Hongkongers are living longer now, but are we living better?
Paul Yip says that if Hongkongers want to be healthier for longer, we need to address suicide, quality of care and work-life balance
According to Centres for Disease Control and Prevention, the US has seen a significant reduction in the seven leading causes of death, including heart disease, neoplasm, etc. However, injury and suicide deaths are on the rise. These deaths usually occur relatively young and have a relatively large impact on life expectancy.
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Population behaviour matters. Some basic elements, like regular exercise and a healthy diet have been neglected, especially among those from the lower socio-economic groups. It doesn’t matter if heart bypass surgery can be performed miraculously, it is the obesity in the population and lack of exercise that kills.
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Hong Kong can’t take improvement in life expectancy for granted. To maintain our standard of care, we need to invest in primary health care by promoting healthy living and injury prevention. Investing in prevention and improving well-being in the population at large would be much more cost-effective than spending billions of dollars more on tertiary and hospital care.
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For example, it is estimated that every year, about 6,000 people have been admitted to hospitals for treatment due to self-harm and the average time spent in the hospital is about 3.2 days. If we take HK$3,000 per day as an average cost, this costs the system HK$57.6 million a year. Some other costs, including the loss of economic productivity and costs to other family members and follow-up heath care have not been taken into account yet.
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Furthermore, though we are living longer, our data suggests that the amount of days each person is hospitalised has not been reduced. This means the burden on the hospital system has increased, and will continue to increase as lifespans extend. This poses a serious challenge to the sustainability of our system.
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We need to reduce demand by promoting a healthy population and increasing the hospital service supply. New technology must also be developed to reduce the duration of hospital stays without compromising quality of care. Our system needs to improve its efficiency to cope with the anticipated increase.
Improving accessibility and affordability of leisure and recreational facilities is important. The availability of sports grounds, green and open spaces, swimming pools and libraries is important for physical and mental well-being in the community.
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The government should provide the infrastructure and environment to promote healthy living and the community should take responsibility for its own health.
Paul Yip is a chair professor (population health) and the director of the Centre for Suicide Research and Prevention at the University of Hong Kong