Singapore named healthiest country

17 August 2012
Tan Weizhen

SINGAPORE - A report by financial data agency Bloomberg that ranked Singapore as the healthiest country out of 145 nations came as a surprise to some healthcare experts and Members of Parliament, who were expecting other nations such as Japan, Switzerland or the Nordic countries to come out tops.

The report, released by Bloomberg Rankings on Wednesday, used three main indicators for countries with a population of at least one million to tabulate its total health score.

Ten per cent was placed on life expectancy at birth and infant mortality. Another 10 per cent went to survival to 65 years and life expectancy at that age.

The bulk of the weightage - 40 per cent each - went to causes of death by disease and death rates according to three age groups.

Professor Phua Kai Hong, of the Lee Kuan Yew School of Public Policy, and MP Dr Lam Pin Min pointed out that the Japanese, for instance, are ahead in terms of life expectancy, a common benchmark when it comes to measuring the health of a nation.

"It is not unexpected that Singapore will rank high as one of the healthiest nations in the world but being in the pole position did come as a pleasant surprise to me," said Dr Lam, who chairs the Government Parliamentary Committee for Health.

Prof Phua noted that, in the yearly World Health Organization indicators, Singapore is not in top position, although it is among the top.

In determining the rankings, the Bloomberg report used a "health risk penalty" on countries with populations that led unhealthy lifestyles.

These indicators included the percentage of the population that smokes, has high blood pressure and high cholesterol, is infected with HIV or does not exercise. It also included environmental factors such as sanitation and pollution.

Despite the people in Singapore leading better lifestyles than those in other countries, Prof Phua said this is not determinative of the health of the population.

He found the study wanting in that it largely measures deaths, with 80 per cent going to such indicators.

"If you are talking about poor health, death is the ultimate climax, of course. But, in between, are we really creating the conducive environment for good health? Such a method doesn't say if people actually live healthy lives. They can live longer but, perhaps, they are kept alive because of good medical treatment."

Prof Phua felt that a better, although more difficult, way would be to measure disease rates rather than deaths.

Dr Lam was also sceptical about indicators such as smoking, HIV infection and alcohol consumption, and how these findings are obtained.

"Very often, these may be under-reported as such social behaviours can be a taboo in our culture," he said.

Both Dr Lam and MP Fatimah Lateef also said that the study did not take into account mental health, an aspect that most experts deem important in measuring the health of a population - and an area that Singapore could do more in.

While many experts welcomed the ranking, they also drew attention to areas that the Republic could improve on.

Dr Jeremy Lim, Chief Executive of Fortis Colorectal Hospital, named end-of-life care, control of chronic diseases and healthcare affordability as areas to be focused on, while Dr Lateef pointed to preventive and sexual healthcare.