Development of Type 2 Diabetes

12 Ms Kuik Shiao-Yin asked the Minister for Health (a) what are the main social determinants that are central to the development and progression of Type 2 diabetes in Singapore; (b) how does the Ministry work with other agencies to measure and mitigate the impact that the social determinants currently play in disease development; and (c) how does the Ministry work with clinicians to customise self-management recommendations to individual patients' needs.

The Senior Minister of State for Health (Dr Lam Pin Min) (for the Minister for Health): Mr Speaker, Sir, social determinants of health refer to non-medical factors that influence health. Examples include educational level, economic status, employment, family background and community support. Social determinants can affect health through their impact on modifiable lifestyle risk factors, early detection and intervention of diseases, accessibility and utilisation of healthcare services, as well as self-care ability.

Studies in other countries have shown that social determinants, such as lower income and educational levels, are associated with a higher prevalence of diabetes. We expect a similar trend in Singapore.

The Ministry of Health works with social Ministries, community organisations and volunteers to reach out to all Singaporeans to promote healthy living. We also ensure that healthy lifestyle and healthcare services are accessible and affordable to all Singaporeans, regardless of their social circumstances. However, we cannot emphasise enough that everyone must make an effort to choose and live a healthy lifestyle.

Recognising that the early years of a child's life are crucial to good health outcomes in his or her later life, the interagency NurtureSG Taskforce engaged community self-help groups and Family Service Centres to come up with recommendations aimed at fostering healthier habits from young. These include providing healthier food options in all schools and Institutes of Higher Learning (IHLs) to support our vision of "Healthy Meals for Every Child" and increasing opportunities for physical activity in preschools, mainstream schools and IHLs, with the aim of making healthy living more accessible for children of all social backgrounds.

We go the extra mile to promote and ensure access to a healthy lifestyle in children and youths, especially vulnerable groups. Students under the Ministry of Education's Financial Assistance Scheme have their fees waived for health check-ups at HPB's Student Health Centre and are issued vouchers for spectacle frames and free lenses should they require visual aids. Through such national efforts, we strive to create a conducive environment for healthy living for all children and youths in Singapore.

Through the efforts of HPB, healthier food choices are available in our schools and community. HPB also partners other Government agencies to organise free exercise sessions at parks, malls and other public spaces. Our public healthcare system and subsidies ensure that all Singaporeans, regardless of background, have access to affordable and quality healthcare services.

In addition, targeted initiatives have been introduced for specific population segments. HPB engages voluntary welfare organisations to improve the quality of food donations to lower-income households. To encourage earlier disease detection and intervention among the lower income, Community Health Assist Scheme card holders enjoy highly subsidised screening services for chronic diseases under the Screen for Life programme.

We recognise that social determinants, such as social isolation and poor health literacy, can affect a person's capacity and motivation to make appropriate lifestyle changes and adhere to treatment. Our healthcare providers engage stakeholders, such as patients, caregivers and community partners, to develop ways to help patients in these areas.