Singapore - Health

Singapore's population enjoys one of the highest health levels in all of Southeast Asia. This achievement is largely attributed to good housing, sanitation, and water supply, as well as the best hospitals and other medical facilities in the region. Fully 100% of the population had access to safe drinking water and 99% had adequate sanitation in 1994–95. Nutritional standards are among the highest in Asia. Singapore is financing medical care with a combination of personal contribution and government assistance. In 1984, Singapore initiated a Medisave scheme, a compulsory savings plan for medical expenses. About half the population pays hospital bills through this plan, although as of 1990 the plan did not cover outpatient expenses. Workers must contribute 3– 4% of their earnings to a medical savings account to be used for medical expenses. The contribution of workers is matched by employers. As of 1999, total health care expenditure was estimated at 3.2% of GDP.

In 1990, there were 19 hospitals, five of which were administered by the government, and five were "government restructured" (as of 1989, given a large degree of administrative autonomy). The remaining nine hospitals were privately run. The main multidisciplinary hospitals are Alexandra Hospital, Changi Hospital, Tan Tock Hospital (all government run); and National University Hospital, Singapore General Hospital, and Toa Payoh Hospital (all government restructured). In 1991, there were 3,779 doctors, 600 dentists, and 10,240 nurses; in addition, there were almost 600 pharmacists (80% of whom worked in privatelyowned establishments). As of 1999, there were an estimated 1.6 physicians and 3.6 hospital beds per 1,000 people.

An estimated 74% of married women (ages 15 to 49) used contraception in 1993. The fertility rate in 2000 was 1.5 children per woman during her childbearing years. As of 2002, the crude birth rate and overall mortality rate were estimated at, respectively, 12.8 and 4.3 per 1,000 people. Life expectancy in 2000 was 78 years and infant mortality was 3 per 1,000 live births. In the same year, 100% of the population had access to health care services.

According to a national health survey by the Ministry of Health, high cholesterol had fallen from 27% in 1984 to 19% in 1992; hypertension levels were also down from 15.3% to 13.6% in the same period. There were 5,457 deaths due to cardiovascular disease in 1995. More men than women smoked in Singapore in 1995 (31.9% vs. 21.7%). However, smoking had increased among 18–19 year olds, from 12% in 1984 to 15.2% in 1992; for 20–39 year olds, the increase was 15.8% to 19.4%. The occurrence of diabetes increased from 4.7% in 1984 to 8.6% in 1992 among people 18–69 years; cancer increased as well. Fourteen percent of Singaporeans exercise regularly.

Leading causes of death per 100,000 people in 1990 were communicable diseases and maternal/perinatal causes, 114; noncommunicable diseases, 498; and injuries, 39. There were 48 cases of tuberculosis per 100,000 people reported in 1999. In 1995, vaccination rates for children up to one year old were as follows: tuberculosis, 97%; diphtheria, pertussis, and tetanus, 95%; polio, 93%; measles, 88%; and hepatitis B, 91%. In 1999, rates for DPT and measles were, respectively, 94% and 93%.

The slow growth of the HIV epidemic in Singapore may be attributed to general awareness and programs promoting condom use at STD clinics. As of 1999, the number of people living with HIV/AIDS was estimated at 4,000 and deaths from AIDS that year were estimated at 210. HIV prevalence was 0.2 per 100 adults.

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