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Singapore's successful public housing programme is a source of political legitimacy for the ruling People's Action Party. Beng-Huat Chua accounts for the success of public housing in Singapore and draws out lessons for other nations. Housing in Singapore, he explains in this incisive analysis, is seen neither as a consumer good (as in the US) nor as a social right (as in the social democracies of Europe). The author goes on to look at the ways in which Singapore's planners have dealt with the problems of creating communities in a modern urban environment. He concludes that the success of the public housing programme has done much for Singapore.

Singapore's successful public housing programme is a source of political legitimacy for the ruling People's Action Party. Beng-Huat Chua accounts for the success of public housing in Singapore and draws out lessons for other nations. Housing in Singapore, he explains in this incisive analysis, is seen neither as a consumer good (as in the US) nor as a social right (as in the social democracies of Europe). The author goes on to look at the ways in which Singapore's planners have dealt with the problems of creating communities in a modern urban environment. He concludes that the success of the public housing programme has done much for Singapore.

Singapore's successful public housing programme is a source of political legitimacy for the ruling People's Action Party. Beng-Huat Chua accounts for the success of public housing in Singapore and draws out lessons for other nations

ObjectivesDaily numbers of COVID-19 in Singapore from March to May 2020, the cause of a surge in cases in April and the national response were examined, and regulations on migrant worker accommodation studied.MethodsInformation was gathered from daily reports provided by the Ministry of Health, Singapore Statues online and a Ministerial statement given at a Parliament sitting on 4 May 2020.ResultsA marked escalation in the daily number of new COVID-19 cases was seen in early April 2020. The majority of cases occurred among an estimated 295 000 low-skilled migrant workers living in foreign worker dormitories. As of 6 May 2020, there were 17 758 confirmed COVID-19 cases among dormitory workers (88% of 20 198 nationally confirmed cases). One dormitory housing approximately 13 000 workers had 19.4% of residents infected. The national response included mobilising several government agencies and public volunteers. There was extensive testing of workers in dormitories, segregation of healthy and infected workers, and daily observation for fever and symptoms. Twenty-four dormitories were declared as ‘isolation areas’, with residents quarantined for 14 days. New housing, for example, vacant public housing flats, military camps, exhibition centres, floating hotels have been provided that will allow for appropriate social distancing.ConclusionThe COVID-19 pandemic has highlighted migrant workers as a vulnerable occupational group. Ideally, matters related to inadequate housing of vulnerable migrant workers need to be addressed before a pandemic.

Using unique consumer financial transactions of more than 56,000 consumers, we study the consumption response to a housing policy experiment in Singapore that resulted in a decrease in access to home equity. Using difference-in-differences analysis, we find a significant negative consumption response to the policy shock. Moreover, the consumption response is concentrated in credit card spending and is stronger among individuals with limited access to credit market or with a high precautionary saving motive. These results suggest that a decrease in access to home equity reduces the role of housing as a self-insurance mechanism for consumption smoothing.

We study the effect of superstition and conspicuous spending motives on housing demand and price in Singapore. We find that buyers pay less for homes with unlucky addresses and more for homes with lucky addresses. There were fewer housing transactions on inauspicious days of the lunar calendar when people are advised to avoid making major economic decisions. This suggests that superstitious belief still affects economic activities. The demand for lucky addresses is also weaker on these inauspicious days, suggesting that superstitious belief indeed affects the demand for lucky addresses. Moreover, the price premium for a lucky address is significantly higher for apartments of larger size or on top floors. Because these two housing features can signal wealth and are highly visible, the larger price premium suggests that conspicuous spending motives also play a significant role in the Singapore housing market. We also find that informed buyers, even with less superstitious or conspicuous spending motives, might still pay price premiums for lucky addresses. In contrast, uninformed buyers are unlikely to pay a premium for these addresses. This paper was accepted by Tomasz Piskorski, finance.

Background Primary care patients with prediabetes is a priority group in the clinical, organisational and policy contexts. Engaging in regular physical activity is crucial to prevent diabetes for this group. The objectives of the study were to assess factors associated with meeting the recommendation of at least 150 min of moderate/vigorous physical activity weekly, and to explore facilitators and barriers related to the behaviour among primary care patients with prediabetes in Singapore. Methods This was a mixed methods study, consisting of a cross-sectional survey involving 433 participants from 8 polyclinics, and in-depth interviews with 48 of them. Adjusted prevalence ratios (aPR) were obtained by mixed effects Poisson regression model. The socio-ecological model (SEM) was applied, and thematic analysis performed. Results The prevalence of meeting the recommendation was 65.8%. This was positively associated with being male (aPR 1.21, 95%CI 1.09–1.34), living in 4–5 room public housing (aPR 1.19, 95%CI 1.07–1.31), living in executive flat/private housing (aPR 1.26, 95%CI 1.06–1.50), having family members/friends to exercise with (aPR 1.57, 95%CI 1.38–1.78); and negatively associated with a personal history of osteoarthritis (aPR 0.75, 95%CI 0.59–0.96), as well as time spent sitting or reclining daily (aPR 0.96, 95%CI 0.94–0.98). The recurrent themes for not meeting the recommendation included lacking companionship from family members/friends, medical conditions hindering physical activity (particularly osteoarthritis), lacking knowledge/skills to exercise properly, “no time” to exercise and barriers pertaining to exercise facilities in the neighbourhood. The recurrent themes for meeting the recommendation included family/peer influence, health/well-being concerns and education by healthcare professionals. Conclusions Much more remains to be done to promote physical activity among primary care patients with prediabetes in Singapore. Participants reported facilitators and barriers to physical activity at different levels of the SEM. Apart from the individual and interpersonal levels, practitioners and policy makers need to work together to address the organisational, community and policy barriers to physical activity.

The Singapore Perspectives series is a yearly publication that provides critical analysis of emerging trends and issues Singapore faces in terms of social, economic and political development. It is a quick and essential reference for understanding the broad policy discussions that animate thought leaders, policy-makers and the public in the country during the immediate period or that are likely to do so in the short and medium term.

Introduction It is well-established that low socioeconomic status (SES) influences one’s health status, morbidity and mortality. Housing type has been used as an indicator of SES and social determinant of health in some studies. In Singapore, home ownership is among the highest in the world. Citizens who have no other housing options are offered heavily subsidised rental housings. Residents staying in such rental housings are characterised by low socioeconomic status. Our aim is to review studies on the association between staying in public rental housing in Singapore and health status. Methods A PubMed and Scopus search was conducted in January 2017 to identify suitable articles published from 1 January 2000 to 31 January 2017. Only studies that were done on Singapore public rental housing communities were included for review. A total of 14 articles including 4 prospective studies, 8 cross-sectional studies and 2 retrospective cohort studies were obtained for the review. Topics addressed by these studies included: (1) Health status; (2) Health seeking behaviour; (3) Healthcare utilisation. Results Staying in public rental housing was found to be associated with poorer health status and outcomes. They had lower participation in health screening, preferred alternative medicine practitioners to western-trained doctors for primary care, and had increased hospital utilisation. Several studies performed qualitative interviews to explore the causes of disparity and concern about cost was one of the common cited reason. Conclusion Staying in public rental housing appears to be a risk marker of poorer health and this may have important public health implications. Understanding the causes of disparity will require more qualitative studies which in turn will guide interventions and the evaluation of their effectiveness in improving health outcome of this sub-population of patients.

Background Socioeconomic status (SES) is a well-established determinant of health status and home ownership is a commonly used composite indicator of SES. Patients in low-income households often stay in public rental housing. The association between public rental housing and mortality has not been examined in Singapore. Methods A retrospective, cohort study was conducted involving all patients who utilized the healthcare facilities under SingHealth Regional Health (SHRS) Services in Year 2012. Each patient was followed up for 5 years. Patients who were non-citizens or residing in a non-SHRS area were excluded from the study. Results A total of 147,004 patients were included in the study, of which 7252 (4.9%) patients died during the study period. The mean age of patients was 50.2 ± 17.2 years old and 7.1% ( n  = 10,400) of patients stayed in public rental housing. Patients who passed away had higher utilization of healthcare resources in the past 1 year and a higher proportion stayed in public rental housing ( p  < 0.001). They also had higher rates of co-morbidities such as hypertension, hyperlipidaemia and diabetes. ( p  < 0.001) After adjustment for demographic and clinical covariates, residence in public rental housing was associated with increased risk of all-cause mortality (Adjusted hazard ratio: 1.568, 95% CI: 1.469–1.673). Conclusion Public rental housing was an independent risk factor for all-cause mortality. More studies should be conducted to understand health-seeking behavior and needs of public rental housing patients, to aid policymakers in formulating better plans for improving their health outcomes.