Roundtable Series 1: Health
On Friday 5th May, the Centre for Research on the Economics of Ageing (CREA) started the first of its roundtable initiatives and outreach events for 2017. Having completed 21 waves (surveys) - all thanks to the wonderful support from our respondents – this first roundtable focused on the topic of health. It was an interesting afternoon of discussions based on the rich and high-frequency data which CREA possesses.
Medical practitioners, policymakers, voluntary welfare organisations and other research centres took time off their busy schedule and we had a full-house in the Boardroom. When everyone had settled in, Professor Bryce Hool - Director of CREA and Dean of SMU’s School of Economics - thanked everyone for their attendance and explained why the Centre was embarking on these outreach activities. CREA has evolved to a stage where we want to broaden our research questions to address the complexities of a fast-ageing Singapore population.
To ensure that everyone had a clear understanding of the data collection process at CREA and the significance of the Singapore Life Panel® (SLP), Associate Director, Ms Jiaming Ju, gave a brief presentation.
Research Fellow Terence Cheng kicked off our first session on the topic of healthcare spending, revealing that 4.4% of an average household’s total expenditure goes towards healthcare. Four per cent of respondents have had catastrophic spending (defined as more than 25% of non-food spending dedicated to healthcare) in the past year.
Over 19 months of the SLP, 1 in 4 of our respondents experienced a health shock – defined as acquiring a new chronic condition such as heart disease, cancer or a stroke. Data from the SLP showed that health expenditure increases immediately after the health shock, only returning to normal around five months later. Cancer has the largest impact, increasing health costs by around $1,300 in each of the first two months after diagnosis.
Besides costing money, new chronic conditions also reduce our respondents’ ability to work, and reduces their income. Strokes and psychiatric problems cause the largest reduction in work.
SLP data also indicates that when men suffer a health shock, their wives end up working longer hours to supplement lost household income. However, we only saw this effect for women who were already employed; unemployed or retired women were not observed to go back to work after their husbands fell ill. This suggests that households can better prepare themselves for health shocks by keeping both spouses employed as long as possible (even if only part-time). Spouses must also provide caregiving for their sick spouses or pay for professional care – and we see a corresponding rise in housekeeping costs after a health shock.
One in three respondents visit the doctor in any given month. Professor Rhema Vaithianathan, CREA’s Co-Principal Investigator and SLP Director, showed that the presence of existing chronic conditions is a far more significant driver of doctor visits than age alone. For example, a 70 year-old with no chronic conditions visits the doctor less often than a 50 year-old with one or more. Cancer is a big driver of primary care utilisation and hospital spending.
Our survey also looked at whether our respondents find it easy to use the healthcare system. Those who find it difficult to navigate the health system report worse health in general, and recover more slowly after a health scare. This could suggest that improving Singaporeans’ health literacy could result in better outcomes for them.
With Singapore popularly known as a food paradise, the SLP also asked our respondents how often they ate at hawker centres and Western style fast food restaurants. We found that 1 in 2 respondents eat at a hawker centre a least once a week, compared to 1 in 4 for fast food restaurants.
Controlling for socio-economic differences, women are half as likely as men to have visited a hawker centre in the last week. Similarly, those who live alone are 50% more likely to have eaten at a hawker centre than those with someone at home. Married female respondents who worked were 1.7 times more likely to than those who didn’t. People with more formal education are more likely to eat at fast food restaurants than those with less. This data suggests that as women become more educated and work later in life, we are likely to see an increase in the patronage of women at hawker centres and fast food restaurants.
A notable suggestion that surfaced from the Roundtable was for CREA to determine the factors that help respondents age well and thus reduce their healthcare spending. It was suggested that there are many unexplored economic opportunities which can flow from healthy ageing.
Please find the programme here.
The event was covered by several news media outlets, see the following:
AsianScientist: The Economics of Ageing Well
Channel U, News Tonight : Watch Video
Channel 8, News Tonight: Watch Video
Singapore Tonight : Watch Video