Healthy Longevity in Southeast Asia: Just a Utopian Dream?
- Bridges M&C team
- 1 day ago
- 7 min read
Updated: 6 minutes ago
Longer life expectancy in Southeast Asia drives the need for seniors to have better quality of life, vitality and independence throughout their final years.
According to the World Health Organization (WHO), life expectancy in the region has increased significantly, with Singapore having an average life expectancy of over 84 years, one of the 10 countries with the highest life expectancies in the world. Countries such as Thailand have also reported significant gains in life expectancy, up to 75 years in 2025 from 71 years in 2000.
But how many of these years are spent in good health? As life expectancy rises, so do the challenges associated with aging, including the onset and management of chronic diseases and healthcare costs. In Singapore and Japan, for instance, there is a growing emphasis on not just living longer, but living in good health, known as healthy longevity. The focus of healthy longevity is not just on extending the number of years you live, but also maximizing the quality of life, independence and vitality throughout those years.
Shifting healthcare paradigms
Healthcare systems in Southeast Asia are still largely reactive, focusing on diagnosing and treating diseases as and when they occur. However, the increasing burden of chronic diseases such as diabetes, heart disease and cancer has highlighted the urgent need for a preventive approach, as opposed to a reactive approach to public health.
“The COVID-19 pandemic has been one of the factors contributing to the conversation around preventive medicine. In the aftermath of the pandemic, people have become much more aware about their health. They want to enjoy their lives and live a full life to a ripe old age, and preventing and managing chronic disease is a big part of that,” says Dr Hisham Badaruddin, longevity medicine physician.
Public health policies have a part to play in influencing the public in embracing preventive health. In Singapore, there are various public health initiatives aimed at promoting healthy lifestyles including the National Steps Challenge by the Health Promotion Board. The government’s HealthierSG initiative serves as a starting point for healthcare to be decentralized from public health institutions to communities and homes, and mobilizing family doctors to support citizens, their caregivers and families, in taking charge of their own health, and making informed healthcare decisions.
In Japan, the Metabo Law which has been credited for reducing the incidence of metabolic syndrome, and preventing chronic diseases encourages citizens between the ages of 40 to 74 to undergo regular health check-ups. Introduced in 2008, the policy also mandates that companies offer health screenings to employees, where men with a waist circumference of over 85cm and women with a waist circumference of over 90cm are referred to counselling sessions.
Improving health span
Recent data indicates there is a gap of 8 to 13 years between average life expectancy and average healthy life expectancy, even in countries with longer life expectancies such as Singapore, Japan, China and the United States. Dr Hisham believes that improving the health span or healthy life expectancy of the population requires a shift in mindset about what preventive health constitutes.
“Current preventive medicine approaches only scratch the surface of healthy longevity, as they are still largely centered around screening and identifying presence of illnesses. Physicians need to be trained in healthy longevity and embrace it as part of their practice; not just identifying illnesses but also preventing them from occurring," explains Dr Hisham.
Professor John Eu-Li Wong, Isabel Chan Professor in Medical Sciences and Executive Director, Centre for Population Health, National University of Singapore (NUS) said at the Nikkei Forum: The 6th Super Active Ageing Society Conference 2024, "Health is the outcome of multiple determinants, where genetic factors contribute to only about 30%, while social, behavioral and environmental factors determine about 60% of outcomes. The remaining 10% is determined by health systems and services.”
He added, “Health is a complex system, which requires multi-sectoral input to achieve the desired outcome. In tackling obesity for example, just focusing on the quality and type of food is not enough. We have to look at urban design, what type of work the patients are doing, physical activity and transport, climate, air pollution, physical safety, and so on.”
Fellow forum speaker Linda P. Fried, Dean of Columbia University’s Mailman School of Public Health and Director of Robert N Butler Columbia Aging Center, said, “Health is malleable, and the outcomes are shaped by the many modifiable factors that affect our health across our lives. Prevention works and matters at every age or stage of life. We have strong evidence that individuals aged 50 with healthy habits, such as regular exercise, a balanced diet, low alcohol intake and not smoking, are likely to live 8 to 11 years longer in good health compared to those with unhealthy behaviors.”
She shared, "Creating healthy longer lives has a high return on investment, for the individual, family, and society. As an individual, living a long life in good health is certainly powerful. For multigenerational families, it makes a huge difference to family well-being to have older adults who are active and engaged, and not ill. Older people can make a substantial contribution to their families and communities with healthy longevity."
“We are learning that as we age, we develop expertise and capabilities we may not have had before. Older people have been shown to be much more effective at conflict resolution, emotional regulation, tolerance and generosity. They also increasingly look for meaning and purpose in their lives, and focus on 'generativity', that is the ability to leave the world a little better than when you found it.”
Healthy longevity in practice
The shift towards healthy longevity will have significant societal and economic implications, as healthier populations are more productive, can contribute to the economy, reduce national healthcare expenses and boost overall societal well-being.
In practice, longevity medicine is an extremely personalized and multifaceted approach to individual health, taking into consideration a spectrum of biological, lifestyle and environmental factors in improving one’s health.
“We start with a very comprehensive consultation where we go through your current health concerns, what you want to achieve in terms of health, past medical history and any family risk factors. We then assess your lifestyle such as what you eat, your physical activity, sleep patterns, current stressors in life and supplements you take. Your social circles and work environment is also looked at."
:We then take blood biomarkers as our starting point, and analyze body composition parameters such as body fat percentage, skeletal muscle mass, visceral fat index. This information serves as the basis of the longevity analysis and recommendations to improve health span. The report will also contain the next steps to take to reduce health risks and other tests to do if required,” explains Dr Hisham, who has been in medical practice for 30 years, and began his journey into preventive medicine about 23 years ago.
One of his patients was an obese woman in her mid-30s who wanted to reduce 20 kilograms in six months.
“When she first came to see me, she was unable to bend down to tie her shoelaces and had to rely on her sister and friends to do it. She was so embarrassed by this and wanted to lose weight, but she did not want to be on medication for weight management undergo surgery. So we achieved her goal through lifestyle modification, caloric measurement, increasing physical activity and building a circle of support around her. Her friends and family were crucial to her journey, so we sat down with them and explained the program to them, and how they could help her. For example, if they saw her snacking, they would have to stop her and reinforce the program” he shares.
Today, her BMI is less than 23 and she continues to check-in with Dr Hisham regularly to maintain and manage her weight.
He elaborates, “It is important to measure patients' progress to ascertain to what extent, longevity medicine works for them and whether we need further tweaks to improve it. I also find that biomarker tests are inter-related. For example, while we would focus on normalizing insulin levels in someone whose levels are elevated to reduce their risk of diabetes, we also examine biomarkers that increase their risk of cardiometabolic disease such as levels of apolipoprotein B, homocysteine, and lipoprotein (a).”
Addressing inequalities
Much of the conversation around healthy longevity occurs in affluent populations. However, the costs of implementing preventive healthcare measures can be high, which may seem misaligned with the reality of healthcare in Southeast Asia, where many countries are still struggling to provide basic healthcare access, especially to marginalized groups, and public health funding is limited.
Barriers such as geographical distance and limited transport options to healthcare facilities and low awareness or public education are factors that hinder many rural populations from accessing healthcare. For low-income communities occupied with surviving on a day-to-day basis, healthy longevity may seem like a distant dream.
However, innovative approaches are emerging to bridge the gap. Countries such as Indonesia and Philippines have initiated community health programs, providing preventive health education and services in rural areas. These programs often leverage local volunteers to disseminate information, conduct health screenings and promote healthy lifestyle choices.
Digital health solutions such as telemedicine, health apps, and wearable devices are gaining traction in Southeast Asia. While this allows for more personalized healthcare recommendations and encourages the shift towards preventive medicine, the effective implementation of these technologies requires addressing disparities in rural populations' access to technology, patient data security, and managing overuse and over-reliance on digital tools.
“Healthy longevity should not be confined to affluent populations alone. My intention is to democratize healthy longevity and make it available to the masses. In the long run, this will lead to reduction in healthcare costs, improved health of individuals and the population, better communities and economies."
"But to do this, it is not only about addressing chronic diseases, we must also address the economic needs of low-income and underserved communities to create a truly inclusive vision of health,” says Dr Hisham.
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