Hong Kong health care and hospitals

Hong Kong health officials consider sugar tax to cure city of its bad health habits

Department of Health sets sights on non-communicable diseases for the next seven years and floats idea of punitive taxes ‘if all else fails’ to convince Hongkongers to live healthier lifestyles

PUBLISHED : Friday, 04 May, 2018, 9:57pm
UPDATED : Friday, 04 May, 2018, 11:07pm

Hong Kong could consider a new sugar tax and increase its alcohol duty “if all else fails” to reduce deaths from non-communicable diseases, the health authority said on Friday as it unveiled its strategy for the next seven years.

Non-communicable diseases, such as cancer and cardiovascular disease, are the top cause of death in the city. In 2016, the diseases accounted for about 55 per cent of all deaths, and took away about 104,600 years of life from the population, Director of Health Dr Constance Chan Hon-yee said, calling the situation “unprecedented”.

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Looking ahead to 2025, the Department of Health plans to focus on four diseases – cardiovascular disease, cancer, chronic respiratory disease and diabetes – and four behaviours that contribute to those diseases – an unhealthy diet, lack of exercise, smoking and too much alcohol.

The strategy was developed along with the Food and Health Bureau.

Chan said Hong Kong was adopting an “incremental approach” to reduce burden of those diseases, instead of following World Health Organisation guidelines that call for a sugar tax and further alcohol and tobacco duties.

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“We have put up targets with indicators. The reason why we put up indicators is because we are serious about what we need to do. As we always say: what gets measured gets done,” she added.

To meet health targets, the department planned to enlist the help of other sectors. For example, to improve diet, schools would be encouraged to serve meals with less salt, sugar and oil. Officials would also work with planning and transport departments to ensure more people have access to sports facilities and improve the city’s walkability.

“We are looking for a win-win situation where improvement in environment could also lead to improvement in health and vice versa,” Chan said. “That’s why the health sector can’t work alone. We need to work with the other sectors.”

Should this approach fail, the department would consider lobbying for punitive taxes on sugar and alcohol, but introducing those measures “is not a simple matter”.

“We need to engage the whole community. People must understand the reason why we have to introduce a particular fiscal policy and members of the public understand why we need to do it. So we need to start with education and understand their perspectives. If all this fails we may need to consider fiscal policies but right now improving members of the public’s health literacy will be of utmost importance,” she said, adding the department will not consider subsidies to encourage healthier living.”

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Dr Regina Ching Cheuk-tuen, head of the surveillance and epidemiology branch of the department’s Centre for Health Protection, said non-communicable diseases were “much more problematic” than communicable diseases, such as measles, which raised concerns in Hong Kong this week amid ongoing outbreaks in Japan and Taiwan.

The No 1 killer in Hong Kong remains cancer, which accounted for 30 per cent of all deaths in 2016, followed by heart disease at 15 per cent. Stroke comprised 7 per cent and diabetes 3 per cent, Ching added.

“These are all non-communicable diseases and to a large extent it is a matter of personal behaviour but an individual’s lifestyle is affected by his environment.”

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“If you don’t give him the choice to choose a healthy way of living, how can he live healthy?”

Ching said one bad habit Hongkongers needed to break was salt consumption. While the city does not smoke much as just 10 per cent reported smoking, a whopping 86 per cent of people aged 15 to 84 reported a salt intake exceeding the WHO-recommended limit of 5 grams a day. Meanwhile, half of Hong Kong’s population is considered obese.

The action plan laid out other bad habits:

93 per cent of primary and secondary students were “insufficiently physically active” in the 2015-16 school year.

About 60 per cent of Hongkongers aged 15 and older consumed alcohol in the last 12 months.

More than 90 per cent consumed less than the WHO-recommended five servings of fruit and vegetables a day.

Ching noted the city’s annual average rate of decrease in mortality from non-communicable diseases was 2.7 per cent before 2010, but between 2010 and 2016, it was 2.2 per cent.

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“It (rate of decline) is still falling, but the slope is milder and flattening out.” she said, adding it would be increasingly difficult to further reduce it as the city has done well in reducing the mortality rates.

Still she said the department was confident of further reducing death rates with the 2025 plan.

Ching said non-communicable disease was “not something we have to bear, it’s something we can avoid”.

“Imagine if you improved your lifestyle, you won’t get sick from a heart attack, you won’t be debilitated by a stroke.”