Developing A One-stop Guide for public sector agencies to create healthy precincts

Health promotion extends beyond informing the community on what they can or cannot do to improve their own health – it calls for a holistic approach that encompasses modifying the built environment, leveraging data and technology, and rallying communities to support the health of their hard-to-reach neighbours.

The Healthy Precinct Index Version 2 (HPIv2) seeks to reinforce this by promoting synergies within government agencies and the community, consolidating and integrating existing resources as well as identifying gaps and opportunities within precincts that agencies can work on to encourage sustained healthier behaviours in communities.

What problem are we trying to solve? To date, 1 in 4 Singaporeans aged 40 years and above has at least 1 chronic disease, largely a result of an ageing population and adoption of unhealthy lifestyles¹. With the Ministry of Health’s paradigm shift of moving beyond healthcare to health, a holistic approach to health promotion is key in encouraging and supporting Singaporeans in leading healthy lives.

At MOHT, the Healthy Precinct Project seeks to influence behaviour in the community by synergising top-down and bottom-up efforts within precincts.

To achieve this aim, the HPIv2 was developed to consolidate existing resources as well as identify research and implementation gaps and opportunities. Building on the first version of the HPI that was produced from the whole-of-government workshop in 2019, Version 2 consolidates evidence-based, quantitative and qualitative strategies that embody a holistic approach to health and identifies emerging opportunities for further development. Case studies have demonstrated the importance of whole-of-society collaborations, and have improved our understanding of hard-to-reach communities, which account for disproportionate prevalence of chronic conditions and subsequently healthcare costs.

The HPIv2 advocates for an integrated and holistic approach: fostering a whole-of-community culture that values healthy living from the ground up, creating an environment that makes healthy living the default, or simpler, for people, and catalysing a supportive operating system with health in policies and multi-sectoral leadership. It proposes principles ranging from ensuring a clean, comfortable and safe environment to increasing access to healthy food and improving health literacy in the community. Each principle is detailed with explanations on the impact of health and its corresponding direct and indirect causal pathways, local and overseas strategies and case studies across the value chain – from governance systems and policy to design strategies, programming initiatives, maintenance and management.

For example, the chapter on ensuring a clean, comfortable and safe environment details the factors contributing to sources of pollution, the community’s exposure to pollutants and the consequent impact on health outcomes. This provides a clear roadmap on how solutions can improve health outcomes by targeting various factors. Building on this framework, the chapter demonstrates the measures to set emission standards in Singapore, which aim to reduce pollution from transportation and heavy industries. It also provides an overseas case study on the Superblock model in Barcelona, which provides insights on how modifying the built environment to promote car-free spaces and walking can reduce pollution.

The HPI is a living document that will be enhanced and adapted in close collaboration with our public sector partners. We hope that with its reiterative approach, the HPI can enhance collaborations in the whole-of-government and community to effect sustained healthy behaviour change within and across precincts, and ultimately, the population.

Acknowledgements: full authorship of HPIv2 was by Denise Tan, Stephanie Tan, Raudhah Razali, Danny Quek and Loke Wai Chiong

[1] Health Promotion Board. (2018). Tips to Prevent and Manage Chronic Diseases in the Workplace. https://www.hpb.gov.sg/article/tips-to-prevent-and-manage-chronic-diseases-in-the-workplace