RR17.1:
Bouquets and Brickbats for Singapore’s “Number One” Rankings”
One of the world’s leading medical journals, The Lancet, revealed that among developed countries, Singapore has the lowest mortality rate for young males (the US has the highest) and attributes this to several factors: virtually no access to guns, drugs, or gangs for Singaporean teens; no “ghetto-type areas”; a good education system that mandates participation in extra-curricular activities; and limiting driver’s licences to those 18 and over.[i]

Sleep Deprivation on the Rise in the Developed World and Endemic in Singapore
On the down side, the increased education-related expectations placed upon Singapore boys and girls by parents and teachers means they are experiencing sleep deprivation, which results not just in crankier children, or shorter tempers, but also in serious mental health issues.[ii] The Wall Street Journal, on January 18, 2011, reported the following: ⁵

• According to America’s National Sleep Foundation’s 2004 “Sleep in America poll” of 1,473 adults with children aged 10 and younger in the home, 13% of school-age children had difficulty falling asleep at bedtime and 26% of pre-schoolers seemed sleepy or overtired during the day, at least a few days a week. About 45% of adolescents aged 11 to 17 got less than eight hours of sleep a night.
• A 2010 study of 392 boys and girls in the US, published in the Journal of Psychiatric Research, showed that those who had trouble sleeping at 12 to 14 years old were more than twice as likely to have suicidal thoughts at ages 15 to 17 as those who didn’t have sleep problems at the younger age.
• Another study in the US of 1,037 children revealed that 46% of those who were considered to have a persistent sleep difficulty at age nine had an anxiety disorder at age 21 or 26. By comparison, of the children who didn’t have sleep problems at age 9, 33% had an anxiety disorder as young adults. This study was published in 2005 in the Journal of Abnormal Child Psychology.

In yet another study, published in 2010 by Science Translational Medicine, neurologists at Harvard Medical School highlighted that staying awake for 24 hours in a row is on par with legal intoxication with alcohol (in driving) in impairing performance. Sleeping only six hours per night for two weeks causes a similar level of impairment as staying awake for 24 hours.⁶

In findings that strike close to home, The Straits Times of Singapore reported in the April 20, 2012 issue that Singaporean children get an average of two hours less sleep than their peers in Switzerland. Paediatricians from Singapore’s National University Hospital studied 372 children aged two to six. The doctors were disturbed to find that the children’s parents thought that their children’s sleep patterns were fine. One of the professors said, “My personal experience is that many children and teenagers (in Singapore) are quite sleep-deprived. They see me in the clinic for headaches, dizziness and poor attention in class.” He also said that after the children took his advice to get more sleep, many of their physical problems improved, and some of the children and teens showed “markedly improved academic ability.”⁷

Singapore Children Have High Rate of Mental Illness
Singapore is certainly well-known for being a stressful city—According to the Singapore Institute of Mental Health, many children in Singapore are likely to face depression, which is the most common mental illness here. Others succumb to alcohol abuse, or end up with obsessive-compulsive disorder (OCD), which is anxiety characterised by obsessions, compulsive rituals, and intrusive thoughts and impulses. Another surprising finding is that Singapore has the world’s highest rate for OCD—3% of the population. (The figure in the U.S. is 2.3% and 1.1% in Europe.) Mental and chronic physical illness such as cancer, heart conditions, diabetes and high blood pressure often go hand in hand. Over 14% of people with chronic physical illness also have a mental illness. Among those with mental illness, over half have a chronic physical illness. ³

Heavy Backpacks Cause Lasting Damage
The Italian Backpack Study done in 1999 found that the average load students carried amounted to 22% of their body weight, thus exceeding the recommended 15%. They also found that 34.8% of students carried more than 30% of their normal body weight at least once during the week.¹²

Researchers in Hong Kong studied students’ lung volume. Scientists found that the average weight of school students’ backpacks was equivalent to 15% of their body weight. However, in the case of those who were carrying up to 20% of their body weight, their lung volume was significantly compromised.¹³

Another study compared the backpack weight of students in India with their counterparts in Houston, Texas. Almost 60% of students aged nine to 20 years old from both countries suffered from chronic back pain! And the percentage of students with back pain who carried backpack loads that constituted only 15% of their body weight regularly was drastically lower.¹⁴

High Rate of Myopia Linked with Lack of Outdoor Light
A study published in The Lancet in May 2012 revealed that myopia has emerged as a major health issue in parts of Asia, affecting 80–90% of graduating school children compared to 10–20% of those completing secondary schooling in other parts of the world: “The higher prevalence of myopia in east Asian cities seems to be associated with increasing educational pressures, combined with lifestyle changes, which have reduced the time children spend outside.”¹⁵

A BBC report also confirmed the findings of this research study: “According to the research, the problem is being caused by a combination of factors—a commitment to education and lack of outdoor light.”¹⁶ The researchers said children who spend two to three hours outdoors a day are “probably reasonably safe” from getting myopia. This could include time spent on the playground and walking to and from school.¹⁷