Adult Health Transition in Low-Income Asia: Evidence from Indonesia and China

John Strauss, Michigan State University
Agus Dwiyanto, Gadjah Mada University
Zhehui Luo, Michigan State University
Bondan Sikoki, RAND

The health and nutrition transition is proceeding rapidly in Asia, including in low-income countries there. In this paper we will examine the rising levels of three key risk factors of health associated with chronic conditions, not infectious diseases: overweight, hypertension and smoking. We use the 1997 and 2000 waves of the Indonesia Family Life Survey and the 1991, 1993 and 1997 waves of the China Health and Nutrition Survey. These surveys are rich in physical health data on all adults (heights, weights, blood pressure, smoking behaviors), allowing us to examine these factors among men and women and among different age sub-groups. We also will examine underlying socio-demographic-economic factors that are associated with these conditions. Initial findings show very similar patterns between Indonesia and China. Overweight has become a problem in both countries, especially among prime-aged women. FOr instance, in Indonesia, among women aged 40-59 the incidence of overweight is 25%. For men the incidence is lower. Income is a strong positive predictor of body mass. Education works in interesting ways, quite different between men and women. For women, body mass rises with education, until higher levels (secondary school in Indonesia), at which point body mass declines with more scholing. This is the pattern one sees in higher income countries. However, for men, body mass increases monotonically with schooling. Hypertension is a problem especially among the elderly, for whom levels are 33% in Indonesia. Smoking in Asia is a male phenomena. Current smoking rates in Indonesia are extremely high, over 70% for men over 20 years. For women rates are under 5%. There has been a tendency for younger cohorts of Indonesians to begin smoking at earlier ages. Higher schooling does seem to slightly reduce current smoking probablities among adults over 20, while income impacts on the amount smoked. We will present these findings and explore in more detail the underlying correlates of these risk factors, that exist in countries in which problems of undernutrtion are still important.