Preventive Health Singapore
by: Dr. Paul Chang, General Practitioner, Regis Medical
Prevention is often better than cure and that is the same when it comes to your health. With Singapore’s ageing population, our government has recognised the need to put a significant focus on investing into preventive healthcare in order to lower the overall healthcare costs as well as the burden of healthcare costs on the families of patients. In 2020 alone, the Singapore government invested S$590 million into preventive healthcare. In 2021, this number increased to S$720 million. This highlights the importance of preventive healthcare in Singapore.
What is Preventive Health?
Preventive healthcare is a proactive approach to managing illnesses and other healthcare concerns. Traditionally, treatment is only given after a patient is diagnosed with certain illnesses. However, some illnesses may only be diagnosed after they have developed in severity, which may not be ideal. This could have been prevented if the patient’s condition had been discovered earlier. Preventive healthcare puts a focus on preventing diseases from developing in the first place through methods such as vaccines, or through early discovery via regular health screening methods.
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Why is Preventive Health Important?
Preventive healthcare is important because chronic diseases and critical illnesses can often do irrecoverable damage to your health. This can heavily reduce your quality of life, affecting your ability to carry out your daily routine.
These diseases can also cost a lot to manage or treat. For example, heart disease related conditions such as heart attack and cardiac arrest can cost between $15,000 to $40,000 in medical bills and hospitalization fees.
Furthermore, chronic illnesses, such as diabetes and hypertension, cannot be completely cured and can cause irreversible damage to your health. It is ideal to safeguard your health through preventive healthcare and avoid critical health issues if possible.
Vaccinations as a Preventive Measure
Coronary Artery Heart Disease
Vaccinations are a vital part of preventive healthcare, as vaccines are designed to help the body build immunity towards specific infectious diseases. Our immune systems are constantly fighting against the germs around us, but may not have the specific antibodies required to fight off certain diseases. Our immune systems can usually become immune to these diseases after contracting the disease once, as the body is now capable of producing the specific antibodies required. This is also called natural immunity.
However, in some cases, certain infectious diseases may be so deadly that the first infection may be fatal or lead to serious health consequences. This is where vaccines come into play. Vaccines imitate diseases, often containing a small dose of the disease itself. When injected into our body, the vaccine triggers our immune systems to respond to it, building immunity towards the specific disease. Additional doses of the vaccines may be required as a single dose may not be sufficient to ensure immunity. Some of the deadliest diseases in human history have been widely prevented thanks to the invention of vaccines, preventing approximately 3.5-5 million deaths every year from diseases like diphtheria, tetanus, pertussis, influenza and measles.
While it is common for vaccines to cause mild side-effects, the positives heavily outweigh these potential side-effects. You can also consult a healthcare professional to assess if you are suitable for vaccination if you have drug/food allergies, underlying health conditions, immunocompromised or are currently under medication.
Common Vaccines for Children and Adults in Singapore
As part of Singapore’s approach towards preventive healthcare, the National Childhood Immunisation Schedule (NCIS) and the National Adult Immunisation Schedule (NAIS) was established.
The NCIS comprises of childhood vaccinations in order to protect every Singaporean child from vaccine preventable diseases that can often be deadly. As of now, the NCIS covers vaccinations against:
- Tuberculosis
- Hepatitis B
- Diphtheria
- Tetanus
- Pertussis
- Poliovirus
- Haemophilus influenzae type b
- Measles, mumps, rubella (MMR)
- Pneumococcal disease
- Human papillomavirus
- Varicella (chickenpox)
- Influenza
Out of the vaccinations listed above, vaccination against measles and diphtheria for children are required by Singapore law. The Health Promotion Board carries out vaccinations regularly in Singaporean Schools. For Singaporean children who remain unvaccinated, parents can bring their children to polyclinics or CHAS GP Clinics to get vaccinated for free if eligible for the NCIS.
For the NAIS, it aims to provide guidance for Singaporeans aged 18 and above who wish to safeguard themselves against vaccine-preventable diseases. For those who have yet to be vaccinated or have certain health conditions that puts them at greater risk of health complications, it is highly recommended that they receive vaccinations. The vaccinations that are recommended and made available have been based on international best practice and the recommendations of the Expert Committee on Immunisation (ECI), taking into consideration:
- Local disease burden
- The age, occupation, pre-existing medical conditions, vaccination history of the individual
- Vaccine safety, efficacy and cost effectiveness of the vaccines in preventing infections among susceptible individuals and reducing complications, morbidity and mortality.
The vaccines recommended by the NAIS protect against the following 11 diseases – Influenza, pneumococcal disease, human papillomavirus, tetanus, diphtheria, pertussis, measles, mumps, hepatitis B, and varicella (chickenpox).
While the onus remains on you to get vaccinated as an adult, the NAIS offers subsidised rates for the recommended list of vaccinations, that are readily available at polyclinics and CHAS clinics. Our GPs can assess your vaccination history and advise you on which vaccines you should get in order to protect yourself.
Health Screening as a Preventive Measure
Another mainstay in preventive healthcare is health screening (/health-screening-singapore). While vaccinations aim to help individuals build immunity towards infectious diseases, there are some diseases that cannot be vaccinated against. This is where health screening comes into play.
Regular health screening allows you to spot any potential health problems that may be developing in your body. With early discovery, the chances of curing your diseases are significantly increased. For example, cancer is the leading cause of death in Singapore, accounting for 28.8% of total deaths in 2018. If detected early, cancer can potentially be treated before it spreads across the body. While the risk of developing chronic diseases increases as you age, it has become increasingly common for young adults to have developed chronic diseases due to poor lifestyle choices and habits. Early detection of chronic diseases allows you to get the treatment you need to control the disease, reducing the risks of health complications and limiting its impact on your life.
Another example from MOH Singapore claim that 1/3 of diabetic patients doesn’t know they have diabetes.
Even if you feel perfectly fine, some conditions may not exhibit obvious symptoms until later stages of development. Furthermore, getting screened regularly can put your mind at ease and assure you that you are in the pink of health.
Preventive Health Screenings for Various Ages
As your risk of developing certain diseases increases as you age, screening tests are usually recommended based on your age.
18 years and above:
Body Mass Index & Waist Circumference measurement, once a year. Screens for obesity, a leading risk factor in the development of various chronic conditions.
- Blood Pressure measurement, once every 2 years. Screens for hypertension.
40 years and above:
- Fasting blood glucose or HbA1c test, once every 3 years. Screens for diabetes mellitus.
- Fasting or/and non-fasting lipid tests, once every 3 years. Screens for high cholesterol.
50 years and above:
- Faecal Immunochemical Test, once a year. Screens for signs of colorectal cancer.
- Colonoscopy, once every 5 to 10 years. Screens for signs of colorectal cancer.
For females, the following additional tests are recommended:
25 years and above:
- Pap Smear test, once every 3 years. Screens for cervical cancer.
- HPV test, once every 5 years. Screens for cervical cancer.
50 years and above:
- Mammogram, once every 2 years. Screens for breast cancer.
The following screening tests are recommended for infants (0 to 4 weeks old):
- Audiometry, screens for hearing loss.
- Screen with umbilical cord blood, screens for Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency.
- Metabolic screen with Tandem Mass Spectrometry (TMS), screens for inborn errors of metabolism (IEM).
- Thyroid Function Test (TFT), screens for primary hypothyroidism.
This list of health screening covers the basics, but there are more types of health screening that you can consider taking up based on your age, medical condition, living habits and family medical history. Your healthcare professional may also recommend you to go for certain types of health screening based on their assessment of your health risks.
Regis Medical offers various comprehensive health screening packages that will address any health concerns that you may have, as well as offering professional consultations with experienced doctors that will explain your test results to you in detail.
Preventive Health as part of the Healthier SG Initiative
The Healthier SG Initiative is an initiative designed by the Singapore government to improve the health and quality of life for all Singaporeans. It aims to enable all Singaporeans to:
- Know your chosen family doctor who will provide care for you
- Know what preventive care steps you can take to improve your health
- Know that you can take steps for better health any time you want
The relationship you form with your family doctor will be important, as it allows your doctor to work better with you, creating personalised health plans that can help you attain better health. As you build rapport with your regular family doctor, you can discuss your healthcare needs and goals freely. The better your doctor knows you and your health, the earlier they may be able to spot early warning signs of potential health problems. Your doctor will be able to address any health concerns you have, recommending suitable health screenings and vaccinations based on your medical history.
Community partnerships between agencies such as the Health Promotion Board, Agency for Integrated Care, People’s Association, SportSG, National Parks Board, creates avenues for Singaporeans to stay active and involve themselves in the community at the same time. This includes nationwide campaigns such as the National Steps Challenge, involving 900,000 participants. Making an active lifestyle fun and rewardable can help Singaporeans find the motivation they need to improve their health and lower their risks of developing chronic diseases.
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