XHS vs. FXH

Last updated Jun 21, 2026

XHS (SPDR S&P Health Care Services ETF) and FXH (First Trust Health Care AlphaDEX Fund) are both Health & Biotech Equities funds - XHS tracks the S&P Health Care Services Select Industry Index while FXH tracks the StrataQuant Health Care Index. Both are passively managed. Over the past 10 years, XHS returned 8.36%/yr vs 7.23%/yr for FXH. A 0.78 correlation means they provide meaningful diversification when combined. XHS charges 0.35%/yr vs 0.61%/yr for FXH.

Performance

XHS vs. FXH - Performance Comparison

The chart below illustrates the hypothetical performance of a $10,000 investment in SPDR S&P Health Care Services ETF (XHS) and First Trust Health Care AlphaDEX Fund (FXH). The values are adjusted to include any dividend payments, if applicable.

Returns By Period

In the year-to-date period, XHS achieves a 14.26% return, which is significantly higher than FXH's 1.61% return. Over the past 10 years, XHS has outperformed FXH with an annualized return of 8.36%, while FXH has yielded a comparatively lower 7.23% annualized return.

XHS

• 1D: 0.99%
• 1M: 7.76%
• YTD: 14.26%
• 6M: 12.85%
• 1Y: 26.83%
• 3Y*: 10.70%
• 5Y*: 1.95%
• 10Y*: 8.36%

FXH

• 1D: -0.42%
• 1M: 0.90%
• YTD: 1.61%
• 6M: 0.70%
• 1Y: 14.86%
• 3Y*: 2.82%
• 5Y*: 0.44%
• 10Y*: 7.23%

*Multi-year figures are annualized to reflect compound growth (CAGR)

XHS vs. FXH - Yearly Performance Comparison

	2026 (YTD)	2025	2024	2023	2022	2021	2020	2019	2018	2017
XHS SPDR S&P Health Care Services ETF	14.26%	18.83%	1.76%	5.15%	-19.87%	9.76%	33.66%	18.81%	1.96%	17.65%
FXH First Trust Health Care AlphaDEX Fund	1.61%	10.16%	0.96%	-4.53%	-12.24%	15.20%	28.00%	22.26%	-1.33%	21.82%

Correlation

The correlation between XHS and FXH is 0.68, which is moderate. They share some common price drivers but move independently often enough to provide real diversification benefit when combined.

	Correlation
Correlation (1Y) Calculated over the trailing 1-year period	0.68
Correlation (3Y) Calculated over the trailing 3-year period	0.76
Correlation (5Y) Calculated over the trailing 5-year period	0.79
Correlation (10Y) Calculated over the trailing 10-year period	0.78
Correlation (All Time) Calculated using the full available price history since Sep 29, 2011	0.78

The correlation between XHS and FXH shifts across timeframes, from 0.68 (1 year) to 0.79 (5 years), reflecting how their relationship changes across market environments.

XHS vs. FXH - Sectors Allocation Comparison

Sectors	XHS	FXH
Healthcare	97.9%	100.0%
Financial Services	2.1%	-
Basic Materials	-	-
Communication Services	-	-
Consumer Cyclical	-	-
Consumer Defensive	-	-
Energy	-	-
Industrials	-	-
Real Estate	-	-
Technology	-	-
Utilities	-	-

Return for Risk

XHS vs. FXH — Risk / Return Rank

Compare risk-adjusted metric ranks to identify better-performing investments over the past 12 months.

XHS

XHS Risk / Return Rank: 43
XHS Sharpe Ratio Rank: 43
XHS Sortino Ratio Rank: 42
XHS Omega Ratio Rank: 42
XHS Calmar Ratio Rank: 46
XHS Martin Ratio Rank: 40

FXH

FXH Risk / Return Rank: 26
FXH Sharpe Ratio Rank: 26
FXH Sortino Ratio Rank: 27
FXH Omega Ratio Rank: 24
FXH Calmar Ratio Rank: 25
FXH Martin Ratio Rank: 28

The rank (0–100) shows how this investment's returns compare to the risk taken. Higher = better. Based on the past 12 months of data, combining Sharpe, Sortino, and other metrics used by quantitative funds and institutional investors.

XHS vs. FXH - Risk-Adjusted Trends Comparison

This table presents a comparison of risk-adjusted performance metrics for SPDR S&P Health Care Services ETF (XHS) and First Trust Health Care AlphaDEX Fund (FXH). Risk-adjusted metrics are performance indicators that assess an investment's returns in relation to its risk, enabling a more accurate comparison of different investment options.

Values are calculated on a 1-year rolling basis and updated daily. Risk-adjusted metrics are more stable over longer periods — use the period switch above to explore them.

	XHS	FXH	Difference
Sharpe ratio: Return per unit of total volatility	1.46	0.91	+0.55
Sortino ratio: Return per unit of downside risk	2.04	1.45	+0.60
Omega ratio: Gain probability vs. loss probability	1.26	1.16	+0.10
Calmar ratio: Return relative to maximum drawdown	2.19	1.20	+0.99
Martin ratio: Return relative to average drawdown	6.05	3.63	+2.42

XHS vs. FXH - Sharpe Ratio Comparison

The current XHS Sharpe Ratio is 1.46, which is higher than the FXH Sharpe Ratio of 0.91. The chart below compares the historical Sharpe Ratios of XHS and FXH, calculated using daily returns over the previous 12 months. A higher Sharpe Ratio indicates better risk-adjusted performance relative to the risk-free rate.

Drawdowns

XHS vs. FXH - Drawdown Comparison

The maximum XHS drawdown since its inception was -39.32%, smaller than the maximum FXH drawdown of -43.70%. Use the drawdown chart below to compare losses from any high point for XHS and FXH.

Drawdown Indicators

	XHS	FXH	Difference
Max Drawdown Largest peak-to-trough decline	-39.32%	-43.70%	+4.38%
Max Drawdown (1Y) Largest decline over 1 year	-11.99%	-12.20%	+0.21%
Max Drawdown (3Y) Largest decline over 3 years	-17.81%	-17.53%	-0.28%
Max Drawdown (5Y) Largest decline over 5 years	-32.62%	-29.49%	-3.13%
Max Drawdown (10Y) Largest decline over 10 years	-39.32%	-30.61%	-8.71%
Current Drawdown Current decline from peak	-0.27%	-8.24%	+7.97%
Average Drawdown Average peak-to-trough decline	-10.17%	-9.45%	-0.72%
Ulcer Index Depth and duration of drawdowns from previous peaks	4.32%	4.01%	+0.31%

Volatility

XHS vs. FXH - Volatility Comparison

SPDR S&P Health Care Services ETF (XHS) and First Trust Health Care AlphaDEX Fund (FXH) have volatilities of 4.59% and 4.43%, respectively, indicating that both stocks experience similar levels of price fluctuations. This suggests that the risk associated with both stocks, as measured by volatility, is nearly the same. The chart below showcases a comparison of their rolling one-month volatility.

Volatility by Period

	XHS	FXH	Difference
Volatility (1M) Calculated over the trailing 1-month period	4.59%	4.43%	+0.16%
Volatility (6M) Calculated over the trailing 6-month period	12.23%	11.43%	+0.80%
Volatility (1Y) Calculated over the trailing 1-year period	17.93%	16.01%	+1.92%
Volatility (5Y) Calculated over the trailing 5-year period, annualized	21.15%	16.56%	+4.59%
Volatility (10Y) Calculated over the trailing 10-year period, annualized	22.41%	18.49%	+3.92%

XHS vs. FXH - Expense Ratio Comparison

XHS has a 0.35% expense ratio, which is lower than FXH's 0.61% expense ratio.

Dividends

XHS vs. FXH - Dividend Comparison

XHS's dividend yield for the trailing twelve months is around 0.23%, less than FXH's 0.84% yield.

Position	TTM	2025	2024	2023	2022	2021	2020	2019	2018	2017	2016	2015
FXH First Trust Health Care AlphaDEX Fund	0.84%	0.75%	0.41%	0.24%	0.20%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%
XHS SPDR S&P Health Care Services ETF	0.23%	0.27%	0.38%	0.23%	0.19%	0.20%	0.23%	2.37%	0.34%	0.22%	0.28%	0.93%

Frequently Asked Questions

Can I hold both XHS and FXH in my portfolio?

XHS and FXH have a correlation of 0.68, meaning they provide meaningful diversification benefit when combined. Depending on your allocation goals, holding both could reduce overall portfolio risk.

Which is riskier, XHS or FXH?

XHS has higher volatility (4.59%) compared to FXH (4.43%). In terms of maximum drawdown, XHS dropped -39.32% vs FXH's -43.70%.

Which ETF is better, XHS or FXH?

On 10-year performance, XHS leads with 8.36% vs 7.23% for FXH. On fees, XHS is cheaper at 0.35% per year. On volatility, FXH has been the lower-risk option at 4.43%. The better choice depends on whether you care most about return, fees, risk, or income.

Which ETF has performed better, XHS or FXH?

Over the 10-year period, XHS has performed better with a 8.36% return vs 7.23%. Past performance does not guarantee future results, so compare this with risk, fees, and fund exposure.

Which ETF is cheaper, XHS or FXH?

XHS is cheaper with a 0.35% expense ratio, compared with 0.61% for FXH.

Which ETF pays a higher dividend yield, XHS or FXH?

FXH has the higher dividend yield at 0.84%, compared with 0.23% for XHS.

What is the main difference between XHS and FXH?

XHS tracks S&P Health Care Services Select Industry Index, while FXH tracks StrataQuant Health Care Index. They also come from different issuers: State Street and First Trust. Their fees differ too: 0.35% for XHS and 0.61% for FXH.

Which has better risk-adjusted returns?

XHS currently has the higher Sharpe Ratio (1.46 vs 0.91), meaning it's delivered slightly more return per unit of risk over the trailing 12 months. However, this ranking shifts over time - use the Risk/Return Score above for a more comprehensive view that combines Sharpe, Sortino, and other measures used by quantitative funds.