BMC Public Health. 2026 Feb 28. doi: 10.1186/s12889-026-26811-9. Online ahead of print.
ABSTRACT
BACKGROUND: Digestive diseases represent an important public health concern in Indonesia, with national surveys reporting notable symptom burden and frequent hospital presentations for conditions such as gastritis, dyspepsia, and gastroesophageal reflux disease (GERD). However, evidence on their social and geographic disparities remains limited. Understanding how socioeconomic status and place of residence are associated with digestive health can guide equitable policy interventions.
OBJECTIVE: This study examined socioeconomic and rural-urban disparities in digestive diseases among Indonesian adults, using nationally representative data from the Indonesia Family Life Survey (IFLS-5).
METHODS: A cross-sectional analysis was conducted among 29,817 adults aged 15 years and above using IFLS-5. Digestive disease was defined based on self-reported doctor-diagnosed disease diagnosed gastrointestinal conditions using IFLS-5 item ‘stomach or other digestive disease”. Socioeconomic status was primarily assessed using an asset-based household wealth index derived by principal component analysis. Multivariable logistic regression was used to estimate adjusted odds ratio (aOR) for digestive disease factors, controlling for sociodemographic, health related factors, behaviours, lifestyle, and environmental factors, including depressive symptoms.
RESULTS: The overall weighted prevalence of doctor-diagnosed digestive disease was 13.11%. The prevalence was higher in urban residents (14.8%) than rural areas (11.4%), and among non-poor (14.2%) than poor adults (12.1%). These differences were statistically significant (P < 0.001). After adjustment, rural adults had lower odds of digestive disease (aOR = 0.88, 95% CI: 0.79-0.98), while wealth index was not significantly associated (aOR = 1.02, 95% CI: 0.94-1.12). Higher education attainment was strongly associated with increased odds of digestive diseases (aOR 1.78, 95% CI: 1.62-1.94) compared with lower education. Female sex, former smoking, comorbid conditions, depressive symptoms, and poor self-rated health were also positively associated.
CONCLUSIONS: In Indonesia, notable differences in digestive diseases were observed across educational and residence groups. Although crude prevalence was higher among urban and non-poor, adjusted analysis revealed persistent disparities mainly driven by education and place of residence rather than household wealth. Reducing the burden of digestive diseases requires policy initiatives to enhance access to healthcare, nutrition, and sanitation, especially in rural and lower-education communities.
PMID:41761161 | DOI:10.1186/s12889-026-26811-9
