Ladies and gentlemen,
1. Let me first thank ILC-UK for inviting me to speak at this event, as well as our Japanese hosts for inviting Singapore to the G20 Health Ministers’ Meeting. I am grateful for the opportunity to share about Singapore’s experiences with prevention in an ageing world, and to learn from others at today’s session.
(A) Introduction: Singapore’s Context
2. Singaporeans’ Life Expectancy at birth has risen from 83.2 years in 2010 to 84.8 years in 2017. Our Health Adjusted Life Expectancy (HALE) increased from 72.9 years to 74.2 years. We have also seen a 16% reduction in mortality rates due to cancer, stroke and heart diseases during this period. This means that Singaporeans are living longer and healthier lives, made possible in part due to better prevention, early detection, and better disease management.
3. However, there has also been an increase in the number of people living with chronic illness. From 2010 to 2017, the prevalence rates of diabetes, hypertension, and hyperlipidaemia among Singapore residents aged 18 to 69 have increased by 4%, 14%, and 33%, respectively. If chronic conditions are not managed well, it could result in more serious health conditions down the road, severely impacting one’s quality of life. This is why Singapore is taking decisive steps towards preventive health and healthy living, shifting our focus beyond healthcare to health.
(B) Life Course Approach to Preventive Health
4. In Singapore, we adopt a life course approach to health, spanning the various life stages from cradle to grave, because good health of older persons rests on the foundations laid down when they are young. Our efforts include three levels of prevention – primary prevention to promote good health and active ageing, secondary prevention for early detection and intervention of disease, and tertiary prevention to improve quality of life through an ecosystem of care.
(C) Primary Prevention: Promoting Good Health and Active Ageing
Taking charge of one’s own health
5. Primary prevention is about empowering citizens to keep healthy and take charge of their own health. For instance, our Health Promotion Board runs a National Steps Challenge to encourage citizens to move more and stay active. We give out pedometers for participants to track their activity and earn rewards based on their activity. By gamifying the process and encouraging social interaction, we see sustained engagement and the development of healthy habits over time. 1 in 3 Singaporeans have signed up for the Challenge, reflecting the popularity of this campaign. And out of those who completed all rewards tiers in the first three seasons, 60% continued to clock a daily average of more than 7,500 steps, even after the Challenge ended.
6. Similarly, the nationwide Eat Drink Shop Healthy campaign incentivises citizens to choose healthier options when they eat, drink, and do their grocery shopping, by allowing them to earn points and redeem rewards when they make healthier choices. In 2018, more than 500,000 people participated in the campaign, with more than 3,500 participating outlets nationwide.
7. We have leveraged technology in other ways to empower Singaporeans to take charge of their own health. For example, HealthHub, a one-stop portal, serves as a digital healthcare companion for each citizen. Through this portal, citizens can access their personal health records and lab tests, and share relevant records with their caregivers and loved ones if they wish. Health Hub also provides useful and relevant health information to users to improve their health literacy.
8. Besides broad-based measures, in 2015, Singapore launched the Action Plan for Successful Ageing, our national blueprint to keep older Singaporeans active and engaged. To share preventive health messages and encourage health-promoting behaviours, we rolled out the National Seniors’ Health Programme, which includes activities in areas such as stroke prevention, falls prevention, and physical activity. We also introduced a Workplace Health Programme to bring preventive health services to workplaces in seven sectors which have a higher proportion of mature workers.
Participating actively
9. But keeping healthy is not just about physical health. Social and health needs are closely intertwined. For example, a lack of social support could make it more difficult for seniors to access health services, and poor health could prevent seniors from participating in social activities in the community. Thus, Singapore’s approach is to take a broader perspective on preventive health by keeping seniors actively engaged in society. This leads to improved mental well-being and stronger social support. For example, for seniors who wish to remain in the workplace, we are raising the retirement age from 62 today to 65, and the re-employment age from 67 today to 70. A study found that individuals who remained in the workforce enjoyed better psychosocial, physical, and functional health than retirees. To encourage lifelong learning, we established the National Silver Academy which offers a wide range of heavily subsidised courses run by education institutes and community-based organisations. We also believe that seniors can continue to make positive contributions to society. We set up the Silver Volunteer Fund to support community partners in creating volunteering opportunities for our seniors.
(D) Secondary Prevention: Early Detection and Intervention of Disease
10. Secondary prevention involves early detection and intervention of diseases to prevent deterioration. Our Health Promotion Board offers ‘Screen for Life’, a national programme where individuals can undergo screenings for a variety of conditions, such as cancer and chronic illnesses. Since May this year, we have introduced non-fasting screening tests for high blood cholesterol and diabetes. This makes screening even more convenient as it does away with fasting, which seniors find challenging.
11. Ageing often comes with a decline in functional abilities such as vision, hearing and even eating, which could affect a person’s well-being and quality of life. So, in 2018, we rolled out ‘Project Silver Screen’ in partnership with the business community. This is a nationwide community-based functional screening programme that checks seniors’ vision, hearing, and oral health, so that appropriate follow-up interventions can be provided in a timely and accessible manner.
12. We also need to actively reach out to seniors, especially those who live alone and are disconnected from the community. To achieve this we appointed Silver Generation Ambassadors, who do door-to-door outreach and encourage seniors to step out and take part in functional screening and active ageing programmes.
(E) Tertiary Prevention: Improving Quality of Life through an Ecosystem of Care in the Community
13. Lastly, we have focused our tertiary prevention efforts on making sure that those who need care can receive services in a timely manner, and can continue to stay in the community. Our seniors want to age in place in an environment they are familiar with, and we have a range of services and networks to support ageing in the community. For example, we have doubled home and community care capacity since 2011. We have also piloted new services such as Care Close to Home, an in-situ assisted living programme with personal care services such as medication reminders and assistance with daily tasks. To link up these services and provide an ecosystem of care surrounding each senior, we have established the Community Networks for Seniors to bring together various government agencies and community partners to connect health and social support for seniors. With these initiatives, we hope to prevent fragmentation of care, and support our seniors to live out their golden years in the community among their loved ones and friends.
(F) Reflections: Need for Continued Sharing of Experiences
14. With a rapidly ageing population, a system anchored on healthcare services will not be sustainable in the long term. This is why Singapore is making a concerted effort to shift beyond healthcare to health, by adopting a cross-Ministry, multi-sectoral approach with participation and support from corporates and individuals. We need a whole-of-society approach so that we can turn silver into gold.
15. Population ageing is a global phenomenon, and Singapore is not the first nor last country which will face these challenges and opportunities. We will need to continue to learn from the experiences of other countries as we journey forward. I spoke about raising the re-employment age in Singapore earlier. In fact, we learnt this from Japan actually, when I visited Tokyo in 2005 during my time as Minister of State for Education and Manpower to study how to help older workers stay employed. Exchange of ideas and sharing of experiences, such as what we are doing today, must continue to take place for us to create better solutions in an ageing world.
16. Thank you once again for inviting me, and I look forward to the rest of the session.