Comparison of Cardiovascular Disease-Related Mortality and Morbidity in Urban and Rural Residential Areas in Jatinangor Subdistrict, West Java, Indonesia: An Epidemiological Community Study

Abstract

Objectives: Residential areas are considered part of the sociocultural aspect for determining health but are rarely studied in a cardiovascular disease-community study in developing countries. Jatinangor, considered a university area, has unique characteristics surrounded by urban and rural villages. We aim to investigate the association of residential areas in Jatinangor with cardiovascular morbidity and mortality.

Methodology: A cross-sectional study from July to November 2018 was done in appointed rural and urban areas in Jatinangor district, West Java, Indonesia. Cardiovascular disease is defined using a self-reported questionnaire. Cardiovascular death was identified through a verbal autopsy performed by a general practitioner as an interviewer. The morbidity data were obtained from September to October 2018, while the mortality data were obtained from July to November 2018. Poisson regression was done to determine the association of residential areas to cardiovascular disease morbidity.

Results: Data were obtained from 1469 respondents; 58.7% were from rural areas. The prevalence of cardiovascular disease morbidity is higher in urban than rural areas (5.6% vs. 2.5%, p=0.004). There were 42 cases of death reported during the study period, with 33 deaths considered caused by cardiovascular disease. The urban-rural differences in cardiovascular mortality showed no significant differences (p=0.388). The unadjusted model of the association of the urban-rural residential area with cardiovascular disease morbidity was (PR 2.253 (95% CI 1.262, 4.024)) while the adjusted model was (PR 2.264 (95% CI 1.257, 4.078, p = 0.007)).

Conclusion: Urban area is associated with two times higher cardiovascular disease morbidity but not with mortality than those who live in rural areas.