Lessons From Primary Health Care in the United Kingdom

Kusuma, Dian

doi:10.20473/jaki.v9i1.2021.4-8

Cited by 4 publications

(3 citation statements)

References 6 publications

(4 reference statements)

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“…Efforts may include health system reforms such as enhanced primary health care in Malaysia or routine assessment national programs such as NHS Health Check in the United Kingdom [ 18 , 36 ]. Healthcare delivery reforms may also include integration with infectious disease platforms [ 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Does the Disparity Patterning Differ between Diagnosed and Undiagnosed Hypertension among Adults? Evidence from Indonesia

et al. 2023

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Background: Healthcare systems in many low- and middle-income countries (LMICs) are not yet designed to tackle the high and increasing burden of non-communicable diseases (NCDs), including hypertension. As a result, a large proportion of people with disease or risk factors are undiagnosed. Policymakers need to understand the disparity better to act. However, previous analyses on the disparity in undiagnosed hypertension, especially from LMICs, are lacking. Our study assessed the geographic and socioeconomic disparity in undiagnosed hypertension and compared it with diagnosed hypertension. Methods: We used the Basic Health Survey (Riskesdas) 2018 and performed geospatial and quantitative analyses across 514 districts in Indonesia. Dependent variables included diagnosed and undiagnosed hypertension among adults (18+ years) and by gender. Results: A high prevalence of undiagnosed hypertension at 76.3% was found, with different patterns of disparity observed between diagnosed and undiagnosed hypertension. Diagnosed hypertension was 1.87 times higher in females compared with males, while undiagnosed hypertension rates were similar between genders. Urban areas had up to 22.6% higher rates of diagnosed hypertension, while undiagnosed hypertension was 11.4% more prevalent among females in rural areas. Districts with higher education rates had up to 25% higher diagnosed hypertension rates, while districts with lower education rates had 6% higher rates of undiagnosed hypertension among females. The most developed regions had up to 76% and 40% higher prevalence of both diagnosed and undiagnosed hypertension compared with the least developed regions. Conclusion: The disparity patterning differs between diagnosed and undiagnosed hypertension among adults in Indonesia. This highlights the need for effective measures, including healthcare system reforms to tackle NCDs in LMICs.

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Section: Discussionmentioning

confidence: 99%

Does the Disparity Patterning Differ between Diagnosed and Undiagnosed Hypertension among Adults? Evidence from Indonesia

et al. 2023

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“…For policy, obesity is already very high among young adults and adults as the primary working population, which may have an economic impact from lower productivity and increased cost of illness due to obesity-related health issues [2]. Moreover, the high burden of obesity among older adults may indicate the need to reorient the health system to better prevent and control obesity and other risk factors throughout the care continuum, from the community to primary care to secondary/tertiary care, potentially through integration with infectious disease platforms [28][29][30]. By sex, a much higher prevalence among women in Indonesia may be related to maternal obesity, indicating that effective intervention at the population and health systems levels are needed at each stage (e.g., pregnancy and post-partum) [31].…”

Section: Discussionmentioning

confidence: 99%

Disparities in Obesity Rates among Adults: Analysis of 514 Districts in Indonesia

et al. 2022

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Background: Globally, it was estimated that over 650 million adults 18 years old and older were obese in 2016. It is an increasing global health challenge with a significant health and economic impact. Thus, understanding geographic and socioeconomic disparities in obesity among adults is crucial. Methods: We combined geospatial and quantitative analyses to assess the disparity in obesity across 514 districts in Indonesia. We used the Basic Health Survey (Riskesdas) 2018 for obesity data and the World Bank database for socioeconomic data. Dependent variables included obesity prevalence among all adults (18+ years), males, females, young adults (18–24 years), adults (25–59 years), and older adults (60+ years). Results: We found significant geographic and socioeconomic disparities in adult obesity in Indonesia. In terms of region, districts in Java and Bali had a significantly higher prevalence of obesity than those in Papua, Maluku, and Nusa Tenggara. Districts in Java had 29%, 32%, 60%, and 28% higher prevalence of obesity among all adults, female adults, young adults, and adults. By income, compared to the poorest ones, most affluent districts had a significantly higher prevalence of obesity; they had a 36%, 39%, 34%, 42%, 33%, and 73% higher prevalence of obesity among all adults, males, females, young adults, adults, and older adults. Similarly, by education, compared to the least educated ones, the most educated districts had a significantly higher prevalence of obesity; they had a 34%, 42%, 29%, 36%, and 80% higher prevalence of obesity among all adults, males, females, adults, and older adults. Conclusions: There are significant disparities in adult obesity among 514 districts in Indonesia. Efforts by policymakers and stakeholders are needed to reduce obesity among adults, especially within districts with high prevalence.

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“…All this indicates the need for health systems reform towards improved prevention of non-communicable diseases and their main risk factors, especially hypertension. Reforms may include changes from the community to primary care and secondary care and integration with infectious disease platforms [ 25 , 26 , 27 ]. By region and socioeconomic status, effective responses to reduce inequalities in hypertension may need to prioritize more affluent urban areas and rural areas with higher hypertension burden and other risk factors for non-communicable diseases [ 28 , 29 , 30 , 31 , 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

District-Level Inequalities in Hypertension among Adults in Indonesia: A Cross-Sectional Analysis by Sex and Age Group

Oktamianti

Kusuma

Amir

et al. 2022

IJERPH

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Background: An estimated 1.28 billion adults 30–79 years old had hypertension globally in 2021, of which two-thirds lived in low- and middle-income countries (LMICs). Previous studies on geographic and socioeconomic inequalities in hypertension among adults have limitations: (a) most studies used individual-level data, while evidence from locality-level data is also crucial for policymaking; (b) studies from LMICs are limited. Thus, our study examines geographic and socioeconomic inequalities in hypertension among adults across districts in Indonesia. Methods: We combined geospatial and quantitative analyses to assess the inequalities in hypertension across 514 districts in Indonesia. Hypertension data were obtained from the Indonesian Basic Health Survey (Riskesdas) 2018. Socioeconomic data were obtained from the World Bank. Six dependent variables included hypertension prevalence among all adults (18+ years), male adults, female adults, young adults (18–24 years), adults (25–59 years), and older adults (60+ years). Results: We also found significant geographic and socioeconomic inequalities in hypertension among adults across 514 districts. All hypertension indicators were higher in the most developed region than in the least developed region. Districts in the Java region had up to 50% higher prevalence of hypertension among all adults, males, females, young adults, adults, and older adults. Notably, districts in the Kalimantan region had the highest prevalence of hypertension, even compared to those in Java. Moreover, income level was positively associated with hypertension; the wealthiest districts had higher hypertension than the poorest districts by up to 30%, but only among males and older adults were statistically significant. Conclusions: There were significant inequalities in hypertension among adults across 514 districts in the country. Policies to reduce such inequalities may need to prioritize more affluent urban areas and rural areas with a higher burden.

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Lessons From Primary Health Care in the United Kingdom

Cited by 4 publications

References 6 publications

Does the Disparity Patterning Differ between Diagnosed and Undiagnosed Hypertension among Adults? Evidence from Indonesia

Does the Disparity Patterning Differ between Diagnosed and Undiagnosed Hypertension among Adults? Evidence from Indonesia

Disparities in Obesity Rates among Adults: Analysis of 514 Districts in Indonesia

District-Level Inequalities in Hypertension among Adults in Indonesia: A Cross-Sectional Analysis by Sex and Age Group

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