Indonesian Family Life Survey Research Articles

Associations between asthma and cognitive functioning among older adults. Does the age of asthma diagnosis matter? Results from the RAND IFLS-5 study

Objective To assess the associations of asthma status or age at asthma diagnosis with cognition using the Telephone Survey of Cognitive Status from a large population-based sample. Further, we investigated the possibility that asthma treatment mediates these associations. Methods This is a cross-sectional study from the Indonesian Family Life Survey Fifth Wave (IFLS-5) collected in 2014–2015. A weighted linear regression model was used to examine the associations between asthma and cognitive functioning scores in adults aged 50 years or older. Of the 6660 total samples included in this study, 176 participants had asthma (2.6%). We controlled for age, sex, and urbanicity with further adjustments for adult covariates or childhood covariates, as appropriate. Results There was no association between overall asthma status and cognitive functioning scores. However, asthma diagnosed at 0–19 years was associated with significantly higher cognitive functioning scores (Beta coefficient = 2.24, 95% CI: 0.62 – 0.87), compared to those without asthma. In the analysis involving current treatment status (restricted analysis), the significant association disappeared among those under current asthma treatment status, indicating that asthma treatment may mediate the association. Conclusion Asthma might not be a risk factor for cognitive impairment. Observations of a significant association of pediatric asthma with higher cognitive scores need further investigation. Understanding cognitive functioning among older adults with asthma may improve the surveillance of cognitive decline inthis age group.

The Effect of Childhood Nutritional Status Changes with Pre-Diabetes And Diabetes Risk among Adolescents: A Retrospective Cohort Study

The first 1000 days of life and before the age of five years is a critical period of nutritional opportunity and vulnerabilitya. Only few have studies that trace individuals from childhood to adolescence examined the influence of childhood undernutrition on diabetes risk. This research was a retrospective cohort study using secondary data from IFLS (Indonesian Family Life Survey) involving 373 adolescents at IFLS-5 (2014) that folllowed at IFLS-3 (2000) and at IFLS-2 (1997). The effect of childhood undernutrition on the risk of pre-diabetes and diabetes in adolescents was analyzed using multinomial logistic regression. The results of this study showed that the prevalence of pre-diabetes was 12.6% and diabetes was 15.0%. The risk factor for pre-diabetes is frequent consumption of fast food (aOR=4.38). Meanwhile, recovering from stunting was a protective factor in adolescents (aOR=0.05). Risk factors for diabetes were stunting (aOR=2.71), deteriorated nutritional status during childhood (aOR=3.85), experienced wasting during childhood (aOR=3.55), and frequent fast food consumption (aOR=3.11). Meanwhile, vegetable consumption was a protective factor of diabetes (aOR=0.37). In conclusion, this study showed that childhood undernutrition on the risk of diabetes. Improvement point is through nutrition programs in childhood and adolescence.

Examining determinants of stunting in Urban and Rural Indonesian: a multilevel analysis using the population-based Indonesian family life survey (IFLS).

In Indonesia, chronic malnutrition leading to stunted growth in children represents a significant issue within the public health domain. The prevalence of stunting varies between urban and rural areas, reflecting disparities in access to nutrition, healthcare, and other socioeconomic factors. Understanding these disparities is crucial for developing targeted interventions to address the issue. The study used data from the fifth wave of the Indonesian Family Life Survey (IFLS), which is a national cross-sectional population-based survey conducted across approximately 13 provinces in Indonesia in 2014-2015. Multivariate and Multilevel logistic regression models were utilized in the analysis to determine the factors associated with the prevalence of stunting in Indonesian children. The multivariate logistic regression analysis indicated that among children aged 24-59 months in Indonesia, stunting was associated with the age of the child, birth weight, maternal nutritional status, and residence. Subsequently, the multilevel logistic regression analysis revealed that in rural areas, the age of the child and birth weight exhibited significant associations with stunting. Conversely, in urban areas, stunted children were influenced by 7 factors, including the child's age (months), age of weaning, birth weight (kg), mother and father's age, place of birth, and maternal nutritional status. Variations in childhood stunting between urban and rural regions in Indonesia were observed, indicating a differential prevalence. The study's findings suggests the importance of age-appropriate nutritional support, healthcare interventions, and growth monitoring. Focused interventions are vital, potentially encompassing initiatives such as improving access to maternal and child healthcare services, promoting adequate nutrition during pregnancy and infancy, and facilitate greater parental engagement in childcare responsibilities.

Relationship between Social Participation and Cognitive Impairment in Low-Educated Older Adults Based on Indonesian Family Life Survey-5.

The increasing older adult population requires attention in terms of education and health, as higher education levels contribute to cognitive reserve and may protect against age-related cognitive impairment. Cognitive reserve is an individual's cognitive flexibility in using cognitive functions affected by brain aging, neurological diseases, and injury. Indonesia has a high prevalence of low-educated older adults, which strongly correlates with progressive cognitive impairment. Identifying risk factors for cognitive decline in this population is crucial. This study determines the factors affecting cognitive impairment in low-educated older adults using cross-sectional data from the Indonesian Family Life Survey-5. This descriptive study analyzed 2,313 low-educated older adults ≥60 years old. Univariate and bivariate analyses were used to describe the sample and identify the relationships between categorical variables. Logistic regression identified the most significant factor affecting cognitive impairment. The prevalence of cognitive impairment in low-educated older adults is 22.6%. The chi-square test revealed significant relationships between those who are aged 75 years, a status other than married, female, living in rural areas, and not participating in social activities. Age is the most prominent factor affecting cognitive impairment in such adults (P<0.001; adjusted odds ratio, 3.232; 95% confidence interval, 2.500-4.180). Cognitive impairment in the aforementioned adults is associated with being ≥75 years old, being a status other than married, being female, living in rural areas, and not participating in social activities. After controlling other variables, low-educated older adults who participated in at least ≥1 social activity in the last 12 months experienced cognitive impairment 0.64 times compared to those who did not participate in social activities.

Improving Stroke Detection with Hybrid Sampling and Cascade Generalization

The prevalence of stroke in Indonesia has increased. One survey in Indonesia that contains information about the health conditions of the Indonesian people is the Indonesian Family Life Survey (IFLS). The proportion of respondents who had a stroke and non-stroke in IFLS5 showed an imbalance with an extreme level of imbalance; hence, this research aims to overcome this problem with SMOTE, SMOTE-Tomek Link, and SMOTE-ENN; then, the balanced dataset is classified using the ensemble and cascade approaches to improve the detection of stroke risk and to identify the important variables. However, the stroke respondents were still challenging to classify after imbalance class handling, presumably because of the large amount of data before and after balancing. The solution is to balance the training data with various percentages. The results showed the best percentage is applied to 5% of the training data, balanced by the SMOTE-ENN, and the ensemble method with the cascade approach increases the sensitivity and balanced accuracy values. Random forest and logistic regression combine models that produce the best performance, with a classification tree as the final model. The important variables obtained from this combination are the addition of probability from random forest, logistic regression, history of hypertension, age, and physical activity.

Social participation among individuals with depression is associated with the use of informal healthcare facilities: findings from the Indonesian family life survey-5

Social participation among individuals with depression is associated with the use of informal healthcare facilities: findings from the Indonesian family life survey-5

Treatment Nonadherence among Multimorbid Chronic Disease Patients: Evidence from 3515 Subjects in Indonesia.

Background and Objectives: Multimorbid patients require intensive treatment for their diseases. However, little research has been given to their treatment adherence as part of its management. This study aims to determine the prevalence and characteristics of chronic disease multimorbidity in Indonesia, alongside its treatment nonadherence. Materials and Methods: We conducted a cross-sectional study using the fifth Indonesian Family Life Survey database among adult subjects aged ≥ 15 years with multimorbidity. Our descriptive and multivariate analyses include sex, age, formal education, ethnicity, geographic residence, demographic residence, household size, insurance ownership, annual income, current self-perceived health status, missing active days, smoking behavior, and body mass index. Results: We identified 3515 multimorbid patients, constituting 30.8% prevalence across chronic disease patients. Hypertension was found to be a prevalent component of multimorbidity (61.2%), followed by digestive diseases (44.5%) and arthritis (30.3%). We identified that 36.4% of the subjects were nonadherent to their chronic disease treatment. Characteristics associated with nonadherence were found to be a good self-perception of health (aOR 1.79, 95% CI 1.54-2.08), active smoking behavior (aOR 1.51, 95% CI 1.14-1.99), no smoking behavior (aOR 1.44, 95% CI 1.08-1.90), missing seven active/productive days or less in the past month due to poor health (aOR 1.36, 95% CI 1.10-1.68), no insurance ownership (aOR 1.20, 95% CI 1.04-1.39), age of 15-65 years (aOR 1.25, 95% CI 1.01-1.55), income below IDR 40 million (aOR 1.23, 95% CI 1.04-1.46), and household size of 2-6 people (aOR 1.17, 95% CI 1.01-1.36). Conclusions: While the prevalence of multimorbidity in Indonesia is generally similar to that observed in previous studies, we have identified patient characteristics related to nonadherence. We suggest that patient's nonadherence was primarily dictated by their self-perception of health and treatment complexity. With the longstanding issue of nonadherence, this study indicated the need to consider creating patient-tailored treatment programs in clinical practice to improve adherence by considering individual patients' characteristics.

Association between poverty, low educational level and smoking with adolescent's working memory: cross lagged analysis from longitudinal data.

Working memory is a crucial element of cognitive function. Previous cross-sectional studies have identified various determinants of working memory in children and adolescents. Nonetheless, no study has yet demonstrated the causal relationship of social determinants with working memory in adolescents. This study explores the causal link between the level of education, smoking, and other factors with adolescent's working memory. This study analyzed secondary data from waves 4 and 5 of the Indonesia Family Life Survey (IFLS), utilizing cross-lagged analysis in Jamovi version 2.4.8. The variables included working memory score, maternal education, household income, stress, educational level, smoking, urbanicity, and physical activity. These variables were extracted from IFLS waves 4 and 5, and each dependent variable in IFLS wave four was controlled by the same dependent variables in IFLS 5. Then, we used cross-lagged analysis to assess the causality between each dependent variable and a working memory score in IFLS wave 5. The findings indicate that level of education had a positive impact on working memory in adolescents aged 15-18 years, with a Beta value of 0.18 (95% CI 0.81-0.2; p < 0.001). Smoking and age were negatively associated with working memory, with Beta values of -0.07 (95% CI -0.65 -0.04; p < 0.029) and - 0.10 (95% CI -0.25 -0.05; p < 0.003), respectively. No evidence was found for a significant correlation between poverty and adolescents's working memory. The findings indicate that increased education levels are associated with improved working memory in adolescents aged 15-18. At the same time, smoking has a negative impact on working memory in this age group.

Analyzing Primary Healthcare Governance in Indonesia: Perspectives of Community Health Workers.

Background Community-integrated health posts (Posyandu) are crucial for extending primary healthcare across diverse geographical and demographic landscapes in Indonesia. Community health workers (CHWs) currently function as the main service delivery actors for Posyandu. However, Posyandu's performance remains below the standards set by the Ministry of Health. This study examines health system determinants that explain the poor performance of Posyandu and, in particular, examines the roles of village and township governance and community health center management in supporting the effectiveness of primary healthcare programs. Methodology We analyzed 638 Posyandus across 13 Indonesian provinces, utilizing data from the 2014 Indonesia Family Life Survey. We evaluated eight health system determinants based on the perceptions of CHWs concerning challenges encountered in Posyandus. These factors were ranked and analyzed to determine the variables that affected Posyandu's poor performance. Both unadjusted and adjusted odds ratios were calculated. Results This study revealed that nearly half of the Posyandus in Indonesia are underperforming, particularly in rural areas. Common challenges include insufficient funds, inadequate equipment, and a lack of permanent buildings. Although only a small percentage mentioned minimal support from village and Puskesmas authorities, the weak governance roles of village heads are reflected in all the concerns mentioned by CHWs. Conclusions The absence of village heads from governance roles has contributed to Posyandu's operational problems as perceived by CHWs. Community health centers (Puskesmas), responsible for providing technical support to Posyandu, should be part of CHW teams and networks. Further discussions are needed to choose a workable governance model to ensure practical, accessible, and sustainable primary healthcare services at the grassroots level.

Interrelationships between physical multimorbidity, depressive symptoms and cognitive function among older adults in China, India and Indonesia: A four-way decomposition analysis

ObjectiveThis paper explores the role of depressive symptoms (mediator/moderator) in the association between physical multimorbidity (exposure) and cognitive function (outcome) among older adults in the three most populous middle-income countries. MethodsThis study used cross-sectional data from China (2015 China Health and Retirement Longitudinal Study), India (2017/2018 Longitudinal Ageing Study in India), and Indonesia (2014/2015 Indonesian Family Life Survey), with a total sample of 73,199 respondents aged ≥ 45 years. Three domains of cognitive tests were harmonised across surveys, including time orientation, word recall, and numeracy. The four-way decomposition analysis assessed the mediation and interaction effects between exposure, mediator/moderator, and outcome, adjusted for covariates. ResultsThe mean age of the respondents (in years) was slightly younger in Indonesia (56.0, SD = 8.8) than in China (59.5, SD = 9.3) and India (60.0, SD = 10.5). The proportion of male respondents was 49.3 % in China, 47.3 % in India, and 47.5 % in Indonesia. Respondents in China had the highest mean cognitive function z scores (54.7, SD = 19.9), followed by India (51.1, SD = 20.0) and Indonesia (51.0, SD = 18.4). Physical multimorbidity was associated with lower cognitive function in China and India (p < 0.0001), with 48.4 % and 40.0 % of the association explained by the mediating effect of depressive symptoms (‘overall proportion due to mediation’). The association was not found in Indonesia. ConclusionCognitive functions were lower among individuals with physical multimorbidity, and depressive symptoms mainly explained the association. Addressing depressive symptoms among persons with physical multimorbidity is likely to have not only an impact on their mental health but could prevent cognitive decline.

Interviewer biases in medical survey data: The example of blood pressure measurements.

Health agencies rely upon survey-based physical measures to estimate the prevalence of key global health indicators such as hypertension. Such measures are usually collected by nonhealthcare worker personnel and are potentially subject to measurement error due to variations in interviewer technique and setting, termed "interviewer effects." In the context of physical measurements, particularly in low- and middle-income countries, interviewer-induced biases have not yet been examined. Using blood pressure as a case study, we aimed to determine the relative contribution of interviewer effects on the total variance of blood pressure measurements in three large nationally representative health surveys from the Global South. We utilized 169,681 observations between 2008 and 2019 from three health surveys (Indonesia Family Life Survey, National Income Dynamics Study of South Africa, and Longitudinal Aging Study in India). In a linear mixed model, we modeled systolic blood pressure as a continuous dependent variable and interviewer effects as random effects alongside individual factors as covariates. To quantify the interviewer effect-induced uncertainty in hypertension prevalence, we utilized a bootstrap approach comparing subsamples of observed blood pressure measurements to their adjusted counterparts. Our analysis revealed that the proportion of variation contributed by interviewers to blood pressure measurements was statistically significant but small: % depending on the cohort. Thus, hypertension prevalence estimates were not substantially impacted at national scales. However, individual extreme interviewers could account for measurement divergences as high as 12%. Thus, highly biased interviewers could have important impacts on hypertension estimates at the subdistrict level.

Prevalence of Metabolic Disease among Adults in Indonesia: A Cross-Sectional Population-Based Survey

Introduction: Metabolic diseases were the leading cause of morbidity and mortality in the world. the World Health Organization, the effective delivery of public health messages has become increasingly complicated due to CKD as a complication of cardiovascular disease and diabetes. Studies have prevalence of metabolic disease among adults in Indonesia. These study aims were to determine the prevalence of kidney, cardiovascular, diabetes. Method: This study uses a cross-sectional study design used from Indonesia Family Life Survey Wave 5 (IFLS-5) organized by Rand Corporation conducted in 2014-2015. A statistical analysis is a descriptive observational study. The total number of respondents un this study was 27,718. Result: Respondents with adult criteria in Indonesia were 52.67% women aged 38.20(±13.64), 78.48% married, 32.94%elementary, and 59.89% urban residents. The prevalence of chronic kidney disease among adults in Indonesia was 1.43% (95% CI: 00.01 – 0.02). The prevalence of cardiovascular disease among adults in Indonesia was 1.64% (95% CI: 00.01 – 0.02). The prevalence of diabetes among adults in Indonesia was 2.33% (95% CI: 00.02 – 0.03). Conclusion: The prevalence of chronic kidney disease, cardiovascular disease, and diabetes in Indonesia is strongly by age and show a relationship between sufferers of these three diseases.

The mediating effect of sleep disturbance on the association between hypertension and depression: a national data analysis

BackgroundSleep disturbance is a common among people with hypertension. However, the mediating role of sleep disturbance in the association between hypertension and depression remains unclear. This study aims to investigate the mediating role of sleep disturbance in the association between hypertension and depression.Materials and methodsThis was cross-sectional study. The data were derived from the Indonesian Family Life Survey Fifth Wave (2014–2015). We include a total of 19,138 adults’ participants with age range from 18 to 65 years old who completed response on the variable of hypertension, sleep disturbance, and depression. The mediating model analysis was processed using the PROCESS macro ins SPSS from Hayes model.ResultsDepression was reported by 22% of total respondents. The group with hypertension showed a substantially higher prevalence of depression than non-hypertension group (P < 0.001). Hypertension had a significant overall effect on depression (β = 0.682; 95%CI 0.489 to 0.875, P < 0.001). The direct effect of hypertension on depression was significant (β = 0.418; 95%CI 0.244 to 0.592, P < 0.001) and the indirect effect that mediated by sleep disturbance was also significant (β = 0.264, 95%CI 0.174 to 0.356, P < 0.001). It is worth noting that sleep disturbance partially mediated the association between hypertension and depression.ConclusionThe findings of this study indicated that sleep disturbance contributed to the etiology of depression and hypertension in adult populations. Nurses should be involved in managing sleep disturbances, such as using behavioral therapy, as it may serve as both a treatment and primary prevention measure for depression and hypertension.Graphical

Does Ethnicity Affect Ever Migrating and the Number of Migrations? The Case of Indonesia

This paper is the first to examine to what extent ethnicity affects ever migrating and the number of migrations across the lifespan for the case of internal migration in Indonesia. We use all five waves of the Indonesia Family Life Survey (IFLS) to study migration behaviour of respondents belonging to some of the largest ethnic groups in Indonesia. Our logistic regression results show that the Minangkabau, Betawi, Madurese, Balinese, Buginese and Makassarese, and Sasak, Bima and Dompu are less likely to ever migrate than the Javanese. Using only migrants and controlling for the first migration and other characteristics, truncated negative binomial regression results show that, in comparison with the Javanese, the Minangkabau and Banjarese have a higher expected number of migrations while the numbers are lower for the Betawi and Balinese. Thus, ethnicity contributes to ever migrating as well as the number of migrations, but we find that the differences between the ethnic groups diminish for the latter. These results also point out that a higher likelihood of ever migrating does not always correspond with a higher number of migrations, highlighting the importance of studying migration count to complement the study of migration as a one-time event.

Factors associated with diabetes mellitus among adults: Findings from the Indonesian Family Life Survey-5

PurposeDiabetes mellitus (DM) is an increasingly prevalent health concern in Indonesia, and national information about its contributing factors remained limited. This study primarily aimed to investigate these factors associated with DM in Indonesia. Patients and methodsThis study utilized data from the fifth wave of Indonesian Family Life Survey-5 (IFLS-5) in 2014. The survey included individuals aged ≥15 years and assessed DM based on the obtained glycated hemoglobin values through dried blood spot specimens. Blood pressure data was acquired using omron digital self-inflating sphygmomanometers, with an average of three readings. Mean arterial pressure was used to classify respondents' hypertensive status, while anthropometric measurements were taken according to World Health Organization guidelines to calculate body mass index, providing data on obesity. Specific questions and protocols evaluated lifestyle information encompassed smoking habits, sleep quality, and physical activity, and sociodemographic factors encompassed age, gender, marital status, ethnicity, and employment status, with accordingly categorized responses. Logistic regression analysis assessed the potential associations between these factors with DM, and the results were reported in terms of odds ratios (OR) with a 95 % confidence interval (CI). The analyses were conducted using the SPSS software program. ResultsThe study included 6740 respondents, of whom 8.4 % had DM. The majority were female (55.2 %), Muslim (89 %), not obese (71.1 %), nonhypertensive (63.3 %), had poor sleep quality (95.9 %), lacked physical activity (77.9 %), and were aged 15–45 years (56 %). Factors that demonstrated higher risks of developing DM are male gender (OR: 1.383, 95 % CI: 1.117–1.712), unemployment (OR: 1.619, 95 % CI: 1.225–2.139), no physical activity (OR: 1.619, 95 % CI: 1.225–2.139), obesity (OR: 3.076, 95 % CI: 2.512–3.766), and hypertension (HTN) (OR: 1.713, 95 % CI: 1.396–2.103). Age between 15 and 44 (OR: 0.348, 95 % CI: 0.295–0.468) has lower likelihood to develop DM. ConclusionThis study has identified associations between HTN, obesity, physical activity, and employment status with DM in Indonesia. Healthcare professionals should integrate more patient-specific factors when designing and implementing tailored interventions to manage DM in Indonesia.

The Retirement Consumption Puzzle Effect in Indonesia: Evidence from IFLS 4 and 5

Introduction/Main Objectives: This study aims to see whether the retirement consumption puzzle occurs in Indonesia. The retirement consumption puzzle refers to when there is a decline in consumption in retirement which is not in line with the life-cycle hypothesis. Background Problems: Previous studies have revealed that consump­tion shifts when entering retirement due to efficient spending. This research analyzes the consumption pattern of the Indonesian elderly peculiarly in the frame of the retirement consumption puzzle. Novelty: There is a lack of studies on the effect of retirement on consumption by Indonesian retirees and prior research has focused on the impact of retirement on household expenditure. Research Methods: This study uses data from the Indonesian Family Life Survey (IFLS) wave 4 and 5 from the years 2007 and 2014. It uses panel data and the total sample is 2,556. It also uses the difference in differences (DiD) method to see whether the change in labor status toward retirement causes a decrease in consumption in households in Indonesia. Then, this study also uses the division of age categories as the robustness check. Finding/Results: The results of this study show that there is a retirement consumption puzzle in Indonesia indicated by a decrease of 19.9% in total expenditure per capita. Conclusion: The consumption decrease in retirement demons­trates that the government should consider pension funds and create social security programs to maintain the welfare of elderly people.

Indonesian Farmers’ Subjective Well-being: Determinants and Effect on Discounting Behaviour

The challenges prevalent in agriculture substantially impact the well-being of farmers compared to that of many other occupations. The national average rating of well-being may not provide a true representation of farmers. This article empirically examines the determinants and the effect of subjective well-being (SWB) on discounting the behaviour of farmers by estimating data from the 2014/2015 Indonesian family life survey. The results show that 72% are among the poorest three on a six-step hypothetical economic ladder. Few farmers (38%) are very satisfied with life as a whole. Having a higher level of education and income increases the chance of a higher SWB. Also, SWB decreases with an increasing level of poor health, feeling unsafe, job dissatisfaction and being older. The results examining the effect of SWB on discounting behaviour suggest that unlike the affective component (positive affect) of SWB, the cognitive component (life satisfaction) does not have a statistically significant effect on discounting behaviour.

Comprehensive childhood vaccination and its determinants: Insights from the Indonesia Family Life Survey (IFLS)

BackgroundImmunization is the most effective intervention for reducing morbidity and mortality rates associated with vaccine-preventable diseases. Despite the Indonesian government's inclusion of several childhood vaccinations in the national immunization program (NIP), the number of unvaccinated or partially vaccinated children remains high. This observational study aimed to determine the completeness of childhood immunization and the factors influencing it in Indonesia. MethodsData were extracted from the fifth wave of the Indonesia Family Life Survey (IFLS). The sample (n = 16,236) consists of children residing in 13 provinces, representing over 80% of Indonesia's population. The difference between groups was tested using the chi-square test. Logistic regression was performed to identify the variables associated with the completeness of basic immunization. Immunization is categorized as complete when children have received all the mandatory vaccines recommended by the Ministry of Health. We examined and compared the results using complete case analysis, inverse probability weighting, and multiple imputations. ResultsThe highest percentages of complete vaccinations were polio, tuberculosis, and DPT. Children who live in Sumatera and Kalimantan were more likely to be fully immunized, with ORs of 0.6 (95%CI 0.48–0.74) and 0.54 (0.37–0.80), respectively. Children who live in urban areas, have mothers who received the tetanus vaccine during pregnancy, have mothers with a higher level of education and health insurance, have fathers aged 41–50, and live with a large number of family members were more likely to be fully immunized (p < 0.05). ConclusionSocioeconomic determinants were strongly correlated with the completeness of childhood vaccination in Indonesia.

Inequalities in Mortality in the Asia-Pacific: A Cross-National Comparison of Socioeconomic Gradients.

Social inequalities in mortality are poorly studied in much of the Asia-Pacific. Using data from harmonized nationally representative longitudinal health and aging surveys our study systematically assesses mortality disparities across 3 standardized measures of socioeconomic status in 7 Asia-Pacific countries. We used data from multiple waves of 7 representative sample surveys: the Health, Income and Labour Dynamics in Australia survey, China Health and Retirement Longitudinal Study, the Indonesian Family Life Survey, the New Zealand Health, Work and Retirement survey, the Korean Longitudinal Study on Ageing and the Health, Aging and Retirement in Thailand survey, and the Japanese Study of Aging and Retirement. We use Cox proportional hazards modeling to examine how the hazard of mortality differs across domains of social stratification including educational attainment, wealth, and occupational status across countries. We found consistent and pervasive gradients in mortality risk in the high-income countries by all available measures of social stratification. In contrast, patterns of inequality in adult mortality in middle-income and recently transitioned high-income countries investigated varied depending on the measure of social stratification, with strong gradients by wealth but mixed gradients by education. Analyzing social gradients in mortality in the Asia-Pacific shows that inequalities, especially wealth-based inequalities, in later-life health are present across the region, and that the magnitude of social gradients in mortality is overall larger in high-income countries as compared to middle-income countries.

Ending child labour: does conditional cash transfer matter? Evidence from Indonesia

Purpose This study aims to investigate the extent to which the Indonesian conditional cash transfer (CCT), known as the Family Hope Program (FHP), impacts the probability of children engaging in labour activities.Design/methodology/approach This study utilizes data from the Indonesian Family Life Survey in 2014, focussing on periods following the implementation of the FHP. To estimate the impact of FHP on child labour in Indonesia, the authors employ a propensity score matching strategy to balance the characteristics observed between the participant and non-participant groups.Findings The estimates show that FHP has no statistical impact on child labour across all matching techniques. This implies that receiving the CCT does not always help poor households decrease the probability of stopping their children from participating in labour activities.Social implications The conditions applied to the beneficiaries, which only require children to attend school without requiring them to stop working, may not effectively address the issue of child labour. The current structure and design of the FHP need to be re-evaluated and improved to effectively combat child labour.Originality/value Despite numerous studies examining the impact of CCT on child labour which remains inconclusive in Indonesia, this study contributes to the existing literature by considering children participating in labour activities across all types of work without focussing on specific education levels or regions.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-07-2023-0580