Hong Kong’s ageing society is prone to ‘rich-person’s diseases’ but help is on the way
Bernard Chan says cardiovascular diseases, cancer, diabetes and chronic respiratory problems are the major causes of death in Hong Kong and linked to the ageing population. The government’s ‘Towards 2025’ action plan is taking steps to address this
By many measures, Hong Kong is one of the healthiest places in the world. We have one of the lowest infant mortality rates, and we come out on top in terms of life expectancy.
But like many developed societies, we are seeing a rise in non-communicable diseases. Cardiovascular diseases, cancer, diabetes and chronic respiratory problems have become the main threats to our health. Around 55 per cent of deaths in Hong Kong are due to these conditions.
Obviously, this trend is related to the ageing of our society – everyone will die of something. But we can live happier and more active lives if we take steps to reduce our chances of suffering from these “diseases of the rich world”.
The government recently released an action plan “Towards 2025” to do just this. Drawing on contributions and advice from a range of local experts and the World Health Organisation, the Food and Health Bureau and Department of Health have announced a set of nine targets, which they hope can be achieved by 2025.
One of the main benchmarks is a 25 per cent relative reduction in risk of premature death from these diseases. This calls for such measures such as improved cancer screening. It is also connected to other specified targets – such as reductions in alcohol, tobacco and sodium intake, and an increase in physical activity among the population.
Other targets cover containing or halting trends, notably of raised blood pressure and diabetes and obesity, and call for improved measures to prevent heart attacks and strokes and to ensure availability of treatments for other major non-communicable diseases.
These aims may seem extremely ambitious or unrealistic, but officials believe they are achievable.
One reason is that the targets are about halting or reversing worrying trends rather than expecting diseases to decline rapidly. In a few instances, such as obesity among primary school kids and smoking among the general population, the trend in recent years is actually in the right direction.
Several of the targets – notably to do with smoking, exercise and diet – make special mention of younger people.
I chair the Committee on Reduction of Salt and Sugar in Food, and one of the areas we have looked at is educating the young and even influencing their tastes – for example by working with school cafeterias. The government’s strategy on non-communicable diseases emphasises this sort of long-term prevention through encouraging healthy behaviour at an early age.
However, it is the older part of the population who face the most critical risks of these chronic conditions. The strategy actually proposes specific intervention among older people at risk, including better medications to control hypertension and diabetes.
The strategy also includes broader supply issues, such as the training of health-care workers, the provision of affordable technologies and drugs, and policies to ensure equitable access to resources. The financial side of things is an issue – but the fact is that a healthier population pays for itself in reduced health-care costs.
Another reason to be see the targets as achievable is that success in one area will have positive impact in others.
People may forget just how much these lifestyle factors and outcomes are connected. Alcohol is related to heart disease and cancers, not to mention mental health problems. Lack of physical exercise is thought to be the main cause of 20 to 25 per cent of breast and colon cancers, and higher proportions of diabetes cases and heart conditions.
High salt intake can raise blood pressure, which in turn can contribute to heart attacks, strokes, dementia, kidney failure and even blindness. Diabetes can lead to major cardiovascular problems, and leg amputation, vision loss and nerve damage. Smoking is connected with 14 per cent of all deaths from non-communicable diseases.
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The strategy is a broad one, with huge implications for Hong Kong as a community. But the implementation comes down to all of us as individuals.
By some estimates, over 85 per cent of us consume too much salt. Over 90 per cent of us aged 15 or over consume less than the WHO recommended five servings of fruit and vegetables a day.
Half of Hong Kong’s adults are obese or overweight, and many of us do not get enough physical activity to keep our basic fitness and muscles in good shape. Perhaps most serious of all: an incredible 93 per cent of primary and secondary students do not get enough exercise.
If you recognise yourself or your family here, you know where to start.
Bernard Chan is convenor of Hong Kong’s Executive Council