National Population Health Survey

Background

The National Population Health Survey (NPHS) is an annual survey conducted by the Ministry of Health and the Health Promotion Board. It was introduced as the National Health Survey (NHS) in 1992 before being renamed as NPHS in 2017. The rebranding involved increasing the survey frequency from every six years to once a year. The NPHS tracks the population’s health and risk factors, as well as lifestyle practices of Singapore residents. This information is then used to monitor the progress of the nation’s heath targets, health policies and health services.¹

Background
Prior to the launch of the NHS in 1992, the Ministry of Health had conducted numerous health surveys throughout the 1970s and 1980s. For example, the nationwide health survey in 1975 shed light on the prevalence rates of tuberculosis, diabetes and kidney and cardiovascular diseases among individuals aged 15 and above.² In 1988, another nationwide survey provided insights into the prevalence of diseases and illnesses associated with factors such as smoking, lack of exercise, poor dietary habits and alcohol consumption.³ In addition, other surveys collected health data like smoking rate, dental health of children, and attitudes towards healthy living.⁴

National Health Survey

In 1991, the Ministry of Health identified potential future health issues, such as heart diseases, stroke, diabetes and cancer, that might arise due to the growing prevalence of sedentary lifestyles and dietary habits associated with increased affluence.⁵ To monitor these diseases and find ways to prevent them, the ministry launched the NHS in 1992 to measure the prevalence of non-communicable diseases – for example, diabetes, high-blood pressure and obesity – among Singapore citizens and permanent residents. The survey also tracked their health behaviour and choices, including physical activity levels and the rates of smoking and alcohol consumption.⁶

The NHS was held once every six years, involving a random sample of Singaporean citizens and permanent residents aged 18 to 69. In the 1992 survey, the sample size was about 3,500. This number increased to about 7,700 by the 2010 NHS, before being replaced by the NPHS. The 2010 survey also increased the maximum age of the participants to 79 years old, even though the findings only focused on those between aged 18 and 69.⁷

National Population Health Survey
In 2016, the NHS was replaced by the NPHS. This new cross-sectional population health survey assesses the health status, risk factors, and lifestyle behaviours and preferences of Singapore citizens and permanent residents. The collected data is then used to monitor the performance of the nation’s health targets and facilitate the planning, evaluation and improvement of health policies and healthcare services.⁸

Managed by the Ministry of Health and the Health Promotion Board, the NPHS collects information on the prevalence of non-communicable diseases such as diabetes mellitus, hypertension and hyperlipidaemia, as well as related risk factors like smoking, alcohol consumption and physical inactivity, based on a representative sample of the resident population. Because two other surveys – National Health Surveillance Survey and Health Behaviour Surveillance of Singapore – have been combined, the NPHS also captures information on chronic disease and cancer screenings, mental health, and influenza and pneumococcal vaccination among Singapore residents.⁹

The NPHS, unlike the NHS, is carried out annually instead of every six years so that timely and regular information on the health of Singapore residents can be obtained. Since its inception, the NPHS sample size has more than doubled, from about 3,000 in 2016 to 6,260 in 2021.¹⁰

Key survey findings
National Health Survey (1992−2010)
The findings from the series of NHS conducted between 1992 and 2010 revealed some notable health trends among the surveyed population:¹¹

• Diabetes prevalence among adults aged 18 to 69 increased from 8.6 percent in 1992 to 11.3 percent in 2010.
• Hypertension prevalence among adults aged 30 to 69 showed a slight increase from 22.2 percent in 1992 to 23.5 percent in 2010.
• The proportion of adults aged 18 to 69 with high total blood cholesterol decreased from 19.4 percent in 1992 to 17.4 percent in 2010.
• The percentage of obese adults aged 18 to 69 years doubled, going from 5.1 percent in 1992 to 10.8 percent in 2010.
• The proportion of adults aged 18 to 69 years engaging in regular exercise of light or moderate intensity increased from 13.6 percent in 1992 to 19 percent in 2010.
• The percentage of daily smokers among adults aged 18 to 69 years decreased from 18.3 percent in 1992 to 14.3 percent in 2010.
• The proportion of adults aged 18 to 69 years regularly consuming alcohol experienced a slight decrease, declining from 2.7 percent in 1992 to 2.6 percent in 2010.

National Population Health Survey (2019−2021)
The findings from the NPHS conducted between 2019 and 2021 indicated several health trends among the surveyed population:¹²

• The prevalence of diabetes among adults aged 18 to 74 remained stable at 6.9 percent in both 2019 and 2021.
• High blood pressure (hypertension) prevalence among adults aged 18 to 74 showed a slight increase from 15.6 percent in 2019 to 15.7 percent in 2021.
• The proportion of adults aged 18 to 74 with high total blood cholesterol increased from 13.6 percent in 2019 to 13.9 percent in 2021.
• The percentage of adults aged 18 to 74 engaging in regular exercise of light or moderate intensity decreased from 35.2 percent in 2019 to 32.5 percent in 2021.
• The percentage of daily smokers among adults aged 18 to 74 decreased from 10.6 percent in 2019 to 10.4 percent in 2021.
• The proportion of adults aged 18 to 74 regularly consuming alcohol increased from 2.1 percent in 2019 to 2.8 percent in 2021.
• Screening participation for chronic diseases (diabetes, hypertension, hyperlipidaemia) among adults aged 40 to 74 decreased from 66.4 percent in 2019 to 59.2 percent in 2021.
• Screening participation for breast, cervical and colorectal cancers in 2021 was significantly lower than in 2019 (breast cancer: 38.7 percent in 2019, 31.1 percent in 2021; cervical cancer: 48.2 percent in 2019, 41.0 percent in 2021; colorectal cancer: 42 percent in 2019, 36.6 percent in 2021).
• The proportion of residents aged 18 to 74 willing to seek mental healthcare increased from 47.8 percent in 2019 to 58.3 percent in 2021.

Author
Lim Tin Seng



Further resources
Epidemiology and Disease Control Department, Ministry of Health, National Health Survey 1998 (Singapore: Epidemiology and Disease Control Department, Ministry of Health, 1999). (Call no. 614.425957 NAT)

Epidemiology and Disease Control Department, Ministry of Health, National Health Survey 2004 (Singapore: Epidemiology and Disease Control Department, Ministry of Health, 2005). (Call no. 614.425957 NAT)

Epidemiology and Disease Control Division, Ministry of Health, “National Population Health Survey 2018/19 Report,” National Health Population Survey 2018/19, Ministry of Health, 28 December 2020.

Epidemiology and Disease Control Division, Ministry of Health, Singapore, “NPHS 2020 Report,” National Health Population Survey 2019/20, Ministry of Health, 6 December 2022.

“National Population Health Survey 2016/17,” National Health Population Survey 2016/17, Ministry of Health, 25 August 2018.



References
1. Epidemiology & Disease Control Division, Ministry of Health, Singapore, “National Population Health Survey 2021 Report,” National Health Population Survey 2020/21, Ministry of Health, 27 December 2022, 2.
2. Masie Kwee, “First Big Survey on Diabetes, Kidney Diseases,” Straits Times, 11 August 1974, 4; “Big Health Survey,” New Nation, 2 April 1975, 4. (From NewspaperSG)
3. Ministry of Health, Annual Report 1988 (Singapore: Ministry of Health, 1989), 25. (Call no. RCLOS 354.59570677 SMHAR)
4. Serena Toh, “S'poreans More Aware of Nutritious Foods,” Straits Times, 14 April 1989, 24; Serena Toh, “Health: S'poreans Score Low,” Straits Times, 1 August 1988, 14; Ray Miller, “Lowering Number of Smokers to 5% of Population,” Singapore Monitor, 12 November 1984, 6; Ray Miller, “Young Singaporeans Have Healthy Teeth,” Singapore Monitor, 13 June 1984, 6. (From NewspaperSG)
5. “Live a Healthy Life: Annual Drive to Begin Next April,” Straits Times, 3 November 1991, Page. (From NewspaperSG)
6. Research & Evaluation Department, Ministry of Health, National Health Survey 1992: Highlights of Main Survey Findings (Singapore: Singapore: Research and Evaluation Department, Ministry of Health, 1993), 2-3. (Call no. RSING 614.425957 NAT); Epidemiology and Disease Control Department, Ministry of Health, National Health Survey 2010 (Singapore: Epidemiology and Disease Control Department, Ministry of Health, 2011), i. (Call no. 614.425957 NAT)
7. Epidemiology and Disease Control Department, National Health Survey 2010, 95. For details on the survey methodology, see 90.
8. Epidemiology & Disease Control Division and Policy, Research & Surveillance Group, National Population Health Survey 2021, 2.
9. Epidemiology & Disease Control Division and Policy, Research & Surveillance Group, National Population Health Survey 2021, 2.
10. Epidemiology & Disease Control Division and Policy, Research & Surveillance Group, National Population Health Survey 2021, 62. For details on the survey methodology, see 77–78.
11. Epidemiology and Disease Control Department, National Health Survey 2010, vii.
12. Epidemiology & Disease Control Division and Policy, Research & Surveillance Group, Health Survey 2021, 3-10.



The information in this article is valid as of May 2023 and correct as far as we are able to ascertain from our sources. It is not intended to be an exhaustive or complete history of the subject. Please contact the Library for further reading materials on the topic.