Singapore

Ranking as the 29th richest naton in the world with a per capita income of $28,600, the heavily industrialized nation of Singapore enjoys overall good health. Singapore's prosperous economy is based in large part on strong international trading ties, particularly in electronics and manufacturing, making Singapore one of the busiest ports in the entire world. Singaporeans are generally literate, although there is a gap between male (96.6 percent) and female (88.6 percent) literacy.

With virtually no poverty, an unemployment rate of only 3.1 percent, and a Gini Index of 42.5, most Singaporeans are relatively comfortable. Access to healthcare, safe drinking water, and improved sanitation is universal. The United Nations Development Programme (UNDP) Human Development Reports [Page 1545]rank Singapore 25th of 177 countries in overall qual-ity-of-life issues.

Under British rule, Singapore enjoyed health benefits common to all British colonies. Following independence in 1965, the country experienced a rapid drop in the proportion of government spending allotted to healthcare. Over the following decades, however, as the government committed more resources to healthcare, the overall quality of health improved. By 1985, the government had quadrupled 1960 healthcare expenditures. In 1960, Singapore could claim only one physician for every 2,573 patients. By 1985, that ratio had dropped to one for 972 patients. By 2006, the number of physicians had narrowed to 1.40 per 1,000 population. Likewise, 4.24 nurses, 0.26 dentists, and 0.28 pharmacists are now available per 1,000 population.

Currently, Singapore spends 4.5 percent of its Gross Domestic Product (GDP) on healthcare and allots $1,157 (international dollars) for health expenditures per capita. The government is responsible for 36.1 percent of all healthcare costs, leaving 63.0 percent to be financed by the private sector. Just over 97 percent of private sector spending involves out-of-pocket expenditures. Social Security funding comprises 21.5 percent of all government healthcare expenses. In 2001, the government announced the establishment of the Health Sciences Authority to oversee health issues.

Singapore has been steadily increasing life expectancy since the 1960s when the average Singaporean lived to only 63 years. Today, the population of 4,292,150 has a life expectancy of 81.71 years, the fourth highest in the world. Singaporean females outlive males an average of five years. This increase in life expectancy is indicative of Singapore's subsidized healthcare and of well-developed public and private pension plans. This safety net is extremely valuable to the elderly population, one-fourth of whom are over the age of 75. However, the economy suffers as the rapidly increasing elderly population draws heavily on the resources of a smaller, younger, working population.

Singapore has the third lowest fertility rate in the world at 1.06 children per woman. Government family planning programs have served as the model for many developing nations. Smaller families have led to an increase in the number of women in the workforce, with female representation more than doubling between 1957 and 1985. All births are attended by skilled personnel. Maternal mortality is low at 13.3 per 100,000 live births. In 1960, 34.9 infant deaths occurred for every 1,000 live births. Today, Singapore has the lowest infant mortality rate in the world at 2.29 deaths per 1,000 live births and an under-5 mortality rate of 3 deaths per 1,000 live births. Only 1 percent of Singaporean children fail to receive tuberculosis vaccinations, and only 6 percent have not been immunized against diphtheria pertussis, and tetanus (DPT) and measles.

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