New workgroup to improve health of Malays and Indians, close ‘significant disparities’ in outcomes across ethnicities: MOH

• Health data suggests cultural differences may influence lifestyle and health behaviours across ethnic groups, said the Health Ministry
• A new workgroup aims to close these “significant disparities” 
• It will focus first on the Malay community before expanding its efforts to cover Indians
• The approach is not an attempt to single out anyone or any group, said the ministry

SINGAPORE — A workgroup formed last month aims to improve the health of ethnic minority groups here, as the Ministry of Health (MOH) seeks to close “significant disparities” in the health behaviours and outcomes across Singapore's ethnic groups.

Announcing this effort during the debate on its budget in Parliament on Friday (March 5), the ministry said in a statement that it would focus its efforts first on the Malay community before expanding it to other groups, such as Indians.

The workgroup will be led by Madam Rahayu Mahzam, Parliamentary Secretary for Health, and Members of Parliament Wan Rizal of Jalan Besar Group Representation Constituency (GRC) and Mariam Jaafar of Sembawang GRC.

This comes as MOH's review of national health data found that the proportion of Malays contracting cancer has gradually increased over the decades.

Malays also have the highest obesity rates as well as high tobacco usage rates compared with the Chinese and Indian communities. The Malay community also has the lowest screening rates for chronic conditions and cancers.

“(The data) suggests that there may be cultural differences influencing lifestyles and health behaviours,” MOH said. 

Citing figures from last year, Mdm Rahayu told Parliament that 14.4 per cent of Malays and 14.2 per cent of Indians have diabetes, compared with 8.2 per cent of the Chinese.

In addition, 37.5 per cent of Malays have higher blood pressure, compared with 36.1 per cent of the Chinese and 29.5 per cent of Indians.

The latest national health survey, conducted in 2019, found Malays had the highest daily smoking prevalence (23 per cent), compared with Indians (10.9 per cent) and the Chinese (8.6 per cent). 

The shares of Indian and Chinese women screened for breast cancer were also higher (both at more than 40 per cent) than those for Malay women, at 28.9 per cent.

In addition, 34.8 per cent of Malay women were screened for cervical cancer, lower than the rate among Chinese women (49.9 per cent) and Indian women (46.1 per cent).

The screening rate for colorectal cancer was the lowest among Malays as well, at 31.9 per cent, compared with 43.6 per cent among the Chinese and 37.5 per cent among Indians.

‘CULTURALLY RELEVANT’ PROGRAMMES

The workgroup will design culturally relevant programmes and help rally the Malay community against poor health habits, MOH said.

“This will entail the co-creation and implementation of year-round healthy living activities in the Malay community, with the overall aim to help improve health and well-being,” it added.

For a start, the workgroup will be supported by the Health Promotion Board (HPB) and organisations such as the People's Association Malay Activity Executive Committees Council, the Islamic Religious Council of Singapore, self-help group Yayasan Mendaki and the Muslim Healthcare Professionals Association.

Other community partners such as voluntary welfare organisations may join the workgroup later to extend its efforts and reach.

A member of the workgroup, Muslim Healthcare Professionals Association honorary secretary Djoni Huang, told TODAY that he believes there would be “good synergy” among representatives of the workgroup to roll out culturally nuanced healthy living activities for the Malay community.

The 48-year-old is also the director of clinical services at Mount Alvernia Hospital and a board member of the Yusof Ishak Mosque.

He advocates focusing on the younger population: “If they lead an unhealthy lifestyle, the risk of developing chronic illnesses, such as diabetes, hypertension and high cholesterol, is as high as those who have already been diagnosed with such conditions.”

‘NOT AN ATTEMPT TO SINGLE OUT ANY GROUP’

In explaining why it started the workgroup for ethnic minority groups, MOH said that it was not an attempt to single out anyone or any group.

“Our objective is health for all, so we want the best approach to things… In doing this, we need to recognise that there are cultural differences, and this is an attempt to do this,” it said.

On why there is no specific initiative for the Chinese community, MOH said: “The Chinese being the majority, any initiative will cater to them.”

The racialised framing of health issues has triggered some public backlash in the past. 

In 2015, for instance, then-law student Fadli Fawzi wrote a letter to Yahoo News Singapore arguing that it is problematic to blame Malay cultural practices or habits for their health issues. 

“This approach is not only insensitive, but also too simplistic and reductionist to truly resolve the issue,” he wrote.

HPB said that it has been placing a focus on ethnic minorities since 2017, after recognising that a more general approach taken over the years had its limitations.

A targeted approach allowed authorities to deal with specific issues, such as the availability of healthy halal food alternatives for the Muslim population, HPB said. 

It added: “We have found that for the Malay community especially, just having a specialised, specific channel to reach out to, have messages attuned to the specific cultural context of the community, has been very, very effective.”

During his National Day Rally speech in 2017, Prime Minister Lee Hsien Loong described diabetes as a health crisis for Malays and Indians. The Government launched a war against diabetes in 2016.