PETALING JAYA: We may be living longer, but we are also spending more of these years in ill health.
According to the Global Burden of Disease Study 2019, the average lifespan of a Malaysian is 75 years, but our average healthspan is only 65.7 years.
“Healthspan is the number of years spent in good health,” explained Malaysian Healthy Ageing Society president and Universiti Malaya consultant geriatrician Prof Dr Shahrul Bahyah Kamaruzzaman.
“This is very much different to lifespan – which is longevity in not so many words – that, for some, may mean an extended period of frailty, both mentally and physically.”
Universiti Malaysia consultant geriatrician Prof Dr Shahrul Bahyah Kamaruzzaman
On average, this period of living with sickness comes to about 9.4 years for Malaysians.
In comparison, it is 13.5 years in the United States (the highest among 27 countries), 10.4 years in Singapore (the highest among the Asean countries in the list), and 8.7 years in Vietnam and Pakistan (the lowest among 27 countries).
Data from the study indicates that the gap between lifespan and healthspan is increasing worldwide.The average global increase is 15%, from a gap of 8.5 years in 1990 to 9.8 years in 2019.
In Malaysia, the gap went up by 4.3%.
South Korea topped the list with an increase of 21.1%, while Singapore went up by 16.5% – the most among the Asean countries in the list.
The Philippines had the least increase at 0.9%.
As to why this is happening, Prof Shahrul said: “There are many factors involved, but it does really go back to your behaviours, as well as the opportunities you have before you to obtain good health.”
Such opportunities, she explained, include available physical infrastructure, education or awareness, and national policies, among others.
Universiti Kebangsaan Malaysia (UKM) Centre for Healthy Ageing and Wellness professor in nutrition and dietetics Dr Suzana Shahar pointed out that advances in medical technology has enabled us to increase our lifespan.
“But it has not tallied with our efforts to keep ourselves healthy, or attention given to prevention (of diseases),” said the UKM Faculty of Medical Sciences dean.
Among the examples she gave as influencing the increasing gap between lifespan and healthspan were the decreasing rate of breastfeeding in Malaysia; the culture of eating out or ordering food delivery where you have no control over the ingredients in your food; couch potato syndrome; and the high rate of obesity and overweight among Malaysians, which is a risk factor in itself for several chronic diseases.
In order to increase our healthspan, Prof Shahrul said that we must “take the road less travelled, which is the road to healthy ageing”.
“If you think of it as healthy ageing, it is thinking of it as the kind of old age where you are enjoying your life to the last minute.
“And hopefully your lifespan is extended, but more importantly, your healthspan is.
“So it’s not just thinking about how long you live, but the quality of that life and health that we need to focus on,” she said.
Her concept for doing this is minimise, mingle and move.
This means that we need to minimise our risk of disease through our behaviours and policies; enhance our social connections via mingling; and keep moving in order to maintain our physical functions.
Prof Suzana agreed that it is a combination of individual responsibility and the right policies to enable a healthy lifestyle “from womb to tomb”.
Some examples of policies she gave include incentivising food manufacturers to reformulate their products so that they are healthier, and incorporating how to live a healthy lifestyle into the school curriculum like in Australia and Japan.
Most importantly, Prof Shahrul emphasised that it’s never too late to start.
“There was one study that followed older men over a couple of years, and found that those who were sedentary, but who became more active over a period of time, saw a just over 40% reduction in early death, compared to those who remained physically inactive.
“And what we put in our mouths… there is an abundance of studies that show the relationship between healthy eating – fruit and vegetable intake – and (reduction in) heart disease, cancer, early death.
“It’s really things that are quite obvious,” she said.