Singapore: The world's sixth 'Blue Zone'

In August 2023, Singapore was named the world’s sixth “Blue Zone”. I didn’t catch the news at the time, but a recent BBC article shared in my group chat piqued my interest.

The original five Blue Zones – Okinawa (Japan), Sardinia (Italy), Nicoya (Costa Rica), Ikaria (Greece), and Loma Linda (California) – are regions where people live the longest, healthiest lives, often well into their 80s. These populations have lifestyles that developed organically and are characterized by

• low impact, high-volume physical activity integrated into daily life

• rich social interactions

• mostly plant-based diets made up of locally sourced whole foods

• low incidence of disease

What’s remarkable is that these habits weren’t planned or imposed — they emerged naturally over centuries, shaped by cultural and environmental influences.

However, Singapore’s entry into the Blue Zone list is different. Unlike the other regions, Singapore’s approach is consciously designed and government-led. Dubbed a Blue Zone 2.0, it has deliberately implemented forward-thinking policies to promote health and longevity.

“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.”

This quote aptly reflects Singapore’s signature style of governance — a little bit of “we know what’s best for you” with a dash of paternal efficiency. Rather than leaving it up to personal choice, they engineered an environment where making healthy decisions is made into the default. It’s a top-down approach that, unsurprisingly, works! Efficient, effective, and undeniably Singaporean.

The BBC article starts off with a striking comparison:

A child born in the country in 1960 was only likely to live (at the time) to 65, but a child born in Singapore today can expect to live to more than 86 according to estimates.

This made me wonder:

1. What is a typical change in life expectancy? Is the 21-ish years that Singapore has achieved extraordinary?

2. Are there any countries whose life expectancy has reversed?

Just to set the scene – Singapore has the 2nd highest life expectancy of any country in 2024 ( CIA World Factbook).

In 2024, Singapore’s life expectancy was 86.7.

By definition, this number is an estimate of the average age that Singaporeans will be when they die. However, it’s also often glossed over whether this is cohort life expectancy or period life expectancy. The first is the average life length of a particular cohort of individuals born in a given year (in this case, all infants born in 2024). This is pretty simple to grasp, conceptually. The second is period life expectancy which is a little more complicated, but the more commonly seen measure (used by the UN and the World Bank when reporting life expectancy). It gives an estimate based on current conditions in a particular year. For example, COVID-19 would mean a dip in both life expectancy values, but for cohort life expectancy in 2020, it might be because a higher number of infants and young children died during those years, while for period life expectancy, it would reflect the overall increase in mortality rates across all age groups during that year. Our World in Data goes into this difference in greater detail.

So, did Singapore have the biggest increase in life expectancy?

Singapore’s change in life expectancy from 1960 to 2022:

## # A tibble: 1 × 2
##   country_name change_in_lfe
##   <chr>                <dbl>
## 1 Singapore             18.2

And a graph of the top 8 countries with the biggest change:

With a change in life expectancy of 18.2 years for Singapore, compared to the top 8 countries whose numbers range from 32 to 45, Singapore definitely did not have the biggest increase in life expectancy.

But is it at least better than average? (Such an Asian thing to wonder, I know.)

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A brief aside in calculating averages and, what makes a country?

(skip this if you’re not into the details)

• I decided to use the ISO 3166 standard which has 249 countries and subdivisions because the data is super accessible, thanks to lukes on GitHub.

• as a former geography student, we know that some countries are contested, and a few may not have even existed in 1960! Which means we should probably double-check the 1960 data.

• indeed, there are some gaps. For example, Israel didn’t have life expectancy estimates for 1960, though it did for 1961. I chose not to impute the missing value for… well, laziness. But also a healthy respect for not imputing when it might not be necessary - after all, I’m comparing 1960 to 2022, not 1960-1961 to 2022.

## # A tibble: 14 × 4
##    country_name             x1960 x2022 change_in_lfe
##    <chr>                    <dbl> <dbl>         <dbl>
##  1 Andorra                   NA    NA              NA
##  2 American Samoa            NA    NA              NA
##  3 Curacao                   65.8  NA              NA
##  4 Cayman Islands            NA    NA              NA
##  5 Faroe Islands             NA    83.3            NA
##  6 Greenland                 NA    71.5            NA
##  7 Israel                    NA    82.7            NA
##  8 Liechtenstein             NA    84.3            NA
##  9 Monaco                    NA    NA              NA
## 10 Northern Mariana Islands  NA    NA              NA
## 11 Palau                     NA    NA              NA
## 12 West Bank and Gaza        NA    73.4            NA
## 13 San Marino                NA    NA              NA
## 14 Seychelles                NA    73.8            NA

Fun stuff: American Samoa, Cayman Islands and Greenland did become “countries” after 1960 – 1967, 1962, and 1979 respectively. Although “becoming countries” is not the right term, because American Samoa is an unincorporated territory of the US, and the Cayman Islands is similar but by the British, and Greenland is also a territory (Denmark).

~~~~~~~~~

And the average life expectancy for all the remaining countries/subdivisions turns out to be:

## [1] 18.00272

And with the previous value of 18.2, Singapore is just slightly above average.

*I’m honestly quite disappointed… Singapore is not exceptional?!*

Anyway, final question:

Any countries with a negative change in life expectancy?

Generally, we would expect life expectancy to increase from 1960 to 2022 because of improvements in healthcare, technology and living conditions! For example, vaccines, better sanitation, better access to clean water and nutrition.

Unfortunately, factors like conflict, economic instability and a global pandemic has reversed life expectancy.

Looking at this graph, it’s clear that life expectancy has taken different paths from 1960 to 2022 for Singapore, China, and Ukraine. Each rise and fall, along with the overall trends, reflects how these countries’ decisions have the power to change the lives of hundreds, thousands, or even millions of people — or to face the challenges of adversity. China’s policy shifts can impact millions, while Ukraine grapples with factors beyond its control, including geopolitical instability and ongoing conflict.

The adorable butt on the cover image is Avery, a very special Singapore Special. They are a 混血 (mixed-blood) breed of dog who naturally came to stick around humans, and are often shy but very curious!