Analysis of structural equation modeling (SEM) the most significant risk factor for Hypertension in the islands regionAnálisis de modelos de ecuaciones estructurales (SEM): El factor de riesgo más significativo para la hipertensión en la región insular

Introduction: hypertension is a non-communicable disease which is a major global public health challenge, especially in areas with limited access to health such as island areas. Island residents also have the potential to experience hypertension, the more dominant factor in this region is limited access to health facilities. While lifestyle, work and physical activity also play a role, barriers to obtaining health services are the main factors influencing the prevalence of hypertension in the islands. This study aims to analyze the risk factors for hypertension on three islands in Sangkarrang Islands District, Makassar City, namely Barrang Lompo Island, Kodingareng Island, and Barrang Caddi Island. Method: the method used is approach Structural Equal Modeling (SEM) to identify the risk factors that most influence the incidence of hypertension. Results: the results of the analysis show that physical activity has a very strong and significant influence on hypertension, with the highest path coefficient on Barrang Lompo Island (0,924). Non-compliance in medication consumption is also the dominant factor contributing to the increase in hypertension on all islands, Kodigareng Island has the highest coefficient of 0,972. Knowledge is also an important factor that contributes to the management of hypertension on all islands, with the greatest influence on Barrang Caddi Island (0,858). On the other hand, the National Health Insurance (JKN) factors (0,197-0,719), distance to health facilities (0,388-0,577), and duration of suffering from hypertension (0,297-0,541) show a weaker and not always significant influence on hypertension. Conclusions: the factors that most influence hypertension on the three islands are physical activity, adherence to treatment, indirect costs, and level of knowledge. Therefore, effective interventions in controlling hypertension in island regions must focus on improving healthy lifestyles, health education, adherence to treatment, and reducing economic barriers in accessing health services.

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