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Socioeconomic Inequality in Hypertension among Adult Indonesian
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
2017 (English)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Background: Hypertension is one of five major global risks for mortality. Globally, hypertension contributes to 212 million DALYs in 2015. As with other middle-income countries, Indonesia suffers the double burden of infectious diseases and noncommunicable diseases including hypertension. The existing health inequalities in the population is also reflected on the inequality in hypertension burden. This study aims to investigate the epidemiology of hypertension burden in term of prevalence, awareness, treatment, and control of hypertension, and to assess socioeconomic inequality of hypertension in Indonesia.

Methods: This study utilized data from the Indonesian Family Life Survey 5 (IFLS-5) collected in 2014-2015. A total 32,034 individuals aged 15 and over were analysed. Logistic regression was used to assess biological and socioeconomic factors associated with the prevalence, awareness, treatment, and control of hypertension. Socioeconomic inequality between residential areas and across the wealth index, created using Principal Component Analysis (PCA), was determined using Concentration Index (CI) and Concentration Curve (CC) analyses.

Results: The prevalence, awareness, treatment, and control of hypertension in Indonesia were 23.8%, 32.7%, 27.8%, and 15.0%, respectively. Age, sex, marital status, residence, educational level, working status, body mass index, and smoking status were associated with prevalence (p<0.05). Factors associated with awareness were age, sex, marital status, body mass index, and wealth index. (p<0.05). Age, smoking status, and wealth index were associated with treatment (p<0.05). Control of hypertension was associated with age and education level (p<0.05). CI was negative for prevalence (urban: -0.047 [95% confidence interval of -0.069, -0.025]; rural: -.0750 [-0.101, 0.049]), meaning that the prevalence was more concentrated in lower socioeconomic groups. The CIs were on the other hand positive for awareness (urban=OR:0.066 [CI: 0.029, 0.103]; rural= OR 0.059 [CI: 0.012, 0.107]), treatment (urban=OR: 0.096 [CI:0.030, 0.162]; rural=OR: 0.183 [CI: 0.087, 0.278], and control (urban= OR: 0.080 [CI: -0.067, 0.227]; rural= OR:0.082 [CI: -0.108, 0.273]), meaning that the awareness, treatment, and control were more concentrated in higher socioeconomic groups.

Conclusion: Prevalence of hypertension in Indonesia is still high while awareness, treatment, and control are remains low. The poor population is more likely to have hypertension, be less aware, poorly treated, and be less have controlled blood pressure. The socioeconomic inequality reduction should be a key goal to achieve better and equal health in Indonesia.

Place, publisher, year, edition, pages
2017. , p. 33
Series
Centre for Public Health Report Series, ISSN 1651-341X ; 2017:29
Keyword [en]
Inequality, hypertension, concentration index
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-142698OAI: oai:DiVA.org:umu-142698DiVA, id: diva2:1163801
External cooperation
Indonesian Family Life Survey (IFLS-5) - Rand Corporation
Educational program
Master's Programme in Public Health
Presentation
2017-05-22, Room N260, Natural Sciences building, Umeå University, Umeå, 16:00 (English)
Supervisors
Examiners
Available from: 2017-12-19 Created: 2017-12-08 Last updated: 2017-12-19Bibliographically approved

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CiteExportLink to record
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Citation style
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