Singapore: A Public Health Perspective (Upon Arrival)

Less than two weeks ago I arrived in Singapore, and evidence of public health practice and success are everywhere!

The built environment (i.e., architecture) is breathtaking—more so because it is so fully integrated into the abundant urban greenspace. Nearly half of this small island nation is covered by vegetation, including the Bukit Timah Nature Preserve, which has more tree species than in all of North America.

From birth to death, Singapore outranks the United States (and nearly every other country) on all metrics of human health. For example, infant mortality is less than one-half the rate in the United States, and life expectancy is 3 to 4 years longer. This, despite the fact that U.S. health expenditures are four times higher than Singapore per capita—and more than six times higher in terms of gross domestic product (GDP). Of course, standard of living along with excellent public housing, education, transport, food and sanitation contribute to these and other extraordinary health outcomes.

Singapore policies and practices support public health. There is a smoking ban in all public places, and e-cigarettes are illegal. Taxis and billboards across this city of 5.6 million people proclaim health messages related to healthy food, modest caloric intake and physical activity. Prime Minister Lee Hsien Loong recently cited diabetes prevention as a priority in his National Day message. The Ministry of Health recognizes the burden of chronic disease, the aging population and risk of communicable disease such as Dengue. For example, the 52nd National Day Parade (more a pageant, really) featured a giant mosquito and “The Mozzie Clap” (promoting prevention by insisting it is everyone’s responsibility to fight mosquito-borne disease), along with an emphasis on youth, family and social harmony: #OneNationTogether—regardless of origin and background, we belong as one people and one nation.

Singapore’s budgetary priorities in health also reflect an enlightened view: moving beyond hospital to community, quality to value, and health care to health. Clearly, we in the United States have a lot to learn.

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Jeannette Ickovics is the Samuel and Liselotte Herman Professor of Social and Behavioral Sciences at the Yale School of Public Health and Professor of Psychology at Yale University. She is a Visiting Professor at Yale-NUS for the 2017-2018 academic year. This is her first trip to Singapore, and she will be writing a monthly blog about her experiences that will appear on Yale School of Public Health social media.