Singaporeans suffering poor health

13 August 2012

Question No. 597

Name of person: Mr Laurence Lien

Question

             To ask the Minister for Health (a) how many years of poor health do Singaporeans suffer throughout their lifetimes; (b) how does this compare with other countries; and (c) how this period of poor health can be significantly reduced.

Answer

            Health Adjusted Life Expectancy, or HALE, is a summary indicator of population health proposed by the World Health Organisation (WHO). HALE adjusts life expectancy for years lived in poor health due to illness or injury. Years spent in poor health can thus be measured as the gap between life expectancy (LE) and HALE. However, we need to be careful in drawing conclusions from the comparison of “years lost to poor health” across countries especially if they have very different HALE or life expectancy. HALE and life expectancy are in themselves important indicators of population health. A country with a smaller gap between life expectancy and HALE but with low values of HALE and life expectancy, may in fact be worse off than another with higher values of HALE and life expectancy.

Based on WHO calculations done in 2007 that are comparable across different countries, the expected number of healthy years lost due to poor health is 7 years in Singaporean men and 8 years for Singaporean women with an average of 8 healthy years lost. This is comparable to countries like UK, USA, Australia, Canada and Sweden; but slightly higher compared with Japan and Switzerland, which have an average of 7 healthy years lost. Based on WHO data, our expectation of healthy years lost at birth has improved by about 2 years for both males and females in 2007 over 2002.

To improve HALE and reduce the number of healthy years lost, we need to encourage Singaporeans to embrace a healthy lifestyle, reduce illnesses and better manage chronic diseases. The Health Promotion Board has several initiatives to promote healthy lifestyle by eating a balanced diet, having sufficient physical activity, and avoiding tobacco use. The IQuit programme helps to encourage current smokers to quit the habit. We are also putting in place measures to make the healthy option the default option; for example, we have worked with hawkers to serve healthier food and food manufacturers to reduce salt in their foods.

Chronic diseases such as diabetes and hypertension, when detected at the early stages, can be effectively managed with medication and lifestyle changes. This prevents the development of related complications and disability, and the loss of healthy years of life. My Ministry, through the healthcare institutions and the Health Promotion Board, has worked with community and grassroots organisations to encourage Singaporeans to undergo health screening for chronic diseases and cancer.

My Ministry has also enhanced the accessibility to and affordability of chronic disease management. The Chronic Disease Management Programme (CDMP) provides systematic, evidence-based care. From 2006, Singaporeans were able to use their Medisave for treatment for diabetes, hypertension, lipid disorders and stroke, followed subsequently by the addition of asthma, chronic obstructive pulmonary disease, schizophrenia and depression. The CDMP was further enhanced in November 2011 to include bipolar disorder and dementia. Singaporeans who are above 40 years of age and from middle and lower income groups can also receive subsidised treatment for chronic and non-chronic diseases at private clinics under the Community Health Assist Scheme (CHAS).

My Ministry will continue to develop initiatives to prevent disease, encourage early screening and ensure good management of chronic conditions. If illness develops, we will also ensure that Singaporeans have access to treatment and rehabilitation that can minimise residual disability.