Dec 19, 2024
By 2050, one in four people in Asia and the Pacific will be over 60 years old. 11. “Adapting to Aging Asia and the Pacific,” Asian Development Bank, accessed November 18, 2023, https://www.adb.org/what-we-do/topics/social-development/aging-asia. This presents a “demographic time bomb” that disproportionately affects developed nations as their populations live longer22. Yeva Nersisyan, Xinhua Liu and L. Randall Wray, “The Unbearable Weight of Aging: How to Deal with the ‘Demographic Time Bomb’,” Levy Economics Institute, April 2023, https://www.levyinstitute.org/pubs/wp_1018.pdf.. Singapore’s population is also ageing rapidly, making it a "super-aged" society33. Hwee Min Ang, "HDB Flats, Estates to be More Senior-Friendly to Prepare for Singapore's 'Super-Aged Society': PM Lee", ChannelNewsAsia, August 20, 2023, https://www.channelnewsasia.com/singapore/national-day-rally-2023-hdb-flats-elderly-ease-upgrades-senior-citizens-3711426.. This raises a wide range of social, economic and health concerns for policymakers.

Pressures

Like other industrialised nations, Singapore’s life expectancy increased over the years, from 61 years in 1957 to 83 in 2022 44. Nabilah Awang, ““Life Expectancy by Sex,” Department of Statistics Singapore, accessed November 18, 2023, https://tablebuilder.singstat.gov.sg/table/TS/M810501.. This can be attributed to improvements in public health, hygiene and standard of living 55. Abhijit Visaria and Rahul Malhotra, “Live Long and Prosper? A Super-Aged Singapore Society Does Not Have to Be a Sad One,” Duke-NUS Medical School, August 26, 2023, https://www.duke-nus.edu.sg/allnews/super-aged-singapore-society.. For instance, research highlights a positive correlation between better nutrition and healthy ageing 66. Yan-Feng Zhou, Xing-Yue Song, An Pan and Woon-Puay Koh, “Nutrition and Healthy Ageing in Asia: A Systematic Review,” Nutrients 15, no. 14 (2023): 3153, https://doi.org/10.3390/nu15143153.. The Ministry of Health conducts the National Population Health Survey annually, in conjunction with the Health Promotion Board’s National Nutrition Survey, to monitor the intake of different nutrients like sodium and sugar among Singapore residents 77. “National Health Surveys Highlight Need to Focus on Healthy Diets and Lifestyles,” Ministry of Health, September 27, 2023, https://www.moh.gov.sg/news-highlights/details/national-health-surveys-highlight-need-to-focus-on-healthy-diets-and-lifestyles.. While these studies identify areas for improvement, Singaporeans have gradually adopted healthier eating habits 88. “National Nutrition Survey 2018 Shows Gradual Improvements in Singaporean’s Dietary Habits,” Health Promotion Board, accessed November 19, 2023, https://www.hpb.gov.sg/newsroom/article/national-nutrition-survey-2018-shows-gradual-improvements-in-singaporeans-dietary-habits., possibly driven by various Health Promotion Board initiatives 99. “Food and Beverage,” Health Promotion Board, accessed November 19, 2023, https://hpb.gov.sg/healthy-living/food-beverage.. Singapore also possesses a technologically advanced healthcare system that has enabled early detection – and thus treatment – of conditions like tuberculosis and cancer 1010. Teresa Cheong, “Why are Singaporeans Living Longer?” HealthXchange, accessed November 18, 2023, https://www.healthxchange.sg/seniors/healthy-ageing/why-singaporeans-living-longer#:~:text=Medical%20advances%20improve%20early%20disease,have%20enabled%20longer%20life%20expectancy., thereby lowering death rates.

Simultaneously, Singapore’s fertility rate has been decreasing since 1960 1111. “Birth and Fertility Rates,” Department of Statistics Singapore, accessed November 18, 2023, https://tablebuilder.singstat.gov.sg/table/TS/M810091., reaching a historic low of 0.97 in 2023. 1212. National Population and Talent Division, Strategy Group, Prime Minister’s Office, Singapore Department of Statistics, Ministry of Home Affairs, Immigration & Checkpoints Authority, Ministry of Manpower, “Population in Brief 2024,” 29, https://www.population.gov.sg/files/media-centre/publications/Population_in_Brief_2024.pdf. This mirrors a global trend of declining birth rates in developed countries. Rapid economic development and inflation have increased living costs 1313. Youyenn Teo, “Shaping the Singapore Family, Producing the State and Society,” Economy and Society 39 no. 3 (2010): 341, https://doi.org/10.1080/03085147.2010.486215., making it more expensive to raise children. According to a YouGov poll, a majority of respondents (52%) below 35 years old did not have children as they “can’t afford to raise children in Singapore”1414. Hwee Min Ang, “The ‘Declining Value’ of Having Children in Singapore - and How to Fit It,” ChannelNewsAsia, March 18, 2023, www.channelnewsasia.com/singapore/birth-rate-fertility-rate-children-kids-marriage-parenthood-3354451., despite the various financial incentives provided by the government. 39% of respondents in the same demographic also feared that having children “would impact [their] career and current lifestyle” 1515. Ang, “The ‘Declining Value’ of Having Children in Singapore.”. Some Singaporeans in this age group are in the “sandwich generation” and face the challenge of supporting both their elderly parents and young children, not just financially1616. Firdaus Hamzah, "Sandwich Generation: How can Those Caring for the Elderly and Children Take Care of Their Finances,” ChannelNewsAsia, September 28, 2022, https://www.channelnewsasia.com/singapore/sandwich-generation-money-elderly-parents-children-singapore-population-2970826., but also in caregiving. Faced with these demands, younger people are defying traditional expectations of family formation and parenthood.

Existing Policies and Measures

Migrant Domestic Workers

The Foreign Maid Scheme was first introduced by the government in 1978. 1717. Jennifer Dodgson, “Foreign Domestic Workers in Singapore: Social and Historical Perspectives,” Lee Kuan Yew School of Public Policy, 2016, 4, https://lkyspp.nus.edu.sg/docs/default-source/case-studies/fdws_in_singapore.pdf?sfvrsn=2ac5960b_2. As of December 2023, 286,500 migrant domestic workers were working in Singapore1818. Hui Yee Tan, “Migrant Domestic Workers in Malaysia, Singapore and Thailand Earn Below Minimum Wage: Study,” The Straits Times, June 15, 2023, www.straitstimes.com/asia/se-asia/migrant-domestic-workers-in-malaysia-singapore-and-thailand-earn-below-minimum-wage-study#:~:text=As%20at%20December%202022%2C%20Singapore,Ministry%20of%20Manpower%20(MOM).. Domestic workers enable their Singaporean employers to balance careers and families by providing care for dependent family members. However, as highlighted by various non-governmental organisations, migrant domestic workers face problems caused by cultural differences1919. Association of Women for Action and Research and Humanitarian Organization for Migration Economics, “Neither Family nor Employee: The Caregiver Burden of Migrant Domestic Workers in Singapore,” November 2020, 5, https://www.aware.org.sg/wp-content/uploads/Neither-Family-Nor-Employee-AWARE-HOME-Report-Nov-2020.pdf., forced labour 2020. Humanitarian Organization for Migration Economics and Liberty Shared, “Behind Closed Doors: Forced Labour in the Domestic Work Sector in Singapore,” January 2019, https://static1.squarespace.com/static/5a12725612abd96b9c737354/t/5c3d7b534fa51aa111983e4a/1547533156689/FINAL+Forced+Labour+Report+V8.pdf., emotional abuse 2121. Humanitarian Organization for Migration Economics, “Invisible Wounds: Emotional Abuse of Migrant Domestic Workers in Singapore,” June 2022, https://static1.squarespace.com/static/5a12725612abd96b9c737354/t/62b2ddfe66959024646ae56c/1655889416169/Invisible+Wounds+-+Emotional+Abuse+of+Migrant+Domestic+Workers+in+Singapore.pdf., and the provision of low-quality and insufficient food 2222. Julie Ham and Aaron Ceradoy, “‘God Blessed Me with Employers who Don’t Starve their Helpers’: Food Insecurity and Dehumanization in Domestic Work,” Gender, Work and Organization 29 (2022): 926, https://onlinelibrary-wiley-com.libproxy1.nus.edu.sg/doi/10.1111/gwao.12643.2323. Shirlena Huang and Brenda S.A. Yeoh, “Foreign Domestic Workers in Singapore: A Neglected Social Issue?” in 50 Years of Social Issues in Singapore, ed. David Chan (Singapore: World Scientific, 2015), 174.. Furthermore, many migrant domestic workers arrive in Singapore with sizeable debts because of agents’ fees. They are afraid to report abuse by their employers, because they cannot risk unemployment, loss of income and repatriation2424. Cheryl L., “Food as Power Tools: How Food and Mealtimes Reflect the Power Dynamics of a Household,” Transient Workers Count Too, July 2023: 25, https://twc2.org.sg/wp-content/uploads/2023/07/Food_as_power_tools_v1.5.pdf. .

Following several high-profile cases of abuse, in 2014, Myanmar prohibited its citizens from working as domestic workers in Singapore2525. Priya Deshingkar, “Criminalisation of Migration for Domestic Work from Myanmar to Singapore - Need for a Radical Policy Shift,” European Journal on Criminal Policy and Research 27 (2021): 135, https://doi.org/10.1007/s10610-020-09477-w.. Such policies disrupt the supply of labour that Singapore is heavily dependent on, and also undermine diplomatic relations between Singapore and neighbouring migrant-sending countries. Fundamentally, society and the government must acknowledge and address the problems faced by migrant domestic workers, and pay greater attention to their welfare.

Healthcare System

Singapore’s healthcare system is a key infrastructure that supports the ageing population. Currently, Singaporeans and permanent residents make up about 72% of Singapore’s registered nurses, with the remaining from other countries2626. Gek Phin Chua, “Challenges Confronting the Practice of Nursing in Singapore,” Asia Pacific-Journal of Oncology Nursing 7, no. 3 (2020): 261, https://doi.org/10.4103/apjon.apjon_13_20.. This overreliance on foreign nurses is a vulnerability, as revealed during the COVID-19 pandemic in 2021 when the Philippines banned its nurses from working abroad to secure its domestic healthcare system2727. Rowalt Alibudbud, “When the ‘Heroes’ ‘Don’t Feel Cared For’: The Migration and Resignation of Philippine Nurses Amidst the COVID-19 Pandemic,” Journal of Global Health 12 (2022): 2, https://doi.org/10.7189/jogh.12.03011. . In addition, as of 2021, the attrition rate of migrant nurses in the public sector was about 15%2828. Charlene Goh and Janarthanan Krishnasamy, “Better Opportunities, Ease of Getting Residency among Reasons Foreign Nurses Leave Singapore to Work Abroad,” The Straits Times, August 10, 2022, www.todayonline.com/singapore/better-opportunities-residency-foreign-nurses-leave-singapore-1966436.. Singapore’s healthcare system is not considered ideal by many migrant nurses, due to insufficient protection against abuse2929. Christy Yip and Lianne Chia, “Why Some Healtcare Workers in Singapore’s Hospitals have Quit - and Others Soldier On,” ChannelNewsAsia, April 28, 2022, www.channelnewsasia.com/cna-insider/why-healthcare-workers-singapore-hospitals-resignations-2647746., heavy workload and poor work-life balance, with many nurses spending 80% of their time at work. 3030. Y. Kowitlawkul, S.F. Yap, S, Makabe, S. Chan, J. Takagi, W.W.S. Tam, M.S. Nurumal, “Investigating Nurses’ Quality of Life and Work-Life Balance Statuses in Singapore,” International Nursing Review 66, no. 1 (2019): 65, https://doi.org/10.1111/inr.12457. Thus, migrant nurses often leave the Singapore healthcare system after some time. Many migrant nurses – particularly those from Southeast Asia – perceive Singapore as a stepping stone before migrating to destinations like the US and Australia. 3131. Jalelah Abu Baker, “What Will It Take to Retain Foreign Nurses when Some See Singapore as a Stepping Stone to the West?” ChannelNewsAsia, August 23, 2023, https://www.channelnewsasia.com/singapore/nursing-foreign-manpower-retention-stepping-stone-3717776. This is a net loss for Singapore in terms of the departure of experienced nurses and the training invested in them.

Augmenting the Workforce and Population

Beyond care workers, the government seeks to complement the resident workforce by attracting migrant workers for various industries. In 2023, Singapore had about 1.24 million migrant workers after excluding migrant domestic workers3232. “Foreign Workforce Numbers,” Ministry of Manpower, accessed November 30, 2023, https://www.mom.gov.sg/documents-and-publications/foreign-workforce-numbers.. While most low- and semi-skilled work-permit holders are considered transient workers, the government welcomes investors, professionals and highly skilled migrant workers 3333. Jessica Pan and Walter Theseira, “Immigration in Singapore,” Background Paper to the World Development Report 2023: Migrants, Refugees, and Societies, April 2023, https://thedocs.worldbank.org/en/doc/080a4bc64cc8a9eb8a2a0e98d97a260a-0050062023/original/WDR-Immigration-in-Singapore-FORMATTED.pdf. who “can contribute to Singapore, share our values and integrate into our society” 3434. National Population and Talent Division, “A Sustainable Population for a Dynamic Singapore,”, January 2013, 3, https://www.strategygroup.gov.sg/images/chart7.png.pdf. to become permanent residents or citizens. Various policies have also been established to facilitate the integration of high-skilled migrants in Singapore society. However, not all Singaporeans agree with the government’s stance. Some Singaporeans are concerned that such “foreign talent” poses unfair competition for jobs, 3535. Catherine Gomes, “Identity as a Strategy for Negotiating Everyday Life in Transience: A Case Study of Asian Foreign Talent in Singapore,” Current Sociology 67, no. 2 (2019): 226, https://doi.org/10.1177/0011392118792929. since they tend to be regarded as “cheaper” and “more hardworking” than locals. 3636. Brenda S.A. Yeoh and Theodora Lam, “Immigration and Its (Dis)Contents: The Challenges of Highly Skilled Migration in Globalizing Singapore,” American Behavioral Scientist 60, no. 5-6: 647, https://doi.org/10.1177/0002764216632831.

The government has introduced several policies to mitigate Singapore’s demographic time bomb. However, managing an ageing population remains a key challenge for Singapore, because a country’s fertility rates are closely tied to residents’ personal decisions, priorities and preferences, which may not be easily influenced by government policies. Population ageing remains a pressing issue, not just in Asia, but across the world, as one in six people will be aged 60 years or over by 20303737. World Health Organization, “Ageing and Health,” October 1, 2022, https://www.who.int/news-room/fact-sheets/detail/ageing-and-health#:~:text=At%20this%20time%20the%20share,2050%20to%20reach%20426%20million.. Countries may be able to address this problem through sharing of best practices and policy experiences, in collaboration with international organisations like the World Health Organization.

Read the case study A “Super-Aged Society”: Defusing Singapore’s Demographic Time Bomb written by Hannah Pang Jing Xuan, which was awarded the Merit Prize in the Case Writing Competition 2023/24 at the Lee Kuan Yew School of Public Policy. 

Access more case studies from the Lee Kuan Yew School of Public Policy.

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