Singapore has been ranked among the world's top 10 nations - and first in Asia - for its readiness to address the challenges and leverage the opportunities of an ageing population, according to a recent study conducted by researchers from the National University of Singapore (NUS) and Columbia University. Switzerland tops the rankings, with Japan ranking 15th globally and second in Asia, while USA ranks 24th.
This research group has previously reported comparisons of adaptation to ageing among developed countries. To conduct the current work, the group developed a new measure - The Global Ageing Index, which permits comparisons between low- and middle-income countries as well as more developed ones to assess the preparedness of 143 countries, covering 95.4% of the world's population, to tackle the challenges of population ageing. The study examines five key domains: well-being, productivity and engagement, equity, cohesion, and security, with input from 25 experts across high-, middle-, and low-income countries.
Led by Assistant Professor Cynthia Chen from the NUS Saw Swee Hock School of Public Health (SSHSPH) and Professor John W Rowe from Columbia University Mailman School of Public Health, the landmark study was published in the scientific journal Nature Aging on 27 December 2024. The research was made possible through the invaluable contributions of Mr Julian Lim, Research Assistant at NUS SSHSPH.
Summarising the key observations of the study, Asst Prof Chen explained, "While high-income countries lead the rankings in readiness for a rapidly ageing society, low- and middle-income nations trail behind. Although low- and middle-income countries often have younger populations today, many are expected to experience rapid population ageing in the future. Individuals with limited financial security may face serious challenges in accessing healthcare later in life. If health and social security systems remain insufficient to address the needs of older adults, the financial burden on individuals and their families could escalate, potentially leading to widespread economic consequences."
"As such, an effective response to population ageing can offer numerous benefits. Countries can mitigate the growth in healthcare costs while harnessing the potential of older adults, whose experience and wisdom can contribute significantly to societies. In the long run, this can lead to global societal benefits. We hope our findings can help prioritise action for countries at all levels of development," she added.
Singapore's global performance across the five domains central to successful adaptation to societal ageing is summarised below:
Well-Being: 1st
A successfully ageing society provides healthcare informed by a sophisticated understanding of the healthcare needs of older persons. Singapore performed best in Well-being, securing the top global ranking in this domain. The nation achieved the world's longest healthy life expectancy at older ages; strong universal health coverage (6th); a high share of life expectancy spent in good health (10th); and high life satisfaction (23rd).
The study noted that in promoting long-term, transformational change, Singapore's Ministry of Health (MOH) has implemented a set of health transformation efforts, including preventive efforts such as screening, immunisation, health promotion (such as the National Steps Challenge and the Healthier Dining programme), and education. MOH has also recently intensified the nation's efforts in chronic disease prevention and management through the implementation of Healthier SG from 2023. This initiative aims to transition the healthcare system from a reactive treatment model to one focused on proactive preventive care.
Security: 6th
Economic and physical security for older persons is a cornerstone of a thriving ageing society. According to the study, Singapore ranks 6th globally in average income and 1st in both perceived safety walking at night and satisfaction with healthcare quality among those aged 50 years and above. Mental health resilience also ranks highly, placing 6th worldwide.
Productivity and Engagement: 17th
A successfully ageing society facilitates the engagement of older persons. In Singapore, while participation in retraining for ages 16-64 ranks impressively at 10th worldwide, other indicators such as labour force engagement among ages 55-64; as well as volunteering, feeling active and productive daily, and job satisfaction among older populations, have been ranked between 41st to 67th. This highlights substantial opportunities to enhance societal engagement and promote personal fulfilment in later life.
Equity: 36th
A society that is ageing well ensures equitable distribution of resources across generations. In Singapore, despite a high ranking for income (9th globally for both living comfortably, and having enough money for food among those aged 50+), there are disparities between young and old populations in income, food, labour force participation and educational attainment, which would require attention.
Cohesion: 42nd
In a successfully ageing society, strong social connections are preserved both within and across generations. Social trust among older adults and the support available to this group in Singapore present a mixed picture. While a significant proportion of older individuals can rely on friends and relatives (24th) and have access to the internet (24th), trust in neighbours ranks 71st. Furthermore, a significant proportion of older adults live alone (115th), suggesting the need for initiatives fostering community connections and reducing isolation.
The research team recognises that MOH has just embarked on Age Well SG in 2024 and is expanding the network of Active Ageing Centres as drop-in nodes for seniors to co-mingle with one another and with neighbours. This also creates opportunities for seniors living alone to be engaged with buddying and befriending programmes, which will help to address the areas which the team has identified.
Proactive and holistic healthy longevity initiatives by Health District @ Queenstown
Singapore's efforts in adapting to an ageing society are exemplified by initiatives such as the Health District @ Queenstown (HD@QT). This is a multi-stakeholder collaboration co-led by the National University Health System (NUHS), NUS, and the Housing & Development Board (HDB) to promote physical, mental and social well-being at every stage of life.
"The findings of this study inform and validate our efforts at the Health District @ Queenstown. We strive to co-create with residents and service providers an inclusive community that fosters healthy, purposeful lives across the lifespan. Successful sustainable programmes from Queenstown, which have been designed to align with the domains of the Global Ageing Society Index, can be scaled to the whole of Singapore to address the evolving challenges of an ageing population," said Professor John Eu-Li Wong, Executive Director of NUS Centre for Population Health and Senior Advisor at NUHS. Prof Wong is also the Co-Chair of the HD@QT Steering Committee.
Prof Wong added, "As initiatives such as HD@QT take root, we hope to demonstrate how societies can turn the challenges of ageing into a blueprint for healthy, purposeful longevity and empowerment."
