title: Do women in major cities experience better health? A comparison of chronic conditions and their risk factors between women living in major cities and other cities in Indonesia.
abstract: BACKGROUND
  Inhabitants of rural areas can be tempted to migrate to urban areas for the type and range of facilities available. Although urban inhabitants may benefit from greater access to human and social services, living in a big city can also bring disadvantages to some residents due to changes in social and physical environments.
  
  
  METHODS
  We analysed data from 4,208 women aged >15 years old participating in the fourth wave of the Indonesia Family Life Survey. Chronic condition risk factors - systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), and tobacco use - among women in four major cities in Indonesia (Jakarta, Surabaya, Medan, and Bandung) were compared against other cities. Fractional polynomial regression models were applied to examine the association between living in the major cities and SBP, DBP, BMI, and tobacco use. The models were also adjusted for age, education, employment status, migration status, ethnic groups, and religion. The patterns of SBP, DBP, and BMI were plotted and contrasted between groups of cities.
  
  
  RESULTS
  Chronic condition prevalence was higher for women in major cities than in contrasting cities (p<0.005). Living in major cities increased the risk of having higher SBP, DBP, BMI and being a current smoker. Chronic disease risk factors in major cities were evident from younger ages.
  
  
  CONCLUSIONS
  Women residing in Indonesia's major cities have a higher risk of developing chronic conditions, starting at younger ages. The findings highlight the challenges inherent in providing long-term healthcare with its associated cost within major Indonesian cities and the importance of chronic disease prevention programmes targeting women at an early age.
authors.affiliation: Research Centre for Generational Health and Ageing, University of Newcastle (Hunter Medical Research Institute), Newcastle, Australia; yodi.christiani@uon.edu.au.
authors.forename: Yodi
authors.initials: Y
authors.lastname: Christiani
authors.affiliation: Research Centre for Generational Health and Ageing, University of Newcastle (Hunter Medical Research Institute), Newcastle, Australia.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Byles
authors.affiliation: Research Centre for Generational Health and Ageing, University of Newcastle (Hunter Medical Research Institute), Newcastle, Australia.
authors.forename: Meredith
authors.initials: M
authors.lastname: Tavener
authors.affiliation: Centre for Health Stewardship, Australian National University, Canberra, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Dugdale
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease / Q000453:epidemiology* / Q000628:therapy; D002947:Cities; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D006973:Hypertension; D007214:Indonesia / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D064424:Tobacco Use / Q000009:adverse effects; D014504:Urban Health; D055815:Young Adult
keywords: BMI; Indonesia; chronic disease; hypertension; urban health; women