% a year at 13.7% volatility, against 8.4% a year at 15.2%.
- Few investments have done better on both counts: only 69 of the 3,633 stocks and funds worth at least $500 million earned more than XLV with less volatility over the past 5 years, among them VTV, VIG and SCHD.
How this works
The table below lists investments that beat XLV over the past 5 years on at least one of these measures: a higher annual return with lower volatility, a higher annual return at similar volatility, a similar return with lower volatility, a higher Sharpe ratio with a smaller worst decline, a higher total return in most periods from 3 months to 10 years, or smaller losses in recent market crashes, and, for funds, the same exposure at a lower expense ratio. It checks XLV's popular alternatives first, then the rest of its own and neighboring categories, then every stock and fund worth at least $500 million, and shows the strongest few in each group. The full list of those with a higher return and lower volatility than XLV follows the table.
Annual return is the annualized total return with dividends reinvested. Annual return, volatility and the Sharpe ratio cover 5 years; the worst decline covers the past 10 years. Green marks a better figure than XLV's. "On the frontier" means no other option shown or tested earned more with less volatility. Funds that hold the same thing are shown once. Beyond the popular alternatives, nothing with more than 1.5× XLV's volatility counts as better.
These figures cover the past 5 years. Green marks a better figure than XLV's.
| Investment | Why it is better | Past 5 years | Downside | Long run | Fit | ||||
|---|---|---|---|---|---|---|---|---|---|
| Annual return?higher is better | Volatility?lower is calmer | Sharpe?return per unit of risk | Worst decline?past 10 years | 10Y returntotal | Corr. with XLV?lower diversifies more | Expenseper year | |||
| XLVState Street Health Care Select Sector SPDR ETF · this page | +8.4% | 15.3% | 0.60 | −28.4% | +202% | 1.00 | 0.08% | ||
 SPYState Street SPDR S&P 500 ETF · S&P 500 | +12.7% | 17.1% | 0.79 | −33.7% | +321% | 0.58 | 0.09% | ||
| Popular alternativesbest 3 shownThe investments people most often weigh against XLV. 3 of 22 passed at least one test. | |||||||||
 VIGVanguard Dividend Appreciation ETF · US Dividend Equity | Higher return, lower volatility | +10.4% | 14.1% | 0.78 | −31.7% | +258% | 0.75 | 0.04% | |
IHEiShares U.S. Pharmaceuticals ETF · Broad Market | Higher return, similar volatility | +12.6% | 16.8% | 0.80 | −29.6% | +151% | 0.90 | 0.37% | |
PPHVanEck Pharmaceutical ETF · Healthcare | Higher return, similar volatility | +11.6% | 15.8% | 0.78 | −29.7% | +153% | 0.89 | 0.36% | |
| Same and neighboring categories, and shared themesbest 6 shownEverything else in Health Care Equity and the categories next to it (Biotechnology, Technology Equity, US Large-Cap Equity, US Dividend Equity), plus XLV's specific themes. 25 of 125 passed at least one test. | |||||||||
 VTVVanguard Morningstar Value ETF · US Large-Cap Value | Higher return, lower volatility | +12.1% | 13.7% | 0.90 | −36.8% | +235% | 0.76 | 0.03% | |
 SCHDSchwab U.S. Dividend Equity ETF · US Dividend Equity | Higher return, lower volatility | +9.7% | 14.3% | 0.72 | −33.4% | +252% | 0.69 | 0.06% | |
HDViShares Core High Dividend ETF · US Dividend Equity | Higher return, lower volatility | +12.9% | 13.0% | 1.00 | −37.0% | +172% | 0.70 | 0.08% | |
RWLInvesco S&P 500 Revenue ETF · US Large-Cap Equity | Higher return, lower volatility | +13.7% | 14.4% | 0.97 | −36.1% | +287% | 0.70 | 0.39% | |
AVLVAvantis U.S. Large Cap Value ETF · US Large-Cap Value | Higher Sharpe, smaller worst decline | +14.0% | 16.9% | 0.86 | −19.5% | — | 0.62 | 0.15% | |
PVALPutnam Focused Large Cap Value ETF · US Large-Cap Value | Higher return, similar volatility | +16.1% | 15.1% | 1.07 | −41.3% | — | 0.69 | 0.56% | |
| The whole marketbest 8 shownEvery other stock and fund worth at least $500 million. 133 of 3,491 passed at least one test. | |||||||||
PJULInnovator U.S. Equity Power Buffer ETF · Broad Market | On the frontierHigher return, lower volatilityHigher Sharpe, smaller worst decline | +10.5% | 8.6% | 1.20 | −18.2% | — | 0.54 | 0.79% | |
FJANFT Vest U.S. Equity Buffer ETF - January · Multi-Asset | On the frontierHigher return, lower volatilityHigher Sharpe, smaller worst decline | +11.1% | 10.5% | 1.05 | −13.6% | — | 0.48 | 0.85% | |
 KOThe Coca-Cola Company · Food & Beverages | Higher return, similar volatilityHigher return in most periods | +14.7% | 16.8% | 0.91 | −37.0% | +204% | 0.62 | — | |
BUFRFT Vest Laddered Buffer ETF · Buffered Equity | Higher return, lower volatilityHigher Sharpe, smaller worst decline | +9.9% | 10.5% | 0.96 | −13.7% | — | 0.57 | 0.10% | |
DBMFiMGP DBi Managed Futures Strategy ETF · Alternatives | Higher return, lower volatilityHigher Sharpe, smaller worst decline | +9.8% | 12.4% | 0.82 | −20.4% | — | -0.03 | 0.85% | |
 TRVThe Travelers Companies, Inc. · Property & Casualty Insurance | On the frontierHigher return in most periods | +22.4% | 22.3% | 1.02 | −46.3% | +347% | 0.55 | — | |
 JEPIJPMorgan Equity Premium Income ETF · Equity Income | Similar return, lower volatilityHigher Sharpe, smaller worst decline | +7.5% | 11.0% | 0.71 | −13.7% | — | 0.79 | 0.35% | |
DIVBiShares Core Dividend ETF · Dividend & Income | Higher return, similar volatilityHigher return in most periods | +13.9% | 15.4% | 0.93 | −36.9% | — | 0.68 | 0.05% | |
What these numbers mean for XLV
- Annual return
- XLV returned 8.4% a year over the past 5 years with dividends reinvested, against 12.7% a year for the S&P 500. At that pace, $10,000 became about $14,900. Annual return is the steady yearly rate that would produce the same total result, so investments held over the same span compare fairly. Guide: What is performance and return? →
- Volatility
- XLV's volatility over the past 5 years was 15.2%, 89% of the S&P 500's 17.1%. Volatility measures how widely returns swing around their average: in roughly two years out of three, XLV's return lands within 15.2% of its average, either way. The higher it is, the rougher the ride and the harder it is to hold through a slump. Guide: Understanding and measuring risk (volatility) →
- Sharpe ratio
- XLV's Sharpe ratio over the past 5 years was 0.60, against 0.79 for the S&P 500, so XLV earned less for each unit of risk than an index fund did. The Sharpe ratio is the return earned above cash for each unit of volatility: two investments with the same return are not equal if one got there with far bigger swings. Guide: Balancing reward with risk (Sharpe ratio) →
- Worst decline
- XLV's worst fall from a peak to a low over the past 10 years was 28.4%, against 33.7% for the S&P 500. Losses and gains are not symmetric: climbing back from a 28.4% fall takes a 39.7% gain. Guide: Market crash risk and tail risk →
- Correlation
- Over the past 5 years, XLV's monthly returns had a correlation of 0.58 with the S&P 500. Correlation runs from 1 (moving in lockstep) through 0 (unrelated) to −1 (moving in opposite directions). They often move together: some diversification next to an index fund, but not a cushion. In the table, the correlation column measures each option against XLV instead: the lower it is, the more that option would diversify a XLV holding. Guide: Correlation and diversification →
Show all 69 stocks and funds worth at least $500 million that earned more than XLV with less volatility
Out of 3,633 tested over 5 years. The strongest 36 are listed, best first, with funds that hold the same thing listed once.
| # | Investment | Found in | Annual return | Volatility | Sharpe | Worst decline | 10Y return | Corr. with XLV | Expense |
|---|---|---|---|---|---|---|---|---|---|
| 1 | PJULInnovator U.S. Equity Power Buffer ETF · Broad Market | Whole market | +10.5% | 8.6% | 1.20 | −18.2% | — | 0.54 | 0.79% |
| 2 | FJANFT Vest U.S. Equity Buffer ETF - January · Multi-Asset | Whole market | +11.1% | 10.5% | 1.05 | −13.6% | — | 0.48 | 0.85% |
| 3 | BUFRFT Vest Laddered Buffer ETF · Buffered Equity | Whole market | +9.9% | 10.5% | 0.96 | −13.7% | — | 0.57 | 0.10% |
| 4 | DBMFiMGP DBi Managed Futures Strategy ETF · Alternatives | Whole market | +9.8% | 12.4% | 0.82 | −20.4% | — | -0.03 | 0.85% |
| 5 | FTLSFirst Trust Long/Short Equity ETF · Broad Market | Whole market | +10.2% | 10.4% | 0.99 | −20.6% | +158% | 0.61 | 0.95% |
| 6 | TDVGT. Rowe Price Dividend Growth ETF · Dividend & Income | Whole market | +9.6% | 13.8% | 0.73 | −19.2% | — | 0.76 | 0.50% |
| 7 | SIXHETC 6 Meridian Hedged Equity Index Option ETF · Broad Market | Whole market | +10.2% | 10.2% | 1.00 | −11.7% | — | 0.68 | 0.31% |
| 8 | LVHIFranklin International Low Volatility High Dividend Index ETF · International Equity | Whole market | +17.0% | 11.1% | 1.48 | −32.4% | +194% | 0.55 | 0.40% |
| 9 | VTVVanguard Morningstar Value ETF · US Large-Cap Value | Same or nearby category | +12.1% | 13.7% | 0.90 | −36.8% | +235% | 0.76 | 0.03% |
| 10 | DBEFXtrackers MSCI EAFE Hedged Equity ETF · International Equity | Whole market | +13.1% | 13.8% | 0.96 | −32.5% | +206% | 0.64 | 0.35% |
| 11 |  VYMVanguard High Dividend Yield ETF · US Dividend Equity | Same or nearby category | +11.3% | 13.8% | 0.85 | −35.2% | +208% | 0.71 | 0.04% |
| 12 | DIVOAmplify CWP Enhanced Dividend Income ETF · Equity Income | Whole market | +11.1% | 11.9% | 0.95 | −30.0% | — | 0.74 | 0.56% |
| 13 | SCHDSchwab U.S. Dividend Equity ETF · US Dividend Equity | Same or nearby category | +9.7% | 14.3% | 0.72 | −33.4% | +252% | 0.69 | 0.06% |
| 14 | EMLPFirst Trust North American Energy Infrastructure Fund · Energy Infrastructure | Whole market | +14.9% | 14.5% | 1.04 | −43.6% | +150% | 0.51 | 0.95% |
| 15 | HDViShares Core High Dividend ETF · US Dividend Equity | Same or nearby category | +12.9% | 13.0% | 1.00 | −37.0% | +172% | 0.70 | 0.08% |
| 16 | GCOWPacer Global Cash Cows Dividend ETF · International | Whole market | +14.1% | 13.6% | 1.04 | −37.6% | +168% | 0.54 | 0.60% |
| 17 | DGRWWisdomTree U.S. Quality Dividend Growth Fund · US Dividend Equity | Same or nearby category | +11.8% | 14.0% | 0.87 | −32.0% | +276% | 0.70 | 0.28% |
| 18 | IWXiShares Russell Top 200 Value ETF · Broad Market | Whole market | +12.7% | 13.8% | 0.94 | −35.8% | +221% | 0.74 | 0.20% |
| 19 | RWLInvesco S&P 500 Revenue ETF · US Large-Cap Equity | Same or nearby category | +13.7% | 14.4% | 0.97 | −36.1% | +287% | 0.70 | 0.39% |
| 20 | FDLFirst Trust Morningstar Dividend Leaders Index Fund · US Dividend Equity | Same or nearby category | +13.9% | 14.4% | 0.98 | −41.4% | +199% | 0.62 | 0.43% |
| 21 | PTLCPacer Trendpilot US Large Cap ETF · Broad Market | Whole market | +9.5% | 11.8% | 0.83 | −26.6% | +188% | 0.58 | 0.60% |
| 22 | HDEFXtrackers MSCI EAFE High Dividend Yield Equity ETF · International | Whole market | +12.8% | 14.2% | 0.92 | −36.4% | +134% | 0.60 | 0.09% |
| 23 | FTHIFirst Trust BuyWrite Income ETF · Dividend & Income | Whole market | +10.3% | 13.3% | 0.81 | −32.7% | +126% | 0.55 | 0.75% |
| 24 | PWVInvesco Large Cap Value ETF · Broad Market | Whole market | +13.5% | 14.2% | 0.97 | −37.6% | +223% | 0.70 | 0.55% |
| 25 | DDWMWisdomTree Dynamic International Equity Fund · International | Whole market | +12.3% | 13.4% | 0.94 | −35.0% | +149% | 0.62 | 0.40% |
| 26 | DHSWisdomTree U.S. High Dividend Fund · Dividend & Income | Whole market | +12.0% | 13.9% | 0.89 | −37.4% | +156% | 0.65 | 0.38% |
| 27 | RODMHartford Multifactor Developed Markets (ex-US) ETF · International | Whole market | +10.6% | 13.5% | 0.82 | −36.0% | +141% | 0.61 | 0.29% |
| 28 | QUSState Street SPDR MSCI USA StrategicFactors ETF · Broad Market | Whole market | +11.1% | 14.2% | 0.81 | −33.8% | +273% | 0.74 | 0.15% |
| 29 | RLYState Street Multi-Asset Real Return ETF · Multi-Asset | Whole market | +9.9% | 13.3% | 0.78 | −34.2% | +128% | 0.50 | 0.50% |
| 30 | FDLOFidelity Low Volatility Factor ETF · Broad Market | Whole market | +9.8% | 13.0% | 0.79 | −34.4% | +249% | 0.74 | 0.15% |
| 31 | DBAInvesco DB Agriculture Fund · Alternatives | Whole market | +10.7% | 13.8% | 0.81 | −35.3% | +62.2% | 0.13 | 0.90% |
| 32 | EDIVState Street SPDR S&P Emerging Markets Dividend ETF · International | Whole market | +11.2% | 13.8% | 0.84 | −40.7% | +119% | 0.34 | 0.49% |
| 33 | AUSFGlobal X - Adaptive U.S. Factor ETF · International | Whole market | +13.2% | 13.6% | 0.99 | −44.2% | — | 0.71 | 0.27% |
| 34 | PTNQPacer Trendpilot 100 ETF · Technology | Whole market | +9.7% | 14.1% | 0.73 | −28.1% | +305% | 0.33 | 0.65% |
| 35 | OUSAALPS Funds O’Shares U.S. Quality Dividend ETF · Dividend & Income | Whole market | +9.4% | 13.4% | 0.74 | −33.1% | +186% | 0.77 | 0.48% |
| 36 | DJDInvesco Dow Jones Industrial Average Dividend ETF · Dividend & Income | Whole market | +11.8% | 13.3% | 0.91 | −34.7% | +227% | 0.76 | 0.07% |
XLV against its popular alternatives
The investments people most often weigh against XLV, compared period by period and year by year.
How do XLV's risk and return compare with its alternatives?
This map plots each investment's annual return over the past 5 years against its volatility, the size of its typical price swings. Investments toward the upper left earned more for a smoother ride, and those toward the lower right earned less for a rougher one. The dashed lines cross at XLV, which divides the map into what did better or worse on each measure.
- Only VIG was both more rewarding and calmer than XLV over the past 5 years, earning a higher annual return with lower volatility.
- 13 of the 20 popular alternatives earned less than XLV over the past 5 years while swinging more, the weaker corner of the map.
- Over the past 5 years, XLV returned 8.3% a year, less than the S&P 500's 12.7%, with lower volatility (15.2% against 17.1%).
Green points earned more than XLV with less volatility; red points earned less with more. Hover over a point for its figures. Total returns with dividends reinvested, annualized.
All figures
| Investment | Annual return | Volatility |
|---|---|---|
| XLK State Street Technology Select Sector SPDR ETF | +19.4% | 26.0% |
| SPY S&P 500State Street SPDR S&P 500 ETF | +12.7% | 17.1% |
| IHE iShares U.S. Pharmaceuticals ETF | +12.6% | 16.8% |
| PPH VanEck Pharmaceutical ETF | +11.6% | 15.8% |
| PJP Invesco Pharmaceuticals ETF | +11.2% | 16.6% |
| VIG Vanguard Dividend Appreciation ETF | +10.4% | 14.1% |
| XLV This pageState Street Health Care Select Sector SPDR ETF | +8.3% | 15.3% |
| VHT Vanguard Health Care ETF | +7.3% | 15.4% |
| XPH State Street SPDR S&P Pharmaceuticals ETF | +7.2% | 21.3% |
| IYH iShares U.S. Healthcare ETF | +7.2% | 15.4% |
| XLP State Street Consumer Staples Select Sector SPDR ETF | +7.2% | 13.8% |
| XHS State Street SPDR S&P Health Care Services ETF | +6.4% | 21.3% |
| IXJ iShares Global Healthcare ETF | +6.4% | 14.8% |
| IBB iShares Biotechnology ETF | +6.2% | 22.4% |
| RSPH Invesco S&P 500 Equal Weight Health Care ETF | +6.1% | 16.8% |
| BBH VanEck Biotech ETF | +5.4% | 21.9% |
| XBI State Street SPDR S&P Biotech ETF | +4.6% | 32.5% |
| RXI iShares Global Consumer Discretionary ETF | +3.3% | 21.1% |
| IHF iShares U.S. Healthcare Providers ETF | +3.1% | 19.3% |
| FXH First Trust Health Care AlphaDEX Fund | +3.0% | 16.8% |
| PTH Invesco Dorsey Wright Healthcare Momentum ETF | +2.9% | 26.0% |
| IHI iShares U.S. Medical Devices ETF | −2.9% | 19.7% |
Has XLV consistently beaten its popular alternatives?
This section compares XLV with the investments people most often weigh against it, checking each one over eight periods from one month to ten years. Counting how often an alternative earned more than XLV helps separate lasting outperformance from a single strong stretch.
- None of the 22 popular alternatives outperformed XLV in at least 3 of 5 short-term and 2 of 3 long-term timeframes. The closest was XLK.
- SPY outperformed XLV over all three long-term periods but in none of the five short-term ones, so XLV has had the better of it lately.
A green cell means the alternative earned more than XLV over that period. "Qualified" marks those that did so in at least 3 of 5 short-term periods and 2 of 3 long-term periods.
| Investment | Periods outperformed | Short term | Long term | Risk · 5 years | Fund | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1M | 3M | 6M | YTD | 1Y | 3Y | 5Y | 10Y | Volatilitylower is calmer | Sharpehigher is better | Worst declinepast 10 years | Expense | Assets | Overlapsame sectors | ||
| XLV State Street Health Care Select Sector SPDR ETF (this page) | — | +6.4% | +13.4% | +23.0% | +17.1% | +26.3% | +47.6% | +49.3% | +202% | 15.3% | 0.60 | −28.4% | 0.08% | $46B | — |
| XLK TechnologyState Street Technology Select Sector SPDR ETF | 2/5 short3/3 long | −4.8% | +5.7% | +20.3% | +29.0% | +29.3% | +131% | +143% | +767% | 26.0% | 0.82 | −33.6% | 0.08% | $125B | 1% |
| SPY Broad MarketState Street SPDR S&P 500 ETF | 0/5 short3/3 long | −0.6% | +3.9% | +9.1% | +13.5% | +15.8% | +89.3% | +81.7% | +321% | 17.1% | 0.79 | −33.7% | 0.09% | $823B | 10% |
| VIG Dividend & IncomeVanguard Dividend Appreciation ETF | 0/5 short3/3 long | +2.4% | +3.4% | +7.8% | +11.5% | +13.7% | +67.0% | +64.0% | +258% | 14.1% | 0.78 | −31.7% | 0.04% | $128B | 19% |
| PTH HealthcareInvesco Dorsey Wright Healthcare Momentum ETF | 2/5 short2/3 long | −4.4% | +1.1% | +9.9% | +19.5% | +27.7% | +101% | +15.3% | +271% | 26.0% | 0.24 | −53.5% | 0.74% | $281M | 99% |
| IHE Broad MarketiShares U.S. Pharmaceuticals ETF | 2/5 short2/3 long | +1.2% | +5.0% | +18.0% | +23.0% | +40.4% | +86.5% | +81.2% | +151% | 16.8% | 0.80 | −29.6% | 0.37% | $1.5B | — |
| PJP HealthcareInvesco Pharmaceuticals ETF | 2/5 short2/3 long | −0.1% | +7.5% | +19.5% | +22.1% | +34.5% | +84.7% | +69.9% | +135% | 16.6% | 0.72 | −34.0% | 0.58% | $550M | 99% |
| PPH HealthcareVanEck Pharmaceutical ETF | 1/5 short2/3 long | +4.5% | +8.2% | +13.3% | +14.1% | +28.5% | +58.7% | +72.8% | +153% | 15.8% | 0.78 | −29.7% | 0.36% | $1.1B | 99% |
| RSPH HealthcareInvesco S&P 500 Equal Weight Health Care ETF | 4/5 short1/3 long | +6.9% | +17.2% | +26.3% | +23.6% | +29.8% | +51.4% | +34.3% | +177% | 16.8% | 0.44 | −30.4% | 0.40% | $905M | 99% |
| BBH HealthcareVanEck Biotech ETF | 4/5 short1/3 long | +4.7% | +23.0% | +29.1% | +30.8% | +39.5% | +68.8% | +29.9% | +142% | 21.9% | 0.35 | −39.9% | 0.35% | $486M | 99% |
| XHS HealthcareState Street SPDR S&P Health Care Services ETF | 3/5 short1/3 long | +4.3% | +5.0% | +30.6% | +31.7% | +36.1% | +76.7% | +36.5% | +173% | 21.3% | 0.40 | −39.3% | 0.35% | $215M | 98% |
| XBI HealthcareState Street SPDR S&P Biotech ETF | 2/5 short1/3 long | −3.2% | +1.5% | +11.3% | +26.2% | +39.7% | +130% | +25.1% | +159% | 32.5% | 0.30 | −63.9% | 0.35% | $10B | 99% |
| IBB Broad MarketiShares Biotechnology ETF | 2/5 short1/3 long | +1.6% | +12.9% | +19.8% | +24.7% | +34.8% | +81.0% | +35.2% | +140% | 22.4% | 0.38 | −39.8% | 0.44% | $11B | — |
| XPH HealthcareState Street SPDR S&P Pharmaceuticals ETF | 1/5 short1/3 long | −5.0% | −4.3% | +8.9% | +16.5% | +31.2% | +80.7% | +41.8% | +65.8% | 21.3% | 0.44 | −36.0% | 0.35% | $451M | 99% |
| VHT HealthcareVanguard Health Care ETF | 0/5 short1/3 long | +5.2% | +11.7% | +21.5% | +16.7% | +25.2% | +50.4% | +42.0% | +200% | 15.4% | 0.53 | −28.9% | 0.09% | $22B | 99% |
| FHLC HealthcareFidelity MSCI Health Care Index ETF | 0/5 short1/3 long | +5.3% | +11.8% | +21.7% | +16.9% | +25.5% | +50.5% | +42.1% | +199% | 15.4% | 0.53 | −28.8% | 0.08% | $3.5B | 100% |
| IHF Broad MarketiShares U.S. Healthcare Providers ETF | 3/5 short0/3 long | +8.0% | +7.1% | +32.6% | +25.5% | +19.0% | +23.8% | +16.4% | +171% | 19.3% | 0.26 | −35.2% | 0.37% | $1.4B | — |
| FXH HealthcareFirst Trust Health Care AlphaDEX Fund | 1/5 short0/3 long | +3.4% | +10.8% | +18.6% | +18.4% | +20.1% | +46.3% | +16.0% | +134% | 16.8% | 0.26 | −30.6% | 0.61% | $1.1B | 100% |
| XLP Consumer StaplesState Street Consumer Staples Select Sector SPDR ETF | 1/5 short0/3 long | +7.1% | +4.1% | +7.9% | +15.1% | +13.2% | +41.5% | +41.4% | +121% | 13.8% | 0.57 | −24.5% | 0.08% | $15B | 0% |
| IYH Broad MarketiShares U.S. Healthcare ETF | 0/5 short0/3 long | +5.5% | +13.0% | +22.3% | +16.5% | +25.2% | +46.1% | +41.8% | +193% | 15.4% | 0.53 | −28.4% | 0.37% | $4.3B | — |
| IXJ InternationaliShares Global Healthcare ETF | 0/5 short0/3 long | +5.7% | +11.2% | +16.0% | +12.6% | +19.7% | +40.3% | +36.5% | +158% | 14.8% | 0.50 | −27.4% | 0.38% | $4.5B | — |
| RXI InternationaliShares Global Consumer Discretionary ETF | 0/5 short0/3 long | +2.1% | −0.3% | −4.0% | −5.1% | −4.9% | +45.4% | +17.8% | +147% | 21.1% | 0.26 | −35.8% | 0.37% | $305M | — |
| IHI Broad MarketiShares U.S. Medical Devices ETF | 0/5 short0/3 long | +4.5% | +7.5% | +1.1% | −12.0% | −10.1% | +19.3% | −13.9% | +138% | 19.7% | -0.05 | −33.3% | 0.37% | $3.7B | — |
How did XLV do year by year?
This table shows each investment's total return in every full calendar year since 1999, along with where XLV ranked among its popular alternatives each year. Annual results reveal how consistently each one kept pace with XLV and how far its good and bad years diverged, detail that multiyear averages tend to smooth over.
- XLV finished ahead of the S&P 500 in 12 of its 27 full calendar years, and behind it in each of the last three.
- Among its popular alternatives, XBI came out ahead of XLV most often, in 12 of the 19 years both traded.
- Ranked against its popular alternatives each year, XLV finished in the top quarter in five of 25 years and in the bottom quarter in four. In 2025, it ranked 13 of 21.
Newest year first. Green marks a year in which the fund came out ahead of XLV; gray means the two finished within a fraction of a point. The rank row places XLV among the alternatives that traded the full year; dark green is the top quarter and red the bottom quarter.
| Investment | Years ahead of XLV | 2025 | 2024 | 2023 | 2022 | 2021 | 2020 | 2019 | 2018 | 2017 | 2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 | 2004 | 2003 | 2002 | 2001 | 2000 | 1999 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| XLV This pageState Street Health Care Select Sector SPDR ETF | — | +14.5% | +2.5% | +2.1% | −2.1% | +26.1% | +13.3% | +20.5% | +6.3% | +21.8% | −2.8% | +6.8% | +25.1% | +41.4% | +17.3% | +12.4% | +3.3% | +19.5% | −23.3% | +7.2% | +7.0% | +6.4% | +1.3% | +14.9% | −0.7% | −0.8% | −11.8% | +19.6% |
| Rank among alternatives | Top quarter in 5 of 25 | 13 of 21 | 12 of 21 | 15 of 21 | 3 of 21 | 2 of 21 | 17 of 21 | 17 of 21 | 3 of 21 | 12 of 21 | 8 of 21 | 10 of 21 | 13 of 21 | 9 of 21 | 13 of 21 | 7 of 20 | 17 of 20 | 13 of 20 | 11 of 20 | 10 of 19 | 6 of 10 | 5 of 9 | 7 of 8 | 6 of 8 | 1 of 8 | 1 of 6 | — | — |
| SPY S&P 500State Street SPDR S&P 500 ETF | 14 of 27 | +17.7% | +24.9% | +26.2% | −18.2% | +28.7% | +18.3% | +31.2% | −4.6% | +21.7% | +12.0% | +1.2% | +13.5% | +32.3% | +16.0% | +1.9% | +15.1% | +26.4% | −36.8% | +5.1% | +15.9% | +4.8% | +10.7% | +28.2% | −21.6% | −11.7% | −9.8% | +20.4% |
| XLK State Street Technology Select Sector SPDR ETF | 15 of 27 | +24.6% | +21.6% | +56.0% | −27.7% | +34.8% | +43.6% | +49.9% | −1.7% | +34.3% | +15.0% | +5.5% | +17.9% | +26.2% | +15.4% | +2.5% | +11.5% | +51.1% | −41.5% | +15.5% | +12.2% | −0.4% | +5.6% | +38.7% | −38.2% | −23.4% | −41.9% | +65.0% |
| VIG Vanguard Dividend Appreciation ETF | 6 of 19 | +14.2% | +17.0% | +14.5% | −9.8% | +23.8% | +15.4% | +29.6% | −2.1% | +22.2% | +12.0% | −1.9% | +10.1% | +28.9% | +11.6% | +6.2% | +14.7% | +19.6% | −26.7% | +5.6% | — | — | — | — | — | — | — | — |
| PTH Invesco Dorsey Wright Healthcare Momentum ETF | 8 of 19 | +27.9% | +2.3% | −4.5% | −20.6% | −3.2% | +67.3% | +34.5% | −1.2% | +50.1% | −12.9% | +1.5% | +14.8% | +44.7% | +15.8% | +6.8% | +13.6% | +21.1% | −34.9% | +16.0% | — | — | — | — | — | — | — | — |
| IHE iShares U.S. Pharmaceuticals ETF | 8 of 19 | +31.7% | +8.2% | +1.1% | −4.9% | +13.1% | +13.7% | +15.5% | −7.8% | +10.7% | −11.8% | +8.8% | +29.9% | +40.3% | +13.4% | +20.9% | +12.7% | +30.1% | −14.8% | +2.4% | — | — | — | — | — | — | — | — |
| PJP Invesco Pharmaceuticals ETF | 10 of 20 | +28.0% | +9.6% | −2.2% | −2.1% | +14.6% | +11.3% | +4.7% | −1.8% | +15.3% | −19.3% | +10.9% | +28.0% | +55.8% | +24.5% | +20.0% | +27.5% | +17.4% | −10.9% | +0.7% | +10.8% | — | — | — | — | — | — | — |
| PPH VanEck Pharmaceutical ETF | 8 of 25 | +22.0% | +8.0% | +7.0% | +2.6% | +17.8% | +5.5% | +19.4% | −5.9% | +15.2% | −17.8% | +3.5% | +23.2% | +36.7% | +18.3% | +15.5% | +1.1% | +17.8% | −19.9% | +2.9% | +10.5% | −4.2% | −8.6% | +7.3% | −24.8% | −13.8% | — | — |
| RSPH Invesco S&P 500 Equal Weight Health Care ETF | 10 of 19 | +9.5% | −1.0% | +4.0% | −9.3% | +23.2% | +18.9% | +25.5% | −0.7% | +23.7% | −4.5% | +8.1% | +29.8% | +41.2% | +20.0% | +6.3% | +10.5% | +39.3% | −26.5% | +10.1% | — | — | — | — | — | — | — | — |
| BBH VanEck Biotech ETF | 14 of 26 | +21.2% | −4.3% | +3.9% | −15.3% | +11.8% | +22.1% | +26.3% | −10.7% | +16.5% | −15.0% | +10.3% | +30.3% | +65.5% | +53.8% | +21.6% | +2.2% | +10.4% | +10.3% | −6.6% | −4.4% | +31.4% | +13.1% | +60.0% | −34.2% | −22.5% | +18.8% | — |
| XHS State Street SPDR S&P Health Care Services ETF | 4 of 14 | +18.8% | +1.8% | +5.2% | −19.9% | +9.8% | +33.7% | +18.8% | +2.0% | +17.6% | −8.3% | +3.2% | +25.3% | +37.4% | +22.0% | — | — | — | — | — | — | — | — | — | — | — | — | — |
| XBI State Street SPDR S&P Biotech ETF | 12 of 19 | +35.9% | +1.0% | +7.6% | −25.9% | −20.4% | +48.3% | +32.6% | −15.3% | +43.8% | −15.4% | +13.6% | +45.0% | +48.4% | +32.7% | +5.2% | +17.6% | +0.4% | −8.5% | +29.1% | — | — | — | — | — | — | — | — |
| IBB iShares Biotechnology ETF | 12 of 24 | +28.0% | −2.4% | +3.7% | −13.7% | +0.9% | +26.0% | +25.4% | −9.5% | +21.1% | −21.4% | +11.6% | +33.8% | +65.5% | +32.2% | +11.7% | +14.8% | +15.2% | −12.3% | +4.4% | +0.7% | +2.5% | +4.8% | +45.8% | −45.8% | — | — | — |
| XPH State Street SPDR S&P Pharmaceuticals ETF | 10 of 19 | +31.6% | +5.0% | +2.9% | −9.8% | −10.5% | +14.7% | +25.6% | −15.3% | +12.0% | −23.2% | +1.7% | +29.5% | +60.8% | +10.9% | +12.8% | +22.5% | +27.6% | −9.0% | −1.0% | — | — | — | — | — | — | — | — |
| VHT Vanguard Health Care ETF | 10 of 21 | +15.4% | +2.7% | +2.5% | −5.6% | +20.6% | +18.3% | +21.9% | +5.6% | +23.3% | −3.2% | +7.1% | +25.5% | +42.7% | +19.0% | +10.7% | +5.6% | +21.8% | −23.3% | +7.9% | +6.6% | +8.2% | — | — | — | — | — | — |
| IHF iShares U.S. Healthcare Providers ETF | 9 of 19 | +0.9% | −7.9% | −1.1% | −7.1% | +24.4% | +17.6% | +22.4% | +9.6% | +25.5% | +1.0% | +5.3% | +27.2% | +36.6% | +17.3% | +9.5% | +11.6% | +35.3% | −43.5% | +18.2% | — | — | — | — | — | — | — | — |
| FXH First Trust Health Care AlphaDEX Fund | 6 of 18 | +10.2% | +1.0% | −4.5% | −12.2% | +15.2% | +28.0% | +22.3% | −1.3% | +21.8% | −5.2% | +0.3% | +25.4% | +47.6% | +20.6% | +5.7% | +19.0% | +51.2% | −29.5% | — | — | — | — | — | — | — | — | — |
| XLP State Street Consumer Staples Select Sector SPDR ETF | 11 of 27 | +1.5% | +12.2% | −0.8% | −0.8% | +17.2% | +10.1% | +27.4% | −8.1% | +13.0% | +5.0% | +6.8% | +15.7% | +26.3% | +10.7% | +14.0% | +13.8% | +14.3% | −15.0% | +12.7% | +14.5% | +2.8% | +7.6% | +11.0% | −20.1% | −9.9% | +25.5% | −14.3% |
| IYH iShares U.S. Healthcare ETF | 9 of 25 | +13.2% | +3.0% | +2.2% | −4.5% | +23.4% | +15.6% | +20.8% | +5.7% | +22.2% | −2.7% | +5.8% | +25.2% | +40.9% | +18.8% | +11.2% | +4.0% | +20.9% | −22.8% | +8.1% | +6.1% | +7.7% | +4.1% | +18.5% | −21.3% | −13.4% | — | — |
| IXJ iShares Global Healthcare ETF | 6 of 24 | +15.0% | +0.5% | +3.6% | −4.9% | +19.6% | +12.7% | +23.2% | +2.8% | +20.4% | −6.0% | +6.0% | +17.3% | +35.8% | +17.7% | +10.7% | +1.9% | +17.6% | −20.8% | +3.8% | +10.4% | +6.8% | +4.0% | +18.2% | −17.9% | — | — | — |
| RXI iShares Global Consumer Discretionary ETF | 9 of 19 | +13.2% | +17.3% | +27.6% | −29.1% | +16.3% | +24.5% | +26.8% | −6.3% | +22.9% | +3.1% | +5.8% | +3.0% | +38.2% | +25.4% | −4.9% | +23.2% | +37.5% | −39.3% | −3.8% | — | — | — | — | — | — | — | — |
| IHI iShares U.S. Medical Devices ETF | 11 of 19 | +6.9% | +8.6% | +3.2% | −19.8% | +21.1% | +24.2% | +32.7% | +15.4% | +30.8% | +9.3% | +9.7% | +22.5% | +37.6% | +16.0% | −0.1% | +11.4% | +38.4% | −36.7% | +18.6% | — | — | — | — | — | — | — | — |
Risk and diversification
How XLV has fallen, how it held up in crashes beside the S&P 500 and its popular alternatives, and what moves independently of it.
What were XLV's worst declines?
A drawdown is the decline from a peak to the lowest point before a new high. This section presents XLV's five deepest drawdowns since it began trading in 1998, alongside the S&P 500's return over the same dates, and how long each took to recover. Together, these figures show how much an investor could have lost and how long it took to get back to even.
- Not every decline was the market's doing: XLV fell 17.1% from September 2024 to May 2025, while the S&P 500 rose 5.4%.
- The slowest recovery came after XLV fell 33.3% from January 2000 to September 2001; it did not regain that peak until June 2005, four years later.
- In three of XLV's five worst declines, the S&P 500 held up better over the same dates.
Green means XLV fell less than the S&P 500 over the same dates. Based on daily closing prices with dividends reinvested.
| During | XLV fell | S&P 500, same dates | Peak | Low | Time to the low | Back at the peak | Time to recover |
|---|---|---|---|---|---|---|---|
| 2008 financial crisis | −39.2% | −53.9% | Dec 2007 | Mar 2009 | 15 months | Apr 2011 | 2.1 years |
| Dot-com bust | −33.3% | −31.4% | Jan 2000 | Sep 2001 | 20 months | Jun 2005 | 3.8 years |
| Covid crash | −28.4% | −32.3% | Jan 2020 | Mar 2020 | 2 months | Jul 2020 | 4 months |
| 2011 euro debt crisis | −17.3% | −16.0% | May 2011 | Aug 2011 | 3 months | Jan 2012 | 5 months |
| No named crash | −17.1% | +5.4% | Sep 2024 | May 2025 | 8 months | Nov 2025 | 6 months |
How did XLV do in stock market crashes?
This section measures how far XLV, the S&P 500 and each alternative fell from peak to trough during every major market crash since 2000. A smaller decline means an investment held up better, and comparing results across crashes shows whether that resilience was consistent or a one-off.
- XLV fell less than the S&P 500 in seven of the ten crashes it has traded through. The clearest case was the dot-com bust, when XLV fell 29.8% and the S&P 500 fell 47.5%.
- Among its popular alternatives, XLP held up best, falling less than XLV in seven of the ten crashes they both traded through.
Newest crash first. Each figure is the fund's deepest fall within the crash window; green means a smaller fall than XLV.
| Investment | Held up better | 2023 regional bank crisisMar 2023 | 2022 bear marketJan 2022 | Covid crashFeb 2020 | Late-2018 sell-offSep 2018 | February 2018 volatility shockFeb 2018 | 2015 China and oil sell-offAug 2015 | 2011 euro debt crisisJul 2011 | 2010 flash crashMay 2010 | 2008 financial crisisOct 2007 | Dot-com bustMar 2000 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| XLV This pageState Street Health Care Select Sector SPDR ETF | — | −1.7% | −16.1% | −27.9% | −15.4% | −6.8% | −15.9% | −15.8% | −1.4% | −39.2% | −29.8% |
| SPY S&P 500State Street SPDR S&P 500 ETF | 1 of 10 | −3.4% | −24.5% | −33.7% | −19.3% | −6.5% | −12.8% | −17.9% | −1.5% | −55.2% | −47.5% |
| XLK State Street Technology Select Sector SPDR ETF | 1 of 10 | −3.2% | −32.4% | −31.1% | −23.8% | −6.7% | −12.7% | −15.9% | −2.1% | −53.0% | −82.0% |
| VIG Vanguard Dividend Appreciation ETF | 2 of 9 | −3.1% | −20.4% | −31.6% | −17.3% | −6.3% | −10.1% | −15.6% | −1.4% | −46.8% | — |
| PTH Invesco Dorsey Wright Healthcare Momentum ETF | 0 of 9 | −5.8% | −26.9% | −27.9% | −34.2% | −6.7% | −40.3% | −22.3% | −2.4% | −50.4% | — |
| IHE iShares U.S. Pharmaceuticals ETF | 2 of 9 | −2.6% | −16.0% | −26.8% | −21.6% | −6.4% | −24.6% | −16.5% | −1.9% | −35.5% | — |
| PJP Invesco Pharmaceuticals ETF | 2 of 9 | −1.7% | −17.3% | −26.3% | −20.2% | −7.0% | −26.6% | −15.6% | −2.1% | −33.6% | — |
| PPH VanEck Pharmaceutical ETF | 3 of 10 | −1.5% | −20.3% | −28.6% | −18.4% | −5.9% | −22.8% | −14.2% | −0.9% | −38.0% | −47.6% |
| RSPH Invesco S&P 500 Equal Weight Health Care ETF | 0 of 9 | −2.6% | −20.4% | −30.4% | −19.3% | −6.5% | −18.0% | −18.4% | −1.8% | −40.4% | — |
| BBH VanEck Biotech ETF | 3 of 10 | −2.9% | −27.4% | −20.9% | −23.4% | −7.0% | −30.3% | −17.0% | −0.7% | −25.9% | −67.9% |
| XHS State Street SPDR S&P Health Care Services ETF | 1 of 6 | −4.9% | −25.8% | −39.3% | −22.1% | −3.5% | −27.3% | — | — | — | — |
| XBI State Street SPDR S&P Biotech ETF | 2 of 9 | −6.9% | −43.6% | −32.9% | −32.5% | −5.5% | −42.6% | −26.7% | −4.1% | −37.5% | — |
| IBB iShares Biotechnology ETF | 2 of 9 | −3.5% | −28.6% | −23.5% | −26.5% | −6.5% | −34.3% | −22.3% | −4.3% | −34.6% | — |
| XPH State Street SPDR S&P Pharmaceuticals ETF | 1 of 9 | −4.8% | −17.8% | −31.9% | −28.3% | −7.1% | −31.9% | −17.4% | −1.4% | −31.1% | — |
| VHT Vanguard Health Care ETF | 0 of 9 | −2.1% | −17.0% | −28.9% | −17.0% | −6.7% | −18.8% | −17.1% | −1.7% | −39.1% | — |
| IHF iShares U.S. Healthcare Providers ETF | 1 of 9 | −3.3% | −19.1% | −35.2% | −19.7% | −4.2% | −24.6% | −25.9% | −2.3% | −58.9% | — |
| FXH First Trust Health Care AlphaDEX Fund | 1 of 9 | −2.9% | −19.4% | −30.6% | −24.6% | −6.3% | −27.5% | −21.3% | −2.1% | −43.7% | — |
| XLP State Street Consumer Staples Select Sector SPDR ETF | 7 of 10 | −1.4% | −16.3% | −24.3% | −13.5% | −5.1% | −9.2% | −10.7% | −0.6% | −32.4% | −32.9% |
| IYH iShares U.S. Healthcare ETF | 1 of 9 | −1.8% | −16.6% | −28.3% | −16.4% | −7.0% | −18.6% | −16.9% | −1.7% | −38.5% | — |
| IXJ iShares Global Healthcare ETF | 2 of 9 | −1.3% | −17.5% | −27.2% | −14.5% | −6.4% | −17.8% | −15.7% | −0.9% | −40.5% | — |
| RXI iShares Global Consumer Discretionary ETF | 2 of 9 | −3.3% | −33.2% | −35.1% | −20.7% | −4.7% | −16.6% | −20.8% | −0.6% | −58.1% | — |
| IHI iShares U.S. Medical Devices ETF | 1 of 9 | −2.6% | −26.8% | −33.0% | −19.2% | −8.2% | −13.8% | −21.0% | −2.5% | −49.6% | — |
How closely does XLV move with the S&P 500?
Upside capture measures how much of the S&P 500's gains an investment kept in the months the market rose, and downside capture how much of its losses it took in the months the market fell. An investment that captures more of the gains than the losses has compounded ahead of the market over time. This section compares XLV with its popular alternatives on both measures, and on beta (how strongly each has moved with the market), over the past 10 years.
- Only XLK and VIG had a higher capture ratio (upside capture divided by downside capture) than XLV's 0.94, out of 20 popular alternatives with the same record.
- Over the past 10 years, XLV captured 76% of the S&P 500's gains in rising months and 81% of its losses in falling months, with a beta of 0.66. Its share of the market's losses was slightly larger than its share of the gains.
Monthly total returns over the past 10 years, measured against SPY. 100% capture or a beta of 1.00 means moving in line with the S&P 500. Green marks a better figure than XLV's: more upside, less downside or a higher capture ratio. Sorted by capture ratio.
| Investment | Upside capture | Downside capture | Capture ratio | Beta |
|---|---|---|---|---|
| XLV This pageState Street Health Care Select Sector SPDR ETF | 76% | 81% | 0.94 | 0.66 |
| XLK State Street Technology Select Sector SPDR ETF | 128% | 100% | 1.28 | 1.19 |
| VIG Vanguard Dividend Appreciation ETF | 85% | 86% | 0.99 | 0.84 |
| PTH Invesco Dorsey Wright Healthcare Momentum ETF | 99% | 108% | 0.92 | 0.89 |
| VHT Vanguard Health Care ETF | 78% | 84% | 0.92 | 0.70 |
| IYH iShares U.S. Healthcare ETF | 76% | 82% | 0.92 | 0.67 |
| XLP State Street Consumer Staples Select Sector SPDR ETF | 53% | 60% | 0.89 | 0.55 |
| IHE iShares U.S. Pharmaceuticals ETF | 70% | 81% | 0.87 | 0.66 |
| PPH VanEck Pharmaceutical ETF | 69% | 80% | 0.87 | 0.65 |
| IXJ iShares Global Healthcare ETF | 71% | 81% | 0.87 | 0.63 |
| PJP Invesco Pharmaceuticals ETF | 67% | 79% | 0.85 | 0.63 |
| IHF iShares U.S. Healthcare Providers ETF | 78% | 93% | 0.84 | 0.80 |
| RSPH Invesco S&P 500 Equal Weight Health Care ETF | 85% | 104% | 0.82 | 0.84 |
| XHS State Street SPDR S&P Health Care Services ETF | 88% | 109% | 0.80 | 1.00 |
| BBH VanEck Biotech ETF | 77% | 98% | 0.79 | 0.79 |
| IBB iShares Biotechnology ETF | 80% | 103% | 0.78 | 0.81 |
| FXH First Trust Health Care AlphaDEX Fund | 78% | 100% | 0.78 | 0.80 |
| XBI State Street SPDR S&P Biotech ETF | 93% | 122% | 0.76 | 1.01 |
| IHI iShares U.S. Medical Devices ETF | 82% | 108% | 0.76 | 0.84 |
| RXI iShares Global Consumer Discretionary ETF | 91% | 121% | 0.75 | 1.06 |
| XPH State Street SPDR S&P Pharmaceuticals ETF | 71% | 108% | 0.66 | 0.81 |
What diversifies XLV?
Correlation measures how closely two investments move together, on a scale from 1 (in lockstep) through 0 (unrelated) to -1 (in opposite directions). This section lists large ETFs and stocks whose returns have had a low correlation with XLV's. Because such investments tend not to fall at the same time, pairing XLV with them can reduce a portfolio's overall swings.
- Moving a fifth of the money in XLV into FJAN would have cut the portfolio's volatility by 13% over the past 5 years and raised its annual return (+7.5% for XLV alone, +8.4% for the mix).
- Among large ETFs, DXJ, FJAN and MLPX have moved largely independently of XLV over the past 5 years, with correlations of 0.48 or lower, and each still earned a positive 5-year return.
- Among large stocks, CAH, CLS and FIX have moved largely independently of XLV over the past 5 years, with correlations of 0.46 or lower, and each still earned a positive 5-year return.
Only ETFs with at least $1.0B in assets and stocks worth at least $10B, with a correlation below 0.5 over the past 5 years and a positive return, are included, ranked by Sharpe ratio; funds that hold the same thing are shown once. The year columns are the years in which XLV lost money. The last two columns show a portfolio that is 80% XLV and 20% the other investment, rebalanced monthly.
ETFs
| Investment | Correlation | 5Y return | Sharpe | 2022 | 2016 | 2008 | 2002 | 2001 | 2000 | 80/20 mix volatility | 80/20 mix annual return |
|---|---|---|---|---|---|---|---|---|---|---|---|
| XLV State Street Health Care Select Sector SPDR ETF (this page) | 1.00 | +49.3% | 0.60 | −2.1% | −2.8% | −23.3% | −0.7% | −0.8% | −11.8% | 14.8% | +7.5% |
| DXJ InternationalWisdomTree Japan Hedged Equity Fund | 0.40 | +225% | 1.34 | +6.0% | +1.1% | −20.8% | — | — | — | 13.1% | +11.3% |
| FJAN Multi-AssetFT Vest U.S. Equity Buffer ETF - January | 0.48 | +69.0% | 1.05 | −4.0% | — | — | — | — | — | 12.8% | +8.4% |
| MLPX EnergyGlobal X - MLP & Energy Infrastructure ETF | 0.41 | +135% | 0.97 | +21.5% | +36.3% | — | — | — | — | 13.8% | +10.2% |
| SMH TechnologyVanEck Semiconductor ETF | 0.27 | +323% | 0.97 | −33.5% | +35.6% | −44.7% | −47.0% | −14.6% | — | 15.3% | +13.9% |
| GLD CommoditiesSPDR Gold Shares | 0.24 | +126% | 0.96 | −0.8% | +8.0% | +4.9% | — | — | — | 13.1% | +9.9% |
| XLE EnergyState Street Energy Select Sector SPDR ETF | 0.31 | +177% | 0.93 | +64.4% | +28.0% | −39.0% | −14.8% | −18.2% | +24.4% | 14.3% | +11.0% |
| EWT TechnologyiShares MSCI Taiwan ETF | 0.25 | +153% | 0.89 | −28.9% | +17.7% | −45.3% | −24.4% | +2.1% | — | 14.0% | +10.8% |
| EUFN InternationaliShares MSCI Europe Financials ETF | 0.49 | +133% | 0.89 | −8.8% | −2.7% | — | — | — | — | 14.2% | +10.3% |
Stocks
| Investment | Correlation | 5Y return | Sharpe | 2022 | 2016 | 2008 | 2002 | 2001 | 2000 | 80/20 mix volatility | 80/20 mix annual return |
|---|---|---|---|---|---|---|---|---|---|---|---|
| XLV State Street Health Care Select Sector SPDR ETF (this page) | 1.00 | +49.3% | 0.60 | −2.1% | −2.8% | −23.3% | −0.7% | −0.8% | −11.8% | 14.8% | +7.5% |
| CAH Medical - DistributionCardinal Health, Inc. | 0.46 | +479% | 1.55 | +54.1% | −17.5% | −39.6% | −8.3% | −2.5% | +108% | 15.0% | +13.5% |
| CLS Hardware, Equipment & PartsCelestica Inc. | 0.07 | +3,143% | 1.47 | +1.3% | +7.4% | −20.5% | −65.1% | −25.6% | −2.3% | 17.2% | +26.3% |
| FIX Engineering & ConstructionComfort Systems USA, Inc. | 0.22 | +1,636% | 1.46 | +17.0% | +18.3% | −15.2% | −9.4% | +73.7% | −71.1% | 16.3% | +22.1% |
| MCK Medical - DistributionMcKesson Corporation | 0.38 | +413% | 1.44 | +51.8% | −28.3% | −40.4% | −27.2% | +4.9% | +61.2% | 14.5% | +12.9% |
| MPC Oil & Gas Refining & MarketingMarathon Petroleum Corporation | 0.23 | +690% | 1.41 | +86.6% | +0.7% | — | — | — | — | 14.7% | +15.6% |
Common questions
What was XLV's worst drawdown?
XLV's deepest decline since it began trading in 1998 was 39.2%, from December 2007 to March 2009. It took 25 months from the low to climb back to its old high.
What were XLV's best and worst years?
Over 27 full calendar years, XLV's best year was 2013, when it returned 41.4%. Its worst was 2008, with a return of -23.3%.
Is there a better investment than XLV?
Among XLV's popular alternatives, VIG earned more than XLV with less volatility over the past 5 years: 10.4% a year at 14.1% volatility, against 8.4% a year at 15.2%. Looking beyond its popular alternatives, VTV (US large-cap value) and SCHD (US dividend equity) earned more than XLV with less volatility over the past 5 years. VTV returned 12.1% a year at 13.7% volatility, against 8.4% a year at 15.2%.
Is XLV more volatile than the S&P 500?
No. XLV's volatility over the past 5 years was 15.2%, 89% of the S&P 500's 17.1%. Volatility measures how widely returns swing around their average: in roughly two years out of three, XLV's return lands within 15.2% of its average, either way. The higher it is, the rougher the ride and the harder it is to hold through a slump.
What is XLV's Sharpe ratio?
XLV's Sharpe ratio over the past 5 years was 0.60, against 0.79 for the S&P 500, so XLV earned less for each unit of risk than an index fund did. The Sharpe ratio is the return earned above cash for each unit of volatility: two investments with the same return are not equal if one got there with far bigger swings.
How correlated is XLV with the S&P 500?
Over the past 5 years, XLV's monthly returns had a correlation of 0.58 with the S&P 500. Correlation runs from 1 (moving in lockstep) through 0 (unrelated) to −1 (moving in opposite directions). They often move together: some diversification next to an index fund, but not a cushion. In the table, the correlation column measures each option against XLV instead: the lower it is, the more that option would diversify a XLV holding.
What are the best alternatives to XLV?
None of the 22 popular alternatives we compared outperformed XLV in at least 3 of 5 short-term and 2 of 3 long-term timeframes, which says more about XLV's strength than about its alternatives.
Did XLV outperform the S&P 500?
XLV finished ahead of the S&P 500 (SPY) in 12 of 27 full calendar years. In 2025, it returned +14.5%, against +17.7% for the index.
How did XLV do in stock market crashes?
XLV fell less than the S&P 500 (SPY) in seven of the ten major crashes it has traded through, and further in one. The clearest case was the dot-com bust, when XLV fell 29.8% and the S&P 500 fell 47.5%.
What diversifies XLV?
These had a low correlation with XLV over the past 5 years and still earned a positive 5-year return: among large ETFs, DXJ (correlation 0.40), FJAN (correlation 0.48) and MLPX (correlation 0.41); among large stocks, CAH (correlation 0.46), CLS (correlation 0.07) and FIX (correlation 0.22). A correlation near zero means the two have moved largely independently.
How we measure
- Short-term periods are 1M, 3M, 6M, YTD, 1Y; long-term periods are 3Y, 5Y, 10Y. An investment outperformed in a period when its total return, with dividends reinvested, was higher than XLV's. Returns within 0.5 points or 3% of XLV's, whichever is larger, count as a tie.
- "Qualified" means outperforming in at least 3 of 5 short-term periods and 2 of 3 long-term periods. "All-weather" means outperforming in every long-term period and all but one short-term period.
- Popular alternatives are the funds and stocks most often compared with this one. We include only those that trade today, are not leveraged or inverse, and hold at least $200 million.
- Volatility is the annualized standard deviation of daily returns over 5 years, a measure of how much the price typically swings in a year. The Sharpe ratio is the return above cash for each unit of that volatility.
- A decline, or drawdown, runs from a peak to the lowest close before the next high. The worst decline ever uses all the price history we have; comparisons between funds use the past 10 years so that younger funds are judged on the same stretch.
- Sector overlap is the share of assets two funds hold in the same sectors. Correlation and the mixed-portfolio figures use monthly returns.
- Upside and downside capture follow Morningstar's definition: the compound monthly return in the months the S&P 500 rose (or fell), divided by the S&P 500's compound return in those months. Beta measures how strongly monthly returns have moved with the S&P 500. All three use the same window for every investment.
- Figures are computed from daily adjusted prices and update after each trading day. Past performance does not predict future results.
More research
Popular alternatives to XLV
XLKState Street Technology Select Sector SPDR ETF- SPYState Street SPDR S&P 500 ETF
- VIGVanguard Dividend Appreciation ETF
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