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Pamela J. Stoddard, MA, Community Health Sciences, University of California, Los Angeles, P.O. Box 951772, Los Angeles, CA 90095, 415-681-1893, pstodda@yahoo.com

Extensive research in developed countries has shown that higher socioeconomic status is associated with better health at each level of the socioeconomic ladder, a pattern known as a “social gradient.” However, research has suggested that in developing economies, some socioeconomic gradients may be nonexistent or reversed, in that some unhealthy behaviors and poorer health outcomes may increase rather than decrease as status rises. This may be due to the inability of the poor, in relation to those of higher status, to afford unhealthy behaviors such as smoking and higher calorie diets, while at the same time having more physical activity in manual occupations. This study tests the hypothesis that socioeconomic gradients in Indonesia are flat or reversed. Although studies have examined gradients elsewhere in Asia, little is known about their shape in Indonesia. Through the use of logistic regression, I investigate the existence and direction of socioeconomic gradients for smoking and overweight among Indonesian adults and adolescents and for high blood pressure among adults. I then examine the extent to which these gradients differ by gender and urban/rural residence. Data for this study are from the Indonesian Family Life Survey (2000), a household survey representing 83% of the population. The importance of identifying the shape of socioeconomic gradients in developing economies such as Indonesia cannot be understated; if some poorer health behaviors and outcomes are associated with higher status, the improving socioeconomic position of many may only increase prevalence of chronic disease, rather than reduce risk as in developed economies.

Learning Objectives: