Trends in health screening participation and lifestyle behaviours after participation in a free, access‐enhanced screening intervention in a low‐income Singaporean rental‐flat community

Our objective was to evaluate the impact of an access‐enhanced health screening intervention on screening adherence in a rental‐flat community. In Singapore, public rental flats provide heavily subsidised rentals for the needy who cannot afford to own their own homes; with a majority of Singaporeans (≥85%) staying in owner‐occupied public housing. We observed trends in health screening adherence and health behaviours among residents of a multi‐ethnic public rental‐flat community in Singapore from 2013 to 2017, after participation in a free, access‐enhanced multi‐modality screening programme in 2011. Residents staying in neighbouring owner‐occupied housing who participated in the same screening programme served as a basis of comparison. A total of 478 rental‐flat residents and 505 owner‐occupied flat residents participated. In the rental‐flat community, hypertension screening rates improved from 18.3% (24/131) in 2013, to 61.2% (52/85) in 2015 and 44.2% (34/77) in 2017 ( p  < .001). For diabetes, rates improved from 26.2% (43/164) → 47.0% (54/115) → 49.5% (45/91; p  < .001). For dyslipidaemia screening, rates improved from 18.2% (31/170) → 39.6% (38/96) → 47.5% (38/80; p  < .001). In the owner‐occupied community ( n  = 505), screening rates largely remained stagnant (hypertension: 52.2% → 75.0% → 54.5%, p  = .059; diabetes: 66.0% → 56.5% → 66.7%, p  = .434; dyslipidaemia: 53.1% → 50.0% → 57.1%, p  = .818). In the rental‐flat community, unhealthy behaviours increased from 2013 to 2017, with higher proportions of overweight (30.4% → 24.8% → 52.1%, p  < .001), higher smoking (11.7% → 36.9% → 32.5%, p  < .001) and higher drinking rates (1.4% → 0.7% → 8.1%, p  < .001). This shift was also reflected in the owner‐occupied community, with higher percentages of overweight and higher drinking rates ( p  < .001).