Singaporeans physically less active during Covid-19: National health survey

SINGAPORE – The Covid-19 pandemic significantly affected the health of Singaporeans, with fewer of them engaging in physical activity and the country seeing a drop in the number of people going for chronic disease and recommended cancer screening.

This highlights the need for Singaporeans to take care of their own health, particularly against the backdrop of an ageing population, said the Ministry of Health (MOH), which released the latest National Population Health Survey on Tuesday.

On a positive note, the self-reported uptake for pneumococcal and influenza vaccination went up during the survey period, though Covid-19 was the overwhelming threat then. More people were also willing to seek help from healthcare professionals to cope with stress.

This is the first set of survey results affected by the pandemic, said MOH. It was conducted among residents aged 18 to 74, who answered a questionnaire between July 2020 and June 2021.

Health screening participation fell, compared with the year before the pandemic hit, likely because non-urgent services, which included screening services, were deferred, MOH said.

This is significant in the case of screening for chronic diseases, where participation fell from about 66 per cent in 2019 to about 59 per cent in 2021, but the percentage of those who self-reported chronic diseases was comparable to pre-pandemic days.

About 7 per cent of Singapore residents surveyed reported having diabetes, 14 per cent reported having high blood cholesterol, and 16 per cent reported having high blood pressure. MOH said these figures may not reflect the actual prevalence.

“These self-reported figures are comparable to 2019, but need to be treated with caution,” said MOH. “Fewer persons had gone for chronic disease screening during the Covid-19 pandemic, and there could be significant levels of undiagnosed chronic conditions.”

This is because some people may not be aware that they have these chronic diseases, unless health checks such as weight measurement, urine and blood tests are done. The health examinations will be done in 2023 as part of the two-yearly survey cycle for the National Population Health Survey.

The results come as Singapore prepares to launch its major preventive health strategy known as Healthier SG in the second half of 2023. Screening for diabetes, high blood pressure and high blood cholesterol, as well as for breast, cervical and colorectal cancers, will be fully funded under Healthier SG.

Another cause for concern, especially for an ageing population, is that fewer residents met the recommended level of at least 150 minutes of moderate-intensive physical activity a week.

This figure fell from about 80 per cent in 2019 to about 71 per cent in 2021. Notably, leisure-time regular exercise was lowest among older adults aged 60 to 74 (24 per cent) and highest among young adults aged 18 to 29 (40.5 per cent) in 2021.

On mental health, the survey found that while more are willing to seek help from healthcare professionals to cope with stress (58.3 per cent in 2021 versus 47.8 per cent in 2019), those aged 60 to 74 were the least willing to do so, while those aged 30 to 39 were the most willing to do so.

Similarly, the willingness to seek help from informal support networks decreased with age.

During the pandemic, seniors not only went for Covid-19 jabs, but influenza and pneumococcal jabs too.

The proportion of older residents aged 65 to 74 who had influenza vaccination rose from 24.2 per cent in 2019 to 32.4 per cent in 2021. The self-reported pneumococcal vaccination coverage among seniors aged 65 to 74 also increased from 10.3 per cent in 2019 to 22.4 per cent in 2021. These numbers point to a promising rise, said MOH.

The prevalence of smoking remained stable at 10.4 per cent in 2021, compared with 10.6 per cent in 2019, according to the survey. The survey did not capture the prevalence of vaping.

Experts have said that the decline in smoking rates here has hit a plateau. They also said that even if statistics include responses to queries on vaping, they may not paint the full picture of tobacco use, given that vaping and other alternative forms of nicotine consumption are illegal here.

MOH said in its release that it will enhance educational efforts in schools to prevent the picking up of smoking at a young age, while continuing to help smokers quit through its smoking cessation programmes.

Binge drinking prevalence also remained stable at 9.6 per cent in 2021, compared with 10.2 per cent in 2019. Binge drinking occurs when men consume at least five alcoholic drinks in a single drinking session in the month preceding the survey. For women, it is four alcoholic drinks.

“While the latest survey suggests some increase in health literacy and behaviour, such as an uptake in vaccination, overall, there are worrying signs that the overall health of the population has deteriorated,” said Professor Teo Yik Ying, the dean of Saw Swee Hock School of Public Health at the National University of Singapore.

When fewer people go for health screening, the risk of undetected chronic conditions such as cancer, diabetes and cardiovascular diseases, such as heart disease and stroke, increases, he added.

“These are conditions where early detection and treatment can prevent many unnecessary complications, and so we should review and perhaps rejuvenate our health programmes to reinforce health screening.”

The survey provides an annual pulse check of the health of the overall population, and it is clear that the roll-out of Healthier SG has become even more important, said Prof Teo.