Policies to prevent 3 highs can relieve healthcare burden

February 22, 2022 10:29
Over 80% of Hong Kong citizens consume more than the World Health Organization’s recommended maximum daily intake (5g) of dietary sodium (salt).
Photo: Reuters

Hong Kong people’s stressful work, fast pace of life, imbalanced diet and sedentary lifestyle contribute to Three “Highs”, which is the main culprit of chronic diseases that people begin to suffer at an increasingly younger age. In face of Hong Kong’s ageing population, the Government should offer Three “Highs” screening for the middle-aged as early as possible for disease prevention, lessening the burden on the medical system.

The threats that Three “Highs” pose to population health

Three “Highs” refers to hypertension (high blood pressure), hyperglycaemia (high blood glucose) and hyperlipidaemia (high blood lipid). The latest Population Health Survey 2014/15 showed that among the population aged 15-84, 27.7% have hypertension, 8.4% have diabetes and 49.5% have hyperlipidaemia. Three “Highs” are the major risk factors for chronic illnesses such as cardiovascular diseases (CVDs) and cancers.

The Government used the Framingham risk model to predict the population’s risk of CVDs over 10 years, including coronary heart disease, stroke, peripheral artery disease and heart failure. Results showed that among persons aged 30-74, the mean CVD risk by 2025 is 10.6%, meaning that for every 1,000 persons, there would be 106 with CVDs.

Furthermore, in 2000, 47.9% of the population aged 65 and above were afflicted with at least one kind of chronic condition. The figure surged to 75% in 2020, reflecting an elevated risk of citizens suffering from chronic diseases.

The gravity of obesity in Hong Kong

It is noteworthy that obesity is a serious problem in Hong Kong. About half of the population aged 15-84 are overweight or obese, and over 80% of citizens consume more than the World Health Organization’s recommended maximum daily intake (5g) of dietary sodium (salt).

Worryingly, obesity is emerging at earlier ages. The detection rate of overweight and obese primary school students in the school year 2019/20 was 19%, meaning that one out of five students is too heavy. Weight issues are likely to persist after the adolescents enter adulthood, increasing the likelihood of CVDs, as high cholesterol and hypertension are more prevalent among the overweight and obese. Therefore, these students will face higher risks of developing illnesses related to bones and joints, fatty liver disease and sleep apnea. The Department of Health has responded by promoting a healthy diet with appropriate physical activities in schools to tackle child obesity. The Government should also strategically target the middle-aged in disease prevention, raising their awareness towards Three “Highs” prevention.

Tens of billions of healthcare savings to be generated

OHKF released a research report titled “Strategic Purchasing: Enabling Health for All” in December 2021, which proposed free screening and disease management for Three “Highs” for citizens aged 45-54. Participants who are not diagnosed with Three “Highs” can receive a HK$350 subsidy to see a family doctor in the private sector for a follow-up consultation. Those who are diagnosed with Three “Highs” can receive lifelong follow-up care.

Findings of the population-based telephone survey showed that up to 75% of respondents without chronic diseases are willing to participate in the proposed scheme. OHKF believes that Three “Highs” screening will not only enable early detection of chronic diseases, it can also raise citizens’ awareness of risk factors for future disease, so at-risk adults can change their lifestyles to prevent Three “Highs” from deteriorating, reducing the likelihood of illness development.

As the saying goes, “An ounce of prevention is worth a pound of care.” The current heavy burden on the medical system and ageing population calls for prompt preventive measures from the government, which OHKF’s study projects can save tens of billions of medical expenses over thirty years of the scheme’s implementation. In short, Three “Highs” prevention is beneficial to both the government’s coffers and the individuals’ health.

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Stephen Wong is Senior Vice President and Executive Director of Public Policy Institute, Our Hong Kong Foundation. Amy Liu Mei Heung is Managing Editor at Our Hong Kong Foundation.