Preventive measures in health can make Year of the Tiger safe
This article appeared originally in the CHINADAILY on 31 January, 2022.
Authors: Pamela Tin, ahead of healthcare and social development
The Lunar New Year arrives at the crucial moment that Hong Kong continues to battle against the highly contagious omicron coronavirus variant. Especially for a densely populated city like Hong Kong, the golden rule is to act proactively at the community level, with all hands on deck. As the city anticipates the beginning of a brand new year, the long-established concept of prevention remains key to personal safety and to maintaining the city’s overstretched health system.
The eve of the Year of the Tiger witnessed increasingly strenuous public health measures that include the tightening of social-distancing measures and travel bans to curb the fifth wave of the COVID-19 pandemic in the special administrative region. The top healthcare experts continue to advise residents to “get vaccinated immediately”.
The growing flock of Hong Kong residents at local vaccination centers is a manifestation of the preventive strategy amplified by the intensifying threat that omicron poses to the city. It is exemplary of people’s willingness to follow experts’ advice. Importantly, it is also exemplary of people’s preparedness to cope with the imminent threat: They have been ready to engage in any necessary preventive measure at all costs to protect themselves and the people around them.
Before omicron rampaged through the world, preventive care had already been treated as an important cornerstone of primary healthcare development. It has been a prioritized health policy goal of the incumbent administration. Primary prevention relates to health promotion and educational programs for the prevention of diseases. Secondary and tertiary prevention focus on early detection of diseases, and subsequent management and rehabilitation. As an example, regular health checks are the most straightforward way to detect a disease at its onset, even before the emergence of symptoms. Of its many benefits, preventive care is important for early disease detection and subsequent intervention that could result in health cost savings and essentially contribute to health system sustainability.
However, it has been a tradition among the ethnic Chinese that they refrain from acknowledging sickness. In a recent population-based survey conducted by Our Hong Kong Foundation (OHKF) and The Chinese University of Hong Kong, nearly 40 percent of respondents aged 18 or above have never, or only irregularly, undergone screening for hypertension, diabetes and hyperlipidemia (HDH) — the top three chronic diseases afflicting the population in Hong Kong.
While the young population is typically considered to be at lower risk of chronic diseases, it is worth noting that the risk has been escalating in all age groups in the past two decades. According to government statistics, in the age group between 45 to 54 years old, 15.8 percent developed chronic diseases in 2000, but the number soared to 25.4 percent in 2021. For our older population (aged 65 and above), the number surged from 47.9 percent to 75 percent. The findings also show that while 98 percent of respondents acknowledged that screening would help with early identification and treatment of chronic diseases, only around 60 percent of respondents took action. Such results should not to be taken lightly — they demonstrate an imminent threat to public health in Hong Kong. In parallel to attuning to the threat, encouraging prevention and incentivizing related behavior across all age groups will become important in tackling Hong Kong’s ever-growing expenses in curing chronic diseases.
In a recently released health policy report, “Strategic Purchasing: Enabling Health for All”, OHKF put forward a new chronic-disease screening voucher and management plan that incentivizes residents aged 45-54 to undergo free HDH screening, provided by private primary-care providers. The proposed program is positioned as a demonstration of optimizing government resources allocation to address prioritized health needs. The program serves as a good example of leveraging financial incentives, and integrating screening and management plans, and expanding the choice of service outlets to enhance public willingness to take care of one’s health.
A supplementary budget analysis indicates that just applying the program to diabetes screening and management will generate savings of approximately HK$12.5 billion ($1.6 billion) in healthcare expenditures over 30 years. It is also expected to prevent approximately 47,000 deaths caused directly or indirectly by diabetes and prediabetes. Designed to encourage residents to engage in preventive care and illustrate associated benefits, the program presents an opportunity for achieving the triple-win scenario: reducing government expenditures; alleviating the burdens on the healthcare providers in the public sectors, including hospitals; and, what is most important, improving public health.
In the context of tackling COVID-19 or alleviating the growing burden caused by the chronic diseases, Hong Kong must foster a prevention-oriented mindset. Embracing the tenet that “preventing works better”, Hong Kong needs to be proactive in acknowledging the trend of healthcare needs, strategically allocating resources to address the urgent demands, and encouraging individuals to take preventive measures. The city thus can nip the potential systemic fractures in the bud. As the director-general of the World Health Organization put in his Christmas speech about what came before preparedness and response: Preventative measures should be the common goal both for personal healthcare and the public health system.