PETALING JAYA: The high prevalence of non-communicable diseases (NCDs) among low-income Malaysians underscores the need for broader government intervention beyond health screening programmes, say public health experts.
While initiatives such as PeKa B40 help identify illnesses early, screening alone would have limited impact unless followed by several necessary steps, including follow-up treatments.
Public health expert Dr Chan Chee Khoon said inadequate health literacy and limited opportunities to adopt healthier lifestyles continue to place many lower-income households at greater risk of chronic diseases.
“Health screening may help with early detection of preclinical illness, but if the necessary follow-up is not available or affordable, some people may prefer not to know,” he said.
Dr Chan also said Malaysia’s public healthcare funding model is no longer sufficient to tackle the country’s growing burden of NCDs.
He said the government’s allocation of around 2% of gross domestic product (GDP) to healthcare may have been sufficient decades ago, when the country’s health priorities were infectious diseases and malnutrition.
“Today, the challenge is different. NCDs require primary care-led, whole-of-government and whole-of-society efforts encompassing health promotion, disease prevention and long-term treatment... 2% of the GDP is grossly insufficient,” he said.
The Health Ministry said three in every four people from low-income households who underwent free health screenings under PeKa B40 last year were found to have at least one NCD.
As many as 227,891 people were identified as having at least one of four NCDs: obesity, high cholesterol, diabetes or high blood pressure.
Public health medicine specialist Datuk Dr Zainal Ariffin Omar said the findings reflected how poverty and other social determinants of health continue to shape disease patterns among the B40.
“The health of the B40 falls within what we call the social and economic determinants of health, broadly defined as the conditions in which people are born, grow, live, work and age, as well as their access to power, money and resources.
“These determinants have a powerful influence on health inequities.
“The high prevalence reflects what we call ‘the poverty penalty’ in health, where poverty is intrinsically linked to disease,” he said.
He noted that financial insecurity, long working hours and limited access to healthier food choices and physical activity opportunities further increase the risk of chronic illnesses.
Dr Zainal urged the government to bring screening services directly into low-income communities through mobile health units and outreach programmes at public housing projects, community centres and mosques.
“Relying solely on clinic-based schemes like PeKa B40 leaves a massive gap in participation.
“The government should increase the deployment of mobile health units, partnering with community centres, local mosques and community leaders to provide weekend or after-hours testing at low-income housing projects,” he said.
Meanwhile, public healthcare specialist Prof Dr Sharifa Ezat Wan Puteh of Universiti Kebangsaan Malaysia said initiatives like PeKa B40 should continue, but they must be supported by measures that improve healthcare accessibility.
She suggested expanding transport assistance for patients, particularly those in rural areas with limited public transport.
“Public clinics are usually underfunded and can only provide the bare minimum due to limited budgets, insufficient manpower and outdated infrastructure.
“The government can improve these facilities with better assets, manpower and trained specialists to cater to the higher demand for primary care and population health in general,” she said.
