Executive Summary
Singapore faces a critical juncture as it approaches super-aged society status by 2030. While government initiatives enjoy widespread support, a significant implementation gap threatens the effectiveness of preventive health strategies. This case study examines the disconnect between policy awareness and behavioral adoption among older adults, drawing on research from Singapore Management University’s Centre for Research on Successful Ageing (ROSA).
The SMU Centre for Research on Successful Ageing study of 7,056 Singaporeans aged 53-80 found that while over 90% support preventive healthcare programs like Healthier SG and believe regular health screenings are important, only about half have enrolled and just a fifth intend to do so.
The Gap Between Support and Action
Among those enrolled in Healthier SG, annual health screenings and medical reviews are most widely used, but referrals to allied-health professionals, community exercise or wellness classes, and lifestyle or nutrition advice remain significantly under-utilized. This suggests awareness alone isn’t translating into behavior change.
About 30% of older adults don’t engage in any physical activity at all, and while over 82% are aware of Nutri-Grade labels on drinks, habitual preferences persist—only about 22% request wholegrain options regularly.
What’s Needed
The research emphasizes that healthy aging requires more than medical care—it needs neighborhoods, communities and routines that make living well part of everyday life. The quality of relationships among neighbors is more important than structural living conditions for aging in place, as close contacts encourage active participation and foster a sense of belonging.
The study suggests Singapore needs to shift toward preventive, community-based systems that embed healthy behaviors naturally into daily life, rather than treating them as separate activities requiring special effort.
Case Study: The Healthier SG Paradox
Background
In August 2025, ROSA surveyed 7,056 Singaporeans between ages 53 and 80 to assess attitudes and behaviors toward healthy aging initiatives. The study revealed a stark paradox: overwhelming policy support coupled with limited everyday adoption.
Key Metrics
Policy Support vs. Enrollment:
- 90%+ support Healthier SG program
- 90%+ agree regular health screenings are important
- 50% have enrolled in Healthier SG
- 20% intend to enroll
Service Utilization Among Enrollees:
- High: Annual health screenings, medical reviews
- Low: Allied-health professional referrals, community exercise classes, lifestyle/nutrition advice
Lifestyle Behaviors:
- 50% engage in moderate to vigorous physical activity
- 30% engage in no physical activity at all
- Average fast-food consumption: once weekly
- Average hawker centre meals: five times weekly
- 82% aware of Nutri-Grade labels
- 50% request less sugar regularly
- 22% request wholegrain options regularly
Critical Insights
The Awareness-Action Gap: Despite high awareness of health services and preventive measures, translation into sustained behavioral change remains limited. This suggests that information alone is insufficient for driving health outcomes.
Healthcare Seeking Patterns: Over 80% of Healthier SG enrollees still seek multiple doctors, primarily for second opinions or specialized care. This indicates that continuity of care—a core principle of the program—faces practical challenges in implementation.
Dietary Habits: While awareness of healthier options exists, habitual preferences dominate daily choices. The low adoption of wholegrain options despite moderate sugar reduction requests suggests selective health consciousness rather than comprehensive dietary change.
Root Causes Analysis
Systemic Barriers:
- Preventive services not sufficiently integrated into daily routines
- Community-based wellness programs lack visibility or accessibility
- Gap between enrollment and active engagement with full service spectrum
Social Infrastructure:
- Traditional family structures changing (more singles, fewer children)
- Need for stronger neighborhood-based support systems
- Under-leveraged potential of community spaces as “third places”
Built Environment:
- Top functional amenities for aging in place: medical facilities, transport, eateries, shops
- Under-utilized spaces: community centres, Active Ageing Centres, parks
- Physical environment not optimized for embedding healthy behaviors
Strategic Outlook: 2025-2035
The Super-Aged Society Challenge
By 2030, Singapore will officially become a super-aged society. With a shorter runway than countries like Japan or South Korea, Singapore requires accelerated innovation and sharper interventions to address the healthy aging imperative.
Emerging Opportunities
1. Leverage High-Trust, High-Literacy Population
Singapore’s older adults represent a uniquely educated cohort with strong trust in government institutions. This provides a foundation for implementing sophisticated, technology-enabled health interventions that might face resistance in other contexts.
2. Revive “Kampung Spirit” for Modern Context
Traditional community bonds offer a template for neighborhood-based support networks. Reimagining neighbors as extended family members can create organic social safety nets that complement formal healthcare systems.
3. Shift from Institutional to Community-Based Care
With institutional care models becoming unsustainable, the “aging in place” paradigm requires comprehensive support systems that extend beyond physical accessibility to include social connectivity and preventive health infrastructure.
Strategic Recommendations
Short-Term (2025-2027): Bridge the Implementation Gap
Redesign Service Delivery:
- Integrate preventive health services into existing routines rather than creating separate programs
- Co-locate wellness services with high-traffic amenities (hawker centres, transport hubs, markets)
- Simplify referral processes for allied-health professionals
Enhance Communication Strategy:
- Move beyond awareness campaigns to behavioral nudging
- Demonstrate tangible benefits through peer testimonials and community champions
- Address specific barriers to engagement identified through user research
Pilot Neighborhood Health Hubs:
- Transform community centres and Active Ageing Centres into integrated wellness destinations
- Combine social activities, exercise classes, and health monitoring in single locations
- Create “third places” that naturally encourage healthy behaviors
Medium-Term (2027-2030): Build Supportive Ecosystems
Redesign Built Environment:
- Urban planning that prioritizes walkability and social interaction
- Parks and open spaces designed for intergenerational activities
- Healthy food options as default in public spaces
Strengthen Social Infrastructure:
- Formalize neighbor support networks with light-touch coordination
- Incentivize social connectivity alongside health metrics
- Create platforms for older adults to contribute skills and knowledge to community
Expand Preventive Services:
- Scale up community-based exercise and wellness programs
- Improve visibility and accessibility of nutrition counseling
- Integrate mental health and social wellbeing into preventive care
Long-Term (2030-2035): Transform Aging Paradigm
Develop Predictive Health Models:
- Use data from longitudinal studies like Singapore Life Panel to identify early intervention opportunities
- Personalize preventive strategies based on individual risk factors and preferences
- Create feedback loops between policy, practice, and outcomes
Foster Age-Friendly Innovation Ecosystem:
- Encourage private sector solutions for healthy aging challenges
- Support social enterprises addressing gaps in community-based care
- Develop export-ready models for other rapidly aging societies
Reframe Aging Narrative:
- Position older adults as active contributors rather than passive recipients of care
- Celebrate productive aging and intergenerational exchange
- Challenge ageist assumptions in policy and practice
Critical Success Factors
Policy Integration: Healthy aging cannot be a standalone initiative—it must be woven through housing, transport, urban planning, and community development policies.
Measurement Evolution: Move beyond process metrics (enrollment rates) to outcome metrics (quality of life, functional independence, social connectivity).
Adaptive Implementation: Continuous feedback and rapid iteration based on what older adults actually need and use, rather than what policymakers assume they need.
Whole-of-Society Approach: Government cannot solve healthy aging alone. Private sector, community organizations, families, and older adults themselves must be active partners.
Risk Factors and Mitigation
Key Risks
Engagement Fatigue: Over-programming and excessive outreach may lead to disengagement rather than participation.
Inequality Amplification: Tech-enabled solutions and community-based programs may inadvertently benefit already-healthy, well-connected older adults while leaving vulnerable populations behind.
Resource Constraints: Ambitious healthy aging agenda competes with other national priorities for funding and attention.
Cultural Resistance: Some older adults may resist interventions perceived as paternalistic or inconsistent with their values.
Mitigation Strategies
- Design for simplicity and opt-in participation rather than complex mandatory programs
- Explicit equity targets with specialized outreach to isolated and vulnerable groups
- Demonstrate cost-effectiveness of prevention vs. treatment to justify resource allocation
- Co-design initiatives with older adults to ensure cultural appropriateness and genuine buy-in
Conclusion
Singapore’s healthy aging challenge is fundamentally about closing the implementation gap between good intentions and daily behaviors. The high support for initiatives like Healthier SG provides a strong foundation, but success requires moving beyond awareness to embedding healthy choices seamlessly into the fabric of daily life.
The research findings suggest that quality of social relationships matters more than structural conditions for successful aging in place. This insight should drive a reorientation toward community-based, relationship-centered approaches that leverage Singapore’s unique advantages: a literate older population, high government trust, compact urban form, and strong social cohesion.
With less than five years until super-aged society status, Singapore has both the imperative and the opportunity to pioneer innovative models of healthy aging that could benefit rapidly aging societies worldwide. The key is to act decisively on the evidence, remain adaptive to what works in practice, and maintain unwavering focus on making healthy aging not just possible, but natural and joyful.
This case study is based on research from SMU Centre for Research on Successful Ageing’s study “Living Well: The Built, Lived, and Social Determinants of Well-being” conducted in August 2025 with 7,056 Singaporeans aged 53-80.