Improving health outcomes and wellbeing of older adults

The contribution of team members on a research project can get taken for granted, with storied senior leaders gaining most of the attention.

A recent exception is Micah Tan, an associate researcher at the Centre for Research on Successful Ageing (ROSA) at Singapore Management University (SMU). For his collaborative work at ROSA, Tan was recognized with an inaugural 2022 Research Staff Excellence Award.

Winning the award has given me a strong sense of fulfilment and has inspired me to want to do more, both for the SMU community but also more generally in terms of contributing to the health and wellbeing of older adults."

Micah Tan, Associate Researcher, Centre for Research on Successful Ageing (ROSA), Singapore Management University

Tan was drawn to a research career through his interest in people.

"From a young age I loved to interact with people and to learn more about different cultures, and I found that conducting social science research was an ideal way for me to put this interest to good use," he says.

Tan's work has concentrated on older adults, which could seem surprising for a comparatively young academic.

"Much of my motivation for wanting to conduct research related to older adults comes from my own personal experiences," he says. "Growing up, I watched my own parents go through the transition from working full-time to retirement and it made me think about what that transition meant and what life should be like in retirement.

"Also, Singapore is facing a rapidly ageing population and it is becoming increasingly important for us to address social issues emerging from this demographic trend."

Consistent messaging

A paper co-authored by Tan, which caught the eye of the Awards panel, was written during the early days of the COVID pandemic and identified that a key attitudinal barrier leading to vaccine hesitancy among older residents was trust, or lack of it, in the government's messaging.

"One thing to clarify is that our research found that a large majority of Singaporeans did still have high trust in the government throughout the pandemic. However, for the few that did not, I think one key factor that may have led to this was the rise in alternate narratives in the media," Tan says.

"[Government] messaging can at times be drowned out by the immense flood of other perspectives and narratives one can easily find on social media and on the internet. When you are faced with so many different narratives and you don't have a strong level of trust existing in more reliable sources, you can easily get lost.

"One key factor that has been identified by researchers to shape the levels of trust that people hold is consistency in messaging."

Holistic measures

ROSA's title begs the question of how to define 'ageing successfully'.

"I think an important dimension of aging successfully involves remaining well-integrated within your community even in later life," Tan says. "This doesn't just consist of keeping in touch with friends and family, but should also consist of being able to contribute meaningfully to your community in some way.

"I think that we all want to feel we are part of something larger than ourselves [and] we want to feel valued by our communities. If we can help more older adults find meaningful ways to participate in their communities, I think we will go a long way in helping more people age successfully."

In a ROSA brief co-authored by Tan, wellbeing among older adults features as a desirable outcome. How can such a broad, even amorphous term as wellbeing be quantified as a research topic?

"This is a great question but is one that unfortunately does not have a good answer (yet)," Tan says. "ROSA's primary aim is to develop a holistic measure of wellbeing for older adults that can be operationalised and used in Singapore as, currently, no such measure exists.

"At ROSA, we pay attention to four primary dimensions of wellbeing – economic, psychological, social and mental – and we are striving to create a holistic measure of wellbeing that can span all four dimensions."

The same brief highlights economic expectations as an indicator of older adult wellbeing during a financially challenging period.

"Research has found that people are often aware of their own financial situations and are more able to estimate how much they will be affected by a particular financial challenge, relative to crude estimates at the population level.

"Being negatively affected by a financial challenge will certainly have negative impacts on other aspects of wellbeing, such as experiencing poorer mental health due to the stress of not having enough."

Health outcomes

Rising cost of living pressures is a worldwide issue. The latest in a series of ROSA briefs focuses on its impact on older Singaporeans.

"We have found that healthcare is a key concern for older adults, and for good reason. We interviewed our respondents to try to get an idea of why this was so, and many of our respondents saw a negative health shock as one of the few life events that could potentially wipe out all of their savings for retirement," Tan says.

"This is due to the immense costs that could be incurred if one were to be diagnosed with, for instance, cancer. Costs for treating such a condition can be extreme even with health insurance, and could financially cripple someone even if they had tried their best to prepare for such a scenario.

"For this reason, many older adults that we have spoken to have mentioned how they are most afraid of such an event happening, and often cite healthcare as a key financial concern."

In its summary, the brief recommends targeted support for those experiencing more severe financial difficulties, such as older adults with low socioeconomic status, as well as those who are unemployed, laid off, or on sick leave. Financial support needs to focus on providing for necessities – utilities, groceries and healthcare needs – as respondents were most concerned about the affordability of such items. And the government needs effective communication of its mitigation measures.

Tan proposes that his next project will also be concerned with health issues.

"I'm becoming more interested in researching life course factors that shape health outcomes among older adults. Specifically, looking at how conditions in early life can shape health in later life," he says.

"Studies have shown that exposure to stressful environments in early life can have lasting and permanent effects on your physiology that make you more vulnerable to certain health conditions in later life."