Remarks by Minister Indranee Rajah at Singapore's Women Health Conference

Professor Aaron Thean, Deputy President (Academic Affairs) and Provost at the National University of Singapore Professor Chong Yap Seng, Dean of the Yong Loo Lin School of Medicine, National University of Singapore Professor Michelle Williams, Former Dean of the Harvard T.H. Chan School of Public Health, Harvard University Professor Zhang Cuilin, Director of the Global Centre for Asian Women’s Health, Yong Loo Lin School of Medicine, National University of Singapore Professor Frank Hu, Chair of the Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University

Ladies and Gentlemen

Good morning. It is a great pleasure to be here with you to join you today for the launch of the Global Centre for Asian Women’s Health, based at the National University of Singapore’s Yong Loo Lin School of Medicine, as well as the opening of the inaugural Women’s Health Conference.

Women’s Health as a Cornerstone of Healthy Families and Societies

Women face distinct health challenges at different stages of life. From youth to senior years, a woman will go through unique experiences – such as menstruation, menopause, and for some, conception and childbirth. Every woman should seek care for her individual needs and circumstances, to keep her in good physical, mental and emotional health consistently.

Prioritising health not only empowers women to lead vibrant lives, but also enables them to positively impact their families and society. While we are progressively shifting away from traditional gender roles in the household, women still are the main caregivers in many families. Beyond the home, many women also concurrently juggle work responsibilities, as they make up 47% of our employed residents . They add diversity in skills, values and perspectives to our workplaces, and when placed in leadership roles, support better governance and culture-building within our institutions. Women with good health are better positioned to be the best versions of themselves at home and at work. This in turn empowers them to achieve their career aspirations while pursuing their personal goals and at the same time, caring for their loved ones.

Given this context, I am pleased to see the establishment of the Global Centre for Asian Women’s Health, or GloW for short. GloW envisions the advancement of Asian women’s health and well-being throughout the different stages of their lives, in Singapore and worldwide. The Centre’s mission statement, “Healthy and Happy Women; Healthy and Happy Family; Healthy and Happy Society”, aptly acknowledges women as the cornerstone of our families and society, and the importance of women’s health not only for their own wellbeing, but also that of our broader community.

The theme of today’s Conference, “Promoting Women’s Health and Healthy Longevity: from Laboratory to Kitchen”, is a meaningful one. It emphasises the importance of supporting women’s health for both their present well-being and their future longevity. It also spotlights the need for women, as individuals, to take charge of their personal wellbeing by incorporating healthy practices and routines into their daily lives. This is aligned with our efforts under Healthier SG, to shift the focus of healthcare upstream from acute care to preventive care, and to support Singaporeans in taking proactive steps to manage their health.

There are policies and programmes in place to support women at each stage in taking charge of their health needs. Let me explain the various health needs through the various stages of a woman’s life, and how to address them.

Supporting Women’s Health Across Life Stages

First, the habits that we develop in the formative years of childhood often carry through to adulthood. As such, establishing a healthy lifestyle early on sets a strong foundation for one’s long-term wellbeing and reduces the risk of developing chronic health issues. We encourage our children to cultivate healthy habits from young through the Health Promotion Board (HPB)’s programmes in schools. These holistic programmes span across various aspects of health – the Healthy Meals in Schools Programme, for instance, helps students maintain good nutrition by working with the canteen vendors to provide healthier food and beverage options, while the Active Youth Programme offers workout sessions for schools to increase physical activity among students.

In schools, students also receive annual health screenings for early detection of health issues. One potential issue is scoliosis, which is a condition with curved spine that is more common in girls than boys. To detect and address this early, girls in Primary 5 start to receive spinal checks during their annual health screening. All adolescent girls and young women are also recommended to receive the Human Papillomavirus (HPV) vaccination between the ages of 9 and 26 to protect themselves against cervical cancer, based on the National Childhood Immunisation Schedule and National Adult Immunisation Schedule. To support this, MOH fully subsidises the HPV vaccination for all Secondary 1 female students as part of HPB’s school-based health programme. HPV vaccination subsidies are also available for females aged 9 to 26 when taken at polyclinics and Community Health Assist Scheme (CHAS) clinics in Singapore.

As women transition to adulthood, it is important to sustain sufficient levels of physical activity to maintain good health, reduce the risk of chronic diseases, improve mental and cognitive health and prevent unhealthy weight gain. The last one is much harder to achieve. These activities should incorporate muscle-strengthening exercises, which help to improve our ability to perform daily activities, increase bone density and reduce symptoms of anxiety and depression. However, the 2022 National Population Health Survey found that a lower percentage of women were meeting the recommended sufficient total physical activity level and muscle-strengthening activities compared to men. The prevalence of abdominal obesity, which is associated with higher health risks, was also slightly higher in females than males. So I encourage adult women to consciously engage in healthy lifestyle habits and exercise regularly, which will reap health benefits in the long run. A good way to do so is by participating in HPB initiatives such as the National Steps Challenge and Lumihealth to inculcate active lifestyle habits. Accompanying that, HPB’s “Move IT” physical activity programmes run island-wide, making exercise accessible to residents, with free workout sessions covering a wide range of activities from Zumba to Kickboxing, and are open to all to join. There is something to interest everyone, and a great opportunity to stay active while bonding with family and friends.

Reproductive issues often come to the fore in adulthood as well. Take conception for example. Maintaining a healthy lifestyle without heavy alcohol consumption or smoking could improve a couple’s chances of conception. Fertility declines with age for both men and women, and particularly after age 35 for women due to the normal age-related decrease in the number and quality of eggs that remain in women’s ovaries. Our Marriage and Parenthood survey tells us that many are not aware that reproduction technology cannot compensate for age-related decline in fertility. For instance, in Singapore, based on 2016 to 2020 data, the Assisted Reproduction Technology (ART) success rate was around 25% for women aged 30 to 34 years old. This fell to about 7% for those aged 40 and above.

In June this year, we implemented Elective Egg Freezing (EEF) to give women who wish to conceive and be parents an option to do so if they marry later. Eligible married couples who require ART treatment and Intra-Uterine Insemination (IUI) can also tap on the Government’s co-funding support. However, the journey is not an easy one. I’ve heard from couples with fertility issues on the challenges they face and the support they need, especially those who are working and need to take time off for various fertility treatments. With more people getting married later, fertility health will become more of an issue. So we must continue to encourage and make available options for couples to address potential fertility issues earlier, and workplaces to be more supportive of couples undergoing fertility treatments.

Upon successful conception, women need to take special care of their health during pregnancy and childbirth as these come with their own risks of complications. I am glad to hear that GloW has been undertaking research on potential pregnancy complications, the implications for women’s long-term health, and how these could be mitigated. For example, one study found that women who had developed gestational diabetes during pregnancy could lower their risk of developing Type 2 diabetes later on in life by 90%, simply by maintaining healthy lifestyles This once again emphasises the importance of healthy living in the present, to support healthy longevity in the long-term.

From middle-age onwards and into their senior years, women need to take even more proactive steps to keep healthy. According to the Singapore Cancer Registry, breast cancer is the most common cancer among women aged 30 to 79 years, and the incidence of breast cancer, after adjusting for age, has risen nearly four times compared to five decades ago. Regular screenings can help in early detection and improve the prognosis and survival rates. Eligible Singapore Citizens enrolled in Healthier SG will receive fully subsidised cancer screenings. So again, I strongly encourage every woman to check your screening eligibility and sign up for screening today.

Women also undergo menopause at this stage. Due to the reduction in oestrogen levels, women who have undergone menopause are more susceptible to osteoporosis compared to men of a similar age. Hence, it is important for women to also start taking care of their bone health early. This can be done by incorporating calcium-rich foods such as dairy and green leafy vegetables in one’s diet to ensure sufficient daily calcium intake, and engaging in regular physical activities that include weight-bearing exercises.

From Laboratory to Kitchen: Translating Research to Real-Life Practice

I’ve just highlighted the health needs and risks at each point of women’s lives, the support provided by the Government and how we can actively take charge of our own personal health. This awareness must be supported by robust, evidence-based research, and women need to be able to access the information and understand how it can be applied to our daily lives.

It is commendable that GloW has made the translation of scientific knowledge into clinical and public health practices its core mission. This is illustrated by the work of Professor Zhang Cuilin and her team of researchers, who have been working to identify lifestyle factors that could influence women’s health outcomes in areas such as diabetes and fetal growth, and potential interventions to prevent diseases. I understand that the conference organisers have also arranged a cooking demonstration to share healthy recipes with participants. It is a great way to translate research into something practical and accessible for all.

Conclusion

Let me conclude by emphasising that there is no magical remedy to achieving better women’s health. Rather, it requires a holistic strategy comprising forward-looking research into women’s health issues, public policy intervention and support, and individual effort to maintain healthy lifestyles. It also requires consistency which I think that is something that is often overlooked. It is the small, little things that you do everyday over a long period that actually help in the long term. Not the sudden burst of energy in a week to say I will suddenly go for aerobics or you do that for one week and you think it is going to last you a lifetime. It doesn’t work that way. It is the small regular constant practices and if there is one thing that women should take away, it is that.

So I am excited by the potential to chart a healthier and happier future for Asian women in Singapore and worldwide. I wish you every success in your efforts, and to all participants, I wish you a fruitful conference.

Thank you very much.