Determinants of the demand for health screening in Malaysia: The case of the aged population

The increase in the prevalence of heart disease has become a serious public health issue. Hypercholesterolemia and hypertension are two main modifiable health risk factors for heart disease. In a fast ageing society, proper preventive measures should be adopted, particularly to achieve healthy aging. The objective of the present study is to examine the factors affecting the use of two health tests, namely blood cholesterol and blood pressure screenings among adults aged 60 years and above in Malaysia. Nationally representative data collected through the National Health and Morbidity Survey 2011 (NHMS, 2011) by the Ministry of Health, Malaysia were analysed. The survey used a two-stage stratified sampling method. Enumeration Blocks were selected in the first stage, while the second stage involved selection of Living Quarters. The proportions of those not using the blood cholesterol (45.4%) and blood pressure (30.8%) tests are alarmingly high. A bivariate probit model is applied to examine the determinants of the use of these two health screening tests. The results show that education, ethnicity, location of residence, employment status, health insurance and smoking significantly affect the decision of the aged population to undergo these tests. Key findings are, first, time is a more dominant factor than income in determining health screening behaviour among the aged population. Second, being covered by insurance increases the propensity to undergo health screening. Third, smokers have a lower likelihood of screening than non-smokers. The findings suggest that intervention programmes should be targeted at the less-educated, employed individuals, individuals not covered by health insurance and smokers.