Friday, 27 April 2012

Singapore 'has lowest youth death rate': The Lancet Adolescent Health 2012

Experts attribute journal's ranking to outreach to the young, absence of ghettos
By Goh Chin Lian, The Straits Times, 26 Apr 2012

THE death rate of male adolescents in Singapore is the lowest among rich countries, better than in the Netherlands, Sweden and Japan, The Lancet has said.

Singapore experts attribute this low rate to factors such as youth outreach, and public housing policies that prevent ghettos, which reduce deaths that can arise from suicide, drug abuse, violence, and other reasons.

The Lancet, a medical journal, published four papers online yesterday supporting a move to put the world's 1.1 billion adolescents in the centre of health policies, arguing that this would impact adult health and economic development.

One paper, in particular, analysed the social factors that influence the health of young people aged 10 to 24 years, and concluded that structural factors such as national wealth, income inequality, and access to education were the 'strongest determinants of adolescent health'.

Also crucial, it added, are safe and supportive families and schools, together with positive and supportive peers.

The report compared the death rate of males aged 15 to 19 years old against national wealth, measured by a country's gross domestic product.

The figures it used for Singapore were from 2006; for other countries, the numbers were taken from various years dating back to 2000.

The report found that Singapore had fewer than 50 deaths per 100,000 adolescents, a third of the United States, less than half of Kuwait and slightly over half of Norway.The Netherlands, Sweden and Japan also had fewer than 50 deaths, but slightly more than Singapore.

The report also noted that cultural, religious and other social factors had a strong moderating effect on structural factors such as wealth.

Responding to the findings, a Ministry of Health (MOH) spokesman said Singapore achieved a low mortality rate by establishing an environment that was conducive to health and mental well-being.

'Globally, major causes of death in adolescents include road traffic injuries, suicides, violence, maternal deaths. Singapore's mortality rates from these causes are low in adolescents,' she added.

Institute of Mental Health (IMH) medical board chairman Daniel Fung said suicides and accidents formed the bulk of adolescent deaths here: 20 to 30 youth under 19 years old commit suicide each year. Most were aged between 15 and 19.

Comparative figures of other countries are not available. Recent studies show that in Ireland and New Zealand, there are more than 10 suicides for every 100,000 teenagers.

A high-income country like Singapore can afford to develop its social service sector to help youth, the experts noted.

For instance, over 1,000 teenagers with emotional problems are referred to IMH each year through outreach programmes, said Dr Fung.

Teenagers here also have limited access to drugs and guns, which has reduced substance abuse and violence.

And despite a high income gap, neighbourhoods here are not segregated along income lines, as they are in the US, noted National University of Singapore sociologist Ho Kong Chong.

He said: 'All the poor and desperate don't hang out in one place. You don't have 'schools' for criminals arising from low-income neighbourhoods.'

It helps, too, that young people in Singapore are often active in their school's co-curricular activities, said Associate Professor Ho.

'Group life is important as an antidote to depression and thoughts of suicide.'


Mortality rate of youth aged 10 to 24 in 27 high-income countries:

United States 
New Zealand 


Highest (globally): Kazakhstan, Lithuania, Russia

Highest (high-income countries): Finland, Norway, Ireland, Japan, New Zealand, Switzerland

Lowest: Singapore, Greece, Italy, Spain

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