Spatial Distribution and Factors Contributing to the Spatial Clustering of Hypertension in Thai Older Population
Abstract
This correlational study aimed to describe hypertension's spatial distribution and clustering, comparing demographic, social and health, and Active Ageing Index (AAI) factors between high-risk and low-risk areas. The study areas covered 76 provinces of Thailand (excluding Bangkok), utilizing secondary data in 2022. Spatial data analysis was performed with GeoDa 1.20, and map presentations were created using QGIS 3.30.3. The differences in mean values of variables between high-risk and low-risk areas were analyzed using SPSS 29.0. Statistics used included prevalence, proportion, Spatial Empirical Bayesian smoothed rates, Moran’s, LISA, and t-tests.
The results showed that the median of hypertension prevalence rates by province in 2022 was 40.07% (Minimum=26.83, Maximum=54.30). A total of 11 provinces (14.5%) recorded prevalence rates exceeding the target threshold (not exceeding 31.5%). Spatial clustering analysis identified 12 provinces (15.8%) as high-risk areas and 16 provinces (23.7%) as low-risk areas. The factors that showed statistically significant differences between high-risk and low-risk areas were the proportion of older persons (P = 0.008), density of alcohol distribution points (P = 0.010), and the AAI in Independent, Health, and Secure Living (P = 0.018). These findings underscore the critical need to prioritize and allocate resources for mitigating risk and enhancing care for elderly individuals with hypertension, particularly in high-risk areas in which special attention should be given to provinces characterized by a high proportion of older population, high density of alcohol distribution points, and elevated scores on AAI in Independent, Health, and Secure Living.
References
Bureau of Policy and Strategy, Office of Permanent Secretary of Ministry of Public Health. (2022). Public Health Statistics 2022. Retrieved 5 August 2023 from https://dmsic.moph.go.th/index/detail/9127
Department of Medical Services (DMS), Ministry of Public Health. (2020). A guide to providing new-style diabetes and hypertension clinic services, focusing on people (for practitioners) 2563. Retrieved 22 August 2023 from https://dmsic.moph.go.th/index/detail/8448
Department of Medical Services (DMS), Ministry of Public Health. (2020). Handbook of Integrated, People-Centered Health Service in New Normal Diabetic&Hypertensive Clinic (For Healthcare Workers. Retrieved 22 April 2023
Department of Medical Services (DMS), Ministry of Public Health. (2022). Final research report: Development of a new service model for patients with non-communicable diseases (diabetes and hypertension). Retrieved 22 April 2023 from https://agingthai.dms.go.th/agingthai/wp-content/uploads/2023/01/research_01.pdf
Ekpalakorn, W., Phakcharoen, H., Sathiannoppakao, W. (2021).The 6th National Health Examination Survey
-2020. Retrieved 22 August 2023 https://www.hsri.or.th/printed-matter/399
IBM Corporation. (2023). SPSS Statistics (Version 29.0) [Computer software]. IBM Corporation. https://muit.mahidol.ac.th/docs/users-guide/manual-install-programs/manual-spss/manual-install-spss29-windows/
Kanchanapibulwong, A., Khamwangsanga, P., Kaewta, S. eds. (2020). Situation report on NCDs, diabetes, hypertension and related risk factors 2019. Bangkok: Aksorn Graphic and Design Publishing.
Krainara, K. (2022). The Effect of Taste Stimulation Program fer Sodium Intake among High Risk of Hypertension. Thammasat University Hospital Journal. 7(3), 83-94. https://he02.tci-thaijo.org/index.php/TUHJ/article/view/260570
Luc Anselin. (2023). Geoda TM (Version 1.20) [Computer software]. https://geodacenter.github.io/download_windows.html
Luxsana, P. (2022). Perceived Health and Behavioral Health of Patients with Diabeted Mellitus in the Inter Medicine Ward at Chumphon Khet Udomsak Hospital, Thailand. Thai Jounal of Plublic Health and Health Sciences; TJPHS. 15-32. file:///C:/Users/to3ii/Downloads/002-%E0%B8%A5%E0%B8%B1%E0%B8%81%E0%B8%A9%E0%B8%93%E0%B8%B2_1.pdf
Maairkien, S., Areechokchai, D., Saita, S., & Silawan, T. (2020). Time Series Analysis and Forecast of Influenza Cases for Different Age Groups in Phitsanulok Province, Northern Thailand. Current Applied Science and Technology, 20(2), 310-320. https://doi.org/10.14456/cast.2020.18
McNeil, E., Inthawong, Y., Assanangkornchai, S. (2015). Access to alcohol and binge drinking among vocational college students: A multilevel study in a tourist destination province of Thailand. The International Journal of Alcohol and Drug Research, 5(2), 47-55.
National Statistical Office, Ministry of Digital Economy and Society. (2017). Active Ageing Index of Thai Elderly. Bangkok: Text and Journal Publication Co., Ltd.
National Statistical Office, Ministry of Digital Economy and Society . (2024). Active Ageing Index of in Thailand 2024. Text and Journal Publication Co., Ltd.
National Statistical Office, Ministry of Digital Economy and Society . (2021). The 2021 health behavior of population survey. Retrieved 22 August 2023 from https://www.nso.go.th/nsoweb/storage/survey_detail/2023/20230505110449_84709.pdf
National Health Security Office. (2022). National Health Security System Development Report, Fiscal Year 2022. Bangkok: Saengchan Printing Limited Partnership.
National Health Security Office. (2019). A network of 38 civil society organizations and Isan farmers submitted a proposal to the Hazardous Substances Committee to ban 3 harmful chemicals. Retrieved 22 April 2025 from https://ddc.moph.go.th/odpc7/news.php?deptcode=odpc7&news=9879&news_views=155
Office of International Policy Development. (2017). Report on the burden of disease and injury in the Thai population 2014. Nonthaburi: The Graphic Systems Co., Ltd.
Office of the Permanent Secretary of Ministry of Public Health, (2023). Health Data Center (HDC). Retrieved 22 August 2023 from
https://hdc.moph.go.th/center/public/standard-report-detail/e46c73b57c9eeb2f07759a9e9bc50fb3
Official statistics registration systems, Department of Provincial Administration, Ministry of Interior. (2023). Elderly population. Retrieved 22 August 2023 from https://stat.bora.dopa.go.th/stat/statnew/statMenu/newStat/home.php
QGIS Development Team. (2022). QGIS Geographic Information System (Version 30.30.3) [Computer software]. https://www.qgis.org/en/site/index.html
Saita, S., Silawan, T., Parker, D. M., Sriwichai, P., Phuanukoonnon, S., Sudathip, P., Maude, R. J., White, L. J., & Pan-Ngum, W. (2019).
Spatial Heterogeneity and Temporal Trends in Malaria on the Thai⁻Myanmar Border (2012_2017): A Retrospective Observational Study. Tropical medicine and infectious disease, 4(2), 62. https://doi.org/10.3390/tropicalmed4020062
Saita, S., Maeakhian, S., & Silawan, T. (2022). Temporal Variations and Spatial Clusters of Dengue in Thailand: Longitudinal Study before and during the Coronavirus Disease (COVID-19) Pandemic. Tropical medicine and infectious disease, 7(8), 171. https://doi.org/10.3390/tropicalmed7080171
Sanont, R. (2019). Marketing Communication of High Calories Food Related to Obesity Consuner Behavior in Adolescents. PSAKU Intenational jounal of interdisciplinary Research, 8(2), 434-444. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3553086
Samranbua, A., Thamchareontakul, B. Optimal Healthy Lifestyle for High Blood Pressure Reduction. The Journal of Baromarajanani College of Nursing, Nakhonratchasima, 23(2), 121-132. https://he02.tci-thaijo.org/index.php/Jolbcnm/article/view/105947/83994
Sammatat, S., Boonsith, N., & Lekdee, K. (2015). Mathematical spatial analysis for multiple disease mapping applications to hypertension and ischemic heart disease. Retrieved 22 August 2023 from https://sci.rmutp.ac.th/web2558/wp-content/uploads/2017/09/research_2557/Exp/2557Exp_sunee.pdf
Siripanitch, S., Mueanphung P., Saengchanthip, A., Direkphok, B. (2011). Cold Weather Death Surveillance in Thailand, October 2010 – February 2011. Weekly Epidemiological Surveillance Thailand, 42(44). https://he05.tci-thaijo.org/index.php/WESR/article/view/2747/2550
Strategy and Planning Division, Office of Permanent Secretary of Ministry of Public Health. (2022). Annual Report 2022. Bangkok: Aksorn Graphic and Design Publishing.
Strategy and Planning Division, Office of Permanent Secretary of Ministry of Public Health. (2023). Five-year government action plan (2023 - 2027). Retrieved 5 August 2023 from https://spd.moph.go.th/wp-content/uploads/2023/05/MOPH_plan-66-70-for-web.pdf
Suranaree University of Technology. (2022) SUT and the “Wellness Wconomic Corridor of Thailand” in Southern Isaan. Retrieved 22 April 2025 from https://www.sut.ac.th/pridemag/article/detail/28
The Excise Department. (2023). Number of registered alcohol-selling stores in 2022 [Personal communication]. 5 september 2023.
Verapol, K., Nithirat, B., (2020). The Delvelopment of Elderly Health Screening and Elderly Health Promoting Program for Preventive
Long-Term Care, based on the Concept: “Do not fall, do not forget, do not depress and good eats” Regionak Helth Promotion Center 9 Journal, 14(34), 158-171. https://he02.tci-thaijo.org/index.php/RHPC9Journal/article/view/242483/165587
Whitehead, M. (1992). THE CONCEPTS AND PRINCIPLES OF EQUITY AND HEALTH. International Journal of Health Services, 22(3), 429–445. Retrieved 22 April 2025 from http://www.jstor.org/stable/45131055
World Health Organization (WHO). (2022). Global status report on noncommunicable disease 2022. Geneva: World Health Organization.
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