Friday 19 October 2018

Singaporeans' average life expectancy to reach 85.4 years in 2040: Study

Singapore 3rd in global life expectancy rankings
By Linette Lai, Health Correspondent, The Straits Times, 18 Oct 2018

Singaporeans are expected to remain among the longest-lived people in the world in 2040, according to a new study published in the medical journal, The Lancet.

Researchers estimate the average lifespan in Singapore will go up from 83.3 years in 2016 to 85.4 years by 2040, placing it third out of 195 countries.

Spain is expected to place first with an average lifespan of 85.8 years, while Japan will come in second at 85.7 years.

Other countries predicted to be in the top 10 include Switzerland, Portugal, Italy, Israel, France, Luxembourg and Australia.

As a general rule, said researchers in the paper, their forecasts "point to a world where most populations are living longer and many health improvements are likely to occur if current trajectories hold".

The study was carried out by the Institute for Health Metrics and Evaluation, an independent health research organisation at the University of Washington. Its findings were released yesterday.

The researchers' conclusions were based on data from the 2016 Global Burden of Disease study, which highlighted the main factors behind sickness, disability and death in individual countries.

The current study is "unprecedented in scope" and provides more robust statistical modelling than previous forecasts, said Dr Kyle Foreman, the lead author.



The study also predicted that several high-income countries, such as the United States, Canada and Norway, are expected to slip significantly in the rankings, as other countries make larger gains.

The average life expectancy in the US was forecast to go from 78.7 in 2016 to 79.8 by 2040. However, this relatively small increase means the US will fall from 43rd to 64th place.

Dr Foreman cautioned that nothing is set in stone. "The future of the world's health is not pre-ordained and there is a wide range of plausible trajectories," he said.

The director of data science at the Washington institute noted: "But whether we see significant progress or stagnation depends on how well or poorly health systems address key health drivers."

The study also highlighted the top 10 causes of death in each country. For Singapore, the top three in 2040 are forecast to be lower respiratory infections, such as pneumonia, followed by dementia and ischaemic heart disease.

Mr Christopher Gee, a senior research fellow at the Institute of Policy Studies, said Singapore's investment in public health over the past few decades has meant most people have grown up in "an ever-improved environment with high standards of healthcare".

He said an area to focus on in the coming years is community care.

Associate Professor Angelique Chan, executive director of the Centre for Ageing Research and Education at Duke-NUS Medical School, also noted: "The right mix of planning, policies and programmes can mean the difference between reaping the longevity dividend with healthy, active and socially engaged seniors staying productive longer, or bearing an increasing public health bill due to more sickly, frail and poorly ageing older adults."

























Let's stop looking at 65 as our use-by date
In Singapore, people can expect to have 73.62 years of good health. It's time to shift mindsets and see ageing as opportunity, not decline.
By Salma Khalik, Senior Health Correspondent, The Straits Times, 1 Nov 2018

In Singapore, people are not just living longer, they are also living the highest number of years in good health, pipping Japan by almost half a year and the rest of the world by a year or more.

In 2016, Singaporeans with a life expectancy of 83.73 years enjoyed 73.62 years in good health.

The Japanese had a longer life expectancy of 83.94 years, but only 73.16 of those years were healthy ones.

Yet, much rhetoric around ageing in Singapore is rather negative, especially with regard to those aged 65 and above.

With Singaporeans remaining healthiest the longest in the world, it's time to shift mindsets on what ageing means for the country.

At a recent discussion on ageing at The Straits Times-AIA Roundtable, "Managing Singapore's health with an ageing population: What more needs to be done?", panellists were optimistic about the future, in spite of the country's rapidly ageing population.

Health-wise, Singapore appears to be doing quite well.

What came through in the hour-long discussion was that the problem is not so much the ageing population, but rather the attitude of people here towards ageing.

As Dr Jeremy Lim of consultancy firm Oliver Wyman put it: "There are cultural biases against seniors and the kind of stereotypical image is not a very positive one."

First, Singapore uses the international figure of 65 years to define the elderly.

The Government keeps putting out figures on support ratios, that is, the number of working adults it takes to support one elderly person aged 65 and older.

So the Prime Minister's Office puts out information like: "By 2030, the number of Singaporeans aged 65 and above is projected to double to 900,000.

"That means one in four Singaporeans will be in that age group, up from one in eight today."

What such information does not say explicitly - but does imply - is that having people over 65 is going to be, at best, a challenge to be overcome or, at worst, a major problem.

But so what if there will be lots of people aged 65 and older? While it is true some among this group might be frail, how about the many who will remain healthy and productive?

Singaporeans are not just living longer - life expectancy has been going up by three years every decade - but staying healthier for more years.

So if people here live 73.6 years in good health, isn't it about time to change the "use-by date"?

Back in 1965 when Singapore gained independence, life expectancy was just 65 years.

Using 65 years as a worldwide definition of the elderly makes sense, since according to the United Nations, global life expectancy is 70.5 years.

But as people here live more than 13 years longer than the global average, we should revisit the concept of ageing and dependency ratios to fit our national profile, and not just go with global figures that may paint a worse picture than is the reality in Singapore.

To a certain extent, the Government has acknowledged that when it extended the re-employment age here to 67 years.

It also recently announced that from April next year, to qualify for a levy concession for a foreign domestic worker under the aged person scheme, the "aged person" will have to be 67 years old, up from the 65 years today.

That suggests the "use-by date" might be extended by two years - a welcome if small shift in mindset.

But what is really needed is a paradigm shift in the way we look at the elderly. It should not be based on chronological age but rather on whether a person remains healthy and active.

And healthy does not mean that the person does not have any chronic ailments, but rather how well he is able to keep them in check to continue living a meaningful life.



Senior Minister of State for Health Amy Khor admits that there is "some bias, some ageism" in Singapore, but with the tight clamp on foreigners coming here to work, companies are increasingly looking at how they can retain their experienced older workers, and even modifying the way the work is done to accommodate them.

There are companies that employ people beyond the legal re-employment age of 67 years.

If this trend continues, then the working population gets a boost while the dependent population shrinks.

Dr Khor said it is obvious that future seniors will be very different from the older generation today.

There is already a big difference in attitude and ability between the Pioneer Generation, or citizens born in 1949 or earlier, and the newly coined Merdeka Generation comprising citizens born in the 1950s.

That being the case, the way we look at seniors must also change.

We should look at the proportion of the population who are seriously ill or frail, and not at the number who have just celebrated their XX birthday.

Healthy and active older people who choose not to continue working may still contribute to society, and not just by doing voluntary work or looking after grandchildren.

These are people who would likely be financially independent. They go to the cinemas, shop and travel, pumping money into the economy.

On a national level, there will still be some unhealthy years at the tail end of our lives. But if we start taking care of our health from a younger age, the number of years of ill health might be shortened, or those years of disability can be managed so that we can continue enjoying quality lives.

Then the entire equation changes. Instead of fearing an ageing population, we would welcome it as it would mean more productive years for everyone.

Like Dr Khor said, people would then look at ageing differently and positively, adding: "You embrace it because you can make better use of your longer life years."




Related
Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–40 for 195 countries and territories -16 Oct 2018

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