By: Harry Curzon

In line with our ongoing work exploring the role of Prevention in an ageing world, we recently published a report on healthy ageing in Hong Kong.

There is a general consensus that healthcare systems that prevent disease and limit long-term illness and disabilities are good for our health and at the same time play a crucial role in supporting the economic sustainability of health systems.

Whilst Hong Kong’s health system has been ranked as the most efficient in the world, it is coming under increasing strain as the population ages. The median age of the population of Hong Kong is predicted to rise from 43 to 51 by 2065.

With the older population growing in Hong Kong, it is estimated that there will be a greater number of people with complex health conditions. One survey found that 26% of 45-54 year olds, 44.5% of 55-64 year olds and 74.3% of those aged 65+ had been diagnosed with chronic health conditions. The rates of dementia are consistently on the rise, with a recent study projecting the number of people aged 60 and over with dementia to increase by 222% between 2009 and 2039.

Hong Kong’s healthcare system prioritises curative care and its primary health care system currently lacks the funding to sufficiently meet the needs of its ageing population. Hong Kong has only 73 public general outpatient clinics to provide primary care to its population of nearly 7.5 million people.

Public primary care delivery is also constrained by a shortage of doctors. In 2017, there were 1.91 doctors to provide for every 1,000 people. The recruitment of doctors from abroad is moreover constrained by language barriers and strict registration requirements.

Due to the shortage in public primary healthcare, pressure on hospital accident and emergency departments has increased as they become the primary point of contact with the health system for those unable to afford private healthcare.

In recent years, Hong Kong has launched several preventative healthcare initiatives designed to tackle the care challenges of Hong Kong’s ageing population. For example, the Hong Kong Housing Authority has partnered with the Hong Kong Polytechnic University and the Department of Health to provide free health visits to public rental housing (PRH) estates, as about a quarter of PRH tenants are aged 60 or above.

Additionally, the Health Care Voucher scheme, introduced in 2009, aimed to shift demand for primary care services to the private sector. Under the scheme, people aged 65 and above are given HK$2,000 (approximately £200) each year to spend on primary preventative services.

However, although these preventive health schemes have had some success in promoting prevention there seems to be a lack of overall strategy to ensure that initiatives are integrated to prevent illness effectively and there remains to be a lack of data on how individuals act to protect their own health.

For Hong Kong to build on its strong healthcare foundation and implement effective prevention schemes, there is a need to:

• Develop a comprehensive healthy ageing strategy;
• Review the role of the voluntary and community sector in supporting healthy ageing;
• Encourage the role of community pharmacy as a site for preventative healthcare interventions.

As populations in countries such as Hong Kong age, it will be important to support people to live healthier lives for longer. By prioritising preventative interventions within its healthcare system, Hong Kong could more adequately cope with the challenges of its rapidly ageing population. As a country with a high-middle sociodemographic index, the case of Hong Kong helps us to understand the potential for action through prevention in countries across the world.

Following our series of engagement events on prevention in an ageing world, we will be launching our final report on the health and productivity burden of preventable diseases in later life, as well as recommendations for action at a launch reception in London on Friday, 28 February 2020.

Read the full report of our findings on Healthy ageing in Hong Kong. To find out more about the Prevention in an ageing world programme and the upcoming global launch event, please visit our Prevention in an ageing world programme page.