HEALT HYSG TASKFORCE REPORT TABLE OF CONTENTS FOREWORD

CONTENTS FOREWORD

3 Over the years, the Ministry of Health (MOH) and the Health Promotion Board (HPB) have been FOREWORD increasing efforts to encourage to lead healthier lifestyles. However, we recognise that such efforts need to be extended beyond the health sector and involve other parts of government and society. We understand that in a fast-paced society such as , 4 EXECUTIVE SUMMARY health may not always be at the forefront of our minds. As such, we need to make healthy living easy, convenient, and accessible, to encourage Singaporeans to embark on their life-long THE STATE OF HEALTH IN SINGAPORE health journeys. BURDEN OF DISEASE 8 The HealthySG Taskforce was set up to explore ideas that harness the power of our community, 01 infrastructure, and technology, to better nudge Singaporeans towards adopting a healthy lifestyle. MODIFIABLE RISK FACTORS 9 The Taskforce is not just about coming up with a one-off list of recommendations, but it seeks HEALTH TRENDS AND STATISTICS 10 to generate a national movement, a call to action. In order to succeed in transforming the health promotion landscape, we will need the active participation of everyone from all walks of life. SOCIOECONOMIC GRADIENT AND HEALTH INEQUALITIES 13 We hope that this report will raise awareness of the importance of making healthier choices, so that we may not only lead longer lives, but also enjoy a better quality of life. PUBLIC CONSULTATIONS MEMBERS OF THE HEALTHYSG TASKFORCE 02 WHO DID WE CONSULT? 15 WHAT DID WE TALK ABOUT? 16 WHAT DID WE FIND? 17 SUMMARY TABLE OF IDEAS GENERATED 20 ON MENTAL & WORKPLACE HEALTH 22

HEALTHYSG TASKFORCE RECOMMENDATIONS CHAIRMAN THE 3Es – 25 MR BAEY YAM KENG MS LOW YEN LING 03 EMPOWERMENT 26 Senior Parliamentary Senior Parliamentary Secretary for Transport and Secretary for Education ENGAGEMENT 31 Culture, Community and Manpower; & Youth Chairman of Mayors’ ENVIRONMENT 39 Committee and Mayor of South West District, IMPLEMENTATION TIMELINES 46 PA Board CONCLUSION

WORKING WITH SINGAPOREANS, FOR SINGAPORE 49 MR AMRIN AMIN 04 Senior Parliamentary ACKNOWLEDGEMENTS 50 Secretary for Health and Home Affairs

ANNEX A: 51 Terms of Reference

ANNEX B: 52 A/PROF MUHAMMAD MS SUN XUELING FAISHAL IBRAHIM Senior Parliamentary Partner Agencies and Ministries Senior Parliamentary Secretary for Secretary for Social & National Development Family Development and Home Affairs and Education HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG

3 EXECUTIVE SUMMARY EXECUTIVE SUMMARY

Singaporeans are among the For five months between January and May 2019, we actively engaged experts and the public to help identify gaps in the current health promotion landscape and ideate for potential solutions. EXECUTIVE longest living and healthiest More than 300 Singapore residents were consulted via online and face-to-face platforms. Participants included health professionals and experts in fields such as public health, social work, people in the world. health technology, behavioural insights, built environment, sociology, as well as members of the SUMMARY public, both young and old, from different backgrounds. This serves as a testament to the strong foundation that has been laid by the Ministry of Health (MOH), the Health Promotion Board (HPB) and partners over the years AIM OF THE PUBLIC CONSULTATION to encourage Singaporeans to lead healthier lifestyles through efforts such as the Healthy Living Master Plan. Nevertheless, societal changes and technological progress continue to pose challenges, such as sedentary lifestyles and over-consumption of unhealthy foods.

Such lifestyle habits can have a negative impact on our health. Over the last few decades, chronic diseases in our population has increased and now make up more than 80% of the disease burden. The key risk factors affecting the development of chronic diseases in Singapore include poor dietary habits such as our high salt and sugar intake, tobacco use, and sedentary lifestyles. In light of GATHER UNDERSTAND GAPS IN IDEATE AND COME PERCEPTIONS OF THE CURRENT HEALTH UP WITH POTENTIAL these trends, we recognise that there is still more that HEALTH FROM PROMOTION LANDSCAPE, AS SOLUTIONS TO BRIDGE we can do. Moreover, while our overall is PEOPLE OF ALL OBSERVED FROM DIFFERENT OR FILL GAPS AND relatively high, health inequalities exist in our population, WALKS OF LIFE. DEMOGRAPHICS IN THE CHALLENGES. with higher smoking and overweight prevalence among COMMUNITY. Singaporeans from lower income families. There is thus a need for us to move Singaporeans towards healthier lifestyle habits, to prevent or delay the development of While there were diverse views on what health meant to each individual, many faced similar chronic diseases amongst our citizens. challenges in leading a healthy lifestyle. To the participants, staying healthy meant being free of physical illness and mental stress, being physically active, and eating well. Most agreed that health To collectively enhance the quality of life of all should be a top priority. While many felt that leading a healthy lifestyle was mainly a matter Singaporeans, we need to coordinate efforts and of personal motivation and commitment, challenges such as time constraints and competing maximise the use of resources for health in a more demands (i.e. work, caregiving) were key barriers that were difficult to overcome. In fact, synergistic manner. Going further upstream means that participants shared that they wanted to act on their health, and would appreciate more support efforts towards health promotion need to be extended – be it from the government or the community around them – to empower them to do so. beyond the health sector, towards a whole-of-society and whole-of-government collaboration. To overcome these challenges, participants gave ideas that centered around increasing the accessibility and affordability of healthier living options, to make them more convenient. The HealthySG Taskforce, led by Senior Parliamentary This included suggestions to improve the physical and social environment around the individual Secretary (SPS) for Health – Mr Amrin Amin, was hence – such as making healthier dining options even more readily available, and organising physical set up in November 2018, with the vision to transform activity programmes which they could attend together with friends and family, such as making our health promotion landscape with the infusion of healthier dining options even more readily available, and organising physical activity programmes health in various aspects of our lives, policies, and which they could attend together with friends and family, since the community would help to environment. Together with the SPSes from other bolster motivation to take part. Participants also mentioned how technology could help, ministries, the Taskforce explored how best to incorporate by providing them with greater access to services that would allow them lead a healthier lifestyle, health considerations into each ministry’s work. or giving them more information on healthier habits. HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG

4 5 EXECUTIVE SUMMARY CHAPTER 1 - THE STATE OF HEALTH IN SINGAPORE

The feedback gathered from the public consultation gave us valuable insights into the complexity of how people view health and what influence their behaviours, which in turn, affect their health outcomes. Personal motivation is key. However, it is also important to ensure that the surrounding community and environment facilitate healthier lifestyles, given the various challenges the individual faces in everyday life. 01 Arising from this, the Taskforce recommendations centred around three thrusts, namely Empowerment, Engagement, and Environment.

THE 3Es THE STATE OF HEALTH EMPOWERMENT ENGAGEMENT OF MODIFYING OUR OF INDIVIDUALS: OUR COMMUNITY: ENVIRONMENT:

Encourage and equip individuals to Targeted programmes, enhancing Enhance physical and social take charge of their own health service journeys, strengthening aspects of the environment to by lowering access barriers and social-health integration. become more conducive for IN SINGAPORE leveraging technology. healthy living.

We will elaborate on the eleven recommendations under these three thrusts in this final report. Collectively, they aim to promote the health of Singaporeans of all ages and backgrounds. We hope that this HealthySG Taskforce Report will highlight to Singaporeans that healthy living is a journey rather than a destination, where we can spur and support each other. The key to our success is also to partner with Singaporeans and the community, to work together, and ensure effective co-delivery of these initiatives.

Singaporeans are living longer, but not necessarily healthier lives. For a better quality of life, good health in these added years is key, and this starts upstream.

6 7 CHAPTER 1 - THE STATE OF HEALTH IN SINGAPORE CHAPTER 1 - THE STATE OF HEALTH IN SINGAPORE

BURDEN OF Modifiable Disease RISK FACTORS With the improvements in healthcare services and ongoing health promotion efforts, RISKY HEALTH BEHAVIOURS Singaporeans are living longer. Between 1990 and 2017, life expectancy at birth in Singapore rose by 8.7 years, from 76.1 to 84.8 years on average. The health- According to the 2017 Burden of Disease study in adjusted life expectancy (HALE) at birth also rose, increasing by 7.2 years, from Singapore, behavioural and metabolic risks (blood 67.0 to 74.2 years. pressure, glucose etc.) were the leading risk factors for the disease burden. However, while Singaporeans may be living longer, we need to ensure that these added years are quality years of life. Key behavioural risks factors that affect the development of chronic diseases include poor dietary habits and SMOKING LACK OF EXERCISE UNHEALTHY DIETS tobacco use. These risk factors are habits and behaviours that we can change and improve. Hence, it is crucial for us to intervene and improve health promotion efforts, +8.3 years 84.4 so that we can spend as many years of our lives as years possible in good health. LIFE EXPECTANCY 76.1 years (Years of life lost) (Years lost to disability)

+7.2 years 74.2 DIETARY years RISK 67.0 HEALTHYLIFE EXPECTANCY years TOBACCO

HIGH BLOOD PRESSURE 1997 ...... 2017 HIGH FASTING PLASMA GLUCOSE

HIGH BODY-MASS To do this, we need to address risk factors for chronic diseases such as cardiovascular diseases, stroke, INDEX high blood pressure, and diabetes, which now make up more than 80% of the disease burden. Of the 0 20,000 40,000 60,000 80,000 100,000 total burden, 35% was due to modifiable risk factors, which are defined as risky health behaviours such as smoking, lack of exercise, and unhealthy diets. DALYs (Disability- Adjusted Life Years)

1 The HALE at birth is the average number of years a person can expect to live in full health at birth. 2 The burden of disease is measured using Disability-Adjusted Life Years (DALYs). This time-based measure is calculated as the sum of the Years of Life Lost (YLL) due to premature deaths in the population, and the Years Lost due to Disability (YLD) for people living with a health condition or its consequences. REPORT TASKFORCE HEALTHYSG

8 9 CHAPTER 1 - THE STATE OF HEALTH IN SINGAPORE CHAPTER 1 - THE STATE OF HEALTH IN SINGAPORE

Singaporeans are exercising more, however leisure time HEALTH TRENDS physical activity remain low 90.0 82.3 !

81.0 Sufficient Total 80.0 Physical Activity AND 73.9 Leisure Time 70.0 Physical Activity 60.9 60.0 Based on our national health surveys, Singaporeans are 50.0 getting more physically active. In order to better tackle the risk factors that contribute to poorer health This comes mainly from incidental in Singapore, we need to take a closer look at the trends and statistics of 40.0 physical activities, such as our these factors to identify possible gaps. 29.4 daily commute to-and-from work. 30.0 While this is a good trend, such 23.6 23.3 Dietary Patterns and Physical Activity 19.0 physical activities are generally of 20.0 lower intensity, as compared to From the latest National Nutrition Survey (NNS) 2018 conducted by moderate-to vigorous-intensity physical activities, which can HPB, we have seen improvements in both the diet quantity and quality 10.0 provide additional benefits to of Singaporeans’ diets. Singaporeans are consuming fewer calories, one’s health. Leisure time regular with the average daily energy intake dropping five per cent from 0.0 exercise remains low, and the 2,600kcal in 2010 to 2,470kcal in 2018, although this is still higher than 2007 2010 2013 2017 level of physical activity also in 2004. Singaporeans are also consuming more wholegrain, fruits and Year reduces with age. vegetables, as well as substituting saturated fat with unsaturated fat. However, salt and sugar intake remain high3. Tobacco

Our smoking rate has been fluctuating between 12% to 14% Prevalence of daily smoking among in the last ten years, with no clear Singapore residents aged 18-69 years has pattern of continuous decline. been fluctuating over the years. Average daily salt intake of Singaporeans was 9.0g, almost twice the recommended amount of 5.0g as advised by ! ! the World Health Organization. 10% of 90% of Singapore’s population Singapore’s population meet recommended intake exceeded the recommended intake Smoking prevalance (%)

3 WHO recommends reducing daily salt intake to less than 5g, and daily sugar intake to less than 10% of daily energy intake (and further to less than 5% of daily energy for additional Year health benefits). Preliminary NNS 2018 data showed that the average daily salt intake of Singaporeans was 9.0g, and average daily sugar intake was 10% of daily energy intake. HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG

10 11 CHAPTER 1 - THE STATE OF HEALTH IN SINGAPORE CHAPTER 1 - THE STATE OF HEALTH IN SINGAPORE

SOCIOECONOMIC Vaccination GRADIENT and Although chronic diseases make up the bulk of the Overall, while life expectancy and HALE are high disease burden in Singapore, it is notable that certain at the national level, health inequalities exist in our infectious diseases contribute significantly to the population. There is a clear socioeconomic gradient burden as well. Pneumonia, for example, is a serious Adult vaccination rates in health risk behaviours and outcomes, with higher lung disease that is consistently ranked as the smoking and overweight prevalence among people second most common cause of death in Singapore for influenza and from lower income families. Diets tend to be poorer INEQUALITIES in the past five years, second only to cancers. pneumococcus are in this group, with lower protein and higher salt and Two common causes of pneumonia are infection sugar consumption. by influenza virus and pneumococcus bacteria. ! very low compared to compulsory This is consistent with what has been observed in other developed countries such as in the United Vaccination against pneumococcus and influenza Kingdom, Australia and Japan. These findings have also been published in scientific studies and are recommended under the National Adult childhood vaccinations. literature reviews, where it has been established that socioeconomic factors such as education and Immunisation Schedule for personal protection, income levels do affect health statuses. As such, higher mortality and morbidity rates have been to help lower the risk of developing pneumonia and consistently observed groups with lower socioeconomic statuses (SES) in many countries. other complications. However, vaccination rates among adults remain low. In view of the health trends stated above, as well as the health inequalities observed within our population, we need to have more effective strategies to protect the health of all Singaporeans.

CHILDHOOD VACCINATIONS ADULT VACCINATIONS

95% 96% 14% 12%

Living and working condition

Work Unemployment Environment 100%

80% Water and sanitation Education 60%

40% Healthcare Services 20% Agriculture and food production 0% 2 1 3 Housing 4

MEASLES, DIPHTHERIA, INFLUENZA PNEUMOCOCCAL MUMPS AND TETANUS AND 65-74 65-74 RUBELLA PERTUSSIS YEARS OLD YEARS OLD (DOSE 1 AT 2 (COMPLETED YEARS OLD) PRIMARY Dahlgren and Whitehead COURSE AT Dahlgren and Whitehead 2 YEARS OLD) model of health determinants model of healthshow determinantsthe social and economic Source: Communicable Diseases Surveillance Singapore 2017 Source: National Population Health Survey 2016/17 Pilot show the socialcircumstances and economic that determine HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG circumstancesthe health that determine of a population 12 the health of a population 13 CHAPTER 2 - PUBLIC CONSULTATIONS CHAPTER 2 - PUBLIC CONSULTATIONS

WHO Consult?DID WE 02 More than 300 Singapore residents consulted via:

aged between 18 and 60 years old In order to understand and gather public views on the current and future health promotion landscape, PUBLIC the Taskforce consulted with members of the public, • Online Consultation professionals and experts between January and April on REACH 2019. We engaged over 300 Singaporean residents aged between 18 and 60 years old, from different • 4 closed focus group discussions (FGD) ethnicities and socio-economic backgrounds. CONSULTATIONS We heard their views on the existing gaps and • 5 open public group sessions challenges in adopting a healthy lifestyle, and sought ‘YOU SPOKE, WE LISTENED’ ideas on how to address them. Participants Included:

Members of public, both young and old, from 1 different backgrounds

Health professionals and experts in fields such as public health, social work, health technology, 2 behavioural insights, built environment, sociology.

We engaged the public to We reached out to different communities through open better understand the different online recruitment and communities’ motivations, needs, specific avenues such as and challenges in adopting a social service agencies and non-governmental organisations. healthy lifestyle. HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG

14 15 CHAPTER 2 - PUBLIC CONSULTATIONS WHAT DID WE Ta l k ABOUT? Topics Discussed:

In the closed FGDs, professionals in relevant fields, such as technology, infrastructure and the social sector, shared their perspectives on healthy living. Their views helped us to deepen our understanding of the issues, and they offered ideas on how to tackle the Physical Diet and challenges of living healthily in different contexts and Tobacco Activity Nutrition for different segments of the population.

Mental Screening and well-being vaccinations WHAT DID WE find? Public Attitudes Towards Health

Across all public consultation sessions, being healthy was perceived as an essential part of life – a goal Public sessions were then organised to build on the everyone strives to either achieve or maintain. findings from the FGDs, and to gather more views and Healthy living was seen to be beyond physical health, perspectives from diverse participants. Feedback was to include mental health. sought on gaps and challenges to healthy living, and ideas and initiatives to address these gaps. Physical health was perceived as a balance between eating healthy and exercising frequently. It was The online consultation served as an additional avenue widely agreed that this was a difficult goal to achieve, for the public to provide feedback. All the feedback however some participants also recognised that these and ideas contributed to the development of the final are individual lifestyle choices, which they had better recommendations, and helped make them relevant and control over. As for mental health, external triggers useful for addressing the identified gaps. such as work stress, transitional life issues and juggling multiple roles and responsibilities were cited as factors that impact people’s emotional well-being. Some HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG participants expressed that these were societal issues that they had less control over. 16 17 CHAPTER 2 - PUBLIC CONSULTATIONS CHAPTER 2 - PUBLIC CONSULTATIONS

Overall, findings from the public consultation support that health is multi-faceted, and goes beyond the individual, to include socioeconomic and environmental ENVIRONMENTAL “We only exercise when you factors. Individuals hold personal attitudes, values and beliefs on what health means and how to attain health. fall sick, only if you see These factors interact with their social environment, a need to. If I don’t see including their families, friends and communities, and SOCIAL anything wrong now, I won’t finally intersect with larger systems in the society and environment these collectively impact on various do anything. As long as I have health outcomes for the individual. Interestingly, the mind-sets, motivators and influences of health across the different age no illness, it won’t drive me to groups differed widely. The young adults do anything. “ It is thus crucial to adopt the view of the micro and youths tended to be more externally (individual), meso (social influence) and macro motivated, with societal and peer pressure (environment), in understanding health concerns forming the main sources of influence that and challenges of Singaporeans, as well as to look at INDIVIDUAL shape their health behaviours. Also, most ways of improving existing programmes, policies, “healthy behaviours” such as eating well and and initiatives to encourage healthy living in Singapore. exercising were for aesthetic purposes of looking good, rather than for better health.

On the other hand, the older working “Need to set personal goals, adults and elderly were more likely to be intrinsically motivated. There was a because when you have no stronger sense of personal responsibility Ideation goals in mind, you won’t and accountability for their health outcomes. The idea of ageing gracefully In line with this framework, ideas were generated for these go anywhere.” and ageing well was a greater concern, three tiers based on the five broad health topics. Based on and hence actions were generally taken the public feedback received, lack of time for healthier with the idea of self-maintenance in behaviours (e.g. exercise) and perceived lack of accessibility mind. Setting personal goals was seen as and affordability of healthier choices were raised as common important in maintaining one’s health. barriers to participants’ pursuit of good health. Specifically, participants highlighted that competing demands on time, such as work and caregiving responsibilities, often made it hard to exercise during leisure time. Often times, the unhealthy option was also perceived to be more convenient to opt for when looking for a quick meal. Persons from lower income families said that they faced competing demands for their limited time and resources. Their priorities were to Many of the ideas generated were hence centred around increasing the convenience, accessibility and ensure a basic standard of living for their family. “In the heartlands and affordability of healthy options, for food, exercise, and preventive health services. Tending to the family’s needs, such as their coffee shops, you don’t really children’s health and well-being, often took Social support and influence were cited as major factors for many to start getting healthy. Many brought precedence over their own health. Healthy living get healthy options like up instances in which they continued an exercise regime because they had a friend to exercise with. would need to be made inclusive, communal, salads. If you want to make Similarly, participants who smoked shared that the support from their family and friends was key to helping convenient, and affordable in order to engender them quit the habit. long-term behavioural changes. it yourself, it gets quite expensive.” There were also suggestions to further leverage advances in technology to nudge and guide individuals towards healthier options and behaviours, as these would be easy and effortless to incorporate into their daily lives.

These were insightful suggestions, and the Taskforce had taken many of them into consideration in the crafting of its final recommendations. HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG A summary of the key insights gathered is provided in the following summary table on the next page. 18 19 CHAPTER 2 - PUBLIC CONSULTATIONS CHAPTER 2 - PUBLIC CONSULTATIONS SUMMARY TABLE OF ideas GENERATED INDIVIDUAL SOCIAL ENVIRONMENTAL

Physical • Increase affordability • Increase incentives for • Encourage more group • Create a platform • Create separate • Build more parks Activity of gym memberships. participating in existing activities as that would to find people with walking and cycling and green spaces government-run physical be more motivating. similar sporting lanes to encourage that will be nice to activity campaigns (e.g. interests to make active mobility. run and walk in. National Steps Challenge). friends and exercise together.

Diet and Nutrition • Increase the availability • Increase water coolers Have more • Increase affordability • Create recipes and • Consider the of healthier options to encourage drinking educational campaigns of healthier food. cooking demonstration minority or as Singaporeans are water instead of sugar- for health literacy. videos for easy and disadvantaged groups. eating out more. sweetened beverages healthy home-cooked food. or introduce sugar tax.

Mental

well-being • Increase awareness about the • Engage companies and • Educational campaigns avenues that are available for employers to improve to help identify persons • Have more de-stigmatising campaigns mental health assistance. work-life balance. at risk or in need of as mental illness and mental health mental health aid. is still seen as a taboo subject.

• • •

NO Tobacco SMOKING ZONE

• Increase the affordability and • Encourage social and peer support in • Have more no smoking zones. acessibility of smoking cessation tools. quit journeys instead of using scare tactics.

Screening and vaccinations • Educate on the • Reduce the cost • Incentivise employers to give time-offs • Make vaccinations and screening importance of of adult vaccinations. for screening and vaccinations. more easily accessible. early detection. HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG

Represents ideas that were incorporated into the final recommendations 20 21 CHAPTER 2 - PUBLIC CONSULTATIONS CHAPTER 2 - PUBLIC CONSULTATIONS

On & WORKPLACE HEALT H The Taskforce recognised that mental health is an issue of concern across the various demographic groups. The feedback highlighted the gaps that exist in the current system. One main area of concern which participants across the age groups brought up, was the stigmatisation of mental health. They also commented that it would be helpful if more information was provided on how they could help those around them who are suffering from mental health issues.

Each age group faced their own challenges with regards to mental health, given that it is a complex and multi-faceted issue. Among the youths, mental health issues generally revolved around stress and anxiety, particularly in the context of managing school work. With adults, a large part of the discussion was on issues from the workplace and challenges faced by Senior Minister of State for Health, Dr Amy trying to achieve work-life balance. For older adults, Khor and Minister of State for Manpower, Mr Zaqy concerns arose around dementia and ageing. Mohamad, looks into promoting the safety, health and well-being of workers. Apart from physical health, The Taskforce noted that a lot of work has been the Committee also explores how to promote good Summary done for mental health in recent years, such as the Existing efforts are also in place to help address mental well-being amongst the workforce, such as Beyond the Label Campaign which was launched by the concerns raised by the participants. For youths, providing programmes aimed at helping working Overall, the public consultations National Council of Social Service (NCSS) in 2018 to NurtureSG had identified mental well-being as an area adults cope with stress, which can lead to burnout if reflected that current initiatives address the mental health stigma faced by persons of increasing concern for our students. To address not managed properly. living with mental health conditions in our society, and this, MOE and HPB invested in efforts to strengthen introduced by the government the enhanced Community Mental Health Masterplan peer support in schools and institutes of higher learning Lastly, regarding mental health issues faced by the to encourage healthy living have announced in 2017, to support persons with mental (IHLs), by providing resources and training for students. elderly, the Agency for Integrated Care (AIC) has been effective. However, there health conditions. The Tote Board also set aside funding to develop been promoting a dementia-friendly Singapore. remains challenges, and more can upstream programmes to help the young achieve better This includes creating a community where citizens We understand that the key to addressing mental mental well-being and resilience. are aware of dementia and are able to ensure that be done. There were many good health is to enhance mental resilience, and strengthen their neighbourhoods are safe and easy for persons ideas proposed during the public medical and community support. As such, MOH will For working adults, the workplace was regularly identified living with dementia to navigate in. For this, they have consultation process. The discussions be looking into these areas going forward, while also as the main influence on mental wellness, as it was a established Go-To Points within the community, which allowing time for the new government initiatives to primary source of stress for many. Since working adults function as safe spaces for those living with dementia; helped shape the Taskforce’s bear fruit. These efforts require comprehensive and spend most of their time at work, the workplace also and have created a mobile application that provides recommendations, which will be long term attention. As such, the Taskforce has not serves as a key touchpoint for participation in health resources for individuals and care-givers alike. addressed mental health in its recommendations, but programmes. The Tripartite Oversight Committee elaborated in the following chapter. the feedback will be relayed to the relevant agencies. for Workplace Safety and Health, which is co-chaired Given the existence of good work to promote physical and mental health at workplaces, the Taskforce has

also focused its attention on the other areas. REPORT TASKFORCE HEALTHYSG

22 23 CHAPTER 3 - HEALTHYSG TASKFORCE RECOMMENDATIONS CHAPTER 3 - HEALTHYSG TASKFORCE RECOMMENDATIONS

Following the feedback gathered from the public THE consultation sessions, the Taskforce adopted the 3 S same three-tiered individual-social-environment framework and developed eleven recommendations 03 E along three thrusts – the 3Es: Empowerment Engagement Modifying our of individuals of our community Environment Encourage and equip individuals Targeted programmes, Enhance physical and social to take charge of their own health enhancing service journeys, aspects of the environment to by lowering access barriers and strengthening social-health become more conducive for HEALTHYSG leveraging technology. integration. healthy living. TASKFORCE Adult Vaccination HealthySG Programme Health promoting RECOMMENDATIONS Subsidies for disadvantaged groups Infrastructure

Smoking cessation Active Living programme for support working adults and seniors

Healthy Precinct Toolkit

e-Coaching & wearables One-stop service platforms To transform our health promotion landscape with the Healthy food infusion of health in various ecosystem aspects of our lives, policies,

and environment. Lifelong Virtual Enhanced community Health Booklet outreach and volunteerism REPORT TASKFORCE HEALTHYSG

24 25 CHAPTER 3 - HEALTHYSG TASKFORCE RECOMMENDATIONS CHAPTER 3 - HEALTHYSG TASKFORCE RECOMMENDATIONS

RECOMMENDATION

OneIncrease the affordability and accessibility1 of vaccinations BACKGROUND recommended under the Vaccination is an important National Adult Immunisation public health intervention.While Schedule (NAIS). NAIS vaccinations are generally • MOH will subsidise vaccinations recommended recommended for personal under the NAIS for Singaporeans and Permanent Residents. The subsidies will be available at all protection, they are currently not Community Health Assist Scheme (CHAS) General subsidised. This could be a reason Practitioner (GP) clinics and polyclinics for for their low take-up rates. Singaporeans, and at all polyclinics for Permanent EMPOWERMENT Residents, to be rolled out before end 2020. High coverage rates of recommended vaccinations can • With increased affordability and accessibility, we expect more adult Singaporeans to take up OF INDIVIDUALS lower both individual and societal vaccinations, and target a more than three-fold disease burden, and can lead to increase in coverage to over 50% in five years’ time. better overall health outcomes for • In the long run, we aim to protect more the country. Singaporeans from vaccine- preventable diseases. At the system-level, this will also enable us to reduce the healthcare costs due to these diseases.

NAIS VACCINATION 18-26 years 27-64 years ≥ 65 years

INFLUENZA dose annually dose annually

PNEUMOCOCCAL* or doses dose each The Taskforce recommends addressing the barriers that prevent Singaporeans from HUMAN PAPILLOMAVIRUS doses taking greater personal responsibility for their TETANUS, DIPHTHERIA AND PERTUSSIS dose for each pregnancy

health. We want to encourage individuals to MEASLES, MUMPS AND RUBELLA doses take charge of their own health by increasing the affordability of effective interventions, HEPATITIS B doses improving accessibility to services, and VARICELLA (CHICKENPOX) doses leveraging technology. * Pneumococcal vaccines in the NAIS Recommended for adults Recommended for Recommended for REPORT TASKFORCE HEALTHYSG include PCV13 and PPSV23 who have not been previously adults with specific adults who meet vaccinated or lack evidence of medical conditions age requirement 26 past infection/immunity or indications 27 CHAPTER 3 - HEALTHYSG TASKFORCE RECOMMENDATIONS

RECOMMENDATION Tw o2 Make smoking cessation support BACKGROUND more affordable, accessible, and comprehensive. Of the estimated 350,000 daily

smokers in 2017, 1 in 6 thought • MOH, together with HPB, will work with public about quitting in the next 12 healthcare institutions (PHIs) namely hospitals, months. However, only 3 in 100 national specialty centres (NSCs) and polyclinics, to better identify and refer smokers who smokers actually attempted to quit. wish to quit smoking, to structured smoking Furthermore, 1 in 7 ever smokers cessation programmes in our healthcare and had quit completely in their lifetime. community settings. While there may be a variety of • As there may be different care models within and across settings that can achieve good quit reasons why smokers may not be rates, MOH will provide funding for public sector To support more smokers to quit successfully, willing or unable to take the first • healthcare clusters to test out their proposed MOH will subsidise the cost of treatment for step, we need to do more to care models in selected PHIs to determine the eligible smokers enrolled in the PHIs’ cessation The pilot is planned nudge smokers to move from most effective model of care. programmes during the testing care model to run between March 2020 and March 2022. period. The treatment can include behavioural pre-contemplation to taking actions, support and NRT such as nicotine patches, gums,

and to improve the effectiveness • Target groups will include: and lozenges to reduce the withdrawal symptoms. - Inpatients who are smokers (public hospitals); of programmes in helping smokers - will support smokers to quit successfully. This would - Expecting mothers and their spouses who Certified quit consultants are smokers (public Obstetrics & during their quit journey, through intensive allow us to reduce the smoking Gynaecology settings); and counselling session(s) and follow-ups for up to a year. The quit consultant will help to assess prevalence rate, which has remained - Outpatients who are smokers (e.g. polyclinics the smoker’s nicotine dependence and motivation and NSCs) largely unchanged over the past to quit, and provide advice to assist in quitting few years. • While smokers can quit unassisted, behavioural and reducing the chances of relapse. support and nicotine replacement therapy (NRT) have proven to be effective in increasing - For smokers who have been assessed to be the success of quitting in those who are suitable for NRT use, he/she will have access to nicotine dependent. fully subsidised NRT during the recommended period. The programmes are expected to reach at least 10,000 smokers in the next two years.

QuitLine 1800 438 2000 QUIT 4 Only smokers who are contemplating to quit smoking, enrolled in a cessation programme in the participating public healthcare institutions, and have been assessed by a GUM healthcare professional as being suitable for NRT usage will be able to have access to fully subsidised NRTs during the recommended period.

5 8 – 12 weeks of NRT is recommended for most tobacco users undergoing a tobacco quit attempt. Source: Health Promotion Board-Ministry of Health Clinical Practice REPORT TASKFORCE HEALTHYSG Guidelines 1/2013: Treating Tobacco Use and Dependence

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RECOMMENDATION Three3 Provide e-health coaching via BACKGROUND wearables and personalised Over the years, much has been technology.

done to encourage individuals to • HPB is partnering with industry innovators to nudge lead healthier lifestyles. Technology Singaporeans towards better habits in physical affords us a way to go even activity, sleep, nutrition and emotional well-being. ENGAGEMENT further, to empower the individual MIND EXERCISE DIET to take greater ownership of their health, and support them via timely OF OUR COMMUNITY reminders, nudges, and feedback. In our public consultation sessions, participants expressed an interest in HEART RATE SLEEP technology-enabled solutions, given the proliferation of mobile phones zzz and the public acceptance of wearables. E-health coaching could be a way to reach our citizens • Individual biometric data such as sleep quality, at scale, with the eventual goal heart rate and stress levels, can be collected via a wearable device, so personalised nudges can of more personalised messaging, be provided to better encourage users to work relevant to the individual. towards their health goals.

- One such initiative is FitBit’s Live Healthy SG that harnesses technology, behaviour insights To better engage Singaporeans on and analytics to help Singaporeans get healthier Healthy 365 App through behaviour change their health, the Taskforce recommends enhancing the citizen’s experience of - Participants can link their wearables to health challenges on HPB’s Healthy 365 application available services, which requires agencies in order to enjoy its incentives and rewards. to be more integrated and targeted in - With algorithms that could better tailor health their programming. advice, messages and programmes to each individual in a timely manner, Singaporeans There is also a need to customise health can take greater ownership of their own health and get healthier through meaningful promotion for disadvantaged segments, to and sustained behaviour change. make it easy and convenient for them to - Programme was officially rolled out in end adopt and maintain healthy living. REPORT TASKFORCE HEALTHYSG October 2019.

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RECOMMENDATION RECOMMENDATION Four4 Five5

Track personal health status BACKGROUND via Lifelong Virtual Health Every Singaporean child currently Booklet (vHB). has a hardcopy Child Health Booklet • HPB will develop a Lifelong vHB for Singaporeans that parents use to track and keep to use as a comprehensive, reliable and relevant health records, such as personalised health repository to monitor and immunisation history, growth charts, take charge of their health across their life course. and developmental progress. • We hope to launch a Minimum Viable Product of This allows parents or caregivers the vHB by end 2020 to easily monitor the child’s health status and preventive health needs. Members of the Taskforce visited Kok Fah Technology Farm with families and were treated to a cooking demonstration and We want to extend the benefits of educational farm tour to promote healthier eating. the Child Health Booklet to adults, such that they would have an easy Targeted help for BACKGROUND and convenient way of referring to disadvantaged their health records. This empowers There is evidence to suggest that there are health groups to improve the individual to better understand inequalities in our population. In general, people their health. their health status, nudging them to from lower income background have a higher • The Taskforce recommends adopt healthier lifestyle behaviours. prevalence of smoking and overweight/obesity, to provide a more targeted and exercise less. programme delivery, with activties and incentives In terms of nutrition, people from low income that are customised to the households consume higher proportion of refined needs and circumstances of carbohydrates and lesser protein. These health the disadvantaged groups. behaviours contribute in part to their poorer • We will focus on improving health outcomes. Given the unique challenges nutrition for a start, before expanding to other that this population segment may face, a targeted areas such as health programme, designed around their lifestyles, screening, physical activity, has the potential to have a better impact on their and mental well-being. health status. HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG

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RECOMMENDATION

6Targeted active living programmes BACKGROUND for working adults & seniors.

From the public consultation • Two pilot projects will be jointly introduced by feedback, we have identified the SportSG and HPB to improve physical activity need for targeted physical activity levels amongst the working adults and seniors. programmes for working adults and 1) The Working Adults Project will target at-risk seniors. The former is an age group Professional, Managers, Executives and Technicians, by offering them an integrated package comprising that has to balance their careers HPB’s workplace programme and a 12-week and family, and hence finds it hard Active Health programme, to increase the adoption to maintain healthy habits. For the of healthy habits and a more active lifestyle. seniors, with rising life expectancy, - We will offer Active Health’s physical activity readiness assessments as part of an integrated we need to help them age well. package to companies which are participating in • This will be manifested as a ‘healthy living By tapping on their respective HPB-run workplace activities. passport’ programme for lower income families, domain expertise, SportSG and - The aim is to help individuals understand their with incentives/rewards given upon completion health and fitness baseline through a of healthy living activities such as HPB can develop integrated and comprehensive assessment protocol developed holistic programmes for these two by Active Health for adults. - Guided healthier eating trails, supermarket identified population two groups. - A pilot involving three companies (Sushi Express, tours, cooking classes and nutrition Chinese Swimming Club, and Raydent Supplies workshops. started in October 2019.

- Subsequently, other components such as health screening and mental wellness can be weaved in for holistic engagement.

- The healthy living activities will be tailored to meet their needs and circumstances, such as literacy levels, working hours, and access. • We will also actively identify social service It will also aim to address affordability via agencies and community volunteer groups tailored messaging and education. who serve the lower income families to weave in the healthy living components to the services • Trained HPB Health Ambassadors will also they already provide. This would ensure that partner with and engage the families, to provide health is included on their agenda, and in their support on their journey. conversations with these families.

• We will explore multiple channels to reach • We aim to reach at least 15,000 residents after out to this community, among which existing launch of the full programme in Q2 2020. networks and platforms under the Ministry of On-site assessments to help Social and Family Development (MSF) and individuals understand their health People’s Association (PA) would be key. and fitness baselines and obtain

tips on how to manage and/or REPORT TASKFORCE HEALTHYSG improve their health.

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RECOMMENDATION Seven7 One-stop Service Platforms. BACKGROUND • To better synergise government services and There are numerous services and resources to make it more convenient for the facilities for health and wellness public, three one-stop service platforms are recommended. which are available to the public. Examples include government 1) The Ministry of Culture, Community and Youth (MCCY) and SportSG will embark on an initiative facilities booking, rewards systems to make the search for available spaces more and programmes calendaring. convenient, and enhance citizens’ experience in Common one-stop service platforms booking facilities. should be built to help Singaporeans • The initiative will provide citizens with seamless enjoy better access to these public access to sports and community facilities, to make it easier for citizens to participate in 2) The Integrated Seniors’ Pilot aims to improve resources by creating a more sports and community activities. and maintain functional mobility among seniors seamless and convenient experience. aged 50 years and above. Seniors will attend • We will roll it out by Q3 2020. a 6-week programme by HPB to learn about falls prevention, importance of strength, balance 2) SportSG and HPB are running the Incentives and flexibility exercises and be equipped with Exchange Project which will allow Singaporeans to strategies to minimise the risk of injuries, in the redeem their reward points across the platforms. event of a fall. • Singaporeans may convert their HPB Healthpoints Upon completion of the 6-week programme, to ActiveSG Credits. seniors will be encouraged to attend an extended programme by SportSG, which will reinforce the • This will incentivise greater participation and importance of strength, balance and flexibility enable cross-promotion of health promotion through regular and progressive exercises. activities by both agencies. In addition, seniors will also be introduced to a wide variety of exercise programmes and sports interest • It is expected to commence in Q2 2020. groups as a way to seed strong social bonds

among the seniors and sustain active living through 3) SportSG and HPB will also jointly roll out a calendar of physical activity programmes. sports and exercise, at the same time, maintaining - We will roll the pilot out in selected ActiveSG functional fitness. and PA venues, including community • The joint calendar will offer and allow citizens centres of pre-selected group representation - This pilot will raise awareness of strength, to view programmes offered by participating constituencies (GRCs) and such as Hong Kah balance and flexibility (SBF) exercises which aids agencies to suit their needs, ages, abilities Community Centre and Bukit Gombak Sport in fall prevention. and interests. Centre, by Q4 2019. - It would also serve to help maintain and improve • We will roll it out by Q3 2020. - These two pilots will functional fitness through both SBF exercises support healthy habits in in transition, and and regular participation in sports. working adults help seniors maintain strength and prevent falls. HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG

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RECOMMENDATION

Enhance community activation via quality8 volunteer engagements.

BACKGROUND Volunteers are key to community outreach efforts. Community bonding and building health conversations are MODIFYING OUR mutually reinforcing. To this end, HPB will enhance its engagement, training and ENVIRONMENT deployment plan for its volunteers, the Health Ambassadors, to maximise this potential.

• We aim to enhance the outreach of health volunteers • Pilot the integration of HPB Health Ambassador by shifting from quantity to quality, from an network with public hospital volunteers: ad-hoc touch-and-go, to a longer-term relationship building between volunteers and residents. - Cross-train and deploy volunteers to optimise volunteer pool. • Volunteers will receive enhanced volunteer training by HPB to include health skills (for example, skills - Expand range of volunteers’ skills to better in conducting an exercise class for seniors) and meet beneficiaries’ needs. soft-skills (for example, in the areas of - Target to implement the integrated volunteer Our environment encompasses communication and befriending). programmes across the public hospitals by both physical (e.g. facilities and • HPB will pilot the integration of HPB Health Q1 2020. Ambassador network with public hospital volunteers, - Early pilots include assisting with Horticultural infrastructure) and social (e.g. availability which includes the following: Therapy Sessions for rehab patients in Yishun of food options and social programming) Community Hospital, promoting post-screening health coaching services with SingHealth aspects, and the Taskforce recommends under their Eastern Community Health Outreach programme, and participating in the National making both domains more conducive to University Hospital System’s Health Peers training. healthy living and influencing individual - On-board other agencies’ volunteer networks

choices to that end. REPORT TASKFORCE HEALTHYSG in the future via SG Cares.

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RECOMMENDATION

Continuous enhancements to the Built Environment to support healthy living.

• To further support healthy living among residents, HDB will continue enhancing the planning and design Nine9 of both existing and new estates.

BACKGROUND In developing Housing & Development Board (HDB) towns, HDB continues to plan, design and programme spaces to promote healthy living by encouraging physical activity. Where possible, such spaces are also introduced to older estates through upgrading and rejuvenation programmes. Beyond HDB towns, NParks has also put in place more than 350 parks and gardens linked by approximately 300km of park connectors. Our green spaces - Tengah Town will have community spaces close - Where possible, the environment of older are curated to attractmore people to go outdoors and reconnect with nature. to residents’ doorsteps, a car-free town centre estates will also be improved through upgrading for better walkability, and a 5km-long forest and rejuvenation programmes, such as through The Ministry of Transport (MOT) and (LTA) corridor to connect residents with nature. introducing new or improved community have built an extensive network of 200km of covered link-ways to make spaces, amenities, and connectivity infrastructure. walking to the nearest transport hub a more pleasant experience. There is currently also about 440km of cycling paths, including park connectors. To encourage more Singaporeans to participate in active mobility like walking and cycling, MOT/LTA will continue enhancing our physical environment with supporting infrastructure.

Photo by: NParks Photo by: NParks

• NParks will continue enhancing its parks to attract more visitors and to encourage a more active lifestyle.

- Enable both young and old to experience health and well-being effects of nature through more therapeutic gardens and nature playgardens, as well as organise more healthy lifestyle activities with Photo by: LTA HPB and SportsSG. REPORT TASKFORCE HEALTHYSG

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RECOMMENDATION

Te n10Encourage greater community BACKGROUND ownership in shaping environments via the Healthy Precinct Toolkit Presently, health promotion policies (HPT). and programmes are largely government-led. However, a much- • The MOH Office for Healthcare Transformation needed complementary approach (MOHT) has developed a HPT to empower the community and its leadership to take is to facilitate more community ownership of, and shape their social and physical ownership in enhancing their environment based on their needs. lived environment to facilitate • This involves a three-step process: healthy living. (i) engage the community to understand their needs; This is important as the community (ii) collaboratively plan and coordinate solutions • MOT and LTA will work together with agencies to with relevant stakeholders; and triple the distance of our cycling path network by can provide useful insights on the 2030. LTA will also add another 150km of covered issues that matter most to them. (iii) evolve and refine initiatives to support link-ways to the existing 200km to facilitate a Residents may play a part in deciding healthy living. more comfortable walking environment. how best to infuse health in where • As part of the development of the Healthy Precinct - By 2030, eight in ten households will be within a they live, that is best suited to their Toolkit, MOHT established a Co-Creators’ Group ten-minute walk of a train station. in July 2019. The Co-Creators’ Group consists of needs and preferences. volunteers from Jurong Spring grassroots • On 2 November 2019, MOT and LTA rolled out the organizations, VWOs, HPB Health Ambassadors, Active Commute Grant for co-funding of end-of- and SportSG Team Nila. trip facilities such as showers and lockers at workplaces to allow commuters to freshen up at their destinations.

- This will make it easier and more convenient for Singaporeans to walk, run or cycle to work, and stay physically active and healthy. HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG

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RECOMMENDATION Eleven11 BACKGROUND In recognition that Singaporeans are dining out more frequently, HPB introduced the Healthier Dining Programme (HDP) in 2014 to encourage Singaporeans to choose healthier options when eating out. Since December 2016, the HDP was extended to the mass meal settings, specifically hawker centres and coffee shops. Currently, 100% of hawker centres have 50% of stalls offering at least one healthier option under the HDP. HPB continues to work with various partners across the food ecosystem to increase the accessibility and availability of healthier options.

• MOHT held multiple engagement sessions • The DET will be piloted in two precincts, Jurong with the Co-Creators’ Group to design the HPT. Spring and Woodlands, through a Healthy Precinct An initial concept, defined within the HPT, is a Committee, while exploring other potential sites. Digital Engagement Tool (DET). The DET aims to The pilot in Jurong Spring started in Q4 2019. empower community leaders to collect non- • Formation of a Healthy Precinct Committee has sensitive public opinions about their neighbourhood. begun in Jurong Spring, with key community This will provide ground sensing on the precinct’s volunteers taking the lead to scout for and recruit health behaviours and its health-influencing socio- health-enthusiastic members for the Committee environmental determinants allowing the community These founding volunteers have engaged multiple to intervene on their own. The Taskforce recommends a two-prong approach to improve the community groups serving resident seniors, - A trial of the first component of the DET (version families, ethnic minorities and vulnerable segments, food ecosystem with greater availability of healthier options. 0.1), a digital survey, was successfully completed to ignite interest and rally support for their on 27th August 2019, with a closed group of community’s health promotion efforts. Over time, 1) Incorporate health as a consideration in Price-Quality 2) HPB will increase the number of stalls that offer 39 people. In collaboration with an identified group the Committee will be able to use the Healthy tenders for new eating houses tendered out by HDB. at least two healthier options by 400 by 2021. of users within Jurong Spring, MOHT is currently Precinct Toolkit to improve the healthy behaviours working on version 0.2 of the DET. of their community. If successful, the toolkit • A portion of the tender score is dedicated to health • This is expected to increase the availability of can then be rolled out to other Healthy Precinct component, to encourage healthier food offerings healthier options at eating houses and hawker - Version 0.2 includes a refined dictionary for the Committees or similar committees across the nation. or products. centres, reducing the barrier to healthier eating. digital survey component based on feedback from August 2019, and the next immediate DET • 21 tenders have been awarded so far, and HDB will • By reaching the target, it is estimated that an component – an automated report that allows be tendering about 34 more in the next five years. additional 500,000 meals bought by users to filter results by demographics. MOHT consumers per month, or six million per year,

will test version 0.2 in late 2019. would be healthier. REPORT TASKFORCE HEALTHYSG

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IMPLEMENTATION

The slew of recommendations will be rolled Timelines out across the next two years. A summary Implementation of one-stop inter-agency of the timelines for their implementation is Physical Activity and Sport Calendar portal provided below.

Roll out senior centric Minimum viable product physical activity pilot for Lifelong Virtual programme and Working Health Booklet Adults pilot project

Move towards more Integration of HPB Health hawker stalls with at least Ambassador network with 2 healthier choices public hospital volunteers

YOUR CHOICE Launch of HPB Incentives Exchange Extention of subsidy for collaboration with industry Project for Healthpoints NAIS vaccinations for health coaching and ActiveSG credits

Preview of HealthySG Update of pilot smoking Programme for cessation care models disadvantaged families Launch of Healthy Launch of HealthySG Facilities booking portal Precinct Toolkit Pilot in Programme for HEALTHY FOOD FOR one precinct disadvantaged families EVERYONE

Q3 CY 2019 Q4 2019 Q1 2019 Q2 2020 Q3 2020 & beyond

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WORKING WITH SINGAPORE, 04 FOR SINGAPORE We want to see a Singapore where everyone is able to grow up and grow old healthily, where barriers to healthy living are minimised, and the necessary support for health-seeking behaviours can be provided to all.

We understand that the key success factor to transforming the health promotion landscape and instilling healthy habits is to work with every CONCLUSION Singaporean to ensure the effective co-delivery of these initiatives.

The HealthySG recommendations are by no means the end point. Singapore’s healthy journey will continue well into the future, even after all the recommendations are rolled out. Nevertheless, this is a significant first step which must be sustained with the continual support of all Singaporeans.

For better health, better life – a better Singapore.

The key success factor is working with Singaporeans to ensure the effective co-delivery of these initiatives. HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG

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ACKNOWLEDGMENTS ANNEX A:

We would like to extend our warmest thanks to all TERMS OF REFERENCE our partners who have journeyed together with us this past year. We are truly grateful for the time, Undertake a review of the current and evolving effort and commitment displayed by all those involved health promotion landscape in Singapore; in this process.

Engage the community to better understand Special thanks to members of the public who the motivations, needs and challenges for generously shared their thoughts on how we adopting a healthy lifestyle, especially among can improve the health promotion landscape in the vulnerable groups; Singapore. Your feedback has helped shape these recommendations, and we are grateful for the honest Conduct an international scan of health promotion sharing which enabled us to examine how we can strategies adopted globally to glean best practices; better approach issues to come up with more holistic solutions. Develop appropriate inter-agency strategies and approaches to strengthen health promotion efforts across the population segments; and

Formulate an action plan to promote the infusion of health in all aspects of our lives, policies and environment. HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG

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ANNEX B: NOTES

PARTNER AGENCIES ...... AND MINISTRIES ...... • Early Childhood Development Agency (ECDA) ...... • Health Promotion Board (HPB) ...... • Housing Development Board (HDB) ...... • Land Transport Authority (LTA) ...... • Ministry of Culture, Community and Youth (MCCY) ...... • Ministry of Health (MOH) ...... • Ministry of Health Office for Healthcare Transformation (MOHT) ...... • Ministry of National Development (MND) ...... • Ministry of Social and Family Development (MSF) ...... • Ministry of Transport (MOT) ...... • National Parks Board (NParks) ...... • People’s Association (PA) ...... • (SportSG) ...... • Urban Redevelopment Authority (URA) ...... HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG

52 53 CHAPTER 4 - CONCLUSION

NOTES NOTES

...... HEALTHYSG TASKFORCE REPORT TASKFORCE HEALTHYSG

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