Educational inequalities associated with health-related behaviours in the adult population of Singapore

Abstract

Introduction: Socioeconomic differences in health-related behaviours have been widely studied in the Western populations, but are seldom considered in Asian populations. We examined the effect of education attainment on health-related behaviours (physical activity, cigarette smoking and alcohol consumption) among non-institutionalised Singaporeans aged 18-69 years.

Methods: We used data from the Singapore National Health Survey 2004. Information on physical activity, cigarette smoking, alcohol consumption and sociodemographic characteristics was collected from 4,084 adults. Age-adjusted prevalence of the three health-related behaviours by educational attainment was calculated by the direct method. Logistic regression models, adjusted for age, gender, ethnic group and employment status, were used to estimate the odds ratio and 95% confidence interval, in order to study the prevalence of health-related behaviours according to educational attainment.

Results: The prevalence of physical inactivity, daily smoking and regular alcohol consumption was found to be consistently highest among men and women with the least education. Prevalence of physical inactivity and smoking was inversely related to educational attainment for both genders. However, no clear gradient was found between education and alcohol consumption for men and women.

Conclusion: Less-educated Singaporeans were more likely to smoke daily, drink alcohol regularly or not to exercise regularly. Health promotion policies or programmes aimed at encouraging healthy lifestyles in the Singapore population should take into account the educational inequalities in these health-related behaviours.