Written Assignment – Part 1

Like other countries, the situation relating non-communicable diseases in Hong Kong

is worsening every year. According to “Towards 2025”, “in 2016, the major NCD, namely

cardiovascular diseases accounted for about 55% of all registered deaths.” As the Chief

Executive of Hong Kong suggests, “the government bureaux/departments should be

encouraged to lead by example to actively implement the measures under the “Towards 2025:

Strategy and Action Plan to Prevent and Control Noncommunicable diseases through

promoting a healthy diet, physical activity and reducing tobacco and alcohol-related harm”

Her suggestion is strongly agreed on, and in order to understand the situation better, it is

crucial to analyze the contributing factors to non-communicable diseases in Hong Kong.

          According to the World Health Organization, there are four main risk factors for non-

communicable diseases. These include tobacco consumption, physical inactivity, the

excessive consumption of alcohol, and unhealthy diets (“Noncommunicable Diseases”).

Smoking is considered to cause 14% of all deaths from non-communicable diseases and

about 50% of the smokers die of tobacco-related diseases. Globally, tobacco consumption is a

serious issue, and although in Hong Kong the situation is relatively better at 10% in 2017, the

government and health organizations should aim to reduce more (Food and Health Bureau

and Department of Health). To achieve the proposed target by 2025, which is a 30% relative

reduction in the prevalence of current tobacco use in persons aged 15+years, the government

proposes a number of measures (Food and Health Bureau and Department of Health).

According to “Towards 2025: Strategy and Action Plan to Prevent and Control Non-

communicable Diseases in Hong Kong”, “Hong Kong adopts a progressive and wholistic

approach comprising regulation, enforcement, publicity, education, smoking cessation and

taxation.” The government has also been increasing resources for education to raise
awareness, publicity, smoking cessation, and enforcement of the tobacco control legislation

(Food and Health Bureau and Department of Health). The declining trend of tobacco

consumption in Hong Kong reflects the effectiveness of government measures on the

reduction of tobacco. However, smoking is a demerit good and the government should work

to eliminate it completely in the long run. Examining this topic from a smoker’s perspective,

smoking is an addictive habit and often a form of relieving stress. The strong measures by the

government may affect the mental state of smokers, as they are addicted to tobacco and have

no choice but to buy the highly taxed products or find another way to relieve stress.

          Moving to the next risk factor of non-communicable diseases, according to the

“Global Recommendations on Physical Activity for Health” published by the World Health

Organization, “physical inactivity is estimated to be the underlying cause for approximately

21-25% of breast and colon cancer, 27% of diabetes and approximately 30% of ischaemic

heart disease” (World Health Organization). It is highly suggested for adolescents to spend at

least 60 minutes a day exercising and about 150 minutes per week for adults (Food and

Health Bureau and Department of Health). According to the data collected by the Health

Assessment Questionnaire (HAQ) of the Student Health Service Centres in 2015/16 school

year, the percentage of students who were insufficiently physically active was 93%.” The

percentage is huge and although the benefits of health benefits is well-known, including

increased physical fitness, reduced body fat, and enhances mental health, putting exercise

into our daily lives seems highly intangible. The proposed target regarding this topic is “a

10% relative reduction in the prevalence of insufficient physical activity among adolescents

and adults by 2025”.

          Exercising is a merit good. In addition to its benefit to an individual’s physical and

mental state, it also contributes to social well-being: sustainable development in the

community. Some examples include, “energy-saving, cleaner air and alleviating the effects of

climate change” (Food and Health Bureau and Department of Health) According to the

“Towards 2025: Strategy and Action Plan to Prevent and Control Non-communicable

Diseases in Hong Kong”, “promoting physical activity participation is considered a priority

in the prevention and control of non-communicable diseases in Hong Kong”. In 2008, a

Working Group on Diet and Physical Activity (WGDPA) was formed and in 2010 the

“Action Plan to Promote Diet and Physical Activity Participation in Hong Kong” was

launched by WGDPA. The platform was launched to blend physical activities into the daily

lives of people. In addition, The Sports Commission was established in 2005 to advise the

policies, strategies, and implementation framework for sports development of the government

in Hong Kong. Despite all interventions including the ones mentioned above, the situation of

physical inactivity does not seem to be improving significantly in the near future. The biggest

risk factor of physical inactivity in adolescence seems to be coming from the massive

workload of secondary students and lack of free time to spend on exercising. Both physical

inactivity and a huge amount of school work contribute to the worsening of a student’s

mental health.

          According to the “Towards 2025: Strategy and Action Plan to Prevent and Control

Non-communicable Diseases in Hong Kong”, alcohol consumption can cause more than 200

disease and injury conditions, including liver and heart diseases, cancers, a range of mental

and behavioral disorders, to mention just a few (Food and Health Bureau and Department of

Health). In Hong Kong locally, “the estimated total alcohol consumption per capita (aged 15+

years) fell from 3.87 liters in 1990 to 2.62 liters in 2010 but gradually increased to 2.86 liters

in 2016. The local target relating to alcohol consumption is “at least 10% relative reduction in

the prevalence of excessive binge drinking and harmful use of alcohol (harmful
drinking/alcohol dependence) among adults and in the prevalence of drinking among youth

by 2025”. To achieve the proposed target, a Working Group on Alcohol and Health (WGAH)

was formed in 2009 and has published the “Action Plan to Reduce Alcohol-related Harm in

Hong Kong” in 2011, setting out priority areas, 10 recommendations, and 17 more specific

actions to reduce Alcohol-related harm in Hong Kong. The Health Department in Hong Kong

has been carrying out public education regarding alcohol-related harm, especially among

Hong Kong youngsters (Food and Health Bureau and Department of Health).

          A local target relating to healthy eating (one of the four factors of NCD), is a “30%

relative reduction in mean population daily intake of salt/sodium by 2025”. It is well-known

that high salt consumption leads to “high blood pressure and the risk of heart disease and

stroke” (Food and Health Bureau and Department of Health). The WHO’s recommended

amount of salt per adult per day is 5grams, which is half of the 10grams that an average adult

in Hong Kong consumes per day. Though the government took different measures

encouraging healthy dieting and reducing salt intake, it should be taken into account that

dietary habit is not easy to change and the fight is going to last long.

          Carrie Lam’s statement is justified. It is highly encouraged for the government to

implement the measures under the “Towards 2025: Strategy and Action Plan to Prevent and

Control Noncommunicable Diseases in Hong Kong”. This could be done by promoting a

healthy diet, physical activity, and reducing tobacco and alcohol consumption.
Part 2 – Policy Brief

Ischaemic Health Disease and Physical Education in Schools

Executive summary

The policy brief is about implementing a policy that will change the lives of students

– relieve their stress and boost up energy! Though it may sound intangible, the detailed brief

explains how it should be approached, and if followed it will lead to favorable results.

Introduction

Ischaemic heart disease, also known as coronary heart disease is a non-

communicable disease with severe symptoms (NHS Choices). The symptoms include

shortness of breath, pain throughout the body, feeling faint, and feeling sick (NHS Choices).

According to NHS, “coronary heart disease is the term that describes what happens when

your heart’s blood supply is blocked or interrupted by a build-up of fatty substance in the

coronary arteries”.  This disease can be the result of smoking and excessive alcohol

consumption (NHS Choices). Though depending on the state of the patient medicine will be

prescribed and surgery may be taken, to treat this non-communicable disease, regular

exercise and stopping smoking is the answer.

To prevent the non-communicable diseases resulting from physical inactivity

including ischemic heart disease, World Health Organization recommends “encourage

students (for children aged 5-17) to engage in physical activities for at least 60 minutes of

moderate-to-vigorous-intensity physical activities daily through the Physical Education (PE)

Key Learning Area Curriculum Guide” (Food and Health Bureau and Department of Health).
 Physical inactivity is one of the leading factors contributing to noncommunicable

diseases in line with smoking, excessive alcohol consumption, and unhealthy dieting (Food

and Health Bureau and the Department of Health). According to the data collected by the

Health Assessment Questionnaire (HAQ) of the Student Health Service Centres in 2015/16

school year, the proportion of students who were insufficiently physically active was 93%.” 

Government intervention seems highly necessary to move closer to the proposed target, “a

10% relative reduction in the prevalence of insufficient physical activity among adolescents

and adults by 2025” (Food and Health Bureau and Department of Health).

Intervention

World Health Organization recommends to “encourage students (for children aged 5-

17) to engage in physical activities for at least 60 minutes of moderate-to-vigorous-intensity

physical activities daily through the physical education (Food and Health Bureau and

Department of Health). Policy implementing Physical Education classes every day into all

primary to secondary schools in Hong Kong will be the intervention discussed.

Having Physical Education classes every day of the school week will lead to higher

effectiveness in classes all week since it will eventually energize students. The policy may

sound incompatible taking into account the workload of high school students in Hong Kong,

however, it is even harder to find time to exercise in free time out of school. Having a one-

hour exercise at school, as a result, will save more time than to make an effort to exercise

during free time which often feels like a burden.

The government, students, and the school staff are all involved in this intervention.

The government should set a policy of having 60 minutes of Physical Education classes every

day for students and making it a compulsory subject like Mathematics and English. This
policy may be supported by all health organizations in Hong Kong, including the Hong Kong

Elite Athletes Association, Hong Kong Child Health Foundation, and the Physical Fitness

Association of Hong Kong China and EDB (Food and Health Bureau and Department of

Health). However, this policy may be opposed by high school students and their parents,

since the upper-class students are busy coping with academic subjects and an overwhelming

amount of workload.

It is important that the students and the parents understand that physical exercise

leads to better mental health and improvement in stamina. Though it may be tiring in the

beginning, as the person gets used to being physically active, s/he will in turn gain energy

from exercising. Exercising is one of the best methods for relieving stress and boosting up

self-esteem, which are two main problems upper-class students suffer from.

60 minutes of exercise per day for every student may seem rigorous in the beginning,

due to an individual’s physical ability and state. Instead of making Physical Education classes

last one hour from the very beginning, it may be better to extend the duration of class over

time. Starting from 30 minutes a day and increasing by 10 minutes every month or so seems

suitable.

Of course, the physical ability and state of individual students will be taken into

account and those who are physically unable to attend Physical Education classes will be

excused from attending. However, the ones who are able will be strongly encouraged to

attend the classes every day. This may raise issues relating to the freedom of students when

choosing which class they want to take or not.

Implementation Plan
 To work out the policy, first, the government should implement the policy in all

public and private schools. Each school will then figure out whether they need to hire more

teachers for physical education or reallocate the already existing teachers. One crucial

procedure that has to be undergone is the rescheduling of classes to fit Physical Education

from Monday to Friday. Whether to have an hour in the morning, in between other classes, or

when the classes are all finished, will be decided for each school separately according to their

convenience.

The policy should last at least a year in order to see its pros and cons. Whilst many

students will see improvements in their health and mental state, others who dislike physical

education may feel pressured and stress from the obligation to participate in physical

education classes every day. If the student feels that they are in fact losing more than earning

from following the policy, they may be excused after a year (assuming that the student has no

problems with physical ability, otherwise would be excused from the beginning). Although

this approach may be seen as too stubborn, it is believed to be needed in order for the policy

to work out.

To encourage students to willingly follow the policy, the health organizations in

Hong Kong, including Hong Kong Elite Athletes Association, Hong Kong Child Health

Foundation, and the Physical Fitness Association of Hong Kong China may visit the schools

and share how physical education can benefit the health of students and their school life. The

benefits of physical education is well-known, however, the serious disease physical inactivity

may cause is not emphasized enough.  

The plan will be implemented in phases: the PE classes in schools will start from 30

minutes a day and increase by 10 minutes every month. Starting from 30 minutes, in the
beginning, will not give rise to too much opposition. Therefore, after implementing 30

minutes of Physical Education classes, the plan may be fixed depending on how the public

accepts the policy. Whether a person is educated or not educated, it is a fact that exercising

every day enhances health. Just as it has always been, physical and mental well-being is

something everyone wishes to achieve. Thus, I believe that the public is mature enough to

understand the plan.

A step-by-step approach is the key to the plan. To not end up with the opposition and

scare the bureaucracy, everything should build up in small incremental steps and not move

forward to the next step until things are settled in the previous step. The procedure should be

and will be adjusted towards improvement if issues are raised from the public.

Evaluation Plan

Students will take two anonymous surveys: one before the implementation of the

policy and one a year after the policy has been implemented. The survey will consist of

questions relating to their mental and physical state. The two surveys will be compared and

contrasted to check if the policy has reached its aims. It is believed that if the policy

successfully implements, the improvement in the physical and mental health of students is

guaranteed. A healthier generation also means a more effective workforce in the economy in

the future so it could be concluded that the benefits of physical education overweight the

risks.
 Works Cited

Food and Health Bureau, and Department of Health. TOWARDS 2025 Strategy and Action Plan to

Prevent and Control Non-Communicable Diseases in Hong Kong. May 2018.

NHS Choices. “Overview - Coronary Heart Disease.” NHS, 2019, www.nhs.uk/conditions/coronary-

heart-disease/.

“Noncommunicable Diseases.” Www.Who.Int, www.who.int/health-topics/noncommunicable-

diseases.

World Health Organization. “Physical Activity.” Who.Int, World Health Organization: WHO, 23

Feb. 2018, www.who.int/news-room/fact-sheets/detail/physical-activity.