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Published in: International Journal for Equity in Health 1/2018

Open Access 01-12-2018 | Review

A systematic review of health status, health seeking behaviour and healthcare utilisation of low socioeconomic status populations in urban Singapore

Authors: Catherine Qiu Hua Chan, Kheng Hock Lee, Lian Leng Low

Published in: International Journal for Equity in Health | Issue 1/2018

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Abstract

Introduction

It is well-established that low socioeconomic status (SES) influences one’s health status, morbidity and mortality. Housing type has been used as an indicator of SES and social determinant of health in some studies. In Singapore, home ownership is among the highest in the world. Citizens who have no other housing options are offered heavily subsidised rental housings. Residents staying in such rental housings are characterised by low socioeconomic status. Our aim is to review studies on the association between staying in public rental housing in Singapore and health status.

Methods

A PubMed and Scopus search was conducted in January 2017 to identify suitable articles published from 1 January 2000 to 31 January 2017. Only studies that were done on Singapore public rental housing communities were included for review. A total of 14 articles including 4 prospective studies, 8 cross-sectional studies and 2 retrospective cohort studies were obtained for the review. Topics addressed by these studies included: (1) Health status; (2) Health seeking behaviour; (3) Healthcare utilisation.

Results

Staying in public rental housing was found to be associated with poorer health status and outcomes. They had lower participation in health screening, preferred alternative medicine practitioners to western-trained doctors for primary care, and had increased hospital utilisation. Several studies performed qualitative interviews to explore the causes of disparity and concern about cost was one of the common cited reason.

Conclusion

Staying in public rental housing appears to be a risk marker of poorer health and this may have important public health implications. Understanding the causes of disparity will require more qualitative studies which in turn will guide interventions and the evaluation of their effectiveness in improving health outcome of this sub-population of patients.
Literature
1.
go back to reference Economist T. Worldwide Cost of Living Report 2017. 2017. Economist T. Worldwide Cost of Living Report 2017. 2017.
2.
go back to reference Singapore S. Key Household Income Trends 2016. 2016. Singapore S. Key Household Income Trends 2016. 2016.
4.
go back to reference Wilkinson RG, Marmot M. Social determinants of health: the solid facts: World Health Organization Regional Office for Europe; 2003. [accessed 1st Dec 2015]. Wilkinson RG, Marmot M. Social determinants of health: the solid facts: World Health Organization Regional Office for Europe; 2003. [accessed 1st Dec 2015].
5.
go back to reference Grotto I, Huerta M, Sharabi Y. Hypertension and socioeconomic status. Curr Opin Cardiol. 2008;23(4):335–9.CrossRefPubMed Grotto I, Huerta M, Sharabi Y. Hypertension and socioeconomic status. Curr Opin Cardiol. 2008;23(4):335–9.CrossRefPubMed
6.
go back to reference Chan A, Malhotra C, Malhotra R, Ostbye T. Living arrangements, social networks and depressive symptoms among older men and women in Singapore. Int J Geriatr Psychiatry. 2011;26(6):630–9.CrossRefPubMed Chan A, Malhotra C, Malhotra R, Ostbye T. Living arrangements, social networks and depressive symptoms among older men and women in Singapore. Int J Geriatr Psychiatry. 2011;26(6):630–9.CrossRefPubMed
7.
go back to reference Stafford M, Marmot M. Neighbourhood deprivation and health: does it affect us all equally? Int J Epidemiol. 2003;32(3):357–66.CrossRefPubMed Stafford M, Marmot M. Neighbourhood deprivation and health: does it affect us all equally? Int J Epidemiol. 2003;32(3):357–66.CrossRefPubMed
8.
go back to reference Riva M, Bambra C, Curtis S, Gauvin L. Collective resources or local social inequalities? Examining the social determinants of mental health in rural areas. Eur J Pub Health. 2011;21(2):197–203.CrossRef Riva M, Bambra C, Curtis S, Gauvin L. Collective resources or local social inequalities? Examining the social determinants of mental health in rural areas. Eur J Pub Health. 2011;21(2):197–203.CrossRef
10.
go back to reference Dunn JR, Hayes MV, Hulchanski JD, Hwang SW, Potvin L. Housing as a socio-economic determinant of health: findings of a National Needs, gaps and opportunities assessment. Can J Public Health. 2006;97:S11–S5.PubMed Dunn JR, Hayes MV, Hulchanski JD, Hwang SW, Potvin L. Housing as a socio-economic determinant of health: findings of a National Needs, gaps and opportunities assessment. Can J Public Health. 2006;97:S11–S5.PubMed
11.
go back to reference Singapore DoS. Home ownership rate of resident households. 2016. Singapore DoS. Home ownership rate of resident households. 2016.
13.
go back to reference Wee LE, Wong J, Chin RT, Lin ZY, Goh DE, Vijakumar K, et al. Hypertension management and lifestyle changes following screening for hypertension in an Asian low socioeconomic status community: a prospective study. Ann Acad Med Singap. 2013;42(9):451–65.PubMed Wee LE, Wong J, Chin RT, Lin ZY, Goh DE, Vijakumar K, et al. Hypertension management and lifestyle changes following screening for hypertension in an Asian low socioeconomic status community: a prospective study. Ann Acad Med Singap. 2013;42(9):451–65.PubMed
14.
go back to reference Wee LE, Koh GC. Individual and Neighborhood social factors of hypertension management in a low-socioeconomic status population: a community-based case-control study in Singapore. Hypertens Res. 2012;35(3):295–303.CrossRefPubMed Wee LE, Koh GC. Individual and Neighborhood social factors of hypertension management in a low-socioeconomic status population: a community-based case-control study in Singapore. Hypertens Res. 2012;35(3):295–303.CrossRefPubMed
15.
go back to reference Wee LE, Koh GC, Yeo WX, Chin RT, Wong J, Seow B. Screening for cardiovascular disease risk factors in an urban low-income setting at baseline and post intervention: a prospective intervention study. Eur J Prev Cardiol. 2013;20(1):176–88.CrossRefPubMed Wee LE, Koh GC, Yeo WX, Chin RT, Wong J, Seow B. Screening for cardiovascular disease risk factors in an urban low-income setting at baseline and post intervention: a prospective intervention study. Eur J Prev Cardiol. 2013;20(1):176–88.CrossRefPubMed
16.
go back to reference Wee LE, Koh GC, Chin RT, Yeo WX, Seow B, Chua D. Socioeconomic factors affecting colorectal, breast and cervical cancer screening in an Asian urban low-income setting at baseline and post-intervention. Prev Med. 2012;55(1):61–7.CrossRefPubMed Wee LE, Koh GC, Chin RT, Yeo WX, Seow B, Chua D. Socioeconomic factors affecting colorectal, breast and cervical cancer screening in an Asian urban low-income setting at baseline and post-intervention. Prev Med. 2012;55(1):61–7.CrossRefPubMed
17.
go back to reference Wee LE, Yong YZ, Chng MW, Chew SH, Cheng L, Chua QH, et al. Individual and area-level socioeconomic status and their association with depression amongst community-dwelling elderly in Singapore. Aging Ment Health. 2014;18(5):628–41.CrossRefPubMed Wee LE, Yong YZ, Chng MW, Chew SH, Cheng L, Chua QH, et al. Individual and area-level socioeconomic status and their association with depression amongst community-dwelling elderly in Singapore. Aging Ment Health. 2014;18(5):628–41.CrossRefPubMed
18.
go back to reference Wee LE, Yeo WX, Yang GR, Hannan N, Lim K, Chua C, et al. Individual and area level socioeconomic status and its association with cognitive function and cognitive impairment (low MMSE) among community-dwelling elderly in Singapore. Dement Geriatr Cogn Disorders Extra. 2012;2(1):529–42.CrossRef Wee LE, Yeo WX, Yang GR, Hannan N, Lim K, Chua C, et al. Individual and area level socioeconomic status and its association with cognitive function and cognitive impairment (low MMSE) among community-dwelling elderly in Singapore. Dement Geriatr Cogn Disorders Extra. 2012;2(1):529–42.CrossRef
19.
go back to reference Liang En W, Sin D, Wen Qi C, Zong Chen L, Shibli S, Choon-Huat Koh G. Chronic pain in a low socioeconomic status population in Singapore: a cross-sectional study. Pain Med. 2016; Liang En W, Sin D, Wen Qi C, Zong Chen L, Shibli S, Choon-Huat Koh G. Chronic pain in a low socioeconomic status population in Singapore: a cross-sectional study. Pain Med. 2016;
20.
go back to reference Wee LE, Sin D, Cher WQ, Li ZC, Tsang T, Shibli S, et al. "I'm healthy, I don't have pain"- health screening participation and its association with chronic pain in a low socioeconomic status Singaporean population. Kor J Pain. 2017;30(1):34–43.CrossRef Wee LE, Sin D, Cher WQ, Li ZC, Tsang T, Shibli S, et al. "I'm healthy, I don't have pain"- health screening participation and its association with chronic pain in a low socioeconomic status Singaporean population. Kor J Pain. 2017;30(1):34–43.CrossRef
21.
go back to reference Ng CW, Heng BH, Molina JA, Wong LY, George PP, Cheah J. Demographic and Lifestyle characteristics associated with non-willingness to participate in health promotion programmes among adults of a lower socioeconomic status in Singapore. Glob Health Promot. 2012;19(4):9–19.CrossRefPubMed Ng CW, Heng BH, Molina JA, Wong LY, George PP, Cheah J. Demographic and Lifestyle characteristics associated with non-willingness to participate in health promotion programmes among adults of a lower socioeconomic status in Singapore. Glob Health Promot. 2012;19(4):9–19.CrossRefPubMed
22.
go back to reference Wee LE, Koh GC. The effect of neighborhood, socioeconomic status and a community-based program on multi-disease health screening in an Asian population: a controlled intervention study. Prev Med. 2011;53(1–2):64–9.CrossRefPubMed Wee LE, Koh GC. The effect of neighborhood, socioeconomic status and a community-based program on multi-disease health screening in an Asian population: a controlled intervention study. Prev Med. 2011;53(1–2):64–9.CrossRefPubMed
23.
go back to reference Wee LE, Cher WQ, Sin D, Li ZC, Koh GC. Primary care characteristics and their association with health screening in a low-socioeconomic status public rental-flat population in Singapore- a mixed methods study. BMC Fam Pract. 2016;17:16.CrossRefPubMedPubMedCentral Wee LE, Cher WQ, Sin D, Li ZC, Koh GC. Primary care characteristics and their association with health screening in a low-socioeconomic status public rental-flat population in Singapore- a mixed methods study. BMC Fam Pract. 2016;17:16.CrossRefPubMedPubMedCentral
24.
go back to reference Wee LE, Lim LY, Shen T, Lee EY, Chia YH, Tan AY, et al. Choice of primary health care source in an urbanized low-income community in Singapore: a mixed-methods study. Fam Pract. 2014;31(1):81–91.CrossRefPubMed Wee LE, Lim LY, Shen T, Lee EY, Chia YH, Tan AY, et al. Choice of primary health care source in an urbanized low-income community in Singapore: a mixed-methods study. Fam Pract. 2014;31(1):81–91.CrossRefPubMed
25.
go back to reference Low LL, Wah W, Ng MJ, Tan SY, Liu N, Lee KH. Housing as a social determinant of health in Singapore and its association with readmission risk and increased utilization of hospital services. Front Public Health. 2016;4:109.CrossRefPubMedPubMedCentral Low LL, Wah W, Ng MJ, Tan SY, Liu N, Lee KH. Housing as a social determinant of health in Singapore and its association with readmission risk and increased utilization of hospital services. Front Public Health. 2016;4:109.CrossRefPubMedPubMedCentral
26.
go back to reference Wong TH, Skanthakumar T, Nadkarni N, Nguyen HV, Iyer NG. Survival of patients with head and neck squamous cell carcinoma by housing subsidy in a tiered public housing system. Cancer. 2017;123(11):1998–2005.CrossRefPubMed Wong TH, Skanthakumar T, Nadkarni N, Nguyen HV, Iyer NG. Survival of patients with head and neck squamous cell carcinoma by housing subsidy in a tiered public housing system. Cancer. 2017;123(11):1998–2005.CrossRefPubMed
27.
go back to reference Reeves RV. Social policy, Singapore style: Lessons for the U.S. 2015. Reeves RV. Social policy, Singapore style: Lessons for the U.S. 2015.
28.
go back to reference Lindstrm C, Rosvall M, Lindstrm M. Socioeconomic status, social capital and self-reported unmet health care needs: a population-based study. Scand J Pub Health. 2017;45(3):212–21.CrossRef Lindstrm C, Rosvall M, Lindstrm M. Socioeconomic status, social capital and self-reported unmet health care needs: a population-based study. Scand J Pub Health. 2017;45(3):212–21.CrossRef
29.
go back to reference Sabanayagam C, Shankar A, Wong TY, Saw SM, Foster PJ. Socioeconomic status and overweight/obesity in an adult Chinese population in Singapore. J Epidemiol. 2007;17(5):161–8.CrossRefPubMed Sabanayagam C, Shankar A, Wong TY, Saw SM, Foster PJ. Socioeconomic status and overweight/obesity in an adult Chinese population in Singapore. J Epidemiol. 2007;17(5):161–8.CrossRefPubMed
30.
go back to reference Coffee NT, Lockwood T, Hugo G, Paquet C, Howard NJ, Daniel M. Relative residential property value as a socio-economic status indicator for health research. Int J Health Geogr. 2013;12:22.CrossRefPubMedPubMedCentral Coffee NT, Lockwood T, Hugo G, Paquet C, Howard NJ, Daniel M. Relative residential property value as a socio-economic status indicator for health research. Int J Health Geogr. 2013;12:22.CrossRefPubMedPubMedCentral
31.
go back to reference Chen YY, Wong GH, Lum TY, Lou VW, Ho AH, Luo H, et al. Neighborhood support network, perceived proximity to community facilities and depressive symptoms among low socioeconomic status Chinese elders. Aging Ment Health. 2016;20(4):423–31.CrossRefPubMed Chen YY, Wong GH, Lum TY, Lou VW, Ho AH, Luo H, et al. Neighborhood support network, perceived proximity to community facilities and depressive symptoms among low socioeconomic status Chinese elders. Aging Ment Health. 2016;20(4):423–31.CrossRefPubMed
32.
go back to reference Leung YY, Teo SL, Chua MB, Raman P, Liu C, Chan A. Living arrangements, social networks and onset or progression of pain among older adults in Singapore. Geriatr Gerontol Int. 2016;16(6):693–700.CrossRefPubMed Leung YY, Teo SL, Chua MB, Raman P, Liu C, Chan A. Living arrangements, social networks and onset or progression of pain among older adults in Singapore. Geriatr Gerontol Int. 2016;16(6):693–700.CrossRefPubMed
33.
go back to reference Loignon C, Allison P, Landry A, Richard L, Brodeur JM, Bedos C. Providing humanistic care: dentists' experiences in deprived areas. J Dent Res. 2010;89(9):991–5.CrossRefPubMed Loignon C, Allison P, Landry A, Richard L, Brodeur JM, Bedos C. Providing humanistic care: dentists' experiences in deprived areas. J Dent Res. 2010;89(9):991–5.CrossRefPubMed
Metadata
Title
A systematic review of health status, health seeking behaviour and healthcare utilisation of low socioeconomic status populations in urban Singapore
Authors
Catherine Qiu Hua Chan
Kheng Hock Lee
Lian Leng Low
Publication date
01-12-2018
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2018
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-018-0751-y

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