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Background Global health risk factors contribute significantly to mortality and morbidity worldwide, with diverse impacts across socio-economic groups. This study developed a composite index for health risk factors and subdomains, including nutrition, environmental risks, and non-communicable diseases, across 100 countries stratified by human development index (HDI) from 2015 to 2019. The index tracks disparities, trends, and associations with human development, aiding in resource allocation and informed policy-making for reducing health risks and improving global health outcomes. Methods A panel dataset comprising 100 countries, categorized into four HDI groups, was analyzed for the period 2015 to 2019. Health indicators were selected to construct a Health Risk Factors Index based on the World Health Organization’s Global Reference List 2018. The development of the composite index and its sub-domains followed the United Nations Development Programme’s methodology for data normalization, utilized Principal Component Analysis to determine weights, and employed the inverse normalized Euclidean distance formula for aggregation. Spearman’s rank correlation was used to examine the relationships between the composite Health Risk Factors Index, its sub-indices, and the HDI. Results The study revealed that very high HDI countries excelled in the Health Risk Factors Index and sub-indices for nutrition and environmental risks, indicating lower health risks. While low and medium HDI groups performed better in the non-communicable diseases index. Singapore achieved the highest health risk factors index scores in 2015 and 2019. A strong positive correlation was observed between HDI with composite and sub-indices of health risk factors and a negative correlation with sub-index of noncommunicable disease during 2015–2019. Conclusion The study highlights significant disparities in health risk factors across HDI groups, underscoring the need for tailored interventions. In general, very high and high HDI countries require focused efforts on noncommunicable disease-related health risk factors, while low and medium HDI countries should prioritize nutrition and environmental risks. Composite indices like the health risk factor index facilitate benchmarking and policy development, promoting accountability and targeted strategies for global health improvement.

Medical tourism occupies different spaces within national policy frameworks depending on which side of the transnational paradigm countries belong to, and how they seek to leverage it towards their developmental goals. This article draws attention to this policy divide in transnational healthcare through a comparative bibliometric review of policy research on medical tourism in select source (Canada, United States and United Kingdom) and destination countries (Mexico, India, Thailand, Malaysia and Singapore), using a systematic search of the Web of Science (WoS) database and review of grey literature. We assess cross-national differences in policy and policy research on medical tourism against contextual policy landscapes and challenges, and examine the convergence between research and policy. Our findings indicate major disparities in development agendas and national policy concerns, both between and among source and destination countries. Further, we find that research on medical tourism does not always address prevailing policy challenges, just as the policy discourse oftentimes neglects relevant policy research on the subject. Based on our review, we highlight the limited application of theoretical policy paradigms in current medical tourism research and make the case for a comparative policy research agenda for the field.

Hereditary Cancer makes up around 5–10% of all cancers. It is important to diagnose hereditary cancer in a timely fashion, as not only do patients require long-term care from a young age, but their relatives also require management. The main approach to capture at-risk relatives is cascade testing. It involves genetic testing of relatives of the first detected carrier of a pathogenic variant in a family i.e. the proband. The current standard of care for cascade testing is a patient-mediated approach. Probands are then advised to inform and encourage family members to undergo genetic testing. In Singapore, cascade testing is inefficient, around 10–15%, lower than the 30% global average. Here, we describe the cascade testing process and its effort to increase testing in Singapore. Precision Health Research, Singapore (PRECISE), was set up to coordinate Singapore’s National Precision Medicine strategy and has awarded five clinical implementation pilots, with one of them seeking to identify strategies for how cascade testing for hereditary cancer can be increased in a safe and cost-efficient manner. Achieving this will be done through addressing barriers such as cost, manpower shortages, exploring a digital channel for contacting at-risk relatives, and getting a deeper insight into why genetic testing gets declined. If successful, it will likely result in care pathways that are a cost-effective public health intervention for identifying individuals at risk. Surveillance and management of those unaffected at-risk individuals, if caught early, will result in improved patient outcomes, and further reduce the healthcare burden for the economy.

[...]the market-driven efficiency, enthusiastically applauded by some, threatens the doctor-patient relationship because of the rationing of clinical care to manage costs.

Hong Kong, Singapore and Taiwan are three island states that are newly emerged affluent economic areas in Asia. The majority of the populations are ethnically Chinese with a total population of 6.98, 4.5 and 23 million, respectively. Cervical cancer has been declining over the last thirty years in all three states and is largely attributable to widespread opportunistic cervical cancer screening. The age-standardized incidence rates of cervical cancer are 9.6 per 100,000 women in Hong Kong in 2004, 10.6 per 100,000 women in Singapore in 2002 and 18.6 per 100,000 women in Taiwan in 2003. High prevalence of human papillomavirus (HPV) was observed in all three states. In cervical cancer, HPV 16 and 18 are the two most prevalent HPV types, but HPV 58 and 52 are also highly prevalent in these three states. Important epidemiological risk factors for invasive cervical cancer include smoking and age at sexual debut for women, although this is changing towards an earlier age. Of the three states, Taiwan was the first to have a comprehensive national screening programme in 1995 followed by Hong Kong in 2002 and Singapore in 2004. Women in these three states are well aware of cervical cancer and the preventative means by Pap smear screening, although their awareness and understanding of the role of HPV in cervical carcinogenesis is low. Prophylactic HPV vaccines have been licensed in the three states. Routine comprehensive public vaccination programme for adolescent girls has yet to be adopted by the governmental agency, despite an affirmative recommendation by medical professional bodies.

To evaluate the impact of the National Healthy Lifestyle Programme, a noncommunicable disease intervention programme for major cardiovascular disease risk factors in Singapore, implemented in 1992. The evaluation was carried out in 1998 by the Singapore National Health Survey (NHS). The reference population was 2.2 million multiracial Singapore residents, 18-69 years of age. A population-based survey sample (n = 4723) was selected by disproportionate stratified and systematic sampling. Anthropometric and blood pressure measurements were carried out on all subjects and blood samples were taken for biochemical analysis. The 1998 results suggest that the National Healthy Lifestyle Programme significantly decreased regular smoking and increased regular exercise over 1992 levels and stabilized the prevalence of obesity and diabetes mellitus. However, the prevalence of high total blood cholesterol and hypertension increased. Ethnic differences in the prevalence of diabetes mellitus, hypertension, and smoking; and in lipid profile and exercise levels were also observed. The intervention had mixed results after six years. Successful strategies have been continued and strengthened.

The cause of this disease is the new coronavirus, for which we do not have a vaccine. [...]it can be expected that the disease will be very dangerous for the elderly and to those who are already ill. In my article “20 Key Questions and Answers on Coronavirus” posted on the 9th of March, 2020 on Index.hr [1], in answer to question number 18, “With the effectiveness of quarantine in China, can we draw some lessons from this pandemic?”, I stated: “If the virus continues to spread throughout 2020, it will demonstrate in a very cruel way how well the public health systems of individual countries are functioning… In doing so, human errors that can lead to the unnecessary spread of the infection are: (1) omission to properly understand the epidemic parameters; (2) reluctance to make decisions based on the changes in those parameters; and (3) the irresponsible behavior of the population in complying with instructions from the authorities. First of all, there was probably a premature relaxation around the real danger of COVID-19 in Europe.

Since Esping-Andersen (1990) presented the “three worlds of welfare capitalism” thesis based on his study of the OECD countries, there have been debates on whether East Asian countries form a separate world of welfare capitalism or not. The objective of this article is to demonstrate how the study of the health care systems in six East Asian countries (Hong Kong, Singapore, South Korea, Taiwan, Malaysia, and Thailand) plus Japan contributes to the debate on the existence of a distinct welfare regime in East Asia. This objective is met by mainly using the evidence provided by health care typologies to test two hypotheses: 1) There are significant similarities between some of the health care systems in eleven OECD countries and those in Hong Kong, Taiwan, Thailand, South Korea, Malaysia, and Singapore, and 2) there are significant differences in the health care systems between Hong Kong, Taiwan, Thailand, South Korea, Malaysia, and Singapore.