The World’s 6th Blue Zones Region – an Engineered Longevity Hotspot

Excerpt adapted from The Blue Zones Secrets for Living Longer: Lessons From the Healthiest Places on Earth by Dan Buettner, a beautifully illustrated and informative guide to the places on Earth where people live the longest—including lessons learned, top longevity foods, and the behaviors to help you live to 100—plus a surprising new blue zones longevity hotspot.

While famous for its draconian laws governing behavior as trivial as spitting or chewing gum, Singapore ranks among the world’s healthiest, happiest, and longest-lived places on the planet. And it wasn’t always that way.

In 1960, the average newborn in Singapore could expect to live only 65 years. Now, one lifetime later, life expectancy has grown by almost 20 years. Of all the nations in the world, it ranked number one in 2019 for life expectancy at birth, at 84.9 years, six more years than in the United States. What’s more important, Singaporeans rank number one in healthy life expectancy and have the world’s lowest rate of cardiovascular mortality and best health-care system. The number of centenarians on the island more than doubled during the past decade, from 700 to 1,500, as did the number of men and women in their eighties and nineties. Clearly, Singapore has been doing something right for its aging population—and doing it in its own way.

 

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Unlike the other blue zones, Singapore was no isolated region where a traditional culture evolved a lifestyle of longevity over a period of centuries. Instead, it was a busy crossroads of commerce and cultures whose leaders from the start set out to create an environment of health and well-being. In fact, you might even call it a blue zones 2.0—the next frontier of aging.

“Hop in, we’re late,” Foo said, after bidding me a good morning. He was taking me to Yishun, a town on the northern side of the island, to visit Khoo Teck Puat Hospital, where, of course, he served on the board of directors.

KTPH, as it’s known, opened with great fanfare in 2010 as a facility that would “lower one’s blood pressure” just by entering its forestlike grounds. Lauded for its innovative design, it immersed patients in a soothing natural environment with lush vegetation spilling over its balconies, a cascading waterfall, and expansive rooftop gardens, among other features.

To me, the place looked more like a Four Seasons hotel than like a hospital. In fact, as we strolled the breezy lower level, Foo told me the staff had consulted luxury hotels when they designed the rooms, as well as Singapore Airlines when they planned the food service.

And it wasn’t just for the patients and staff, either. The hospital also aimed to draw in the surrounding community. The public was encouraged to enjoy the grounds, too, and to eat at the hospital’s health-oriented restaurants and to take part in tai chi and Zumba classes. People from the neighborhood enjoyed their lunches in picnic areas, while patients in wheelchairs were pushed through an artificial tropical rainforest, instead of languishing in their hospital rooms. Up on the roof, local volunteers tended a 2.5-acre garden that produced organic vegetables, herbs, and fruit for both patients and the public.

 

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Foo led me through the soaring main lobby to meet Dr. Wong Sweet Fun, a deputy chairman of the medical board who oversaw initiatives for the elderly. A thin woman with a welcoming smile, she spoke about the hospital’s outreach with evangelical zeal.

The basic problem, she said, was that people in Singapore were living longer, but their final years weren’t especially healthy ones. Women on the island tended to suffer through 13 years with a chronic illness such as heart disease, diabetes, or cancer, while for men it was 10 years. The main causes were poor diets, sedentary lifestyles, and stress. The hospital’s goal was to turn these around with prevention, education, and lifestyle changes.

“If someone is living with a chronic disease, we don’t make them come to us,” she said. “We go to them.”

The hospital dispatched nurses into the community to conduct free screenings and talk to residents. They connected people living by themselves with others in the community and held cooking classes for healthy recipes. One of Wong’s favorite initiatives was the Share a Pot program, in which volunteers bought discounted vegetables at the market for soup. Other volunteers did the cooking. Seniors were invited to a community center or school for a free meal, a little exercise, and a checkup. In the process, they made some new friends.

“We didn’t focus on their frailty,” she said. “We focused on what was strong in them. We emphasized dignity, not charity.”

As I already knew, Singaporeans as a whole were fairly healthy. In Bloomberg’s annual index of the world’s healthiest nations, the island routinely ranked in the top 10. Compared with the United States, which came in 35th in the 2022 index, Singapore at number 8 spent only a fraction of its GDP on health care, even though it managed to provide health services to more than 92 percent of its population.

Still, when I spoke to officials at the Health Promotion Board, which is responsible for preventive health care on the island, they told me Singapore needed to do better.

“Like many other public health agencies, we focused on education at first,” said Shyamala Thilagaratnam, the outreach director. “But that didn’t work as well as wanted. So we decided to change the environment instead, to make the healthy choice easier.”

Excerpt adapted from The Blue Zones Secrets for Living Longer: Lessons From the Healthiest Places on Earth by Dan Buettner, a beautifully illustrated and informative guide to the places on Earth where people live the longest—including lessons learned, top longevity foods, and the behaviors to help you live to 100—plus a surprising new blue zones longevity hotspot.