S'poreans face lowered risk of dying young

ST Jun 25, 2010

Study says mortality rate is down sharply from 1970; average life expectancy is 81

By Victoria Vaughan

SINGAPOREANS are among the least likely in the world to die early, and the country's mortality rate has gone down by a significant margin compared with that 40 years ago, according to a study reported in top medical journal The Lancet.

Today, Singaporeans can expect to live to an average age of 81, which is a 15-year increase from 1970, when the average life expectancy was 66.

Singapore's Ministry of Health (MOH) said this improvement was due to people here having improved nutrition. It also cited other factors such as advancements in health care, control of infectious diseases and the promotion of healthy living.

Singapore also greatly lowered its mortality rates in some of the main killers here - heart disease, cancer, stroke and accidents or violence.

The study, conducted by the University of Washington and Harvard University in the United States, looked at how the risk of dying young, among those between the ages of 15 and 60 years old, has changed over the past 40 years.

It studied a total of 187 countries. Worldwide death rates for men dropped by 19 per cent and 34 per cent for women from 1970 to this year.

Singapore is ranked the 16th-best nation for men's mortality rate, while it came in 14th for women's. These rankings were a marked improvement from a similar study in 1970 which placed Singapore 72nd and 62nd, respectively.

Japan and South Korea were the only Asian countries to be ranked higher than Singapore.

Iceland's men and Cyprus' women had the lowest risk of early death. On the other end of the scale, people living in African nations Swaziland and Zambia were most at risk of dying young.

Although Singapore has moved up the rankings, MOH said it was important not to be complacent. 'Singapore needs to continue with its effort to combat the associated risk factors of cancer and heart disease as these lifestyle diseases are the main cause of early deaths among adults between 15 and 60 years of age in Singapore today,' said its spokesman.

Three in five deaths here are due to cardiovascular disease and cancer.

Dr Paul Chiam, a consultant cardiologist at the National Heart Centre, said that as Singapore has become more industrialised, the causes of death in the younger population from infectious disease and accidents have declined. But Western diets, sedentary and stressful lifestyles, and smoking have contributed to heart disease becoming one of the leading causes of death here, he added.

Dr Chiam said that public education on leading a healthy lifestyle, and encouragement to go for screenings to detect high blood pressure, diabetes and high cholesterol, were important in combating death from heart disease.

But a less positive effect of a reduction in early death among adults is the burgeoning older population in Singapore.

There are now about eight young people to every elderly person, compared with 10 to one in 1999.

Sociology associate professor Paulin Straughan of the National University of Singapore (NUS) said that Singapore must focus on caring for this ageing population.

'When you have increasing life expectancy and a consistently low total fertility rate, the old-age dependency ratio is not very favourable.

'With the increase of singles and of single-child families, we have to be prepared to deal with an ageing population where the social support from the family is going to be very stressed,' said Prof Straughan, adding that retirement communities and residential care would need to be relooked.

'We need to have the infrastructure for Singaporeans to grow old gracefully and be prepared that many will do so on their own, without family or a spouse.'

She added it was important to note that although many people are living longer, they often have health issues.

Singapore's health-care system needs to have the capacity to cope with long-term disability and palliative care which will be expensive, she said.

Professor Chia Keen Seng, head of the department of epidemiology and public health at NUS, said the key challenge was to prevent disease as the population ages.

'We're going very well at delivering health care... but I think there is a lot that can be done in prevention.'

vvaughan@sph.com.sg

1. What were some of the reasons cited for Singaporeans facing lower risk of dying young?

2. What were some of the challenges Singapore face with improvement in life expectancy?

Stub it out

Today was 'World No Tobacco Day'. This year's focus is making youth more aware of the dangers of smoking. Designated by the World Health Organisation, World No Tobacco Day (WNTD) has been observed on May 31 every year since 1988.

While Singapore has one of the lowest youth smoking rates in the region, with only 9 per cent of youths smoking at least one day in the last 30 days, a significant portion of the campaign will still be targeted at young smokers.

Lisabel Ting

I'm aware some of you are smokers and you find it difficult to kick the habit. You've to make an effort and it's really in the mind. Cigarettes are expensive and smoking is detrimental to your health. Maybe the next article will convince you further.

Smoking can lead to early balding
The claim: Smoking can cause the loss of hair. The facts: If an increased risk of respiratory illness, cancer and heart disease are not reason enough for many smokers to consider quitting, than perhaps a message focused on hair instead of health may do the trick.

Scientists have long speculated cigarette smoke may accelerate hair loss and premature greying. The association was largely attributed to toxins in smoke that can harm hair follicles and damage hormones. According to epidemiological studies, that appears to be the case. A report in the journal BMJ looked at more than 600 men and women, half of them smokers.

After controlling for variables, the researchers found a 'significant' and 'consistent' link between smoking and early greying. Last year, another team studied the link in a group of 740 men in Taiwan, aged 40 to 91 years, notable because Asian men generally have low rates of hereditary baldness. After controlling for age and family histories, the researchers found a greater rate of hair loss among the smokers, a risk that grew with increasing smoking.

One question is whether the link is a result of tobacco toxins directly affecting the scalp, or if smoking is causing severe disease that speeds ageing.

The bottom line: Several studies suggest smoking can lead to premature greying and hair loss. The New York Times

When big is bad