Education, income correlate with S'poreans' life expectancy, health

Health Minister Gan Kim Yong cautioned that comparisons of such statistics need to be interpreted carefully.
Health Minister Gan Kim Yong cautioned that comparisons of such statistics need to be interpreted carefully.ST PHOTO: JASON QUAH

SINGAPORE - Singapore residents with a higher education level have a higher life expectancy than those with lower education levels.

Those aged 25 years old in 2019 who did not complete secondary education are expected to live up to 81 years, while those with post-secondary education and above are expected to live up to 86.8 years old, Health Minister Gan Kim Yong said on Tuesday (Feb 16).

But he cautioned that comparisons of such statistics need to be interpreted carefully, and also gave the assurance that measures are in place to give all Singaporeans, including those from the lower socio-economic groups, good access to healthcare.

In a written reply to a parliamentary question by Mr Leon Perera (Aljunied GRC), the minister noted that this difference is comparable to that observed in countries that are members of the Organisation for Economic Cooperation and Development (OECD).

"Life expectancy has been increasing for both groups over the years. The life expectancy of our lower-educated population is higher than the lower-educated population in most OECD countries," said Mr Gan.

"However, there is room for further improvement, and we will continue to work on ensuring that life expectancy of our lower socio-economic status (SES) groups continue to improve."

Mr Gan, however, cautioned that comparisons of statistics, such as those for life expectancy and rates of chronic illnesses, across population sub-groups based on household income, education attainment or housing type need to be interpreted carefully.

This is because older cohorts of Singaporeans had, on average, lower levels of education attainment compared with younger cohorts, he noted.

Household income also often decreases when a household member retires, and some older persons may move from a larger flat to a smaller one when their children grow up and leave home.

Mr Gan said the older cohorts, regardless of SES, grew up without the benefits of today's healthcare system and health promotion initiatives in their younger days.

"Outcomes associated with education attainments, income quintiles or housing types would thus partly be a reflection of differences between older and younger cohorts, rather than SES per se," he added.

The minister also pointed out that life expectancy is calculated with the assumption that the mortality rates observed today remain unchanged.

Better health and access to better healthcare could mean that younger cohorts may experience improvements in mortality rates as they age and they may therefore have better life expectancy than calculated.

Mr Perera had also asked about the prevalance of chronic illnesses among those with different levels of education, income and housing type.

In response, Mr Gan said a more accurate measure would be to control multiple confounders such as age, gender, ethnic groups and educational levels at the same time using regression analysis.

Based on this, he said men with below secondary education level were 1.7 times more likely to have diabetes, 1.2 times more likely to have hypertension and 1.2 times more likely to have high cholesterol, as compared to those with post-secondary education.

As for women with below secondary education level, the chances were 1.5 times for diabetes, 1.7 times for hypertension, and 1.4 times for high cholesterol compared with those with post-secondary education.

Said Mr Gan: "We have put in place measures to help all Singaporeans, including those from the lower SES groups, have good access to care with good health outcomes.

"Among Singaporeans with primary education and below who have chronic conditions like diabetes, hypertension and high blood cholesterol, more than 90 per cent visited their doctor in the previous year for their condition.

"Hence, in spite of their increased risks, they had good access to healthcare and comparable outcomes with better-educated Singaporeans in managing their blood sugar, cholesterol levels and blood pressure control."

Mr Gan also said Singapore's health promotion programmes are inclusive and affordable so that healthy living is within the reach of all Singaporeans regardless of income.

He cited the Health Promotion Board's Healthy Living Passport Programme that provides lower-income families with health education and healthy living activities, as well as the HealthySG Buddies programme, which will train Health Ambassadors and volunteers to better support lower-income families to adopt a healthy lifestyle.

Schemes like the Community Health Assist Scheme (CHAS), MediSave and MediShield Life also help make healthcare more affordable, with lower-income groups getting more support.

"The Ministry of Health will continue to ensure good access to health promotion programmes, that all Singaporeans have access to affordable, timely and quality healthcare," added Mr Gan.