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International Symposium of Public Health and International Conference of Epidemiology Public Health

ASSOCIATION OF HEALTH CARE ACCESS, LIFESTYLE, AND OCCUPATIONAL ENVIRONMENT WITH INFERTILITY RISK IN THE AGRICULTURAL REGION OF JEMBER

Date Published : 15 September 2026

Contributors

Olivia Listiowati Prawoto

Universitas Jember
Author

Ristya Widi Endah Yani

Universitas Jember
Author

Ulfa Elfiah

Universitas Jember
Author

Mei Syahfriadi

Universitas Jember
Author

Keywords

infertility health care access lifestyle occupational environment agriculture

Proceeding

(2026): PROCEEDING OF 9th INTERNATIONAL SYMPOSIUM OF PUBLIC HEALTH (ISOPH)

Track

General Track

License

Copyright (c) 2026 International Symposium of Public Health and International Conference of Epidemiology Public Health

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Abstract

Background: Infertility is a growing reproductive health problem in Indonesia. The Global Cancer Observatory (2020) reported 61,103 new cases related to women’s reproductive health. In Jember Regency, the prevalence of infertility reaches 15%, while coverage of reproductive health examinations is only 30% among rural women of reproductive age. Method: An analytic case–control study was conducted among 115 respondents (29 cases; 86 controls). Three predictor constructs were built as composite indices: health care access (active National Health Insurance [JKN], screening services, service quality, distance, travel time, cost), lifestyle (smoking, alcohol use, diet, physical activity, hygiene, sanitation), and occupational environment (chemical exposure, working hours, personal protective equipment use). Logistic regression was applied (α = 0.05). Result: The logistic model was significant (χ² = 59.709, df = 3, p < 0.001) with Nagelkerke R² = 0.439. Classification performance was good (accuracy = 0.740; sensitivity = 0.735; specificity = 0.744) and AUC = 0.836. The Hosmer–Lemeshow test indicated good fit (χ² = 9.810, df = 8, p = 0.279). All three constructs showed protective and significant associations with infertility risk: Access_index (B = −0.728; OR = 0.483; p = 0.0037), Lifestyle_index (B = −1.330; OR = 0.264; p < 0.001), and Work_index (B = −1.296; OR = 0.274; p < 0.001). The effect of Access_index was relatively smaller, consistent with the minimal contribution of distance and travel time within the access construct. Conclusion: Health care access, lifestyle, and occupational environment are significantly associated with infertility risk, with lifestyle and occupational factors showing the dominant effects. Policy recommendations should prioritize health-promoting lifestyles, strengthening occupational safety and health (OSH) and PPE adherence, and expanding JKN/screening with improvements in service quality and affordability—rather than focusing solely on geographic barriers.

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How to Cite

Olivia Listiowati Prawoto, O. L. P., Ristya Widi Endah Yani, R. W. E. Y., Ulfa Elfiah, U. E., & Mei Syahfriadi, M. S. (2026). ASSOCIATION OF HEALTH CARE ACCESS, LIFESTYLE, AND OCCUPATIONAL ENVIRONMENT WITH INFERTILITY RISK IN THE AGRICULTURAL REGION OF JEMBER . International Symposium of Public Health and International Conference of Epidemiology Public Health, 130-149. https://e-conference.unair.ac.id/isoph/paper/view/1572