© Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
LETTER TO THE EDITOR
Healthcare and health promotion for the
sub-health state Hong Kong population
KL Hon, MB, BS, MD; Karen KY Leung, MB, BS, MRCPCH
Department of Paediatrics and Adolescent Medicine, The Hong Kong Children’s Hospital, Hong Kong
Corresponding author: Dr KL Hon (ehon@hotmail.com)
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To the Editor—We have previously reviewed a
number of issues and challenges associated with
in-flight medical emergencies.1 Recently, during
a short flight from Hong Kong to Kaohsiung, one
author (KLH) encountered a male passenger who
summoned the flight attendants for medicine as he
was having stomach cramps. The flight attendants
rightly enquired about his history of drug allergy.
Both antacids and paracetamol were available but
only one should be offered; the man opted to take
the paracetamol, and he seemed to feel better within
a few minutes of taking it.
The man claimed that his stomach pain was
triggered by eating and he was fine when empty-stomached.
He denied any consumption of alcohol,
tobacco, or over-the-counter medications. He
claimed that the pain recurred approximately every
month, but he had not seen any doctor about it.
The author took this opportunity to provide health
promotion education, noting the possibility of
peptic ulcer disease and helicobacter infection, and
recommending him to consult a doctor to follow
up on the issue. The male passenger and his female
companion appeared to be mistrustful at first
but were at the end grateful for the health advice
provided.
This episode exposed one of the fundamental
health issues among Hong Kong citizens: living in a
‘sub-health’ state without seeking medical advice.2
This phenomenon is often due to people having a
fear of doctors, antibiotics, steroids, or Western
medicine.3 4 A sub-health state is characterised by
some disturbances in psychological behaviours or
physical characteristics, or in some indices of medical
examination, with no typical pathologic features.5 A
survey conducted by The University of Hong Kong in
2013 revealed that 97% of the surveyed Hong Kong
citizens have experienced at least one sub-health
symptom, and the most affected were aged 30 to
49 years, with an average of more than nine symptoms
each.2 The impact should not be underestimated as
64% of the respondents reported that their daily lives
were adversely affected.2
Public health promotion should target this sub-health state population, to prevent the potential
development of chronic diseases. Health authorities
should consider validated questionnaires to measure
sub-health status in the primary care setting, so that
interventions can be provided before it is too late.6
Author contributions
The authors had full access to the data, contributed to the letter, approved the final version for publication, and take
responsibility for its accuracy and integrity.
Conflicts of interest
As an editor of the journal, KL Hon was excluded from the review process for this letter. The other author has disclosed no conflicts of interest.
References
1. Hon KL, Leung KK. Review of issues and challenges of practicing emergency medicine above 30,000-feet altitude:
2 anonymized cases. Air Med J 2017;36:67-70. Crossref
2. Public Opinion Programme, The University of Hong Kong. Survey on Hong Kong Citizens’ knowledge and opinions
on sub-health. 2013. Available from: https://www.hkupop.hku.hk/english/report/subhealth/index.html. Accessed 24 Dec 2019.
3. Chen J, Xiang H, Jiang P, et al. The role of healthy lifestyle in
the implementation of regressing suboptimal health status
among college students in China: A nested case-control
study. Int J Environ Res Public Health 2017;14. pii: E240. Crossref
4. Wu S, Xuan Z, Li F, et al. Work-recreation balance, healthpromoting
lifestyles and suboptimal health status in
southern china: a cross-sectional study. Int J Environ Res
Public Health 2016;13. pii: E339. Crossref
5. Li G, Xie F, Yan S, et al. Subhealth: definition, criteria for
diagnosis and potential prevalence in the central region of
China. BMC Public Health 2013;13:446. Crossref
6. Yan YX, Liu YQ, Li M, et al. Development and evaluation
of a questionnaire for measuring suboptimal health status
in urban Chinese. J Epidemiol 2009;19:333-41. Crossref