Health Status and Functional Capacity of Indonesian Elderly at the ...

Organised by:
Co-Sponsored:
Malaysian Healthy Ageing Society

Health Status and Functional Capacity of
Indonesian Elderly at the District Level
Evi Nurvidya Arifin
Visiting Research Fellow
Institute of Southeast Asian Studies
Singapore
enarifin@gmail.com

Active Ageing (WHO 2002)
◦ the process of optimizing
opportunities to enhance health,
participation, and security in order
to enhance quality of life as people
age

Outline
◦ Aims
◦ Data
◦ Results:
• SRHS
• Functional Capacity (FC)
◦ Overall
◦ 4 ADLs
◦ An IADL
• Association between SRHS and FC
◦ Concluding Remarks

Aims
◦ to fill the gap on the knowledge of
ageing and health in Indonesia by
examining SRHS, and functional
capacity (ADLs and IADLs) of older
persons
◦ To tests the hypothesis that SRHS is
associated with functional capacity

Data
◦ 2005 SUPAS (Intercensal Population
Census), nationwide survey covered all
provinces except Aceh province and
District of Nias
◦ Selected sample: Population aged 60+
◦ The first nation-wide survey gathered
information on elderly
◦ Published data (29 Volumes)
◦ Unit of Analysis: district level
(388 districts)

Method
◦ Descriptive analysis
• Each of the selected variables
presented in relative number to the
total elderly population in each district
• Presented in charts
◦ Pearson correlation
◦ Univariate and Multivariate
regressions

Variables
◦ Health Variables:
• SRHS (3 responses: Baik (good/healthy), Cukup (not
bad/somewhat healthy), Kurang (bad/somewhat unhealthy))
• Functional Limitation (Yes/No)
◦ 4 ADLs (getting dressed, using toilet,
taking a bath, eating)
◦ 1 IADL (preparing meals)
◦ Region: Java/Bali (JB)
and Outside Java/Bali (OJB)
◦ Type of districts: cities/regencies
◦ Sex

Covered region
Outside Java/Bali
264 districts:
51 cities
213 regencies
Java/Bali
124 districts:
33 cities
91 regencies
Excluded areas

Districts in JB are mostly older populations than
those in OJB
140
120
100
< 6.00
6.00 - 7.99
8.00 - 11.99
12.00+
80
60
40
20
0
Regencies in OJB Regencies in JB Cities in OJB Cities in JB
Districts in OJB are generally young populations

percent
80.0
Good SRHS
Region and Type of Districts
differentiate the percentage
of Good SRHS
100
90
80
70
60
50
40
30
20
10
0
Regencies
in OJB
Regencies
in JB
Cities in
OJB
0 - 29.99
30.00 - 49.99
50.00 - 69.99
Cities in
OJB
70.0
60.0
50.0
Regencies in Java/Bali
Cities in Java
Regencies in Outer
Cities in Outer
40.0
30.0
20.0
10.0
High inequality in good SRHS
across districts
0.0
1 12 23 34 45 56 67 78 89 100 111 122 133 144 155 166 177 188 199 210
District

Sex differential in Good SRHS
80.0
Female
70.0
60.0
50.0
40.0
30.0
More districts having
lower percentages of
good SRHS for females
than males
20.0
10.0
0.0
0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0
Male

Many districts have higher percentages of
Elderly being functionally independent
100
60
50
90
40
80
30
20
10
0
95.0
90.0
85.0
80.0
75.0
70.0
65.0
60.0
55.0
50.0
45.0
40.0
35.0
30.0
No need help
Std. Dev = 10.01
Mean = 80.1
N = 388.00
70
60
50
40
30
Regencies in Java/Bali
Regencies in Outer
Cities in Java
Cities in Outer
Regencies and Cities in JB have
higher percentages of elderly
being functionally independent
1 21 41 61 81 101 121 141 161 181 201

Sex differential
in Physical independency
Female
Higher percentage
of female elderly
with physical
independency than
the male
100.0
90.0
80.0
70.0
60.0
50.0
40.0
30.0
30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 Male

Many districts with no difficulty in each
of ADLs
100
100
80
80
60
60
40
20
Std. Dev = 2.46
Mean = 3.1
0
N = 388.00
0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 16.0 18.0
1.0 3.0 5.0 7.0 9.0 11.0 13.0 15.0 17.0
40
20
0
16.00
15.00
14.00
13.00
12.00
11.00
10.00
9.00
8.00
7.00
6.00
5.00
4.00
3.00
2.00
1.00
0.00
Std. Dev = 2.47
Mean = 2.90
N = 388.00
DRESS
TOILET
100
140
80
120
100
60
80
20
0
24.0
22.0
20.0
18.0
16.0
14.0
12.0
10.0
8.0
6.0
4.0
2.0
0.0
Std. Dev = 2.84
Mean = 3.4
N = 388.00
20
Std. Dev = 3.66
Mean = 4.4
0
N = 388.00
0.0 4.0 8.0 12.0 16.0 20.0 24.0 28.0 32.0 36.0
2.0 6.0 10.0 14.0 18.0 22.0 26.0 30.0 34.0
40
60
40
BATH
EATING

ADLs by Region and Type of Districts:
Indonesia, 2005
Getting
Dressed
40
35
30
25
Regencies in Java/Bali
Regencies in Outer
Cities in Java
Cities in Outer
Using
Toilet
40
35
30
25
Regencies in Java/Bali
Regencies in Outer
Cities in Java
Cities in Outer
20
20
15
15
10
10
5
5
0
1 21 41 61 81 101 121 141 161 181 201
0
1 21 41 61 81 101 121 141 161 181 201
Taking a
Bath
40
35
30
Regencies in Java/Bali
Regencies in Outer
Cities in Java
Cities in Outer
Eating
40
35
30
Regencies in Java/Bali
Regencies in Outer
Cities in Java
Cities in Outer
25
25
20
20
15
15
10
10
5
5
0
1 21 41 61 81 101 121 141 161 181 201
0
1 21 41 61 81 101 121 141 161 181 201

Needing help in Meal Preparation
80
70
60
50
40
30
20
10
0
Regencies in Java/Bali
Regencies in Outer
Cities in Java
Cities in Outer
1 21 41 61 81 101 121 141 161 181 201
Cities in JB have the highest
percentage of elderly needing
help in meal preparation than
those in others

Good SRHS and Physical Independence :
Regression Analysis
Good SRHS is more likely to increase/improve
physical independency
Model
Variables 1 2 3 4 5 6 7
Good SRHS + + + + + + +
Region + + + +
Type of Districs - + -
Sex + + +
R square 0.083 0.253 0.263 0.036 0.193 0.313 0.232
Note: Reference group (RG) for each dichotomous variables is as follows Outside Java/Bali (OJB),
Regency, and Male
Region and sex play important role in physical independence

Good SRHS is statistically significant on affecting
difficulty in eating and taking a bath
Eating
Model
Variables 1 2 3 4 5 6 7
Good SRHS - 0 - - - 0 -
Region - - - -
Type of Districs + +
Sex 0 0 0
R square 0.021 0.079 0.103 0.017 0.018 0.075 0.96
Note: Reference group (RG) for each dichotomous variables is as follows Outside Java/Bali (OJB),
Regency, and Male
Taking a Bath
Model
Variables 1 2 3 4 5 6 7
Good SRHS - - 0 - - - -
Region - - - -
Type of Districs 0 0
Sex + + +
R square 0.025 0.052 0.053 0.025 0.033 0.064 0.064
Districts in Java/Bali have lower percentages of elderly needing help in
either eating or taking a bath than those in OJB

Good SRHS is statistically significant
on Needing help in Meal Preparation
Model
Variables 1 2 3 4 5 6 7
Good SRHS - - - - - - -
Region + + + +
Type of Districs + +
Sex - - -
R square 0.084 0.119 0.364 0.035 0.106 0.143 0.365
Districts in Java/Bali or cities have higher percentages of
elderly needing help in meal preparation than those in OJB

Concluding Remarks
◦ Health inequality with more districts have
high percentage of unhealthy older
persons. Yet, most districts have high
physical independence.
◦ Good SRHS and functional capacity varies
greatly by district, implying that policy
making process at district level should
pay attention to their local needs.
◦ Region, type of districts and sex also play
important role in SRHS and physical
independence.
◦ The two variables have strong positive
correlation.

THANK YOU
enarifin@gmail.com
Or
arifin@iseas.edu.sg