Social Work in Healthcare: Diabetes, Lifestyle and Ethnicity

This report delves into the multifaceted role of social work within the healthcare system of Singapore. It begins by outlining the structure and philosophy of Singapore's healthcare, including its financing mechanisms and commitment to accessible, affordable care. The report then addresses the critical health issue of diabetes in Singapore, examining its prevalence, risk factors, and the government's response. A significant portion of the report analyzes the impact of lifestyle, ethnicity, motivation, and socio-economic status on treatment adherence for pre-diabetes patients, drawing from a MOH report. The analysis emphasizes the importance of lifestyle modification, community-based programs, and culturally sensitive interventions. The report also discusses the core social work values relevant to chronic disease management, highlighting the profession's commitment to patient well-being and holistic care. The report provides an overview of the healthcare system in Singapore, the prevalence of diabetes, the factors that affect the treatment of diabetes, and the role of social work in the healthcare system.

Running head: SOCIAL WORK IN HEALTHCARE
Social Work in Healthcare
Name of the student
Name of the university
Author note

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Table of Contents
Introduction:....................................................................................................................................3
Question 1- Healthcare system of Singapore and its philosophy and financing mechanism:.........3
Question 2- Demonstrating the understanding of critical health related issue:...............................7
Question 3- MOH report regarding prevalence of diabetes in Singapore:......................................9
a) Analyze how lifestyle, ethnicity, motivation, and socio-economic status may impact on the
compliance or treatment adherence of the pre-diabetes:.............................................................9
b) Social work value for chronic disease management:............................................................11
Conclusion:....................................................................................................................................12
References:....................................................................................................................................13
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Introduction:
With the rapid development of complexity within the society in Singapore, the healthcare
needs of this nation are also changing in a rapid manner. As discussed by Khoo, Lim & Vrijhoef
(2014) the intensity of vulnerable groups such as elderly people, people suffering from chronic
diseases and the people with severe mental health issues is also accelerating drastically. In
addition, the medical conditions such as dementia, issues related to stress and dementia are also
experiencing speedy growth. The socio-political aspects of delivering high quality of healthcare
services are also shifting. In this situation, the government is playing significant role in order to
address the healthcare issues. Lim (2013) showed that the healthcare system of Singapore has
become more intricate and multilayered. Present paper would put forth the discussion of the
healthcare practice in Singapore. The way of meeting the specific need of the diabetes affected
patients will also be discussed in the paper.
Question 1- Healthcare system of Singapore and its philosophy and financing
mechanism:
The healthcare system of Singapore is multilayered and intricate and is highly intended
towards satisfying the expanding demand of healthcare. Yoong et al., (2015) observed that
growing population, aging and furnishing the workforce for new economic activities are some of
the significant factors, acting as the driving factor behind the healthcare system of Singapore to
be accelerated. The ministry of Health (MOH) of Singapore is highly committed towards
ensuring the fact that all the citizens of the country are acquiring affordable and medical services.
The healthcare services of Singapore has been designed with the intension of ensuring the fact
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that people are multilayered healthcare facility in a timely and cost effective manner. Both MOH
and its statutory authority possess the responsibility of operating the entire healthcare system of
Singapore by amplifying the healthcare facilities such as hospitals, medical centers, community
health centers, nursing homes, clinics and laboratories which are the key of meeting diverse
healthcare needs of the people (Moh.gov.sg.2019). The Ministry of Healthcare of Singapore is
working consistently for the sake of meeting the diverse healthcare needs of the people in future.
Ho et al., (2019) showed the fact that the healthcare system of Singapore is highly
complicated and has been designed with the intension of promoting the health and wellbeing of
the people. There are various factors in the healthcare model of Singapore which are as follows:
Figure 1: Healthcare Model of Singapore
(Source: Guidemesingapore.com. 2019)
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Singapore
Healthcare
System
Strong relationship
with people and
public sector
Mixed
financing
Social Welfare Policy
and Service Delivery
Stepped Care,
Residualist
Approach

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The government of Singapore is playing a major role in the way of improving the
healthcare system. Yong & Cameron (2019) commented that they are taking special care towards
restructuring the hospitals and specialty centres and leading them to operate their internal
functionality as the private organisations, owned by the government. This is the way, through
which the government is helping both the hospitals and the clinics to provide comprehensive care
to the service users. In addition to that, this restructuring strategy of government is also enabling
the public hospitals to attain management autonomy and flexibility in order to respond properly
to the diverse needs of the patients.
The government healthcare facility is playing a critical role in providing high quality of
care to the mass of the people and deal with the critical cases, which are referred by the other
hospitals. It is imperative to note here that the government has set the benchmark of medical
standards and fees for both the public and private hospitals which are needed to be followed by
them in order to provide high quality of services to the patients as per their requirements
(Guidemesingapore.com. 2019). Core philosophy of the healthcare system of Singapore is to
secure healthy, productive and fit population by preventing chronic disease and promoting
healthy lifestyle. The healthcare system of Singapore is also highly intended towards
accelerating the cost efficiency of health system and thus meets the healthcare demand of
growing population.
Primary Care Networks (PCN) scheme has also been introduced by the Ministry of health
of Singapore in order to enhance their primary care. The aim of government behind introducing
this scheme is to enable the General Practitioner (GP) clinics to align themselves in the network
and thereby provide holistic and tea, based care to the patients. According to this scheme, the
patients can access multi-disciplinary team which comprises of doctors, nurses and primary care
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coordinators and thus manage their chronic condition. At the same time, under this scheme, the
patients can also access additional ancillary and support services such as foot and eye screening
for the patients who are suffering from debates and effective nurse counseling which is very
much needed in order to manage the chronic condition (Moh.gov.sg. (2019).
Mixed financing is one of the major aspects of the healthcare system of Singapore. The
basic philosophy behind the healthcare financing is to have universal healthcare coverage and
ensuring affordable healthcare for all. In addition, Cheng, Li & Vaithianathan (2019) highlighted
by saying that the healthcare financing of Singapore also intends to implement market based
mechanism in order to promote transparency and adapt high end technology for the sake of
improving the healthcare system. The healthcare financing framework of Singapore is presented
below:
Figure 2: Multilayered healthcare system of Singapore
(Source: Moh.gov.sg. 2019)
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Subsidies from government accross primary,
acute, rehabilitative and nursing settings
Universal access, but no 100% subsidy to
avoid over-consumption
Integrating personal and family
responsibiloty
Individual medical savings account for the
healtjhcare practitioners
State-run, low-cost catastrophic health insurance
scheme
Private health insurance
Endowment fund for the patients

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Multiple health insurance schemes have been introduced by MOH in order to provide
high quality of healthcare in a cost effective manner. The fundamental aim behind implementing
medisave scheme is to support the lower income group to get effective healthcare. MOH’s aim
behind executing Medishield and other insurances is to avoid irrelevant and open ended medical
insurance practice which can result in unnecessary medical services. Medishield Life is one of
the major health insurance schemes. The fundamental aim behind designing this health insurance
plan is to help the people to pay larger hospital bills and manage huge cost of outpatient
treatments in the public hospitals (Moh.gov.sg. 2019).
Question 2- Demonstrating the understanding of critical health related issue:
The prevalence of diabetes in Singapore is increasing in a rapid manner. More than 80%
people aged in between 18 to 69 are suffering from chronic diabetes. It has been reported that
Singapore is one of the 22 countries where there are more than 600,000 diabetes can be found.
Kuek et al., (2019) put stress on the fact that there are three major types of diabetes
which include type 1 diabetes which is usually inherited and cannot be controlled, type 2
diabetes which is the most common type of diabetes which can be prevented and gestational
diabetes which generally occurs during pregnancy. In Singapore, diabetes accounts to more than
10% of overall disease burden. This is one of the most severe health related issues in which the
body cannot respond to insulin and thereby leading high degree of blood sugar. It is true that
diabetes is not too much fatal in the short term. However, Marangoni & Garti (2018)
commended by saying that undiagnosed diabetes and improperly controlled diabetes can lead to
severe disease and hamper the quality of life. The diseased related to diabetes can even lead to
death. The risk factors of diabetes are as follows:
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 Obesity
 High risk race
 Women with polycystic ovarian syndrome
 Cardiovascular disease
 Hypertension
 High-density of cholesterol level
 Impaired fasting glycaemia
The prevalence of diabetes among the adults is 13.7%. The report, published by Ministry of
Health of Singapore in the year 2014 shows the fact that there are more than 400,000 residents of
Singapore aged above 18 are suffering from chronic diabetes. It is expected that this statistics of
people suffering from diabetes will become 1,000,000 by 2050. Diabetes is one of the most
chronic medical conditions of Singapore which is considered as the fourth largest disease
(Healthhub.sg. 2019). It has been observed that majority of the ageing population is extremely
exposed towards diabetes. The statistics of diabetes and related risk factors have been presented
below
Male Female Total
Diabetes 10.7% 7.7% 9.1%
Overweight 39.2% 30.0% 34.6%
Obesity 6.1% 7.4% 6.8%
Physical inactivity 31.6% 35.7% 33.7%
Table 1: Statistics of diabetes and other risk factors
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(Source: Who.int. 2019)
It has been reported that:
 This is the 10th leading cause of death in Singapore.
 During 2013, it has been reported that the number of people aged above and suffering
from diabetes is 400,000.
 It is expected that by 2030, this number of diabetes affected people in Singapore will be
600,000.
It is imperative to treat diabetes properly as it can lead to severe health related issues. MOH
is taking effective care towards providing high quality of treatment to the patients who are
suffering from diabetes. Hsu et al., (2015) observed that the fundamental aim of Singapore’s
healthcare system is to improve the lifestyle of the people and protect them from this disease.
Proper screening is one of the initial ways of treating diabetes.
Question 3- MOH report regarding prevalence of diabetes in Singapore:
a) Analyze how lifestyle, ethnicity, motivation, and socio-economic status may
impact on the compliance or treatment adherence of the pre-diabetes:
The prevalence of diabetes is rapidly accelerating. Majority of the people in Singapore
are suffering from this disease which is leading them to suffer from severe health related issues.
Saxena et al., (2017) said that the lifestyle is one of the major factors resulting in chronic
diabetes among the patients. Lifestyle comprises of emotional, social and behavioral factors
which can influence both type 1 and type 2 diabetes. This hampers the medical outcome and the
psychological wellbeing of the people. This is the reason for which individuals with diabetes and
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their families are facing major issues in the ways of integrating diabetes management strategy in
their daily life. There lies the significance of lifestyle modification as it can help in leading the
pre-diabetes to follow the treatment.
Intervention of lifestyle is very much needed in this context as it can help in generating
positive behavior among the people and lead them to follow healthy lifestyle. Community-based
diabetes-prevention program is needed to be considered in this context as it can help in assessing
the glucose level and body mass index for the individuals with pre-diabetes. This is the way;
through which the people can take care towards modifying their lifestyle by assessing the extent
to which they are exposed to diabetes. Blank, R., Burau & Kuhlmann (2017) showed that diet
and exercise counseling are the standard of care which must be integrated within the lifestyle
modification program which can lead the people to lead healthy lifestyle free from the threat of
diabetes.
The ethnicity also plays a major role in protecting the pre-diabetes patients. It is
imperative to note in this context that ethnic difference is one of the major factors of prevalence
of diabetes in the country. It has been reported that the rate of diabetes is high among Africans
and descendants than that of US and UK. In addition, it has also been reported that the rate of
diabetes is high among Asian Indians than that of Korean-Americans. Ethnicity shapes the
behavior of the people and enables them to lead healthy life style which is free from any kind of
threat of diabetes. Britnell (2015) showed that the prevalence of diabetes among the ethnic
minorities can crate major challenge for the healthcare practitioners to provide high quality of
treatment and care. Language barrier, non-ethnically sensitive prevention along with the policies
and procedures of treatment can cause challenge for the healthcare practitioners to provide high
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quality of treatment and care to the ethnic minorities as the prevalence of diabetes is high among
them.
Motivation is another imperative factor to influence the treatment adherence of pre-
diabetes. This can be regarded as the personal urge showed by the people to stay happy and
healthy and thereby stay aside from the harmful effect of diabetes. High degree of motivation
enables the people to take self-care and thereby protect themselves from diabetes (Marangoni &
Garti, 2018). In addition, motivation also plays a significant role in the way of leading healthy
lifestyle by modifying their eating habit and thereby prevents diabetes. The socio-economic
factors also play a major role in treating the pre-diabetic patients. These factors shape the
lifestyle and behavior of the people and lead them to protect themselves from diabetes.
b) Social work value for chronic disease management:
Appropriate management of chronic disease poses major challenge for the social workers
to perform their tasks with utmost efficiency. Thus, it is imperative to follow effective social
work value in order to deal with the chronic disease. As diabetes is one of the most chronic
diseases, following the values of social work can help in treating the disease at the initial stage
and thus promote the health and wellbeing to the people. Person centered approach is one of
the most significant social work value of managing the chronic disease. As per this approach, the
patients are at the heart of healthcare setting and it is imperative for healthcare practitioners to
priorities the requirements of patients before making the treatment plan (Blank, Burau &
Kuhlmann, 2017). As diabetes is one of the most chronic diseases around the world,
implementation of this approach is very much needed as it can help in amplifying the quality of
life and health outcome of the people who are suffering from diabetes. In person-centered care
both the health and social care workers work collaboratively with that of the patients and develop
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their knowledge to manage the disease properly by making informed decision
(Personcentredcare.health.org.uk. 2019).
Existentialist approach is another vital approach of managing chronic disease.
According to this approach, people hold the capability of controlling and changing the lifestyle.
It is the role of healthcare practitioners to support the patients to develop their self-awareness and
assume their personal responsibilities. This is the way, through which people with acute diabetes
can develop positive approach terms of modifying their own lifestyle and promote their health
and wellbeing (Ho et al., 2019). Cognitive behavioral therapy is another vital approach of
treating the patients with chronic disease. This approach intends to improve the behavior of the
people. The person with acute diabetes can show negative attitude for not becoming able to
control their sugar level. This feeling can make them down and hamper their mental health.
There lies the significance of cognitive behavioral therapy as it can help in identifying the
negative thought among the people and transform them into constructive thoughts.
Empowerment approach is another vital way of managing chronic disease. According to this
approach, it is imperative to place the diabetes affected patients at the center of decision and
understand their need before framing the healthcare system (Khoo, Lim & Vrijhoef, 2014).
Conclusion:
Based on the discussion, it can be concluded by saying that the healthcare system is very
much complex and designed especially for the sake of meeting diverse need of patients. The
multi-layered healthcare financing framework is entirely based on the principle of individual
responsibility of the healthcare practitioners and thereby prevents irrelevant unnecessary over-
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consumption of health care services. At the same time, the healthcare practitioners are also
showing high dedication in terms of meeting diverse need of the patients.
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