Women’s Hypertension in Indonesia: The Role of Religion, Trust, and Community Involvement

Abstract

Hypertension, or high blood pressure, is the leading cause of death worldwide and is a key risk factor for cardiovascular disease. Approximately three quarters of individuals living with hypertension reside in low- and middle-income countries (LMICs). In Indonesia – one of the largest LMICs – women’s hypertension rates exceed men’s despite less engagement in risky health behaviors such as tobacco and alcohol consumption. In this dissertation, I explore the relationship between women’s social factors and hypertension because women’s social determinants of health are often overlooked in hypertension research. Specifically, I examine women’s religious involvement, feelings of trust, safety, and reciprocity, and involvement in community groups as potential social factors associated with hypertension. Using data from Wave 5 of the Indonesian Family Life Survey (IFLS), I found religious differences in the likelihood of hypertension. Muslim women – and particularly Muslim women who pray daily but do not engage in salat prayer – had the highest likelihood of hypertension overall, while Hindu women – and particularly women who either participate in daily yoga/meditation or refrain from red meat consumption – had the lowest likelihood of hypertension. I also found that women needing to be alert in the community was associated with lower likelihoods of hypertension compared to women who did not report a need to be alert. Measures of both individual- and community-level thick and thin trust were associated uniquely with likelihoods of hypertension. Finally, I found that women largely did not vary in likelihoods of hypertension by participation in community programs, and there were no significant differences in the relationship between participation and hypertension for mothers and non-mothers.