A recent study which looked at factors influencing health, well-being, activity and productivity levels in older Singaporeans, said that about 62% of older Singaporeans rated their own health as good, very good or excellent with a similar proportion across males and females and ethnic groups, about 38% rated their health as fair or poor.

Another new study by Johns Hopkins Medicine researchers however, said that how healthy people think they are isn’t always an accurate indicator of their risk for cardiovascular disease.

In a study of medical information gathered on more than 6,800 people in the United States, the researchers found that 10% of those who rated themselves in excellent health had measurable evidence of cardiovascular disease without symptoms, putting them at higher risk for a heart attack or stroke.

The better news from their analysis, the researchers say, is that when combined with definitive risk tools, such as coronary artery calcium scans to determine plaque buildup in the heart’s arteries, self-reported perceptions of health do have value and can complement these tools to indicate cardiovascular disease risk.

The researchers note that this study wasn’t designed to determine cause-and-effect but to identify findings that related to one another.

“Our study suggests an important public health message: that even when people perceive themselves to be healthy they may still have significant cardiovascular disease,” said Olusola Orimoloye, M.D., M.P.H., postdoctoral fellow at the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease.

“This means that all adults would benefit from seeing a health care provider to get a more definitive assessment for their risk of disease, even if they think they’re healthy and feel they don’t need to visit the doctor.”

Olusola Orimoloye

Costs however, could be a big inhibitor for some adults from getting a more definitive assessment for their risk of disease.

Income, an insurance company which describes its business as being “driven by a social purpose”, says on its website that a basic heart screening test costs $430.14. Medisave withdrawal limit for outpatient scans for diagnosis or treatment for a medical condition is up to $300 per year per patient, which may mean that a there is an out-of-pocket expense of $130.14 for basic heart screening.

Chairman of the Singapore Democratic Party (SDP), Dr Paul Tambyah, in presenting his alternative healthcare policy recently, referred to the findings of Professor Gerald Koh to make the point that residents have avoided screening and seeking treatment due to prohibitively expensive healthcare costs.

Professor Koh’s study, ‘Multi-disease Health Screening in an Urban Low-income Setting: A Community-based Study‘, published in 2010 in the Annals of the Academy of Medicine, Singapore, tried to determine the participation rates for health screening in a multi-ethnic urban low-income community.

Dr Tambyah said: “I do rounds in general medicine, and it’s very frustrating (when) we see old people coming in with a stroke … I asked them, ‘Have you ever been diagnosed with high blood pressure before?’ and they said, ‘Oh ya, ten years ago somebody said I have high blood pressure’ … ‘Did you take medication?’ ‘No.” ‘Did you get treatment?’ ‘No.’ ‘Why?’ ‘Oh I have no time, I was too busy, it was too expensive, nobody could bring me to the clinic, I was working two jobs …’”

“So these are the realities of what doctors in the public sector see, day in and day out,” he said, adding: “If you don’t go for early screening, if you don’t go for early treatment, you’ll end up with complications.”

Dr Paul Tambyah

By: Ravi Philemon for The Healthy Daily

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