Singapore, 11 August 2025 – A new modelling study published in Nature Aging projects that long-term, sustained lifestyle changes could substantially reduce the burden of chronic disease and generate up to S$650 million (US$462–547 million) in direct healthcare cost savings for Singapore by 20501.
The study, led by researchers from the Saw Swee Hock School of Public Health at the National University of Singapore (NUS SSHSPH), used national health data and a dynamic microsimulation model to evaluate the long-term effects of lifestyle intervention scenarios focused on diet, physical activity and chronic disease management.
The analysis is one of the first to quantify the long-term health and economic impact of behavioural change across different ethnic groups in Singapore’s ageing population.
Principal investigator Assistant Professor Cynthia Chen from SSHSPH said, “This study provides a clearer picture of how lifestyle interventions can influence long-term health and healthcare spending in Singapore, without markedly extending life. Sustained interventions can deliver significant returns, not just in terms of better quality of life, but also in projected healthcare savings of nearly S$650 million by 2050. Even improvements in diet or activity, when widely adopted, can reduce chronic disease and reduce strain on our healthcare system, especially among vulnerable communities. This is not just sound health policy, it’s smart economics.”
Ms Guo Xueying, co-investigator and PhD student at SSHSPH, who conducted the analysis, said, “It was meaningful to see how our modelling could quantify long-term impacts of relatively small lifestyle changes. We hope these findings can support the design of more targeted and equitable prevention strategies.”
Study Highlights
The paper, “Disease burden, lifetime healthcare cost and long-term intervention impact projections among older adults in Singapore”, was published in Nature Aging in July 2025.
Using a dynamic Markov microsimulation model, the Future Elderly Model, the researchers projected future health outcomes and healthcare expenditure among adults aged 51 years and older in Singapore.
The researchers modelled four lifestyle intervention scenarios from 2020 to 2050, aligned with Singapore’s national Healthier SG initiative, focusing on 1) improved blood pressure management, 2) increased physical activity, 3) sodium reduction and 4) a combined intervention using all three strategies.
Key findings include:
- Chronic disease burden on the rise: The prevalence of diabetes, hypertension, stroke, and heart disease is projected to increase sharply among older adults by 2050. Projections show significant disparities in risk factors among different ethnic groups in Singapore.
- Healthcare costs climb: The increasing prevalence of chronic diseases and the development of more advanced treatments propel the demand for healthcare and healthcare infrastructure, potentially driving medical inflation and overall expenditure.
- Health gains are possible: Much of the observed cost savings arise not from widespread improvements in health outcomes or life extensions, but from the fact that most individuals do not experience significant changes in chronic conditions due to population ageing. Approximately 3-7 percent of individuals may experience meaningful improvements in chronic disease status, and gains in total and disability free life years.
- Savings with sustained change: When all four intervention scenarios are applied together, the model estimates S$650 million in cumulative cost savings, mainly by reducing future cases of stroke and heart disease.
- Impact on equity: Minority groups stand to benefit more from targeted preventive efforts, helping to narrow long-standing health disparities. By prioritising preventive strategies, such disparities could be addressed more effectively.
A Stronger Case For Prevention and Policy Investment
The findings add to the growing body of evidence supporting Singapore’s Healthier SG strategy – which focuses on preventive health and early intervention – by quantifying the long term benefits of preventive action, reinforcing the importance of upstream investment in public health and tailored behavioural interventions.
In Singapore, public health efforts already in place include screening and chronic disease management programmes, anti-smoking policies, public education and outreach. In 2021, the Ministry of Health convened a workgroup to help ethnic minority groups gain better health by designing culturally beneficial interventions.
Asst Prof Chen concluded, “Singapore’s rapidly ageing population and increasing healthcare demands make forward-looking policy decisions essential. By projecting future health needs and economic impact, we underscore the need for policies that address the root causes of chronic diseases.”
“Our findings are not only relevant for Singapore but also offer broader insights that are applicable to other ageing societies around the world. Our study presents a compelling and actionable framework to show how investing in preventive health strategies can help improve lives and manage long-term healthcare costs.”
References
- Guo, X., Tysinger, B., Wee, H.L. et al. Disease burden, lifetime healthcare cost and long-term intervention impact projections among older adults in Singapore. Nature Aging 5, 1358–1369 (2025). https://doi.org/10.1038/s43587-025-00915-0.
