Guest blog post contribution by Dr. Peter Ting, Director and Founder of the PALM Centre
By 2030, 40% of Singapore’s workforce is projected to be aged 50 years and over. An aging population means a higher prevalence of chronic diseases such as cancer, diabetes, heart disease, osteoporosis, and dementia – all of which pose challenges to productivity and growth due to increasing absenteeism or presenteeism. There will be an increase in demand for medical services and escalation in medical costs due to increased utilisation of healthcare services together with cost inflation. A report (2017) by Mercer and Marsh & McLennan Companies’ Asia Pacific Risk Centre, revealed that the aging workforce and medical cost inflation in Singapore will drive up the average medical cost per employee by 108% to S$1,973 per year in 2030. Current trends suggest that productivity loss due to sickness absenteeism per employee is projected to increase, leading to a cost of S$3.3 billion in 2030.
This begs the question, how can companies continue to keep their workforce healthy and productive given these new challenges?
Around 80% of chronic disease diseases today are caused by unhealthy lifestyle choices (ES Ford et al. 2009). In the United States, 90% of the nation’s annual healthcare expenditures are for people with chronic and mental health conditions, many of which are rooted in environmental, social and lifestyle factors. While health screening is an established and important part of preventative healthcare, lifestyle medicine is still a relatively unknown entity. Lifestyle medicine is an American and International board-certified medical specialty that employs natural lifestyle interventions in the treatment and prevention of chronic disease, often reducing the need for costly medications or surgeries. The American College of Lifestyle medicine in 2009 defined it as “the therapeutic use of evidenced-based lifestyle interventions to treat and prevent lifestyle related diseases in a clinical setting. It empowers individuals with the knowledge and life skills to make effective changes that address the root causes of disease.”
Poor lifestyle choices, such as smoking, overuse of alcohol, poor diet choices, lack of physical activity, inadequate relief of chronic stress and poor sleep, are key contributors in the development and progression of preventable chronic diseases, including obesity, diabetes mellitus, hypertension, cardiovascular disease, osteoporosis and several types of cancer. Even though doctors encourage healthful behaviours to help prevent or manage many chronic medical conditions, many patients are inadequately prepared to either start or maintain these appropriate, healthy changes. Nevertheless, sustainable healthy lifestyle modifications are possible with appropriate personalised interventions, targeting the above root causes. Medical studies show that adults with common chronic conditions who participate in comprehensive lifestyle modification programs experience rapid, significant, clinically meaningful, and sustainable improvements in biometric, laboratory and psychosocial outcomes. Examples are Ornish reverse heart disease program, CDC’s diabetes prevention programs, and DASH programs targeting hypertension.
There are increasingly more Singaporeans using digital devices to record and track their health metrics such as blood pressure, blood sugar, physical activity, and weight. However many never share this useful health data collected from digital technology with their healthcare providers, resulting in no remedial action being taken. This is a missed opportunity for proactive health management. When relevant health data is shared with their healthcare provider, patients perceive a higher quality of care, they are also more engaged and motivated to make and maintain the necessary lifestyle changes. The doctors and the healthcare team gain better insights into one’s health behaviours, and hence are able to make more personalised and effective recommendations. While it is heartening to see more people keeping track of their health behaviours, there is an even more pressing need for higher-risk individuals to track personal health indicators, as they have much higher utilisation of healthcare services, and are most likely to benefit from guided lifestyle modifications.
In addition to regular health screening to preempt issues, more active engagement with medical providers through self-monitoring tools, preventative care and data sharing with their healthcare professionals are needed. Patient centric technologies, allowing better data access and flow between patients and practitioners across the health continuum – health living, prevention, diagnosis, treatment and home care will help evolve the future of healthcare into a more connected integrated system with patients at its core and optimal health outcomes as the ultimate goal. For more elderly individuals who may not be so savvy with digital applications, their children can also help them get started on managing their health. They can also take an active role together with the health team in ensuring that their loved ones stay on track.
Companies should recognise that true health lies in maintaining good healthy behaviours and promoting a culture of healthy lifestyle both at work and at home. To help companies achieve this easily and effectively, healthcare providers such as Preventive and Lifestyle Medicine Centre (PALM) can help monitor and transform the health habits of groups as well as individuals through digital solutions and scientifically based lifestyle medicine and behavioural change strategies. They can help companies develop tailored initiatives and solutions based on their unique employee health profiles. For example, solutions can vary from educating and facilitating healthy behaviours through a series of customised talks and programs catered to those with just poor health habits and no medical conditions, to more targeted and intensive approaches for individuals with existing chronic diseases or multiple risk factors.
While many companies have already adopted health screening as part of their benefits and best practices, there still remains a large unmet need to ensure that this translates into improvement in health habits and a reduction of future health risk. Lifestyle analysis and lifestyle medicine should play an integral part in the process, empowering individuals to be an active partner in the process.
Dr. Peter Ting is a preventive cardiologist trained at the National University of Singapore, National Heart Centre Singapore, Mazankowski Heart Institute in Canada and Harvard University School of Public Health. Apart from being a very experienced cardiologist, he is also certified in Lifestyle Medicine by the International Board of Lifestyle Medicine. He practices at PRIME Heart Centre Gleneagles Hospital and StarMed Specialist Centre, and is the Medical Director for Preventive and Lifestyle Medicine Centre, which helps companies and individuals design and deliver virtual lifestyle management programmes to help patients reverse or slow the progression of heart disease, hypertension, diabetes etc. thereby reducing the reliance on drugs or surgery.