Achieving sustainable health requires innovative design and effective execution of policies that address environmental, social, and governance concerns. This article highlights key principles for sustainable health policy, including prevention and health promotion, equitable access to healthcare, efficient resource allocation, environmental stewardship, and collaboration across sectors. Additionally, it emphasises the role of community development in creating resilient and socially connected communities. Furthermore, technology plays a crucial role in enhancing social and health outcomes by improving access to healthcare, providing health information and education, enabling data-driven care, supporting social connections, and facilitating proactive and personalised interventions. By integrating these principles and leveraging technology, sustainable health policies can lead to better population health, social equity, and environmental sustainability.
Attaining sustainable health requires innovative design and effective execution of the right policies. Health policy should integrate prevention, equitable access, efficient resource allocation, environmental stewardship and collaboration, to foster well-being. Technology integration enhances social and health outcomes through improved access, data-driven care, social connections, and personalised interventions, supporting sustainable health goals.
Sustainable health, in the context of increasing all-round attention on environment, social and governance (ESG) concerns, requires innovative design and effective execution of policy. A comprehensive approach aims to promote long-term well-being while ensuring the efficient use of resources and minimising negative impacts on society and environment. This is certainly apparent as Singapore transitions into population health and a new way of public health financing, and other countries similarly navigate their way to move their respective systems towards more value-based healthcare. Sustainable health policy recognises the interconnectedness between human health, social equity, and environmental sustainability, and could encompass the following key principles:
I. Prevention and health promotion: First and foremost, as the well-worn adage goes, “Prevention is better than cure”. And did we remember to add, “And much more cost-effective too!” Emphasising preventive measures and promoting healthy lifestyles can reduce the burden of illness and improve overall population health. Policies that prioritise health education, early intervention, and access to preventive services help individuals avoid costly treatments, even as the population as a whole ages. Health-adjusted life expectancy and overall well-being is increasingly recognised as the goals to achieve beyond just improving average life expectancy.
II. Equitable access: Ensuring equitable access to quality healthcare services is essential for sustainable health. Policies should focus on reducing disparities and addressing social determinants of health, such as income, education, social-economic disparity and environment. By providing equal opportunities for all individuals to access healthcare, sustainable health policy aims to improve overall population health outcomes. On this point, the role of health-social-community integration, not just integrating health and social, will be game-changing and will be discussed in the next section of this editorial.
III. Efficient resource allocation: Optimal resource allocation and minimising waste within healthcare systems represent the greatest opportunity to curb ever up-spiralling healthcare costs. Measures include promoting evidence-based practices, adopting cost-effective interventions, and utilising health technologies efficiently. By focusing on value-based care and implementing sustainable procurement strategies, healthcare systems can reduce costs while maintaining or improving the quality of care.
IV. Environmental stewardship: Sustainable health policy recognises the importance of environmental factors in shaping health outcomes. The concept of planetary health and its impact on human health is incontrovertible. Policies should encourage environmentally friendly practices within healthcare settings, such as reducing energy consumption, minimising waste generation, and using eco-friendly materials. Additionally, promoting active transportation, green spaces, and sustainable urban planning contribute to a healthier environment and overall well-being. In Singapore and many other places, government agencies, researchers, academia and private investors alike are rushing to collaborate at the intersection of urban planning and public health, to design and develop healthy cities of the future.
V. Collaboration and multi-sectoral approach: From the previous point, one can see the importance of collaboration between various sectors, including healthcare, education, built and natural environment, and social welfare. Policies that foster partnerships, information sharing, and coordinated efforts among these sectors can address complex health challenges more effectively and promote a holistic approach to well-being.
Community development plays a crucial role in achieving sustainable health and better health outcomes. As the World Health Organisation (WHO) rightly defines it, health is physical, mental and social, and all three are important. When communities build social connectedness, they are resilient and cohesive, individuals have increased access to support systems, resources, and opportunities. Indeed, communities often discover that they already have these “assets” and treasures in their midst, within neighbourhoods and place-based communities of care, and in the process of such asset-based community development (ABCD) entire communities become healthier as residents and citizens care for one another.
Community development, which creates resilient and connected communities, alongside improved quality of relationships, social support, and community engagement, therefore, leads to better population health. When individuals feel connected to their community, they are more likely to engage in healthy behaviours, seek help when needed, and have access to a network of support during challenging times. Socially connected communities have lower rates of mental health issues, substance abuse, violent crime, and other negative health outcomes.
A coordinated approach to health and social policymaking may, for example, use the appropriate and relevant levers to:
1. Promote community engagement, ownership and empowerment, strengthen social ties, build trust, and create a supportive environment that positively influences health outcomes.
2. Build social support networks through creatively designed programs and services that facilitate social support networks within communities — these may include support groups, mentoring programs, brick-and-mortar community centres or even virtual (and hybrid) chat-rooms which offer opportunities for social interaction and collaboration.
3. Increase investment in new (or optimising existing) built and natural environment features, health-promoting infrastructure, recreational facilities and socially activated public spaces - to promote physical and mental well-being and also to foster social connections and a sense of belonging.
4. Address social determinants of health (SDOH) such as poverty, education, and housing; which have been shown repeatedly to be even more impactful on the population’s overall well-being, morbidity and mortality, than having convenient access to the most modern hospitals or advanced therapies.
5. Facilitate collaboration and partnerships, which enable community development efforts to be most effective. Sectors include healthcare providers, government agencies, non-profit organisations, and community leaders. By working together, stakeholders can pool resources, expertise, and knowledge to implement comprehensive and sustainable interventions that promote social health.
When individuals are socially supported, engaged, and connected to their communities, they are more likely to lead healthy lifestyles, seek necessary healthcare services, and experience improved overall well-being.
Last, but certainly not least, in a publication that introduces the latest in healthcare technology and innovation, well-planned and provisioned technology development and deployment, supported by the right policy, improves social and health outcomes by enhancing connectivity, expanding access to information and services, facilitating communication, and empowering individuals and communities.
The recent pandemic has ushered in increased access to healthcare, as demonstrated in the accelerated adoption of telemedicine and telehealth solutions. In tandem, there is now the ability to reach the underserved or remote areas, and create remote access to medical expertise, consultations and follow-up care. Telemedicine can also reduce barriers to healthcare, such as transportation costs and long waiting times, leading to better health outcomes especially for those who may otherwise have difficulty seeking and receiving the care they need and deserve.
Health information and education and timely access to such resources have empowered individuals to make informed decisions about their health. Online platforms, mobile applications, and wearable devices offer health monitoring tools and personalised health recommendations in the form of positive behavioural ‘nudges’. These enables individuals to actively manage their health, engage in preventive measures, and adopt healthier lifestyles. Whether in physical and mental health, especially with chronic lifestyle diseases like diabetes, hypertension, cardiovascular disease continually on the rise.
Technology also enables data-driven health and social care. With vast amounts of data, not limited to health but also including environmental, social and others collected in an increasingly internet of tThings (IOT) world, new knowledge and evidence guide upcoming policies and interventions. For example, by leveraging technologies like electronic health records (EHRs) and data analytics, healthcare systems can identify trends, track population health outcomes, and target interventions to specific needs. In addition, behavioural interventions and tracking are increasingly possible through mobile applications, wearable devices, and sensors which monitor various health parameters, such as physical activity, sleep, and vital signs. Technologies can deliver real-time feedback, reminders, and personalised interventions to promote healthy behaviours and lifestyles. By fostering self-awareness and accountability, technology encourages individuals to make positive lifestyle changes for better health.
Beyond digital health and medical technology, ‘social tech’ which support social and community building should be the next focus. Online platforms and social media networks facilitate connections among individuals facing similar health challenges, creating virtual support communities where individuals can share experiences, exchange information, and provide emotional support. Online support groups and forums are known to contribute to improved mental health outcomes and a sense of belonging, particularly for individuals with rare conditions or stigmatised health issues. Furthermore, if one takes the salutogenic approach, strengthening social connections through technology will maintain and improve health even before the onset of disease.
In planning for and building Healthy Cities and Cities of Tomorrow, data regarding environmental pollution, urban heat, space utilisation, urban transport increasingly available through IOT can be cross-analysed with data on health behaviours, resource utilisations, diseases and longer-term outcomes of the people who grow, learn, live, work and play within the defined and designed space. This offers new levers not only for proactive and personalised healthcare delivery, but also for urban planning and building design for entire populations.
In conclusion, by integrating these inter-disciplinary principles into policy, sustainable health can be achieved, creating a healthcare system that not only meets the immediate needs of individuals but also safeguards the health of future generations. A healthy population and a healthy environment are mutually reinforcing and there needs to be a balance between healthcare delivery, resource management, and social and environmental considerations.
