The effect of neighborhood, socioeconomic status and a community-based program on multi-disease health screening in an Asian population: A controlled intervention study

Objectives. We studied whether individual socioeconomic and neighborhood factors such as living in a poor community independently affected health screening participation. Methods. We studied 3 blocks of public-rental flats (the poorer neighborhood) adjacent to 3 blocks of owner-occupied public housing (the better-off neighborhood) in a precinct in Taman Jurong, Singapore. Demographic details and reasons for not having regular hypertension, diabetes mellitus. hyperlipidemia and colorectal cancer screening were collected from 2009 to 2010. An access-enhancing intervention was implemented in both neighborhoods to raise health screening rates. Results. Participation rates for rental flats and owner-occupied flats were 89.0% (356/400) and 70.2% (351/500) respectively. Living in a better-off neighborhood was independently associated with diabetes mellitus (66% vs. 35%, adjusted odds ratio (AOR) = 2.12, p < 0.01). hyperlipidemia (53% vs. 26%, AOR = 4.34, p < 0.01) and colorectal cancer screening (17% vs. 6%, AOR = 15.43, p < 0.01), as were individual socioeconomic factors such as employment, need for financial aid and household income. Uptake of all screening modalities significantly increased in the poorer neighborhood post-intervention (all p < 0.05). Cost was cited more commonly as a barrier to health screening in the poorer neighborhood. Conclusion. Differing neighborhoods within one geographical location, as well as individual socioeconomic factors, were independently associated with differences in health screening. (C) 2011 Elsevier Inc. All rights reserved.