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Journal of Epidemiology and Public Health
Published by Universitas Sebelas Maret
ISSN : 25490273     EISSN : 25490273     DOI : -
Core Subject : Health,
Public Health
Background: Increased blood pressure for a long time can increase the risk of kidney failure, co­ronary heart disease, brain damage, and other di­seases. In 2019, it is estimated that hyper­tens­ion is experienced by 1.13 billion people in the world with most (two thirds) living in low and mid­­dle income countries. Other study also shows that the police and military are at risk of develop­ing hypertension due to a number of factors such as low know­led­ge about healthy and nutritious food, co-workers who are smokers, and consum­ing alco­hol. This study aimed to analyze the risk factors for hypertension in the police and military in the world using meta analysis. Subjects and Method: This was a meta-ana­lysis and systematic review. The articles used we­re obtained from Google Scholar, Springer Link, Pro­­Quest, and Science Direct databases. Selected arti­cles published from 2000 to 2020. Keywords to search for articles are as follows: hypertension po­lice personnel and military, or hypertension po­lice personnel and military. The articles studi­ed are 3 full text articles with cross sectional stu­dy designs and 1 full text articles with case cont­rol study design. Articles are col­lect­ed using PRI­S­­­MA diagrams, and analy­zed us­ing the Re­vi­ew Ma­nager application 5.3. Results: Overweight (aOR= 1.42; 95% CI = 1.01 to 2.00; p= 0.04), alcohol consumption (aOR­=­ 1.­55; 95% CI= 1.12 to 2.12; p= 0.007), ciga­rette con­­­­sumption (aOR= 1.45 ; 95% CI= 1.06 to 1.97; p= 0.020) is a risk factor for hyper­­­tension in the po­­­lice and military. Conclusion: Overweight, alcohol consump­tion, and cigarette consump­tion, are risk fac­tors for hypertension in po­lice and military personnel.
Arjuna Subject : -
Articles 419 Documents
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Clinical Indicators of Robotic Assisted versus Conventional Spine Surgery: A Systematic Review Hanny Ayu Soegihwangi; Masyitoh Basabih; I Made Esa Sadana Yoga
Journal of Epidemiology and Public Health Vol. 11 No. 2 (2026)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2026.11.02.06

Abstract

Background: Spine surgery has technological breakthrough of robotic assistance systems. The objective of this review is to explore clinical outcome indicators employed for comparison of out-comes of robotic assisted surgery to conventional spine surgery under the framework of evidence-based practice. Subjects and Method: Based on guidelines issued by PRISMA, we systematically searched multi-ple sources, including PubMed, Scopus, and Science Direct databases. Studies comparing robotic assisted and conventional spine surgery were screened and analysed. Clinical indicators were collected and categorized according to surgical, functional, and safety concerns. Results: The 24 review papers reviewed were all published during 2017 – 2025. The study design studies included three RCTs, nineteen RC studies, one prospective controlled study and one PSMC study pointing to the recent incorporation of robotic technologies in spinal surgery. This has revealed five categories of clinical indicators: accuracy benchmarks, operative parameters, safety and complications, functional outcomes, recovery and hospitalization. The most often reported indicator was the precision of the placement of the pedicle screw, followed by time of operation and intraoperative blood loss. Radiation exposure is a very important measure of occupational health and safety. The goal of this comprehensive clinical framework is to identify a method whereby an evidence-based clinical practice framework for efficient application of technological adoption becomes possible which is in favour of sustainable use can help to guide fiscally responsible adoption. Conclusion: The current review establishes a composite framework of clinical indicators of clinical considerations towards robotic versus conventional spine surgery across robotic versus conventional spine surgery, a comprehensive evaluation paradigm. This framework provides a foundation upon which future studies can proceed.
The Influence of Gender, Body Mass Index, Work Fatigue and Noise Exposure on Blood Pressure among Manufacturing Industry Workers Nurvita Eka Rizky; Bhisma Murti; Sumardiyono; Setyo Sri Rahardjo; Revi Gama Hatta Novika
Journal of Epidemiology and Public Health Vol. 10 No. 4 (2025)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2025.10.04.09

Abstract

Background: Noise in the work environment can exceed a set threshold and have an impact on workers' health, including increased blood pressure. In addition to noise, other factors such as work fatigue, body mass index, and gender also contribute to the risk of hypertension. Preliminary studies show that exposure to high noise and manual work activities is at risk of causing fatigue, so it requires further analysis of the influence of these factors on the blood pressure of industrial workers. Subjects and Method: The study design was a cross-sectional study. The study was conducted in Karanganyar Regency, Central Java in February-April 2025. Sampling in this study was conducted using the Fixed Exposure Sampling method, involving 200 worker samples from a herbal medicine factory and a fireworks factory in Karanganyar Regency, Central Java. The method used to collect data in this study was analytical observations with a cross-sectional approach. The analysis used in this study was path analysis. The dependent variable was blood pressure. The independent variables were noise exposure, fatigue, body mass index, and gender. Results: Blood pressure increased with high fatigue (b= 0.15; 95% CI <0.01 to 0.29; p= 0.038), noise exposure (b= 0.15; 95% CI= 0.02 to 0.28; p= 0.020). Blood pressure in female workers was lower than in men (b= -0.14; 95% CI= -0.28 to -0.01; p= 0.034). Blood pressure was indirectly affected by body mass index. Conclusion: This study shows that noise exposure and work fatigue have a direct effect on increasing blood pressure; women have lower blood pressure than men, while body mass index has an indirect effect on increasing the blood pressure of workers.
Association Between Screen Time Duration and Attention- Deficit/Hyperactivity Disorder Symptoms Among Children Aged 4–6 Years Adnan Faris Naufal; Anida Azkia Fitri; Arif Pristianto; Laura Kirana
Journal of Epidemiology and Public Health Vol. 11 No. 3 (2026)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2026.11.03.01

Abstract

Background: The rapid increase in screen time among children has raised urgent public health concerns due to its potential link with Attention- Deficit/ Hyperactivity Disorder (ADHD)-related symptoms. Emerging evidence suggests that excessive and early exposure to digital media may contribute to inattention, impulsivity, and behavioral dysregulation. This study aimed to examine the association between the duration of gadget use and ADHD symptoms in children aged 4–6 years. Subjects and Method: A cross-sectional study was conducted at four early childhood education institutions in Kartasura, Central Java, Indonesia. A total of 87 children aged 4–6 years were included. Screen time duration was assessed using a 7-day parent-reported observation sheet. ADHD symptoms were measured using the ADHD Rating Scale-5 (ADHDRS-5). The association between screen time duration and ADHD symptoms was analyzed using Pearson’s correlation test. Results: There was a statistically significant positive correlation between screen time duration and ADHD symptoms (r = 0.35; p = 0.001). Conclusion: Longer screen time duration is associated with higher levels of ADHD symptoms among children aged 4–6 years.
Determinants of Tuberculosis Incidence Among Children Under Five in Karanganyar, Central Java, Indonesia Ninik Hartini; Bhisma Murti; Setyo Sri Rahardjo; Sumardiyono; Yulia Lanti Retno Dewi
Journal of Epidemiology and Public Health Vol. 11 No. 1 (2026)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2026.11.01.06

Abstract

Background: Tuberculosis (TB) remains a major infectious disease and a leading cause of mortality worldwide, with 10.8 million cases and 1.25 million deaths reported in 2023. Indonesia is classified as a high-burden TB country, with 78,566 cases reported among children under five years of age. Young children are particularly vulnerable due to their immature immune systems. In Karanganyar Regency, Central Java, Indonesia, 137 cases of TB among under-five children were recorded in 2023. This study aimed to analyze the risk factors associated with TB incidence among children under five in Karanganyar Regency. Subjects and Method: This study employed an analytic observational design using a case-control approach. A total of 200 children under five were randomly selected, comprising 50 TB cases and 150 non-TB controls. Data were analyzed using simple logistic regression and path analysis to examine direct and indirect relationships among variables. Results: The incidence of TB among children under five increased with a history of contact with TB patients (b = 0.18; 95% CI = 0.10–0.26; p < 0.001) and living in homes with high humidity (b = 0.09; 95% CI = 0.01–0.17; p = 0.019). Conversely, TB incidence decreased with good lighting (b = -0.11; 95% CI = -0.19 to -0.03; p = 0.005), presence of bedroom windows (b = -0.41; 95% CI = -0.51 to -0.31; p < 0.001), living room windows (b = -0.31; 95% CI = -0.41 to -0.22; p < 0.001), and residence in highland areas (b = -0.13; 95% CI = -0.21 to -0.06; p < 0.001). Nutritional status was negatively affected by TB (b = -0.30; 95% CI = -0.43 to -0.15; p < 0.001) and positively influenced by family income (b = 0.17; 95% CI = 0.03–0.31; p = 0.016), with income exerting both direct and indirect effects through TB. The path analysis model demonstrated good fit (Chi-square p = 0.068; RMSEA = 0.052; CFI = 0.981; TLI = 0.960). Conclusion:  The risk of TB among children under five increases with exposure to adult TB cases and living in humid housing conditions. Conversely, TB incidence decreases in children residing in well-lit homes with bedroom and living room windows and in highland areas. Nutritional status is influenced by both TB and family income, with income affecting TB directly and indirectly.
Pathways to Depression: A Multidimensional Composite Analysis of Socioeconomic Inequalities in a Population-Based Study Wahyu Tri Sudaryanto; Wahyuni; Firmansyah; Afif Ari Wibowo
Journal of Epidemiology and Public Health Vol. 11 No. 3 (2026)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2026.11.03.02

Abstract

Background: Socioeconomic factors are recognized as key contributors to the risk of depression among adults and older populations. However, socioeconomic status (SES) is often measured using single indicators, which may not capture its multidimensional nature. Moreover, the mechanisms through which socioeconomic conditions influence depression remain insufficiently explored. This study aimed to examine the pathways linking socioeconomic inequalities to depression using a multidimensional composite measure of SES. Subjects and Method: A cross-sectional analysis was conducted using data from the 2023 Indonesian Health Survey, a nationally representative population-based survey. SES was constructed using principal component analysis (PCA) based on wealth index, education level, employment status, participation in government social protection programs, and provincial-level income inequality (Gini index). Path analysis was performed to assess direct and indirect relationships between SES, physical activity, comorbidity, and depression. All analyses were conducted using STATA 17. Results: Higher SES was associated with a lower risk of depression. Significant pathways were observed from SES to depression both directly (β= -0.06; 95% CI= -0.07 to -0.06; p <0.001) and indirectly through comorbidity (β= -0.03; 95% CI= -0.03 to 0.02; p <0.001). Conclusion: Socioeconomic inequalities play a critical role in shaping depression risk through multiple pathways.
Determinants of Type 2 Diabetes Mellitus among Adults in Urban and Rural Areas of Sragen Regency, Central Java, Indonesia Novia Erliana Wandansari; Ika Sumiyarsi Sukamto; Setyo Sri Rahardjo; Erindra Budi Cahyanto; Revi Gama Hatta Novika
Journal of Epidemiology and Public Health Vol. 11 No. 2 (2026)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2026.11.02.07

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a non-communicable disease with increasing prevalence in both urban and rural areas. Differences in sociodemographic characteristics and health behaviors between urban and rural populations are suspected to influence the clinical profile and demographic characteristics of T2DM patients. This study aims to analyze differences in T2DM patient characteristics in adults in urban and rural areas of Sragen Regency, Indonesia, and identify the most dominant factors differentiating these two groups. Subjects and Method: This was a comparative observational analytical study with a cross-sectional design conducted in six health centers in Sragen Regency representing urban and rural areas. Research subjects were adult patients with T2DM who met inclusion criteria. Variables examined included age, sex, educational level, income, occupation, and physical activity. Data were collected using structured questionnaires and medical records. Bivariate analysis was performed using the Chi-square test, while multivariate analysis used binary logistic regression. Results: Significant differences were found between T2DM patients in urban and rural areas based on age (p=0.035), educational level (p=0.007), income (p=0.011), occupation (p=0.016), and physical activity (p=0.005). No significant difference was found in sex distribution between the two areas (p=0.078). Binary logistic regression analysis showed that physical activity was the most dominant factor differentiating T2DM patient characteristics in urban and rural areas (OR=2.326; p=0.007). Patients with low physical activity had 2.326 times higher odds of residing in urban areas compared to those with moderate or high physical activity. Conclusion: Physical activity is the most dominant factor differentiating T2DM patient characteristics between urban and rural areas. Area-specific T2DM prevention and control stra­tegies should prioritize physical activity improvement with approaches tailored to local community characteristics.
Health Belief Model Predictors of Tertiary Preventive Behavior and HbA1c Levels among Patients with Type 2 Diabetes Mellitus Anindya Wahyu Utami; Dono Indarto; Erindra Budi Cahyanto; Vitri Widyaningsih; Eti Poncorini Pamungkasari; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 11 No. 2 (2026)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2026.11.02.01

Abstract

Background: Type 2 diabetes mellitus (T2DM) remains a major public health challenge worldwide. This study applied the Health Belief Model (HBM) to examine its association with tertiary preventive behavior and HbA1c levels among patients with T2DM. The study aimed to analyze the effects of HBM constructs on tertiary preventive behavior and their impact on HbA1c levels in patients with T2DM. Subjects and Method: A quantitative study with a cross-sectional design was conducted among 210 patients with T2DM receiving outpatient care at UNS Hospital. Data were collected between September and October 2025. The independent variables included perceived susceptibility, perceived severity, perceived benefits, self-efficacy, and cues to action. The dependent variables were tertiary preventive behavior and HbA1c levels. Data were analyzed using univariate analysis, bivariate analysis with simple logistic regression, and multivariate analysis using path analysis in STATA 13. Results: Self-efficacy (b = 0.190; 95% CI = 0.029 to 0.350; p = 0.020), perceived benefits (b = 0.162; 95% CI = 0.021 to 0.301; p = 0.023), and cues to action (b = 0.294; 95% CI = 0.122 to 0.465; p = 0.001) had direct and significant effects on tertiary preventive behavior. Tertiary preventive behavior (b = −0.183; 95% CI = −0.307 to −0.085; p = 0.004), age (b = 0.134; 95% CI = 0.005 to 0.263; p = 0.041), duration of diabetes (b = 0.164; 95% CI = 0.035 to 0.295; p = 0.014), and family history of diabetes (b = 0.228; 95% CI = 0.104 to 0.351; p < 0.001) had direct and significant effects on HbA1c levels. Sex had direct but non-significant effects on both tertiary preventive behavior and HbA1c levels. Perceived susceptibility and perceived severity exerted indirect but significant effects on tertiary preventive behavior through perceived benefits. Conclusion: Self-efficacy, perceived benefits, cues to action, and sex directly influenced tertiary preventive behavior, whereas perceived susceptibility and perceived severity exerted indirect effects through perceived benefits. Furthermore, tertiary preventive behavior, duration of diabetes, age, family history of diabetes, and sex directly affected HbA1c levels.
Multilevel Analysis of District- and City-Level Contextual Factors Influencing Hypertension Risk Among Adults: An Analysis of Indonesian Health Survey Year 2023 Anindhita Saviorel Rivaldy; Bhisma Murti; Setyo Sri Raharjo; Vitri Widyaningsih; Eti Poncorini Pamungkasari
Journal of Epidemiology and Public Health Vol. 11 No. 2 (2026)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2026.11.02.04

Abstract

Background: Hypertension remains a major public health challenge in Indonesia, with prevalence continuing to rise across different population groups. The burden of hypertension varies across settings, including urban and rural areas, socioeconomic levels, and regional contexts. This study aimed to examine how district- and city-level contextual factors influence the risk of hypertension among adults in Indonesia. Subjects and Method: A cross-sectional study included a sample of 48,878 adults who participated in the 2023 Indonesian Health Survey (Survei Kesehatan Indonesia). The data were analyzed using multilevel multiple linear regression. Results: Multilevel analysis showed that the risk of hypertension increased among individuals aged ≥60 years (b= 4.12; 95% CI= 3.76 to 4.48; p < 0.001), compared with those aged <20 years. Senior high school or higher education (b= –0.40; 95% CI= –0.48 to –0.31; p <0.001) was associated with a lower risk of hypertension compared with individuals with no formal education. Higher BMI was associated with an increased risk of hypertension among individuals with BMI 18.5–25 kg/m² (b= 0.19; 95% CI= 0.09 to 0.30; p < 0.001) and BMI ≥25 kg/m² (b= 0.92; 95% CI= 0.82 to 1.03; p < 0.001). Female sex (b= 0.21; p < 0.001), urban residence (b= 0.06; p= 0.021), and high Gini Ratio (b = 0.17; p < 0.001) increased the risk of hypertension, whereas high physical activity and higher provincial minimum wage reduced the risk. The ICC of 0.37% indicated low variation across districts/cities. Conclusion: Hypertension risk among Indonesian adults is mainly driven by individual factors, while income inequality is the only contextual factor with a significant effect. These results emphasize the need for interventions targeting both personal health behaviors and socioeconomic disparities.
Meta-Analysis Correlations between Hypertension, Smoking, and Severity Risk of COVID-19 Lisa Safaah Novia Larsiani; Didik Gunawan Tamtomo; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 7 No. 3 (2022)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2022.07.03.04

Abstract

Background: Based on the reported cases, 16.9% of COVID-19 patients were accompanied by comorbidities. Hypertension and smoking are suspected to be one of the pathological determinants that play a role in clinical predictors that are predicted to cause a worsening of the patient's condition during the treatment period. This study aimed to examine correlations between hypertension, smoking, and severity risk of COVID-19.Subjects and Method: Meta-analysis was carried out using PRISMA flow diagrams. Article searches through journal databases include: PubMed, Science Direct, Google Scholar. articles used in 2020-2022. The PICOs in this study were, Population: COVID-19 patients, Intervention: hypertension and smoking Comparation: not hypertension and not smoking, Outcome: severity of COVID-19. The keywords in this study were “hypertention” OR “high blood pressure” AND “severe COVID-19” OR “severty COVID-19” OR “patient COVID-19 outcome” “cigarette” OR “smoking” OR “current smoker” OR former smoker” AND “severe COVID-19” OR “severty COVID-19” OR “patient COVID-19 outcome” Inclusion criteria were articles used in full paper articles with a cohort design, relationship size used with aOR, intervention given the association of hypertension and smoking on the severity of COVID-19. Eligible articles were analyzed using the Revman 5.3 application.Results: A meta-analysis of 12 cohort articles originating from Asia, America, Africa, Europe, concluded that COVID-19 treatment patients with hypertension had higher severity 1.82 times compared to those without hypertension (aOR= 1.82; 95% CI= 1.18 to 2.79; p=0.006). Likewise, COVID-19 treatment patients with smoking habit had higher severity than those who do not smoke (aOR= 0.62; 95% CI= 0.14 to 2.65; p=0.520).Conclusion: COVID-19 patients with hypertension have an increased risk of severity. COVID-19 patients with smoking lower risk of severity. Keywords: Severe COVID-19, hypertention, cigarette. Correspondence:Lisa Safaah Novia Larsiani. Masters Program in Public Health. Universitas Sebelas Maret, Jl.Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: nl.lisasafaah@gmail.com Mobile: 089536503803.
The Effectiveness of Wearing Mask and Physical Distancing in Preventing the COVID-19 Transmission Tri Nyantosani Widyawardani; Eti Poncorini Pamungkasari; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 7 No. 3 (2022)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2022.07.03.08

Abstract

Background: Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The increase in the number of cases was rapid, and spread to various countries in a short time. Based on epidemiological and virological studies, it has been proven that COVID-19 is transmitted from symptomatic (symptomatic) people to other people who are in close proximity through droplets and aerosols. The application of health protocols is very effective in preventing transmission. Wearing masks, keeping a distance and washing hands are very important in preventing the spread of COVID-19.Subjects and Method: This study is a meta-analysis using the PICO model. The population is the general public (adults over 18 years), the intervention is to wear masks properly and keep a distance. The comparison is not wearing a mask properly and not keeping a distance. The outcome is prevention of the spread of COVID-19. The articles used in this study were obtained from three databases, namely Google Scholar, PubMed, and Science Direct. The keywords to search for articles were “mask” AND “covid transmission” “physical distancing” AND “cross sectional study”, from 2019 to 2021. The selection of articles was carried out using the PRISMA flow diagram. Articles were analyzed using the Review Manager 5.3 application.Results: A total of 9 case studies from the African, American and Asian continents were selected for systematic review and meta-analysis. The results showed that the use of masks was 2.10 times effective in preventing transmission of COVID-19 and was statistically significant (aOR= 2.10; 95% CI= 1.54 to 2.85; p<0.001). Maintaining an effective distance of 2.35 times in preventing transmission of COVID-19 and statistically significant (Aor= 2.35; 95% CI= 1.44 to 3.83; p<0.001).Conclusion: Wearing a mask and keeping a distance is effective in preventing the spread of COVID-19. Keywords: mask, physical distancing, covid transmission Correspondence:Tri Nyantosani Widyawardani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: nyantosani@gmail.com. Mobile: +62811284836.

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