Diabetes Prevention in the Community: The Singapore Story

Transcription

1 Outline Diabetes Prevention in the Community: The Singapore Story Dr Shyamala Thilagaratnam Director, Regional & Community Outreach Promotion Board, Singapore Introduction The burden of diabetes Key pillars of diabetes prevention Why the community? Building y Community Ecosystems What next? Regional Symposium on Diabetes Current Science and Multi-Stakeholder e Approaches pr to Prevention & Management 1 4 Oct DIABETES BURDEN AT A GLANCE Key Pillars of Diabetes Prevention 1 in 3 lifetime risk? 1 in 3 diabetics are undiagnosed 1 in 3 known diabetics have poor control a b c Estimated numbers ( 000) ~440K diabetics in 2014 ~670K diabetics in 2030 a ~1MIL diabetics in Year d a 1. HEALTHY EATING 2. PHYSICAL ACTIVITY 3. EARLY DETECTION Trim an average of 100kcal per person per day, while improving nutrient quality per unit calorie consumed Improve the quality of meals eaten out and at home Raise average daily caloric expenditure and help individuals maintain healthy weight Promote incidental physical activity and leisure time exercise Reduce undiagnosed diabetes Encourage early detection to prevent disease progression and onset of complications Source: (a) Saw Swee Hock School of Public, SCs & PRs, aged 18 years and above; (b) MOH administrative data; (c) National Survey (NHS) 2010, SCs & PRs, aged years; poor control defined as Hba1c 8%; (d) Extrapolation based on NHS

2 The community is a powerful setting The community setting to address challenges of ageing population The only setting to reach certain groups, including those at higher risk : Elderly Unemployed & socially isolated It is where families come together, after returning from work or school Singapore s resident population: 3.93 million (as of June 2016) (24%) (19%) 936, ,000 (57%) 2,258,000 Ageing population with more years of chronic diseases Social isolation Less family support There is a need to develop new systems of health and social networks in the community No. of single elderly & empty nesters (aged 65+) increasing [VALUE] k [VALUE] k [VALUE] k More living alone or without children Support Ratio declining : the number of residents aged yrs over the number of elderly resident aged >=65 yrs Fewer younger to support the older residents 5 Source: Department of Statistics, Singapore 6 Building y Community Ecosystems Make y Living Accessible, Natural and Effortless Building y Community Ecosystems 7

3 What does easily accessible mean? Making it easier to get active 88% of residents have a health promoting option within 2km of their homes National Steps Challenge (NSC) Exercise sessions in community & workplaces % of residents with access to health promoting options within 2km Number of participants Number of weekly exercise sessions , % 62% 70% 70% 70% 72% 88% 88% 45% of Singaporeans have access to health promoting options within 1km of their homes 151, , , Q1FY15 Q2FY15 Q3FY15 Q4 FY15 Q1FY16 Q2FY16 Q3FY16 Q4FY16 Actual 9 Proportion of Singapore adult residents who engaged in >150 minutes of total physical activity per week increased from 50.7% in 2013 to 57.4% in % of Singaporeans have access to physical activity options within 1km of their homes Sundays@ThePark Where Singaporeans play, shop Community Physical Activity Programmes Promoting Malls REDUCE CALORIC INTAKE ier Dining Programme Number of F&B touchpoints Making it easier to eat healthily IMPROVE QUALITY ier Choice Symbol (HCS) Regular Grocery ier Products ,000 85% 15% 3, (Mar) 82% 18% 1,600 By % 25% Always on. Anytime. Anywhere 11 There are now more than 3,000 touch points islandwide (restaurants, fast food outlets, food courts and hawker centres) offering healthier options, and over 3,500 HCS products are across 70 food categories. 12

4 Regional Symposium on Diabetes - Current Science and Multi-Stakeholder Approaches to Prevention & Management, October 4-5, 2017, Singapore 52% of Singaporeans have access to healthy eating options within 1km of their homes Every Community a y Community HCE Expansion pa Plan FY18 FY16 FY17 eat and drink. Supermarket tours of HCS products at supermarket chain outlets y dining options at shopping malls and hawker centres 1600/6800* (23%) F&B establishments such as Koufu, Kopitiam, NTUC Foodfare are on-board the ier Dining Programme *restaurants, food outlets, coffee shops SUNRISE RC CHP CPAP HDP SUNRISE RC COURTVIEW RC 160 Screening # of Attendees (not unique) PARKVIEW RC VISTA RC VILLE RC ARCADIA RC VILLE RC ARCADIA RC SPRING RC PALMWALK RC 91 Tampines Central Overview RC location 211 SPRING RC 39 Cooking Demo Screening # of Attendees (not unique) 99 CPAP HDP 272 PARKVIEW RC VISTA RC CHP Ambassadors RC location 272 SHC 181 Ambassadors Cooking Demo SHC Legend STARLIGHT RC GREENVALE RC COURTVIEW RC HCEs closer to the ground Legend STARLIGHT RC GREENVALE RC PALMWALK RC Screening 16

5 GREENVALE RC STARLIGHT RC Legend GREENVALE RC STARLIGHT RC Legend SHC CHP SHC CHP CPAP CPAP COURTVIEW RC 16 SUNRISE RC HDP Cooking Demo Screening Ambassadors RC location COURTVIEW RC 137 SUNRISE RC HDP Cooking Demo Screening Ambassadors RC location VISTA RC PARKVIEW RC # of Attendees (not unique) VISTA RC PARKVIEW RC # of Attendees (not unique) 181 SPRING RC VILLE RC ARCADIA RC SPRING RC VILLE RC ARCADIA RC 39 PALMWALK RC PALMWALK RC 95 Community Post The War Efforts The challenge of early detection 79,000 residents reached through 40 diabetes-related talks & roadshows in FY16 Supported by Community Screening 8 in 10 Singaporeans 40 and older have been for screening in the last 3 years 1 1 in 3 diabetics are unaware of their condition 936, ,000 An issue of follow-up post-screening? No confirmatory test? 2,258,000 Ongoing healthy living programmes in HCEs such as national campaigns, free workouts, healthier catering etc. 1. Behavioural Surveillance Survey

6 Making screening and follow-up easier Enhanced Screen for Life subsidies : Detecting diabetes earlier Diabetes Risk Assessment for year olds (from 1 Sep 2017). Those at-risk also eligible for enhanced screening subsidies. cost of the screening tests GP consultation charges for screening visit GP consultation charges for the first follow-up consultation Increasing screening and follow-up touch points in the community - learning from the successful workplace model Increasing screening and follow-up touch points in the community WORKPLACES RELIGIOUS ORGANISATIONS COMMUNITY HEALTH POSTS 3 in 5 followed up with a doctor 50% saw at least 1 improvement in the biometric indicators (i.e. blood pressure, blood glucose and blood cholesterol) by post health screening. 1 in 4 improved from abnormal to normal health status in all aspects of their screening results. E.g. Promoting Mosques Close-to-home screening, personalised health coaching Physical Activity Body Mass Index Smoking Increase in mean physical activity time from 63mins 139mins 12% of those with moderate/high BMI improved their BMI to the next better category. Of these, 36% have now achieved healthy BMIs The prevalence of daily & occasional smoking decreased from 26% to 23% 24

7 Building community ownership, developing local anchors What s next No. of Advocates & Ambassadors 3,000 12,400 15,300 FY12 FY15 FY16 Basic engagement with public at roadshows, programmes (transactional roles) Conducting diabetes prevention talks Leading workshops and interest groups (relational, leadership roles) Initiating own health interest groups Ambassadors - as, or more, effective for health promotion to seniors From ecosystems to empowerment Diabetes awareness talks at Senior Activity Centres Ambassador HPB Vendor Number of participants PAST PRESENT FUTURE *Effectiveness based on post-talk survey % of participants who answered the question correctly: Poorly controlled diabetes can lead to stroke & kidney failure (True) 98.7% 97% Ad-hoc, once-off community events Since 2013 y Community Ecosystems Focus on sustainability, always on Community empowerment Structures / resources for local partners to drive health & social promoting efforts % of participants who would aim to adopt at least one lifestyle practice taught 99.3% 95.8% No. of survey respondents * Unpublished results, from Jul Dec Based on self-administered survey forms after the talk

8 Regional Symposium on Diabetes - Current Science and Multi-Stakeholder Approaches to Prevention & Management, October 4-5, 2017, Singapore PROMOTING HEALTH, PREVENTING DIABETES MAKING THE HEALTHIER CHOICES THE EASIER CHOICES Shameless Advertising 29 Whip out your phones to know your risk now! 30 National Steps Challenge Season 3 Back for the 3rd season bigger, better and with a new look letsbeatdiabetes.sg/dra No charge Who can participate? Participants must be at least 17 years of age Know your risk in 2 minutes Challenge period 28 Oct Apr 2018 Links you to claim subsidised screening* Visit stepschallenge.sg for details MORE GAMES. BIGGER PRIZES. A HEALTHIER YOU. ALL WITH 10,000 STEPS A DAY. *Eligibility conditions apply for subsidy claims