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


CONCLUSIONS
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.
Fong
C W
CW
Epidemiology & Disease Control Division, Ministry of Health Singapore, 16 College Road, College of Medicine Building, Singapore 169854. fong_chee_weng@moh.gov.sg
Bhalla
V
V
Heng
D
D
Chua
A V
AV
Chan
M L
ML
Chew
S K
SK
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D001294:Attitude to Health; D016009:Chi-Square Distribution; D004522:Educational Status; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011336:Probability; D012042:Registries; D018570:Risk Assessment; D017678:Sex Distribution; D012846:Singapore / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology*