The Association between Socioeconomic Status and Adult Mortality in a Developing Country: Evidence from a Nationally Representative Longitudinal Survey of Indonesian Adults

Abstract

Objectives To estimate the association between socioeconomic status (SES) and adult mortality in Indonesia and determine the contribution of adult behavioral risk factors to SES differences in mortality. Methods Discrete failure-time regression models and period life tables were used to estimate life expectancy at age 30 (e 30) across wealth and consumption groups by sex and urban/rural residence. Results For urban men, e 30 increases by an average of 1.10 years per wealth quartile (p =.014) from 38.7 years (95% confidence interval (CI): 37.4-40.5) in the bottom wealth quartile to 42.1 years (95% CI: 40.3-44.1) in the top quartile; for rural men, e 30 increases by an average of 1.35 years per quartile (p =.007) from 40.6 years (95% CI: 39.2-42.5) in the bottom wealth quartile to 44.3 years (95% CI: 42.4-46.6) in the top quartile. SES differences are smaller for women. Behavioral risk factors are inconsistently patterned across SES and do not explain SES differences in mortality. Discussion The associations between SES and adult life expectancy in Indonesia are moderate when compared with developed countries and are not explained by traditional behavioral risk factors. In a context where behavioral risk factors are inconsistent across SES groups, mortality inequality may be driven by inequalities in health care access or other social factors.