Objective: Our objective is to study correlation of socioeconomic status and diagnosis rate of diabetes mellitus in Indonesia
Methods: This is an ecological study on correlation between economic and education level with undiagnosed DM prevalence in Indonesian provinces. Economic level and education level were represented by purchasing power parity (PPP) and mean of years schooling (MYS) respectively, constituent variables to measure human development index (HDI). These factors were adjusted for healthcare access represented by ratio of general practitioners (RGP) per 100.000 inhabitants. All data were obtained from published national data by Indonesian Ministry of Health and Indonesian Central Statistics Body. Correlations between variables were assessed by bivariate correlation and linear regression tests.
Results: Out of 34 Indonesian provinces as of 2013, 32 were included in analysis. Provinces of East and North Borneo were not included because of incomplete uncoupling of data due to their recent separation in 2012. A weak linear correlation were found between undiagnosed DM and PPP with r = -0.384 (p = 0.030), and MYS with r = -0.294 (p = 0.102). On regression analyses, with exclusion of RGP, both PPP and MYS were found to be significant factors (p = 0.015 and p = 0.043 respectively). Furthermore, when RGP included, MYS turned out not significant while PPP was significant factor with β of -0.512 (p = 0.023).
Conclusion: This study reveals negative correlation for socioeconomic risk factors toward undiagnosed DM in Indonesia, especially for purchasing power. This means provinces with higher socioeconomic degree have lower rate of undiagnosed DM, supposedly indicating a good healthcare access in the area. Fundamental difference that may influence insignificancy of socioeconomic risk factors in Indonesia compared to Western countries requires further research. Further population-based studies are needed to assess impact of socioeconomic factors on DM risk in non-Western culture countries.