The pandemic’s impact on healthy ageing
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In the past decade, living to the age of 100 has become a realistic prospect for many Singaporeans. Not only has the quality of healthcare in the country improved, but so has citizens’ awareness of disease risk factors and how their lifestyle choices can reduce or increase risk. In 2021 Singapore still boasts one of the world’s longest average life spans (83.9 years).

The protracted covid-19 crisis might be expected to dent Singaporeans’ prospects of living into their 90s and beyond, or at least their hopes of doing so. An Economist Impact survey completed in June 2021, however, indicates that this is not the case. In fact, a higher percentage of people surveyed (31%) today feel prepared to live to 100 from a health and wellness perspective than was the case in a similar survey conducted in 2018 (23%). A combination of factors is likely behind this optimism, including what appears to be people’s sustained attention to maintaining or improving exercise levels and dietary practices, and possibly the country’s success at keeping coronavirus infection and fatality rates relatively low.

Respondent perceptions of their physical health outlook have largely remained stable during the pandemic. The same is broadly true of mental health, but the share reporting a deterioration is higher than is the case with physical health. A challenge for public health authorities, as for Singaporeans themselves, is to reduce the chances that the mental and emotional toll of the pandemic leads to physical health problems later in life.


A pandemic stress test

One explanation for Singaporeans’ improved view of their physical health, according to Dr Janil Puthucheary, Singapore’s senior minister of state for health, and communications and information, is the country’s success in containing the coronavirus outbreak. “We’ve been fortunate,” he says. “Health outcomes have been good with a low fatality rate. There’s no reason that a person who hasn’t contracted covid-19 should consider it a factor in their potential life expectancy.”

Daniel Fung, chief executive officer of the Institute of Mental Health, also notes that people have sought to maintain a physical exercise regimen during the lockdowns. This is supported by the survey results, which show that respondents’ physical exercise patterns remain largely unchanged from 2018. In 2021, 55% report taking 20 minutes or longer of exercise several times a week, compared with 57% in the earlier survey. Today, 38% say their level of physical exercise has remained unchanged during the pandemic while 31% say it has improved. The analogous figures for their diet are 53% and 27%.

Overall, a large majority of Singaporeans say their physical health has remained stable (52%) or improved (22%) since the onset of covid-19. There is some variation across age groups: respondents between 35 and 54 are more likely than those of other ages to report a deterioration in their physical health—28% compared with 25% in the overall sample, and 18% in the 55-64 age group.

As Figure 1 shows, the picture is somewhat darker when it comes to mental health: 35% overall, and as high as 41% among 25-34 year-olds, say it has deteriorated. This is likely linked to the 42% who report increased stress and anxiety levels as a result of the pandemic.

Increased mental health issues in the population are expected, according to Dr Puthucheary. “They are a result of people’s social isolation, their loss of contact with family and friends, the economic fallout, and their anxiety over livelihoods,” he says. “These are all known stress factors for mental health and have all intensified during the crisis.”

Dr Fung attributes the greater problems experienced by younger people partly to the reduced opportunity for social interactions, which are very important at younger ages. “Young people are struggling in our practice,” he says. Eighteen months since covid-19’s onset, says Dr Fung, “there remain a lot more people seeking our help than had previously been the case. The effects are still being felt.”

Stress levels are likely to subside provided the effects of covid-19 remain contained, but mental health problems are likely to linger. These could have knock-on effects on people’s physical well-being, says Angelique Chan, executive director of the Centre for Ageing Research & Education at the Duke-NUS Medical school. “Mental and physical health are very much interrelated,” she says, “and the former can affect eating behaviours and physical activity levels.”

To their credit, public health authorities have recognised the strains the pandemic has placed on people’s emotional and mental
health and taken actions to address it. For example, the Health Promotion Board (a statutory board under the Ministry of Health) has introduced initiatives during the crisis to help citizens recognise and deal with these strains. One example, the “Brave the New” campaign—which ran from August 2020 to March 2021 and was launched together with the Ministry of Culture, Community and Youth—sought to reassure the public that it was normal to feel stressed or anxious during a pandemic and provided them with tips on coping. Another example, “Hi!JustCheckingIn, an initiative conducted in January-March 2021, encouraged people to check-in on their loved ones and provided advice on how to conduct supportive conversations.

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