Saturday 20 December 2014

Heart attack, suicide among top killers here

By Salma Khalik, Senior Health Correspondent, The Straits Times, 19 Dec 2014

SUICIDE and heart attack were the top causes of deaths among 15- to 49-year-olds here last year, accounting for 337 lives, while the top killer for those aged 70 and older was pneumonia.

These figures, which did not go into greater detail, come from a global study published in The Lancet medical journal yesterday comparing causes of death and burden of disease in 188 countries between 1990 and last year.

In that period, global life expectancy went up from 65.3 years to 71.5 years - though people in Singapore fared far better with women living an average of 84 years and men 79.7 years.

The study was funded by the Bill and Melinda Gates Foundation, with hundreds of collaborators from around the world led by Professor Christopher Murray of the University of Washington.

Prof Murray said collective action against potentially deadly infectious diseases such as diarrhoea, measles, tuberculosis, HIV and malaria has had a huge impact in reducing deaths.

But he added that some major chronic diseases have been neglected and are becoming increasing threats to life, particularly drug disorders, liver cirrhosis, diabetes and kidney disease.

In Singapore, deaths from chronic kidney disease and pancreatic cancer tripled between 1990 and last year. Pneumonia deaths also increased by 56 per cent.

Associate Professor Reshma Merchant, who heads general medicine at National University Hospital, said pneumonia in the elderly is often due to dementia or frailty that causes difficulty in swallowing. She said: "Swallowing problems can have devastating health implications, including dehydration, malnutrition and pneumonia which affects quality of life and increases caregiver burden."

Deaths from congenital problems and asthma fell by 70 per cent and 39 per cent respectively.

The study noted gender differences with far more men in Singapore dying from lung cancer and women from stroke. Last year, 953 men and 550 women died of lung cancer; and 1,449 women and 1,044 men from stroke.

Dr Ross Soo, a senior cancer consultant at the National University Cancer Institute, said many studies show women with lung cancer do better than men - regardless of whether they have radiation or chemotherapy. He added: "The reasons for the gender differences are very complex and are not well understood."

At a global level, standardised for age, deaths from some cancers have fallen since 1990: lung by 9 per cent, breast by 18 per cent and leukaemia by 20 per cent. Deaths from heart disease and strokes have fallen by over 20 per cent.





Malays most unhealthy group
Latest statistics show high incidence of kidney failure, stroke and heart attacks
By Salma Khalik, Senior Health Correspondent, The Sunday Times, 21 Dec 2014

The Malay population is the unhealthiest in Singapore.

Latest statistics from the national disease registry reveal that a disproportionate number of diabetics and patients with kidney failure, heart attacks and strokes come from this group.

Although Malays account for 13.5 per cent of the population, they make up 24.4 per cent of people on dialysis. Once diagnosed with end-stage renal disease, patients need either a transplant or dialysis for the rest of their lives.

The proportion of Malays who have had kidney transplants rose from 8.5 per cent in 2003 to 10.1 per cent last year.

Malays - both men and woman - are also at significantly higher risk of suffering a stroke than people of other races. Malay men are 1.5 times more likely to suffer one compared to Chinese men for instance.

Age-standardised stroke rates for every 100,000 men last year was 296 for Malays, 199 for Indians and 184 for Chinese. For women, it was 195 for Malays, 131 for Indians and 105 for Chinese. Age-standardisation removes the influence of age distribution in each group and allows for a fair comparison.

Malays are also more likely to suffer heart attacks. Since 2010, they have surged past Indians as the ethnic group with the highest rate of heart attacks.

The report said: "The higher incidence of acute myocardial infarction among Malays is likely to be due to their higher proportions of hypertension and high cholesterol compared to the other ethnic groups."

It added that most Malays are unaware of their conditions compared to people of other races.

The only major illness which the Malay population is not the most likely to get is cancer. This is most prominent among the Chinese.

Former storekeeper Mohamad Raihan Yaakub, 68, suffers from diabetes, hypertension and high cholesterol. He rarely exercises but has cut down from one pack of cigarettes a day to one every three days.

The unemployed man started dialysis four years ago and lost his older brother to kidney failure.

He had a blocked artery and had a stent inserted more than a decade ago. His children have no major health problems, but his son has taken up smoking too.

"I tell him not to smoke, but he doesn't listen," he said.

In Singapore, smokers make up almost a quarter of heart attack and stroke sufferers.

Mr Sukandar Kastam, 49, was diagnosed with diabetes when he was only 25 years old. He has been on dialysis for the past six years.

He used to weigh 120kg but has since lost 50kg. He too is unemployed and says he has been turned down time and again for jobs because of his need for dialysis three times a week.

He admits that he does not exercise "because lazy lah". Although he lives fairly near the National Kidney Foundation's dialysis centre in Kim Keat Road, he would ride his motorbike there rather than walk.

Speaker of Parliament Halimah Yacob said community groups and mosques have been organising health-related activities for the Malay community, but a more concerted effort is needed.

"A lot of the pushing will have to be done at the community level and we should partner health-care providers like the hospitals and polyclinics for this effort," she said.

"Also, we should catch them young when habits are not yet formed on eating, exercising and prevention. Taking care of our health is our own responsibility."


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