Not many people were making it past their 85 years

(Oct 8) - A TAMPINES resident held up the obituary page of The Sunday Times at a forum on the recent Central Provident Fund changes to make the point that not many people here were making it past their 85th birthday.
Mr Elendrus Osman, one of 300 residents who showed up at the Tampines West Community Club for the forum, counted only one person out of 32 recently deceased who was above 85.
Mr Mah Bow Tan, a Member of Parliament for the Tampines GRC replied that obituary pages ought not be used as a gauge of life expectancy.
It would have been difficult for him, as it has been and will be for other ministers, to get the man in the street now aged 50 and below to be persuaded on a need for a compulsory longevity insurance that will make monthly payouts from age 85 after their minimum sum runs out.
But the numbers do not lie.
The latest figures from the Department of Statistics say 26,000 people here are now 85 years and older.
And there is more: A baby born here today has the best chance in the world of surviving till his first birthday. Thereafter, he can expect to live to past 80.
To be exact, life expectancy here is 81.8 years on average.
Going by the latest infant mortality and life expectancy data compiled by the United States' Central Intelligence Agency (CIA), Singapore is fourth in the world for life expectancy at birth and No.1 among countries with lowest infant mortality.
The CIA's factbook, updated last month, lists 200 countries by economic performance, health and trade indicators.
At 81.8 years, Singaporeans are living about 20 years more than in the 1950s and 1960s. Given the trend for the past few decades, life expectancy here should continue to edge up.
Why the change over the years?
Put it down to clean water, good infrastructure and a robust health-care system.
Life expectancy here has crept up every decade, from 65.8 years in 1970 to 78 in 2000. As a result, Singaporeans are now outliving people in most developed countries.
A Singaporean can expect to outlive a Norwegian by two years, a Briton by three and an American by 3.8 years.
A Japanese, however, will be around about five months more than a Singaporean.
It is a similar story with infant mortality, which now stands at a chart-topping 2.3 deaths within the first year per 1,000 births.
It is a long way from 1960, when 34.9 babies in every 1,000 born died before they were a year old.
By 1980, the figure was down to eight deaths per 1,000 babies born.
Professor Phua Kai Hong, who teaches health economics at the Lee Kuan Yew School of Public Policy, said Singapore's small size - making physical access to health care easy for everyone - was a big plus in achieving such enviable health outcomes.
'Many small city states do better than big countries with vast populations,' he said.
Indeed, several other small places are in the top 10 for longevity - Macau, Hong Kong and the tiny European states of Andorra and San Marino.
Japan is the only big country among the top five; Sweden, Australia, Switzerland and France make up the rest in the top 10.
Small size aside, Singapore has done well for two other reasons, said Prof Phua.
One is that it does not have 'inner-city slums and an underclass with poor health', and the other is that access to basic health-care here is across the board.
Aside from crediting 'clean water, clean air, safe roads, high education for the masses, good immunisation and the anti-smoking programme', Health Minister Khaw Boon Wan told The Straits Times that individuals here had to take some credit for the way they looked after themselves as well.
He said: 'An engaged population which takes health seriously and strives to maintain a healthy lifestyle will increasingly be a factor.'
Citing diabetics as an example, he said that these individuals could not be cured, but a diabetic who 'actively managed' his disease could avoid unnecessary pain and suffering and live a good life.
'The best measure of success is a long, healthy and happy life,' said Mr Khaw.
Although highly commendable, Singapore's strong showing in the infant mortality and longevity rankings do not tell the full story.
Geriatricians at Alexandra Hospital prefer to consider another indicator in tandem - the quality of life.
Said Dr James Low, who heads geriatric medicine at the hospital: 'It may be more important for us to make a distinction between total life expectancy and 'healthy life expectancy'.'
In other words, he argued, there was little point in living a long life if that life is to be filled with years of pain and suffering.
Dr Lee Jer En, a registrar in geriatric medicine at the same hospital pointed to a survey of older Japanese and Americans published in 2004 which found that 27 per cent wanted long life, but 93 per cent felt it was important to remain in good health till death.
Dr Low, who specialises in health problems assailing the elderly, said: 'We often encounter patients who say they would rather not live that long if their latter years were to be marked with pain, suffering and disability.'
World Health Organisation figures for 2000 say that a man here can expect to spend an average of 7.7 years with some disability, while women, who generally live longer, will suffer for about 9.6 years.
Dr Low predicts that life expectancy will 'continue to climb', though more slowly.
But he is optimistic that the amount of time lived in good health will lengthen 'at a faster pace than the total life expectancy'.
This translates to a better quality of life for the elderly.
Dr Low said work by the multi-ministerial committee looking into the needs of an ageing population, headed by Mr Lim Boon Heng, is already bearing fruit.
'If it is easier for older people to get around with improved housing and transportation systems, it will definitely go a long way to reduce the handicap experience with certain disabilities.'
salma@sph.com.sg