This study explored the determinants of perceived health status and the
income-related health inequality in Indonesia. Indonesia experienced considerable
result in term of health status achievement. However this achievement is relatively
lower than neighborhood countries. Severe economic crisis also influenced health
status of Indonesian especially in 1997. It is important to understand the determinants
of perceived health status and measure the degree of health inequality in Indonesia.
This study is secondary panel data analysis using data from three waves of
longitudinal study of Indonesia Family Life Survey (IFLS) in 1993, 1997, and 2000.
9125 adult individual panel respondents are included in the analysis. Perceived health
status is used to measure the adult health outcome. The predictor consisted of
socioeconomic status, individual lifestyle, physical environment, access to healthcare
services, and social environment. Concentration index, logistic regression, and GEE
model is used as statistical analysis method. Findings indicated the degree of income
related health inequality measured by observed concentration index has largest value
in 1997. Poor health status is concentrated disproportionately in poor income group,
but the degree of inequality is relatively small. Among the predictors of perceived
health status, age, employment, region, acute morbidity, access to safe water, and
outpatient visit are the important predictors. Surprisingly, income did not predict the
health status significantly. The use perceived health status as adult health outcomes
measurement should be carefully considered especially in low developing countries
setting.

This study explored the determinants of perceived health status and the
income-related health inequality in Indonesia. Indonesia experienced considerable
result in term of health status achievement. However this achievement is relatively
lower than neighborhood countries. Severe economic crisis also influenced health
status of Indonesian especially in 1997. It is important to understand the determinants
of perceived health status and measure the degree of health inequality in Indonesia.
This study is secondary panel data analysis using data from three waves of
longitudinal study of Indonesia Family Life Survey (IFLS) in 1993, 1997, and 2000.
9125 adult individual panel respondents are included in the analysis. Perceived health
status is used to measure the adult health outcome. The predictor consisted of
socioeconomic status, individual lifestyle, physical environment, access to healthcare
services, and social environment. Concentration index, logistic regression, and GEE
model is used as statistical analysis method. Findings indicated the degree of income
related health inequality measured by observed concentration index has largest value
in 1997. Poor health status is concentrated disproportionately in poor income group,
but the degree of inequality is relatively small. Among the predictors of perceived
health status, age, employment, region, acute morbidity, access to safe water, and
outpatient visit are the important predictors. Surprisingly, income did not predict the
health status significantly. The use perceived health status as adult health outcomes
measurement should be carefully considered especially in low developing countries
setting.

Title Page ………………………………………………………… i
Approval Page …………………………………………………… ii
Abstract ………………………………………………………………… iii
Acknowledgement ……………………………………………………… iv
Table of Content ……………………………………………………. vi
List of Tables ………………………………………………………. ix
1. CHAPTER ONE: INTRODUCTION …………………………………. 1
1.1. Background …………………………………………………………... 1
1.2. Problem Statements ………………………………………………… 5
1.3. Study Objectives …………………………………………………...5
1.4. Significance of the Study ……………………………………… 5
2. CHAPTER TWO: LITERATURE REVIEW …………………………… 7
2.1. The Multiple Determinants of Health ……………………… 7
2.2. Measuring Health Status and Health Status Indicators 10
2.3. Perceived Health Status …………………………………………..11
2.4. Health Inequality …………………………………………………...12
2.5. Measuring Health Inequality ……….…………………………… 15
2.6. Overview of Current Health Situation in Indonesia …… 18
2.6. Theoretical Framework ………………………………………….... 21
2.7. Conceptual / Operational Framework ……………………….... 22
2.8. Research Hypotheses ………………………………………… 23
3. CHAPTER THREE: RESEARCH METHODOLOGY .................... 26
3.1. Study Design ………………………………………………………….. 26
3.2. Data Description ………………………………………………….. 26
3.3. Survey Instruments ………………………………………………….. 29
3.4. Plan for Data Analysis ………………………………........... 30
3.4.1. Data Editing ……………………………………….…………. 30
3.4.2. Statistical Analysis ………………………………………… 31
3.4.3. Statistical Package ……………………………………………33
3.5. Variable Definition ……………………………………………… 33
3.5.1. Dependent Variable ………………………………………… 33
3.5.2. Independent Variables ………………………………… 34
4. CHAPTER FOUR: RESULTS ………………….…………………… 40
4.1. Descriptive Statistics ………………………………………………… 40
4.2. Analytical Statistics ………………………………………………… 48
4.2.1. Income-related Health Inequality Analysis ……… 48
4.2.2. Comparison of Determinants of Perceived Health
Status in 1993, 1997, and 2000 ………………………… 49
4.2.3. Panel Data Analysis of Determinant of Perceived
HealthStatus in Indonesia ………………………………… 55
5. CHAPTER FIVE: DISCUSSION AND CONCLUSION …………… 61
5.1. Discussion ………………………...……………………………… 61
5.1.1. Descriptive Results ………………………………………… 61
5.1.2. Income-related Health Inequality …………………… 63
5.1.3. Determinants of Perceived Health Status in
Indonesia ..................................... 65
5.1.3.1. Gender ……………………………………… 65
5.1.3.2. Age …………………………………………………… 66
5.1.3.3. Marital Status …………………………………… 67
5.1.3.4. Educational Level ………………………………… 67
5.1.3.5. Employment ……………………………………….... 69
5.1.3.6. Living Standards ………………………………….. 70
5.1.3.7. Geographical Characteristics …………………. 72
5.1.3.8. Physical Environment ……………………....... 74
5.1.3.9. Acute Morbidity Symptoms ………………………… 75
5.1.3.10. Access to Healthcare Service..............75
5.1.3.11. Tobacco Consumption ……………………….......77
5.1.3.12. Social Environment …….…………………….... 78
5.1.3.13. Time Effect …………………………………………… 80
5.2. Limitation of Study ……………………………………… 80
5.3. Conclusion ………………………………………………… 81
5.4. Policy Implication and Recommendation …………………… 84
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