Perhaps you’ve heard of the “Blue Zones,” regions that are characterized by long life expectancies and an unusually high number of centenarians. There is some controversy over the accuracy of the Blue Zones data, but the basic idea of the project – try to identify areas where people seem to live longer and better lives and study them to see what we can learn – makes sense. Not surprisingly, the commonalities that residents from the different Blue Zones seem to share include regular physical activity, a traditional diet that is low in processed foods and made up mainly of home cooked meals, and strong family and community ties.
Five Blue Zones have been identified to date:
Okinawa, Japan
Sardinia, Italy
Ikaria, Greece
Nicoya, Costa Rica
Loma Linda, California
(A quick note on Loma Linda, which is the one Blue Zone located in the United States. Loma Linda is heavily populated by a community of Seventh Day Adventists, who for religious reasons swear of drugs, alcohol and tobacco, and who tend to eat a plant heavy diet and engage in a lot of exercise and social/community/religious events. This distinguishes it somewhat from the more “traditional” communities found in the other regions who are presumably carrying on cultural traditions that date back many centuries at this point.)
While it is interesting to think about how these regions’ cultural habits lead to better health, it is much harder to copy these habits in a modern society. For example, many people in Sardinia work as farmers and shepherds and have to walk steep and hilly terrain every day as part of their normal lives, before they sit down to a dinner grown on their own farm. Good luck replicating all of that in downtown Boston.
Which is why the announcement a few years ago that Singapore has been designated as a new Blue Zone is of such interest. In 1960, the life expectancy in Singapore was 65, well below that of the United States and the democracies of Western Europe. Today, Singapore has one of the world’s highest life expectancies, at 86. In just two generations they have managed to expand their life expectancy by over twenty years.
Importantly, Singapore achieved this through conscious effort by adopting a series of policies intended to improve the health of their population. Theoretically then, Singapore’s success could be replicated in other countries by adopting similar policies.
What are those specific policies? Here are a few:
Cigarettes, alcohol, and sugary drinks are heavily taxed so as to reduce their overall consumption
The city has invested heavily in public parks and public fitness spaces (for example gardens where tai chi or yoga classes are held) to encourage exercise, community, and time spent outdoors
Additionally, the city has heavy traffic congestion and excellent public transportation, so many residents don’t own cars, meaning that even those who don’t do formal exercise get a lot of steps just going through the course of a typical day
Singapore gives tax breaks to families that live near or take in their elderly relatives, thus incentivizing multi-generational living and closer family connections
Singapore has an excellent universal healthcare system. Interestingly, although the system provides for universal coverage, it is not a purely socialist one and many parts of it are driven by the free market. The specifics are too complicated to get into in this post, but point being that rather than sticking to the pure ideology of a “left versus right” mindset when designing their healthcare system, Singapore’s leaders instead took a practical approach. They borrowed from both capitalist and socialist ideas to come up with a hybrid that works very well and is consistently ranked as one of the best in the world. If Americans can ever break free of our current tribalism and get back to valuing compromise and pragmatic results over ideology, we would be wise to study what Singapore has done with their system and try to learn from it.
