Women lose out to men in extra healthy years

Women lose out to men in extra healthy years
According to the Global Burden of Disease 2015 report, women spend the last nine years of their lives in ill health. The Women's Health Committee is focusing on three big culprits: osteoporosis, diabetes and cancer.
PHOTO: The Straits Times

Women here are living longer but lagging behind men when it comes to adding extra healthy years to their lives.

In the decade between 2003 and 2013, men added 5.5 healthy years to their lives. Women, on the other hand, are living only 4.9 healthy years more.

According to the Global Burden of Disease 2015 published in The Lancet last year, women spend the last nine years of their lives in ill health, and men 7.5 years.

Some of the factors that create the years of ill health towards the end of life can be prevented, said Dr Amy Khor, Senior Minister of State for Health. In an interview with The Straits Times, she said it is good that Singaporeans are living longer, but not if those added years are lived in pain and suffering.

In 2015, life expectancy for women here was 84.9 years and for men, 80.4 years, making people here among the longest-living in the world. But women spend 10.7 per cent of their lives in ill health, and men 9.4 per cent. In fact, men here top the world in terms of the number of healthy years they live, according to The Lancet report.

Dr Khor said: "It is really important to tell women, 'Yes, you have got longer lives, but we want you to change your lifestyle to increase your years in good health'."

She chairs the Women's Health Committee, set up in 2012 to focus on problems faced by women to help them reduce the burden of ill health. Under its current three- year road map, which started in 2015, the committee is focusing on three big culprits: osteoporosis, diabetes and cancer.

Osteoporosis, a disease in which bones become so brittle that they break easily, is a major cause of poor quality of life for some women, said Dr Khor. Women experience a rapid loss of bone mass in the years following menopause, unless they work at retaining bone density.

She said: "I see women in their 50s in the community with knee guards, complaining about pain. It (osteoporosis) is part of ageing, but we can delay it."

For diabetes, the focus of the committee is on gestational diabetes mellitus (GDM) - which affects one in five pregnant women here - since it puts both the mother and baby at risk of diabetes in future.

The committee wants such pregnant women to control the GDM and change their lifestyle after giving birth to prevent the diabetes from recurring. For women with obesity, a major risk factor for diabetes, it is getting them to eat better and exercise more.

With cancer, the aim is to encourage women to have screening for breast, cervical and colorectal cancers, which are preventable or very treatable. The committee is working with the Breast Cancer Foundation (BCF) to provide funding for lower-income women to get mammograms. BCF agreed to fund screening of 40,000 women over five years from end-2014.

Dr Khor said getting women to be healthier has spillover effects, because they have influence over three generations - their parents, spouses and children.

Preventing bone loss key to reducing fracture risk

Women face more than double the risk of getting fractures compared with men, largely due to osteoporosis, or major loss of bone mass.

It is one reason they spend 10.7 per cent of their lives in poor health, compared with 9.4 per cent for men.

The Women's Health Committee headed by Senior Minister of State for Health Amy Khor hopes to change this.

Although half the fractures occur in the spine, doctors use hip fractures - which account for one-sixth of all fractures but are better recorded - as a proxy.

Between 2007 and 2009, 1,477 women and 634 men fractured their hips each year. These fractures often result in long periods of immobility, loss of muscle strength and bed sores.

But the bigger problem for women are fractures to their spine, said Dr Chionh Siok Bee, president of the Osteoporosis Society of Singapore.


In fact, half the fractures women suffer occur in the spine, resulting in backache and hunched backs caused by thinning bones that collapse the vertebrae.

Madam Tan See Moy, 67, who has been on medication for osteoporosis for the past three years, fell when getting off her bed last July and broke two of her vertebrae. She needed three months of rehabilitation. She suffered weeks of pain and now takes calcium and exercises regularly to try to preserve her bone mass.

Women start to lose bone mass from age 35, against 45 for men. They also do so at a faster rate - 0.75 per cent to 1 per cent a year compared with 0.5 per cent a year for men. To make matters worse, bone loss for women accelerates to 2 per cent to 3 per cent a year in the year prior to and the two years following menopause.

Dr Chionh, who is also a senior endocrinologist at the National University Hospital specialising in osteoporosis, said the biggest loss in bone mass during that menopausal period is in the spine.

Women also lose bone mass during pregnancy and breastfeeding. Dr Chionh said: "It didn't matter so much in the past when most women did not live past the age of menopause, but it is quite unfair now."

But the news is not all bleak.

Women, and men too, can prevent bone loss by ensuring they consume at least 1g of calcium, 400 IU of vitamin D, which helps the body absorb calcium, and do 30 minutes of weight-bearing exercise a day.

They should also avoid smoking and take no more than one standard alcoholic drink for women and two for men.


This article was first published on Jan 14, 2017.
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