The major risk factor of stroke across Indonesia; a nationwide geospatial analysis of universal health coverage program.

IF 3.2 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Archives of Public Health Pub Date : 2025-07-01 DOI:10.1186/s13690-025-01613-4

Andi Alfian Zainuddin, Rais Reskiawan A Kadir, Hedi Kuswanto, Jumraini Tammasse, Nurul Qalby, Andi Afdal Abdullah, Ari Andini Junaidi, Al Asyary

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Abstract

Background: Stroke is the leading cause of mortality in Indonesia, with hypertension and diabetes mellitus (DM) recognized as well-established risk factors. Moreover, recent epidemiological studies have documented rising incidence, morbidity and mortality of these conditions. Understanding their spatial distribution and interrelationships is crucial for developing targeted public health interventions. This study aims to analyze the geographic distribution of stroke, DM, and hypertension across Indonesia's provinces, evaluate their spatial correlations, and explore their interconnections using advanced spatial modeling techniques.

Methods: The data were collected from the Social Health Insurance Administration Body, which manages Indonesia's universal health coverage, between 2017 and 2022. Crude incidence rates for the diseases were calculated and spatial distribution patterns were analyzed using Global and local Moran analysis. A spatial autoregressive (SAR) model was employed to assess the spatial dependence and interrelationships between these diseases.

Results: The crude incidence rates of stroke, hypertension, and DM were 158.47, 2716.34, and 1503.06 per 100,000 population, respectively. Significant spatial heterogeneity was observed, with certain provinces consistently appearing as high-risk areas across all three diseases. Through SAR analysis, our study identified a significant positive spatial association between DM and stroke incidence, indicating that provinces with higher DM rates also tend to experience elevated stroke burden.

Conclusion: This study mapped the geographical and spatial distribution of stroke, DM, and hypertension across Indonesia and found the pivotal role of DM in driving stroke incidence. By prioritizing high-incidence regions and addressing specific risk factors, targeted interventions can significantly reduce stroke cases and enhance public health outcomes in Indonesia.

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印度尼西亚中风的主要危险因素；全民健康覆盖计划的全国地理空间分析。

背景：卒中是印度尼西亚死亡的主要原因，高血压和糖尿病（DM）被认为是确定的危险因素。此外，最近的流行病学研究表明，这些疾病的发病率、发病率和死亡率都在上升。了解它们的空间分布和相互关系对于制定有针对性的公共卫生干预措施至关重要。本研究旨在分析卒中、糖尿病和高血压在印度尼西亚各省的地理分布，评估它们的空间相关性，并利用先进的空间建模技术探索它们之间的相互联系。方法：数据收集自2017年至2022年间管理印度尼西亚全民健康覆盖的社会健康保险管理机构。计算了疾病的粗发病率，并利用全球和局部Moran分析分析了疾病的空间分布格局。采用空间自回归（SAR）模型来评估这些疾病之间的空间依赖性和相互关系。结果：脑卒中、高血压和糖尿病的粗发病率分别为158.47、2716.34和1503.06 / 10万。观察到显著的空间异质性，某些省份始终是所有三种疾病的高风险地区。通过SAR分析，我们的研究发现糖尿病与卒中发病率之间存在显著的正相关空间关系，表明糖尿病发病率较高的省份也倾向于卒中负担较高。结论：本研究绘制了卒中、糖尿病和高血压在印度尼西亚的地理和空间分布，发现糖尿病在卒中发病率中的关键作用。通过确定高发地区的优先次序和处理具体的风险因素，有针对性的干预措施可以显著减少卒中病例，并改善印度尼西亚的公共卫生成果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Public Health Medicine-Public Health, Environmental and Occupational Health

CiteScore

4.80

自引率

3.00%

发文量

244

审稿时长

16 weeks

期刊介绍： rchives of Public Health is a broad scope public health journal, dedicated to publishing all sound science in the field of public health. The journal aims to better the understanding of the health of populations. The journal contributes to public health knowledge, enhances the interaction between research, policy and practice and stimulates public health monitoring and indicator development. The journal considers submissions on health outcomes and their determinants, with clear statements about the public health and policy implications. Archives of Public Health welcomes methodological papers (e.g., on study design and bias), papers on health services research, health economics, community interventions, and epidemiological studies dealing with international comparisons, the determinants of inequality in health, and the environmental, behavioural, social, demographic and occupational correlates of health and diseases.