Socioeconomic Success and Health in Later Life: Evidence from the Indonesia Family Life Survey

Abstract

Indonesia has been undergoing a major health and nutrition transition over the past twenty or more years and there has begun a significant aging of the population as well. In this paper we focus on documenting major changes in the health of the population aged 45 years and older, since 1993. We use the Indonesia Family Life Survey (IFLS), a large-scale, broad-based panel survey of households and individuals, covering 4 full waves from 1993 to 2007/8. Much of the changes can be seen as improvements in health, such as the movement out of undernutrition and communicable disease as well as the increasing levels of hemoglobin. On the other hand, other changes such as the increase in overweight and waist circumference, especially among women, and continuing high levels of hypertension that seems to be inadequately addressed by the health system, indicate that the elderly population in Indonesia is increasingly exposed to higher risk factors that are correlated with chronic problems such as cardiovascular diseases and diabetes.

In addition to documenting long-run changes in health and its distribution among the elderly Indonesian population, we examine correlations between socio-economic status, principally education and per capita expenditure, and numerous health outcome and behavioral variables. We find generally strong correlations between our health variables and SES and find in particular, the schooling plays a role in reducing the adverse health effects of aging. We also find that for hypertension in particular, that there is a very large degree of underdiagnosis in this population, one that is weakly correlated with SES. This result raises serious questions regarding the ability of the health system in Indonesia to cope with the rapid aging of the population and the transition from infectious to chronic diseases.