Public Health: Singaporeans killing themselves with the good life

Khaw said that more than 60% of reported deaths deaths over a period of 20 years can be directly attributed to the changing nature of the Singaporean's lifestyle.

During that period, the small island that is home to about four million people, has confirmed its place as one of the world's safest places to live, one of the cleanest and one of the healthiest - even small green-spaces have exercise machines (exercise stations) in what at first sight seems like a bizarre grown-up version of a traditional children's playground but which provide a free gym right outside many apartment blocks.

But despite this, what Khaw described as "lifestyle diseases" have taken hold - and will get worse as the population ages.

Cancer, coronary heart disease and stroke have been at the centre of the change, plus diabetes and mental disorders. Forty years ago, Khaw said, infectious diseases were the main killers.

He advocates a more healthy lifestyle - something that may prove more difficult than at first seems. Singaporeans, like Malaysians, are addicted to their cars. Although owning a car, unless one has private parking, is a complete headache in Singapore - if one can get a permit, parking is expensive and charges are unavoidable - those with cars seemingly lose the use of their legs for distances exceeding 50 metres. Those that don't have cars, use taxis for even short distances. In contrast, in Hong Kong, simple observation shows people walking much more. Indeed, Khaw says that three quarters of Singaporeans do no regular exercise.

However, the figures quoted related to percentage of deaths. The valuable measure of deaths from these causes as a percentage of population has not been published. That data would show whether these "lifestyle" diseases are actually increasing amongst the population or whether the change in relative percentages is due to a reduction in the infectious diseases of the past.

Certainly, Khaw said, the public health education programme is bearing fruit. Singapore has amongst the lowest obesity rates in the world at just 7% (compared with the USA's where several states have obesity rates exceeding 30% and the lowest, Colorado, has a rate of 18.7% *)

In smoking, Singaporeans are also doing well with just 14% of the population smoking: but Khaw presented this with adverse spin, saying that one in seven is still far too many and much more neds to be done.

* Source: CDC.GOV