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STEPS Report Indonesia National 2001
STEPS Report Indonesia National 2001
By
S. Soemantri
Julianty Pradono
Dwi Hapsari
Introduction
Sampling scheme of NSES 2001 was used for NHHS 2001. NSES 2001
employed principle of multi stages sampling design. For urban areas, census blocks
(CBs) were selected systematically, and 16 households were drawn in each selected CB
also systematically. For rural areas firstly sub-districts were selected with PPS, secondly
two CBs selected randomly in each selected sub-district and finally 16 households were
drawn systematically in each selected CB. NSES 2001 has sample size of 220,896 HH
(13,806 CB) for Core and 65,280 HH (4,080 CB) for Module. Core sample of NSES
2001 was also used for the sample of Mortality Study of NHHS 2001. Forty percent of
module sample of NSES 2001 was allocated for sample of NHHS 2001: MCH and
Pregnant women FU Studies, and 25% of HHs within this sample was allocated for
NHHS 2001: Morbidity Survey.
Morbidity survey was able to cover 98% of sampled census blocks, but only 84%
of households within the covered census blocks could be visited and 97% of household
members of those visited households were successfully interviewed/examined.
Findings
Total sample of 13,131 persons aged 15 years + for Indonesia was analysed
descriptively for NCD risk factors (Step 1 and Step 2), and only 4,081 persons aged 25
years + in Java-Bali included for blood glucose and total cholesterol descriptive analysis
(steps 3). Table 1 shows distribution of sampled persons aged 15 years+ by age group
and gender for Indonesia, and Table 2 shows distribution of sampled persons aged 25
years+ by age group and gender for Java and Bali. Sampling design of NSES provides
weight for each household selected in the sample, and this weight was used to calculate
the sample distribution (weighted n).
Table 3 shows prevalence rates of various NCD risk factors by age group, gender
and residence. 31% of sampled population aged 25 years + are current daily smoker.
Current daily smoker increases by age group except for the oldest. Smoking is more
prevalent for male and in rural. Alcohol consumption was reported very low only 3%,
more prevalent for male and in rural. Physical inactivity is very high (63%), more
prevalent in urban area than in rural area, and more prevalent for female than male. High
blood pressure was reported for 28% sampled population, increasing by age group, more
prevalent in urban and for female. Indication of obesity (21%) is shown by prevalence
rates of persons with WHR >1 for male and >0.85 for female, which is more prevalent
for women and for those live in urban. Similar pattern is also shown by percentage of
BMI 25kg/m2,16% of persons aged 25 years+ have BMI 25 kg/m2. Prevalence of
hyperglycemia (capillary blood glucose 110mg%) is 8% and prevalence of those with
total cholesterol above 200mg% is 7%.
Mean and prevalence rates for each risk factor by age group and gender are shown
in Tables 4-14.
Table 1
Weighted n (sample) distribution of persons aged 15 years+ by age and gender.
Morbidity Study (NHHS) 2001
Table 2.
Weighted n (sample) distribution of persons aged 25 years+ by age and gender
in Java-Bali, Morbidity Study (NHHS) 2001
Residence
Urban 29.7 2.4 74.7 29.9 22.5 22.8 8.9 8.9 4,082
Rural 32.7 3.7 55.3 26.4 19.8 11.7 6.9 5.2 5,949
Total 31.4 3.2 63.2 27.8 20.9 16.2 7.8 6.9 10,031
Tables 4a and 4b show prevalence of tobacco use by age group for male and
female. Prevalence for male is much higher than for female. For male 78% is ever
smokers, 58% is current daily smokers and the figures for female are 6% and 3%
respectively. Both male and female current daily smokers have similar median age at start
of daily smoking i.e. 19 years old.
Table 4a
Prevalence of tobacco use for male by age group,
Morbidity Study (NHHS) 2001
Alcohol consumption was reported very low in the community. Only 6% among
male respondents reported as current alcohol consumer, and 22% reported as ever
consumer. Lower percentages were reported by female respondents, i.e., 1% and 2%
respectively (Tables 5a and b).
Table 5a
Prevalence of alcohol consumption for male by age group,
Morbidity Study (NHHS) 2001
Age Ever consumed Current alco- Abstainers
(years)
Weighted n
alcohol (%) hol use (%) (%)
15-24 19.6 5.3 80.4 1444
25-34 28.6 6.9 71.4 1326
35-44 27.4 6.7 72.6 1266
45-54 19.7 5.1 80.3 943
55-64 17.9 4.0 82.1 645
65+ 16.1 4.0 83.9 506
Total 22.7 5.7 77.3 6130
Table 5b
Prevalence of alcohol consumption for female by age group
Morbidity Study (NHHS) 2001
Table 6a
Mean of percentages inactive time for male by age groups,
Morbidity Study (NHHS) 2001
Male
Age
(years) Weighted
Mean (95% CI)
n
15-24 1444 63.5 62.3-64.7
25-34 1326 58.5 57.2-59.8
35-44 1266 57.8 56.4-59.2
45-54 943 56.2 54.6-57.8
55-64 645 55.6 53.7-57.5
65+ 506 62.2 59.8-64.6
Table 6b
Percent distribution of mean inactive time for female by age groups,
Morbidity Study (NHHS) 2001
Female
Age
(years) Weighted
Mean (95% CI)
n
15-24 1658 66.7 65.6-67.8
25-34 1728 62.7 61.6-63.8
35-44 1471 60.3 59.1-61.5
45-54 1002 60.4 59.0-61.8
55-64 629 64.5 62.6-66.4
65+ 515 71.0 68.9-73.0
Table 6c
Prevalence of inactive time for male by age group,
Morbidity Study (NHHS) 2001
Male
Age
(years) Weighted n % (95% CI)
15-24 1444 68.1 68.08 68.12
25-34 1326 58.8 58.77 58.83
35-44 1266 55.4 55.37 55.43
45-54 943 53.4 53.37 53.43
55-64 645 53.1 53.06 53.14
65+ 506 65.1 65.06 65.14
6130
Total 59.4 59.39 59.41
Table 6d
Prevalence of inactive time for female by age group,
Morbidity Study (NHHS) 2001
Female
Age
(years) Weighted
% (95% CI)
n
15-24 1658 75.4 75.38 75.42
25-34 1728 69.2 69.18 69.22
35-44 1471 65.1 65.08 65.12
45-54 1002 67.4 67.37 67.43
55-64 629 70.3 70.26 70.34
65+ 515 81.1 81.06 81.14
7003
Total 70.5 70.49 70.51
Mean of weight for female (48 kg) is lower than mean of weight for male (51 kg).
Tables 7a and 7b. The highest weight for both male and female is for age group 35-44.
Mean of height for male is 158cm, 9 cm higher than for female (149 cm). Younger age
group is generally higher than older age group (Table 8a, 8b).
Table 7 a
Mean of weight for male by age group,
Morbidity Study (NHHS) 2001
Age Male
(years) Weighted n Mean (95%CI)
15-24 1444 51.5 51.1-51.9
25-34 1326 56.1 55.7-56.5
35-44 1266 57.0 56.3-57.5
45-54 943 55.9 55.3-56.5
55-64 645 52.6 51.8-53.4
65+ 506 49.5 48.7-50.3
Total 6130 51.3 51.1-51.5
Missing: male 158 (2.6%)
Table 7b
Mean of weight for female by age group,
Morbidity Study (NHHS) 2001
Age Female
(years) Weighted n Mean (95%CI)
15-24 1658 47.2 46.8-47.6
25-34 1728 50.6 50.2-51.0
35-44 1471 52.9 52.3-53.5
45-54 1002 51.5 50.9-52.1
55-64 629 48.1 47.3-48.9
65+ 515 43.8 43.0-44.6
Total 7003 47.7 47.5-47.9
Missing: female 131 (1.9%)
Table 8a
Mean of height in male by age group,
Morbidity Study (NHHS) 2001
Age Male
(years) Weighted n Mean (95%CI)
15-24 1444 160.5 160.1-160.9
25-34 1326 162.0 161.6-162.4
35-44 1266 161.3 160.9-161.7
45-54 943 160.6 160.2-161.0
55-64 645 159.0 158.3-159.5
65+ 506 157.5 156.9-158.1
Total 6130 157.6 157.4-157.8
Missing: male 158 (2.6%)
Table 8b
Mean of height in female by age group,
Morbidity Study (NHHS) 2001
Age Female
(years) Weighted n Mean (95%CI)
15-24 1658 151.4 151.2-151.6
25-34 1728 151.3 151.1-151.5
35-44 1471 151.0 150.6-151.4
45-54 1002 149.9 149.5-150.3
55-64 629 148.8 148.4-149.2
65+ 515 146.9 146.3-147.5
Total 7003 149.2 149.0-149.4
Missing: female 131 (1.9%)
Mean of body mass index (BMI) for male is 20, a little bit lower than BMI for
female (21). Proportion of male respondents with BMI 25 is 8%, and for female more
than double (17%) falls in this category. Both for male and female age group 35-54 tend
to fall in the category compared to other age groups (Tables 9a, 9b, 10a, and 10b). Only 1
% of male respondents fall in the category BMI 30, and for female respondents the
percentage is 4% (Tables 10c and 10d).
Table 9a
Mean of body mass index for male by age group,
Morbidity Study (NHHS) 2001
Male
Age
(years)
Weighted n Mean (95%CI)
15-24 1444 19.9 19.8-20.0
25-34 1326 21.4 21.2-21.6
35-44 1266 21.9 21.7-22.1
45-54 943 21.7 21.5-21.9
55-64 645 20.8 20.6-21.0
65+ 506 19.9 19.7-20.1
Total 6130 20.4 20.3-20.5
Missing: male 158 (2.6%)
Table 9b
Mean of body mass index for female by age group.
Morbidity Study (NHHS) 2001
Female
Age
(years)
Weighted n Mean (95%CI)
15-24 1658 20.5 20.4-20.6
25-34 1728 22.1 21.9-22.3
35-44 1471 23.2 22.9-23.4
45-54 1002 22.9 22.6-23.2
55-64 629 21.6 21.3-21.9
65+ 515 20.3 19.9-20.7
Total 7003 21.3 21.2-21.4
Missing: female 131 (1.9%)
Table 10a
Prevalence of BMI 25 kg/m2 for male by age group,
Morbidity Study (NHHS) 2001
Age Male
(years)
% Weighted n
15-24 2.1 1444
25-34 7.6 1326
35-44 13.1 1266
45-54 13.7 943
55-64 7.3 645
65+ 4.2 506
Total 8.1 6130
Missing: male 158 (2.6%)
Table 10b
Prevalence of BMI 25 kg/m2 for female by age group,
Morbidity Study (NHHS) 2001
Age Female
(years)
% Weighted n
15-24 5.5 1658
25-34 16.6 1728
35-44 27.4 1471
45-54 26.4 1002
55-64 18.4 629
65+ 9.2 515
Total 17.3 7003
Missing: female 131 (1.9%)
Table 10c
Prevalence of BMI 30 kg/m2 for male by age group,
Morbidity Study (NHHS) 2001
Age Male
(years)
% Weighted n
15-24 0.3 1444
25-34 0.8 1326
35-44 1.2 1266
45-54 2.3 943
55-64 0.9 645
65+ 1.2 506
Total 1.1 6130
Missing: male 158 (2.6%)
Table 10d
Prevalence of BMI 30 kg/m2 for female by age group,
Morbidity Study (NHHS) 2001
Age Female
(years)
% Weighted n
15-24 0.9 1658
25-34 3.2 1728
35-44 6.9 1471
45-54 4.9 1002
55-64 2.9 629
65+ 2.6 515
Total 3.6 7003
Missing: female 131 (1.9%)
There is no significant difference between male and female mean of waist to hip
ratio (WHR), 0.86 for male and 0.83 for female (Tables 11a and 11b). However when we
look at prevalence of central obesity (WHR >1.0 for male and WHR>0.85for female)
there is huge difference between male (2%) and female (38%). Difficulty to measure
waist and hip for female respondents by interviewer may be one reason for the difference.
Prevalence of central obesity increases by age group for female (Tables 11c and d).
Table 11a
Mean of waist to hip ratio for male by age group,
Morbidity Study (NHHS) 2001
Male
Age
(years) Weighted n Mean (95%CI)
25-34 1326 0.85 0.81-0.89
35-44 1266 0.86 0.82-0.9
45-54 943 0.87 0.83-0.91
55-64 645 0.87 0.81-0.93
65+ 506 0.86 0.8-0.92
Total 4686 0.86 0.84-0.88
Mising: male 344 (7.3%)
Table 11b
Mean of waist to hip ratio for female by age group.
Morbidity Study (NHHS) 2001
Female
Age
(years) Weighted n Mean (95%CI)
25-34 1728 0.81 0.78-0.86
35-44 1471 0.83 0.79-0.87
45-54 1002 0.84 0.78-0.9
55-64 629 0.85 0.79-0.91
65+ 515 0.85 0.79-0.91
Total 5345 0.83 0.81-0.85
Missing: female 241 (4.5%)
Table 11c
Prevalence of high risk of waist to hip ratio for male by age group.
Morbidity Study (NHHS) 2001
Age Male
(years) Weighted n % (95%CI)
25-34 1326 1.3 1.24 1.36
35-44 1266 1.5 1.44 1.56
45-54 943 4.1 3.93 4.17
55-64 645 2.5 2.52 2.68
65+ 506 1.5 1.41 1.59
Age Female
(years) Weighted n % (95%CI)
25-34 1728 29.5 29.46 29.54
35-44 1471 35.3 35.16 35.34
45-54 1002 41.9 41.65 41.95
55-64 629 44.6 44.34 44.65
65+ 515 52.5 51.64 52.76
Figures of blood pressure (systolic and diastolic) shown in Tables 12a and b
were based on average of two measurements. In the study mercury
sphygmomanometer was used by the doctors to measure blood pressure. The mean of
systolic blood pressure for both male and female is 125 mmHg and the mean of
diastolic blood pressure is 80 mmHg (Tables 12a and b). As expected the mean
increases by age group. Tables 12c and d show the prevalence of blood pressure
140/90 mmHg. For male respondents the prevalence is 26,5% a little bit lower than
for female respondents (29%). The prevalence increases by age groups, for male from
10% for age group 25-34 to 51% for age group 65+, and for female from 11% for age
group 25-34 to 60% for age group 65+. The prevalence in older age group is higher
for female than for male.
Table 12a
Mean of systolic and diastolic for male by age group,
Morbidity Study (NHHS) 2001
Systolic Diastolic
Age Weighted n
(years) Mean (95%CI) Mean (95%CI)
25-34 1728 115.0 114.3-115.5 76.0 75.6-76.4
35-44 1471 122.1 121.3-123.1 79.4 78.8-79.9
45-54 1002 129.7 129.3-130.1 82.1 81.3-82.9
55-64 629 138.3 136.2-140.4 84.8 83.8-85.8
65+ 515 142.7 140.3-145.1 84.9 83.8-86.0
Total 5345 125.2 122.6-127.8 80.0 79.7-80.3
Missing: 47 (0.9%)
Table 12c
Prevalence of blood pressure 140/90 mmHg for male by age group,
Morbidity Study (NHHS) 2001
Male
Age
(years) Weighted
% (95%CI)
n
25-34 1326 10.4 10.35 10.45
35-44 1266 20.8 20.75 20.85
45-54 943 31.6 31.45 31.65
55-64 645 43.9 43.84 43.96
65+ 506 50.9 50.84 50.96
Total 4686 26.6 26.47 26.63
Missing: male 62 (1.3%)
Table 12d
Prevalence of blood pressure 140/90 mmHg in female by age group,
Morbidity Study (NHHS) 2001
Female
Age
(years) Weighted n % (95%CI)
25-34 1728 11.1 11.05 11.15
35-44 1471 23.4 23.45 23.55
45-54 1002 38.2 38.15 38.25
55-64 629 51.0 50.94 51.06
65+ 515 59.6 59.64 59.76
Total 5345 28.9 28.98 29.02
Missing: female 47 (0.9%)
Accutrend GC (dry chemistry) was used to examine blood glucose and total
cholesterol. The instrument used makes possible the field team observes the result
immediately. The examination was only done in Java Bali.
Tables 13a-13b show mean of capillary fasting blood glucose for male and
female in Java and Bali. The mean for male is 85mg% and for female is 82mg%.
Tables 13c depict the prevalence of fasting capillary glucose 110 mg%
(hyperglycemia) for male (9%) and for female (7%). The prevalence increase by age
group. If the criteria of 126mg% is used, the prevalence for male is 4% and for
female is 3% (Table 13d).
Table 13a
Mean of capillary fasting blood glucose (mg%) for male by age group,
Morbidity Study, Java-Bali (NHHS) 2001
Male
Age
(years) Weighted n Mean (95%CI)
25-34 572 81.9 79.9-83.9
35-44 522 83.9 81.1-86.7
45-54 372 86.2 83.0-89.4
55-64 252 84.8 82.0-87.6
65+ 177 91.4 85.0-97.8
Total 1895 84.9 83.5-86.3
Missing: male 365 (11.7%)
Table 13b
Mean of fasting blood glucose (mg%) for female by age group,
Morbidity Study, Java-Bali (NHHS) 2001
Female
Age
(years) Weighted n Mean (95%CI)
25-34 739 75.8 74.2-77.4
35-44 597 81.6 79.2-84.0
45-54 417 86.3 82.7-89.9
55-64 244 86.8 82.6-91.0
65+ 189 83.7 79.7-87.7
Total 2186 81.6 80.3-82.9
Missing: female 432 (11.9%)
Table 13c
Prevalence of capillary fasting blood glucose 110 mg% for male and female by
age group Morbidity Study, Java-Bali (NHHS) 2001
Table 13d
Prevalence of capillary fasting blood glucose 126mg% by sex and age groups
Morbidity Study, Java-Bali (NHHS) 2001
Tables 14a and b show mean of total cholesterol for male and female respondents in
Java Bali. The mean for male is 171mg% and mean for female is 173mg%.
Prevalence of total cholesterol > 200 mg% for male and female are 6% and 8%
respectively (Tables 14c). Prevalence of hypercholesterolemia using cut off point total
cholesterol 193.5 mg/dl is 9% for male and 11% for female (Table 14d).
Table 14a
Mean of total cholesterol (mg%) for male by age group
Morbidity Study, Java-Bali (NHHS) 2001
Age Male
(years)
Weighted n Mean (95%CI)
25-34 572 165.9 164.1-167.7
35-44 522 171.1 168.9-173.3
45-54 372 175.5 172.7-178.3
55-64 252 173.5 170.5-176.5
65+ 177 168.9 165.9-171.9
Total 1895 170.8 169.6-172.0
Missing: male 390 (12.5%)
Table 14b
Mean of total cholesterol (mg%) for female by age group
Morbidity Study, Java-Bali (NHHS) 2001
Age Female
(years)
Weighted n Mean (95%CI)
25-34 739 165.2 163.8-166.6
35-44 597 172.6 170.8-174.4
45-54 417 178.5 175.7-181.3
55-64 244 182.6 179.0-186.2
65+ 189 175.8 172.0-179.6
Total 2186 172.8 171.6-174.0
Missing: female 432 (11.9%)
Table 14c
Prevalence of total cholesterol > 200 mg% for male and female by age group
Morbidity Study, Java-Bali (NHHS) 2001
5
Percent
Male
4
Female
3
0
15-24 25-35 35-44 45-54 55-64 65+
Age range
Mean (kg/m2) 22
21
20
19
18
15-24 25-34 35-44 45-54 55-64 65+
Age range
Definition: kg/m2
Survey Population: National, both urban dan rural populations
Source: Ministry of Health; Indonesia Health Survey (Surkesnas)2001
60
50
Percent
40
30
20
10
0
25-34 35-44 45-54 55-64 65+
Age range
120
Mean (mmHg)
100
80
60
40
20
0
25-34 35-44 45-54 55-64 65+
Age range
Definition: mmHg
Survey Population: National, both urban dan rural populations
Source: Ministry of Health; Indonesia Health Survey (Surkesnas)2001