Multilevel Analysis: Villages do not have Ecological Effect on the Risk of Diabetes Mellitus Type 2 in Surakarta, Central Java

Abstract

Background: Diabetes Melitus (DM) as The Silent Killer has an increasing number of cases. Type 2 diabetes and its complications are a major publ­ic health problem worldwide. Type 2 dia­be­tes is influenced by various factors. This study aimed to analyze the contextual effect of village on the risk of type 2 DM. Subjects and Method: This was a case-con­trol stu­dy conducted in Surakarta, from Novem­ber 20­­19 to January 2020. A sample of 200 patients type 2 DM and non-DM was selected by fixed disease sampling. The depen­dent variable was type 2 DM. The inde­pen­dent variables were family his­tory of DM, diet, phy­sical activity, Body Mass Index (BMI), central obe­­sity, stress, his­tory of hypertension, and smo­k­ing habit. The da­ta were collected by ques­tion­naire and ana­ly­­zed by a multilevel multiple lo­gi­­stic regression run on Stata 13. Results: The risk of type 2 DM was positively asso­ci­ated with family history of dia­betes (b= 2.37; 95% CI= 1.51 to 3.23; p<0.001), poor diet (b= 1.­0­9; 95% CI= 0.71 to 1.86; p= 0.034), low phy­si­cal acti­vity (b= 1.07; 95% CI= 0.12 to 2.02; p= 0.027), cen­­tral obesity (b= 1.01; 95% CI= 0.75 to 1.95; p= 0.034), stress (b= 1.07; 95% CI= 0.15 to 1.98; p= 0.022), history of hyper­­tension (b= 1.08; 95% CI= 0.19 to 1.96; p= 0.016), and smo­k­ing habit (b= 1.31; 95% CI= 0.22 to 2.39; p= 0.018). Village did not have a contextual effect on the risk of type 2 DM with ICC= 0.01%. Conclusion: The risk of type 2 DM is positively associated with family history of DM, diet, low phy­­­si­cal activity, central obesity, stress, history of hy­pertension, and smoking habit. Village do not have a con­tex­tual effect on the risk of type 2 DM. Keyword s : type 2 diabetes mellitus, biopsycho­social, multilevel analysis Correspondence: Anggi Putri Aria Gita. Masters Program in Pub­lic Health, Universitas Sebelas Maret, Jl. Ir. Su­tami 36 A, Surakarta 57126, Indonesia. Email: ang­gi­pag­@­gmail.com. Mobile: +628975406464 Journal of Epidemiology and Public Health (2020), 05(01): 106-118 https://doi.org/10.26911/jepublichealth.2020.05.01.11