Life Expectancy in Indonesia: The Role of Health Infrastructure, Political, and Socioeconomic Status

Document Type : Research Paper

Authors

1 Department of Economics, Universitas Sultan Ageng Tirtayasa, Banten, Indonesia.

2 Development Planning Agency at Sub-National Level, Banten Province, Indonesia.

Abstract

Health development is an effort to fulfill one of the fundamental rights to access good health services. Life expectancy marks the success of development in the health sector. We carefully selected the determinants of life expectancy in Indonesia and collected data in 2010-2018. All 34 provinces in Indonesia were included as the unit of analysis. We use panel data modeling. We carried out a cluster analysis to develop an inter-provincial cooperation group in Indonesia. Life expectancy shows a strong correlation with GRDP per capita, immunization, mean years of schooling, and insurance. GRDP per capita being the strongest of all constructions. Rights, democracy, poverty, Gini index, dependency ratio, illiteracy, and breastfeeding harm life expectancy. Beds, resources, water, toilet, sanitation, and neonatal have a weak influence on life expectancy. The novelty of this paper is to incorporate the impact of health infrastructure development, political regime, and socioeconomic status, and the cluster of provinces that can increase life expectancy. Studies in full democracies prove that politics has a significant on life expectancy. However, this is not confirmed when Indonesia's democracy index from political rights aspects and institutions of democracy aspects is used to see its impact on life expectancy. This study may be the first to look at the effects of health infrastructure development, political regime, socioeconomic status, and clustering in 34 provinces in Indonesia. The results of this study may be helpful for policymakers, and efforts need to be made to ensure a healthy life and support well-being for all ages.

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Main Subjects


Adioetomo, S. M., & Mujahid, G. (2014). UNFPA Indonesia Monograph Series No. 1: Indonesia on the Threshold of Population Ageing. New York: UNFPA-United Nations Population Fund.
Alaydrus, H. (2019). Indonesia Targetkan Akses Air Minum Layak 100 Persen Pada 2030. Retrieved October 29, 2020, from https://bit.ly/2Z90xYw
Allin, S., Grignon, M., & Le, J. (2010). Social Science & Medicine Subjective unmet Need and Utilization of Health Care Services in Canada: What are the Equity Implications? Social Science & Medicine, 70(3), 465-472.
Amaghionyeodiwe, L. A. (2004). Government Health Care Spending and The Poor: Evidence from Nigeria. International Journal of Social Economics, 36(3), 220-236.
Andreev, E. M., Biryukov, V. A., & Shaburov, K. J. (1994). Life Expectancy in The Former USSR and Mortality Dynamics by Cause of Death: Regional Aspects. European Journal of Population, 10(3), 275-285.
Antonio, L., Ciampo, D., & Lopes, I. R. (2018). Breastfeeding and the Benefits of Lactation for Women’s Health. Rev Bras Ginecol Obstet, 40, 354-359.
Aspinall, E. (2013). A Nation in Fragments: Patronage and Neoliberalism in Contemporary Indonesia. Critical Asian Studies, 45(1), 27-54.
Baltagi, B. H. (2015). Econometric Analysis of Panel Data (5th Ed.). Chichester: John Wiley & Sons Ltd.
Becker, G. S. (1962). Investment in Human Capital: A Theoretical Analysis. Journal of Political Economy, 70(5), 9-49.
Becker, G. S., Philipson, T. J., & Soares, R. R. (2005). The Quantity and Quality of Life and the Evolution of World Inequality. American Economic Review, 95(1), 277-291.
Berkat, S., & Sutan, R. (2014). The Effect of Early Initiation of Breastfeeding on Neonatal Mortality among Low Birth Weight in Aceh Province, Indonesia: An Unmatched Case Control Study. Advances in Epidemiology, 2014, 1-7.
Borges, A. P., Reis, A., & Anjos, J. (2016). Willingness to Pay for Other Individuals’ Healthcare Expenditures. Public Health, 144, 64-69.
Central Bureau of Statistics. (2020). Population Distribution by Province. Jakarta: Badan Pusat Statistik.
---------- (2015). Profil Penduduk Hasil SUPAS 2015. Jakarta: Badan Pusat Statistik.
---------- (2013). Proyeksi Penduduk Indonesia 2010-2035. Jakarta: Badan Pusat Statistik.
Chaabouni, S., & Zghidi, N. (2016). On the Causal Dynamics between CO2 Emissions, Health Expenditure and Economic Growth. Sustainable Cities and Society, 22, 184-191.
Chitescu, R. I., & Lixandru, M. (2016). The Influence of the Social, Political and Economic Impact on Human Resources, as a Determinant Factor of Sustainable Development. Procedia Economics and Finance, 39, 820-826.
Chokkanathan, S., & Mohanty, J. (2017). Health, Family Strains, Dependency, and Life Satisfaction of Older Adults. Archives of Gerontology and Geriatrics, 71, 129-135.
Cournane, S., Dalton, A., Byrne, D., Conway, R., Riordan, D. O., Coveney, S., & Silke, B. (2015). European Journal of Internal Medicine Social Deprivation, Population Dependency Ratio and an Extended Hospital Episode - Insights from Acute Medicine. European Journal of Internal Medicine, 26(9), 714-719.
Craigwell, R., Bynoe, D., & Lowe, S. (2007). The Effectiveness of Government Expenditure on Education and Health Care in the Caribbean. International Journal of Development Issue, 11(1), 4-18.
Cutler, D., Deaton, A., & Lleras-Muney, A. (2006). The Determinants of Mortality. Journal of Economic Perspectives, 20(3), 97-120.
Damashinta, C. I. (2018). Sanitasi Indonesia Terburuk Ketiga. Retrieved October 29, 2020, from https://bit.ly/3CbfibW
Dziechciarz-duda, M., & Król, A. (2011). On The Non-Monetary Benefits of Tertiary Education. Econometrics, 3(41), 1-15.
Engineer, M., King, I., & Roy, N. (2008). The Human Development Index as a Criterion for Optimal Planning. Indian Growth and Development Review, 1(2), 172-192.
Erlangga, D., Suhrcke, M., Ali, S., & Bloor, K. (2019). The Impact of Public Health Insurance on Health Care Utilisation, Financial Protection and Health Status in Low: The Middle-Income Countries: a Systematic Review. PloS ONE, 14(8), e0225237- e0225246.
Fan, H., Yan, Q., Coyte, P. C., & Yu, W. (2019). Does Public Health Insurance Coverage Lead to Better Health Outcomes? Evidence From Chinese Adults. Inquiry: The Journal of Health Care Organization, Provision and Financing, 56, 1-10.
Foreman, K. J., Marquez, N., Dolgert, A., Fukutaki, K., Fullman, N., McGaughey, M., ... & Murray, C. J. (2018). Forecasting Life Expectancy, Years of Life Lost, and All-Cause and Cause-Specific Mortality for 250 Causes of Death: Reference and Alternative Scenarios for 2016-40 for 195 Countries and Territories. The Lancet, 392(10159), 2052-2090.
Franco, Á., Álvarez-dardet, C., & Ruiz, M. T. (2004). Effect of Democracy on Health : Ecological Study. BMJ, 329, 1421-1423.
Gerring, J., Bond, P., Barndt, W. T., Moreno, C., Gerring, B. J., Bond, P., Barndt, W. T., & Moreno, C. (2011). Politics: Democracy and Economic Growth: A Historical Perspective How to cite this article: A Historical Perspective. World Politics, 54(3), 323-364.
Gilmour, T., Wiesel, I., Pinnegar, S., & Loosemore, M. (2010). Social Infrastructure Partnerships: a Firm Rock in a Storm? Journal of Financial Management of Property and Construction, 15(3), 247-259.
Ginja, S., Gallagher, S., & Keenan, M. (2019). Water, Sanitation and Hygiene (WASH) Behaviour Change Research: Why an Analysis of Contingencies of Reinforcement is Needed. International Journal of Environmental Health Research, 3(2021), 715-728.
Grzywacz, J. G. (2000). Socioeconomic Status and Health Behaviors among Californians (121-149). In J. J. Kronenfeld (Ed.), Health, Illness, and Use of Care: The Impact of Social Factors. West Yorkshire: Emerald Group Publishing.
Harris, B., & Helgertz, J. (2019). Urban Sanitation and the Decline of Mortality. History of the Family, 24(2), 207-226.
Hassan, F. A., Minato, N., Ishida, S., & Nor, N. M. (2016). Social Environment Determinants of Life Expectancy in Developing Countries: A Panel Data Analysis. Global Journal of Health Science, 9(5), 105-117.
Hum, R. J., Verguet, S., Cheng, Y. L., McGahan, A. M., & Jha, P. (2015). Are Global and Regional Improvements in Life Expectancy and in Child, Adult and Senior Survival Slowing? PLoS ONE, 10(5), 1-14.
Jain, A. K. (2010). Data Clustering: 50 Years Beyond K-Means. Pattern Recognition Letters, 31(8), 651-666.
Jamison, D. T., Jha, P., Malhotra, V., & Verguet, S. (2013). Human Health: The Twentieth Century Transformation of Human Health—its Magnitude And Value. In How Much Have Global Problems Cost The World. Cambridge: Cambridge University Press.
Jones, C. A., Parker, T. S., Ahearn, M., Mishra, A. K., & Variyam, J. N. (2009). Health Status and Health Care Access of Farm and Rural Populations (57). Pennsylvania: DIANE Publishing.
Kabir, M. (2008). Determinants of Life Expectancy in Developing Countries. Journal of Developing Areas, 41(2), 185-204.
Kaplan, R. M., Spittel, M. L., & Zeno, T. L. (2014). Educational Attainment and Life Expectancy. Policy Insights from the Behavioral and Brain Sciences, 1(1), 189-194.
Kim, T. J., Vonneilich, N., Lüdecke, D., & Knesebeck, O. Von. (2017). Income, Financial Barriers to Health Care and Public Health Expenditure: A Multilevel Analysis of 28 Countries. Social Science & Medicine, 176, 158-165.
Kristanto, E., Daerobi, A., & Samudro, B. R. (2019). Indonesian Life Expectancy: Role of Health Infrastructure and Socio-Economic Status. Signifikan: Jurnal Ilmu Ekonomi, 8(2), 159-178.
Kustanto, A. (2020). Pertumbuhan Ekonomi Regional di Indonesia: Peran Infrastruktur, Modal Manusia dan Keterbukaan Perdagangan. Buletin Studi Ekonomi, 25(1), 80-98.
Lake, D. A., & Baum, M. A. (2001). The Invisible Hand of Democracy: Political Control and the Provision of Public Services. Comparative Political Studies, 34(6), 587-621.
Lakshmi, T. S., & Sahoo, D. (2013). Health Infrastructure and Health Indicators: The Case of Andhra Pradesh, India. IOSR Journal of Humanities and Social Science, 6(6), 22-29.
Legido-Quigley, H., Naheed, A., Asita De Silva, H., Jehan, I., Haldane, V., Cobb, B., Tavajoh, S., Chakma, N., Kasturiratne, A., Siddiqui, S., Jafar, T. H. (2019). Patients’ Experiences on Accessing Health Care Services for Management of Hypertension in Rural Bangladesh, Pakistan and Sri Lanka: A Qualitative Study. PLoS ONE, 14(1), 1-23.
Leonti, M., & Casu, L. (2013). Traditional Medicines and Globalization: Current and Future Perspectives in Ethnopharmacology. Frontiers in Pharmacology, 4(Article 92), 1-13.
Lin, R., Chen, Y., Chien, L., & Chan, C. (2012). Political and Social Determinants of Life Expectancy in Less Developed Countries: A Longitudinal Study. BMC Public Health, 12(1), 85-98.
Mahendradhata, Y., Trisnantoro, L., Listyadewi, S., Soewondo, P., Marthias, T., Harimurti, P., & Prawira, J. (2017). The Republic of Indonesia Health System Review. Delhi: World Health Organization.
Martínez, M. del C. V., & Oller, I. M. P. (2019). Health Investment Management Based on Patient Satisfaction With the Primary Care Doctor in the Spanish National Health Service Context. A Gender Perspective. MOJ Gerontology & Geriatrics, 4(5), 204-211.
McMichael, A. J., McKee, M., Shkolnikov, V., & Valkonen, T. (2004). Mortality Trends And Setbacks: Global Convergence or Divergence? Lancet, 363(9415), 1155-1159.
Mello, L., & Pisu, M. (2009). The Effectiveness of Education and Health Spending among Brazilian Municipalities. OECD Economics Department Working Papers, 53(712), 1-22.
Miladinov, G. (2020). Socioeconomic Development and Life Expectancy Relationship: Evidence from The EU Accession Candidate Countries. Genus, 76(1), 1-20.
Ministry of Home Affairs. (2015). The Book of Administrative Code and Regions of Indonesia. Retrieved October 29, 2020, from https://bit.ly/3Ge9DEK
Monteiro, G., & Turnovsky, S. J. (2008). The Composition of Productive Government of Expenditure: Consequences for Economic Growth and Welfare. Indian Growth and Development Review, 1(1), 57-83.
Mooi, E., & Sarstedt, M. (2011). A Concise Guide to Market Research: The Process, Data, and Methods Using IBM SPSS Statistics. Berlin: Springer.
Muntaner, C., Borrell, C., Ng, E., Chung, H., Espelt, A., Rodriguez-Sanz, M., Benach, J., & O’Campo, P. (2011). Politics, Welfare Regimes, and Population Health: Controversies and Evidence. Sociology of Health and Illness, 33(6), 946-964.
Navarro, V., Muntaner, C., Borrell, C., Benach, J., Quiroga, Á., Rodríguez-sanz, M., Vergés, N., & Pasarín, M. I. (2006). Politics and Health Outcomes. Lancet, 368(September 26), 1033-1037.
Negara, S. D. (2016). Indonesia’s Infrastructure Development Under The Jokowi Administration (145-165). In D. Singh and M. Cook (Eds.), Southeast Asian Affairs 2016. Heng Mui Keng Terrace: ISEAS Publishing.
Nomura, S., Sakamoto, H., Glenn, S., Tsugawa, Y., Abe, S. K., Rahman, M., Brown, J. C., Ezoe, S., Maruyama, S., Miyata, H., Mooney, M. D., Naghavi, M., Onoda, T., Ota, E., Otake, Y., Roth, G. A., Murray, C. J. L., & Shibuya, K. (2017). Population Health and Regional Variations of Disease Burden in Japan, 1990-2015: a Systematic Subnational Analysis for the Global Burden of Disease Study 2015. The Lancet, 390(10101), 1521-1538.
Novak, Anica, Žiga Čepar, A. T. (2014). Expected Years of Schooling and Longer Life Expectancy As an Aging Population Factor. Proceedings of the Management, Knowledge and Learning International Conference 2014, Rerieved from https://d1wqtxts1xzle7.cloudfront.net/
Paramita, S. A., Yamazaki, C., & Koyama, H. (2020). Determinants of Life Expectancy and Clustering of Provinces to Improve Life Expectancy: an Ecological Study in Indonesia. BMC Public Health, 20(1), 1-8.
Paramita, S. A., Yamazaki, C., Setiawati, E. P., & Koyama, H. (2018). Distribution Trends of Indonesia’s Health Care Resources in The Decentralization Era. The International Journal of Health Planning and Management, 33(2), 1-11.
Pratiwi, R. D. A., & Wibowo, W. (2016). Pengaruh Karakteristik Sosial Ekonomi Jawa Timur Menggunakan Analisis Regresi Multivariat. Jurnal Sains Dan Seni ITS, 5(2), 199-204.
Qureshi, M. A. (2009). Human Development, Public Expenditure and Economic Growth: a System Dynamics Approach. International Journal of Social Economics, 36, 93-104.
Ray, D., & Ing, L. Y. (2016). Addressing Indonesia’s Infrastructure Deficit. Bulletin of Indonesian Economic Studies, 52(1), 1-25.
Robson, L. S., Clarke, J. A., Cullen, K., Bielecky, A., Severin, C., Bigelow, P. L., Irvin, E., Culyer, A., & Mahood, Q. (2007). The Effectiveness of Occupational Health and Safety Management System Interventions: A Systematic Review. Safety Science, 45(3), 329-353.
Sabogal, R. I., Medlin, E., Aquino, G., & Gelting, R. J. (2014). Sustainability of water, sanitation and hygiene interventions in Central America. Journal of Water, Sanitation and Hygiene for Development, 4(1), 89–99.
Salim, W., & Negara, S. D. (2018). Infrastructure Development Under The Jokowi Administration: Progress, Challenges and Policies (239-264). In H. Hill and S. D. Negara (Eds.), The Indonesian Economy in Transition. Heng Mui Keng Terrace: ISEAS Publishing.
Selck, T. J., & Deckarm, R. (2015). Income, Democracy, and Public Policy: the Effects of Improved Sanitation on Life Expectancy. Journal of Water Sanitation and Hygiene for Development, 5(3), 525-529.
Shen, C. E., & Williamson, J. B. (1997). Child Mortality, Women’s Status, Economic Dependency, and State Strength: A Cross-National Study of Less Developed Countries. Social Forces, 76(2), 667-700.
Shkolnikov, V. M., Andreev, E. M., Tursun-zade, R., & Leon, D. A. (2019). Patterns in the Relationship between Life Expectancy and Gross Domestic Product in Russia in 2005-15: a Cross-Sectional Analysis. The Lancet Public Health, 4, e181–e188.
Sickles, R. C., & Taubman, P. (1997). Mortality and Morbidity among Adults and the Elderly (561-627). In M. R. Rosenzweig & O. Stark (Eds.), Hanbook of Population and Family Economics. Amsterdam: Elsevier Science B.V.
Soares, R. R. (2007). Health and the Evolution of Welfare across Brazilian Municipalities. Journal of Development Economics, 84(2), 590-608.
Sudhinaraset, M., Ingram, M., Lofthouse, H. K., & Montagu, D. (2013). What is the Role of Informal Healthcare Providers in Developing Countries? A Systematic Review. PLoS ONE, 8(2), 1-12.
Suryahadi, A., Kusumawardhani, N., & Izzati, R. A. (2018). The Effectiveness of Social Assistance Programs in Reducing Poverty and Inequality. Retrieved from SMERU Research Institute (In Indonesian).
Tamborini, C. R., Kim, C. H., & Sakamoto, A. (2015). Education and Lifetime Earnings in the United States. Demography, 52(4), 1383-1407.
Taylor, M. (2016). From Conflict to Cooperation? Sudan, South Sudan and Uganda. Retrieved October 29, 2020, from https://bit.ly/3AYfVV7
The Lancet. (2019). Successes and Challenges for Health in Indonesia. The Lancet, 393(10166), 2-20.
The World Bank. (2020). World Development Indicators. Washington, DC: The World Bank.
Todaro, M. P., & Smith, S. C. (2012). Economic Development. London: Pearson Education.
Togobu, D. M. (2018). Gambaran Perilaku Masyarakat Adat Karampuang Dalam Mencapai Pengobatan Dukun (Ma’sanro). Jurnal Kesehatan Masyarakat, 4(1), 16-32.
Triana, V. (2017). Faktor Yang Berhubungan Dengan Pemberian Imunisasi Dasar Lengkap Pada Bayi Tahun 2015. Jurnal Kesehatan Masyarakat Andalas, 10(2), 123-130.
UNDP. (2019). Human Development Report 2019 Inequalities in Human Development in the 21st Century. New York: United Nations Developmet Programme.
Vallin, J., & Meslé, F. (2009). The segmented Trend Line of Highest Life Expectancies. Population and Development Review, 35(1), 159-187.
Vila, L. E. (2014). The Non-Monetary Benefits of Education. European Journal of Education, 35(1), 21-32.
Warburton, E. (2016). Jokowi and the New Developmentalism. Bulletin of Indonesian Economic Studies, 52(3), 297-320.
Wardhana, A., & Kharisma, B. (2020). Angka Harapan Hidup Di Era Desentralisasi (Kabupaten/Kota Jawa Barat). E-Jurnal Ekonomi Dan Bisnis Universitas Udayana, 5, 405-422.
WHO. (2014). Countries Helping Countries. Jenewa: World Health Organization.
Wigley, S., & Akkoyunlu-Wigley, A. (2011). The Impact of Regime Type on Health: Does Redistribution Explain Everything. World Politics, 63(4), 647-677.
Wulandari, R. D., & Laksono, A. D. (2019). Urban-Rural Disparity: the Utilization of Primary Healthcare Centers Among Elderly in East Java, Indonesia. Jurnal Administrasi Kesehatan Indonesia, 7(2), 147-154.
Yu, J., Zhou, J., Long, A., He, X., Deng, X., & Chen, Y. (2019). A Comparative Study of Water Quality and Human Health Risk Assessment in Longevity Area and Adjacent Non-Longevity Area. International Journal of Environmental Research and Public Health, 16(19), 1-19.
Yuan, H., Ma, Q., Ye, L., & Piao, G. (2016). The Traditional Medicine and Modern Medicine from Natural Products. Molecules, 21(5), 1-18.
Zank, S., & Hanazaki, N. (2017). The Coexistence of Traditional Medicine and Biomedicine: a Study with Local Health Experts in Two Brazilian Regions. PLoS ONE, 12(4), 1-17.