Singapore's Secret to a Longer, Better Life
A look inside the world’s boldest public health experiment, which contributed to the doubling of centenarians in the past decade — from 700 to 1,500.
Welcome to a newsletter themed at the intersection of longevity and wine history. 🍷
I’ve been tracking my steps and miles I run using a Fitbit for a few years. This started during the pandemic lockdown when I desperately needed physical challenges that didn’t involve taking care of my father, who was battling a chronic disease, and Grandma Kay (my mom’s mom). She was a healthy 99-year-old, but needed supervision to keep her out of mischief.
It blew my mind when I recently learned that the island-nation of Singapore rewards its residents with “Healthpoints" for daily activities like walking or scanning receipts for healthier food choices. These points are tracked on a Fitbit-like app called Healthy 365. The points are then redeemable at health-oriented restaurants.
Grandma Kay’s old-school. She’s never used technology to track her steps, but a daily walking routine has been part of her regimen for as long as I can remember. Many longevity experts say a regular exercise routine is one of several important keys to longevity.
By contrast, my dad used to play tennis and ballroom dance, but was forced to quit in his mid to late 70s, due to health problems stemming from 30+ years of smoking. Despite quitting 30 years ago, the damage was done. He suffered from chronic obstructive pulmonary disease for years. As his health declined, he became more sedentary. He passed away at 86 in 2023. Watching him suffer in his last few years was heartbreaking.
Singapore has a national anti-smoking initiative supporting those wanting to quit. The program breaks down their quit journey into daily, small, actionable steps. It also provides coaching, and rewards participants for staying nicotine-free.
This is all part of Singapore’s preventative health care program that has resulted in the country having one of the best health care systems in the world. And it has the numbers to prove it.
Marina Bay Sands Hotel in Singapore - photo credit: Andrew Maywah
In 2023, Singapore’s life expectancy of 83.0 ranked second in the world, just behind the small European principality of Monaco. By contrast, the life expectancy in the United States that same year was 78.4.
Singapore is about a fourth of the size of Rhode Island with a population of nearly 6 million people. It hasn’t always been the model for longevity. In 1960, the average newborn in Singapore could expect to live only 65 years. Now, one lifetime later, life expectancy has grown by almost 20 years, writes Dan Buettner in his book, The Blue Zone: Secrets for Living Longer (published in 2023). He calls Singapore the “Blue Zone 2.0—the next frontier of aging.”
In 2008, his first Blue Zone book1 came out. His research team defined blue zones as the world’s aging hot spots that have the highest concentration of centenarians. It declared five blue zones. Singapore did not make that list. The five were: Okinawa (Japan), Nicoya (Costa Rica), Loma Linda (California, USA), Ikaria (Greece), Sardinia (Italy).
Singapore is one of six Blue Zones. The other five are: Okinawa (Japan), Nicoya (Costa Rica), Loma Linda (California, USA), Ikaria (Greece), and Sardinia (Italy).
Unlike the original five Blue Zones, Singapore is no isolated region where a traditional culture evolved a lifestyle of longevity over a period of centuries. Instead, it’s a busy crossroads of commerce and cultures whose leaders from the start set out to create an environment of health and well-being.
One key indicator of its health care system working: the country has the lowest rate of cardiovascular mortality. Also, the number of centenarians on the island has more than doubled during the past decade, from 700 to 1,500, as did the number of men and women in their eighties and nineties.
The Transformation
In his latest book, Buettner writes about Khoo Teck Puat Hospital (KTPH) in the town of Yishun, which opened in 2010 to great fanfare. He says it reminds him of a “Four Seasons” and its amenities are not just for the community’s sick. It has an extensive outreach program encouraging the locals to eat at the health-oriented restaurants and take part in its many tai chi and Zumba classes.
The goal was to tackle chronic problems that had been plaguing Singaporeans. They were living longer, but their final years were not especially healthy.
Women on the island tended to suffer through 13 years with a chronic illness such as heart disease, diabetes, or cancer, while for men it was 10 years, Buettner writes. The main causes were poor diets, sedentary lifestyles, and stress. The hospital’s goal was to turn these around with prevention, education, and lifestyle changes.
“Like many other public health agencies, we focused on education at first,” said Shyamala Thilagaratnam, the outreach director. “But that didn’t work as well as [expected]. So we decided to change the environment instead, to make the healthy choice easier.”
4 Singaporean Life Hacks
More than 20 government agencies have collaborated to make healthy living as natural and effortless as possible for everyone. Here are some of the more popular programs:
Eat, Drink, Shop Healthy Challenge
Scan receipts from participating outlets offering healthier options to earn Healthpoints and e-vouchers.WOW (Workplace Outreach Wellness Program). Brings health screenings, fitness sessions, and lifestyle workshops directly to companies, supporting employee well-being at scale.
Healthy Workplace Ecosystem
Brings free health and wellness activities to office spaces. Offers exercise sessions, health talks, and even mental wellness workshops at corporate locations.Healthier Dining Program
Encourages food outlets to offer meals with fewer calories and less sodium. Participating stalls display the “Healthier Choice” logo.If you’re new here—hi, I’m Kevin!
I’m the author of 🍷 Rain on the Monte Bello Ridge,🍷 my forthcoming memoir about health, aging and winemaking. (Read the origin story of the book.) 🍇
The Centenarian Playbook is my newsletter, which features:
Healthy aging/longevity tips and stories from Grandma Kay’s long life.
Wine history & stories of the Gemello Winery
Ancestry & family research tips
Company Helps Seniors Find Purpose, Skills & Connection Online
People in their senior years, let alone past 100, can find life challenging, especially those struggling to adapt to a fast-moving tech-driven society.
That’s a niche entrepreneur Lawrence Kosick felt he knew well, often providing tech support for his father, who was in his nineties, and his stepmom, who was approaching 100.
So in the fall of 2019, he partnered with Neil Dsouza to cofound GetSetUp, an online learning platform to help seniors live a healthier, happier, more connected life. The company aims to meet the growing demand of the aging population, with classes on fitness, mental health, financial literacy, preventive health and commerce.
Three months after launch, the pandemic lockdown forced everyone online. That included those seniors previously reluctant to live their lives online. Suddenly, they had to just to survive. Medical checkups were done through telehealth. They had to learn to bank and order groceries online. These environmental changes made GetSetUp mission-critical and relevant for many almost overnight.
Five years later, the platform has expanded its offerings to include classes across wellness, financial literacy, mental health, and tech. It evolved based on direct community feedback.
“We survey the community and launch new classes once interest reaches 50 people,” Kosick said.
“We survey the community and launch new classes once interest reaches 50 people,” Kosick said.
One of the unique elements is GetSetUp’s peer-to-peer support system. Seniors helping other seniors during Zoom classes.
“One of the smartest things we did was upskill older adults, and have them be the teachers,” Kosick said. “That’s because they would have the patience, cadence, empathy and vocabulary for people like my father.”
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Buettner’s 2008 book is called The Blue Zones: Lessons for Living Longer From the People Who've Lived the Longest.
Another wonderful email. Kevin, you are the best. reading these monthly letters makes me excited
about getting your book. Save me a copy. Phil
I love that their hospital goes beyond acute care and rehab and offers preventative health services as well. I’ve always thought we need a spa like approach to healthcare centers to include wellness centers of prevention with an integrative approach.