1. Based on the findings of the Global Burden of Disease 2019 study
1 (GBD 2019), Singapore was ranked first globally for life expectancy (LE) at birth and healthy life expectancy (HALE) at birth, with the lowest Disability-Adjusted Life Years (DALYs) per 100,000 population in the world.
2. The GBD study quantifies the magnitude of ill health and premature deaths due to diseases, injuries and risk factors across countries and through time. GBD 2019 provides updated results based on latest data sources, refined methodologies and feedback from GBD 2017
2. The study is an international collaboration led by the Institute for Health Metrics and Evaluation and the World Health Organization and incorporates inputs from public health researchers and government policy makers from many countries, including the Ministry of Health in Singapore.
Life expectancy and healthy life expectancy
3. Overall, the global LE and HALE at birth have increased from 1990 to 2019, from 65.4 years in 1990 to 73.5 years in 2019 for LE, and 56.9 years in 1990 to 63.5 years in 2019 for HALE.
4. Singapore has the highest LE at birth (84.9 years) among countries in the world in 2019. Overall, this is an increase from 1990 (75.6 years), when Singapore was ranked 26th in the world.
3. Based on GBD 2019’s findings, Singapore’s HALE at birth is the highest in the world at 73.9 years in 2019. Overall, this is an increase from 1990 (66.6 years), when Singapore was ranked 16th in the world. HALE is the average number of years that a person is expected to live in good health by taking into account years lived in ill health due to disease and/ or injury. Table 1 below shows the comparison of LE and HALE for the top five countries.
| Rank (in order of higher to lower 2019 HALE) | Country | LE at birth | HALE at birth |
| 1990 | 2019 | 1990 | 2019 |
| 1 | Singapore | 75.6 | 84.9 | 66.6 | 73.9 |
| 2 | Japan | 79.4 | 84.8 | 69.3 | 73.3 |
| 3 | South Korea | 72.1 | 82.9 | 63.4 | 72.0 |
| 4 | Iceland | 78.1 | 84.1 | 67.7 | 71.9 |
| 5 | Switzerland | 77.9 | 84.0 | 66.7 | 71.7 |
Table 1: Country comparison of LE and HALE (in years), 1990 and 2019
Disability-Adjusted Life Years and Attributable Risk Factors
4. According to the GBD 2019 findings, Singapore has the lowest age-standardised DALY burden, in line with the improvement in Singapore’s HALE at birth. Singapore’s age-standardised DALY rate in 2019 was 15,045 per 100,000 population, a decrease from 25,491 DALYs per 100,000 population in 1990. Disease burden in terms of DALYs is a summary measure of the years of healthy life lost due to premature mortality and ill health experienced by a population. Table 2 shows the comparison for DALYs for the top five countries.
| Rank (in order of lower to higher 2019 DALYs) | Country | DALYs | % Change |
| 1990 | 2019 |
| 1 | Singapore | 25,491 | 15,045 | -41.0 |
| 2 | Japan | 20,928 | 15,886 | -24.1 |
| 3 | South Korea | 32,256 | 17,192 | -46.7 |
| 4 | Iceland | 23,361 | 17,421 | -25.4 |
| 5 | Switzerland | 24,919 | 17,635 | -29.2 |
Table 2: Country comparison of age-standardised DALYs (in years), 1990 and 2019
5. Non-communicable diseases made up approximately 80% of the total disease burden in Singapore in 2019. In decreasing order of DALY burden, the top five leading causes of mortality and ill health were cancers (15.5%), musculoskeletal disorders (14.4%), cardiovascular diseases (13.9%), mental disorders (8.3%) and other non-communicable diseases (6.7%) such as urinary diseases or congenital birth defects. Diabetes and chronic kidney disease also ranked among the top 10.
6. The GBD 2019 also found that approximately 35% of the DALY burden in Singapore can potentially be reduced by early intervention on modifiable risk factors. These modifiable risk factors include smoking, poor diet, low physical activity, high blood pressure, high fasting plasma glucose level, high body-mass index and high low-density lipoprotein (cholesterol) level.
7. The Ministry of Health will continue to work with partners and stakeholders to further strengthen our existing initiatives and develop health interventions that can further reduce disease burden. Over time, we hope that the efforts to prevent diseases and to delay or mitigate their complications will lead to continued improvements in health.
[1] GBD 2019 expands the data, methodology and tools from previous GBD studies, producing estimates for 286 causes of death, 369 diseases and injuries and 87 risk factors in 204 countries and territories. https://www.thelancet.com/journals/lancet/issue/vol396no10258/PIIS0140-6736(20)X0042-0
[2] The results of GBD 2017 and GBD 2019 are not directly comparable due to differences in methodologies, datasets and assumptions.
MINISTRY OF HEALTH
28 OCTOBER 2020