Health Promoting Factors at the Household Level, Sung Noen District, Nakhon Ratchasima Province, Thailand: Comparison of Municipal and Non-Municipal Areas

Abstract

Personal health is influenced and related to health promoting factors at the upper levels, in particular household level which varies by area of ​​residence. Differences in area of ​​residence in terms of physical, development, and community health improvement activities performed by the local authorities, involving organizations, and community result in differences in health promoting factors at the household level. This survey aimed to assess health promoting factors at the household level, comparing between municipal and non-municipal areas in Sung Noen District, Nakhon Ratchasima Province, Thailand. The study variables covered holistic health promoting factors at the household level including social and environmental factors, sufficiency economy, and happiness. The samples were 217 households in municipal areas (114 households) and non-municipal areas (103 households) of Sung Noen District, recruited by simple random sampling. In each household, data were collected from representatives of households aged ≥18 years using an interview form. The interview form comprised of five parts: general data and illnesses of household members, social factors, environmental factors, sufficiency economy factors, and happiness factors. The overall and individual health promoting factors were interpreted by categorizing the total score into 3 levels as follows: households had high health promoting factors (80-100%), households had moderate health promoting factors (60-79%), and households had low health promoting factors (0-59%). Data were processed and analyzed by using EpiData version 3.10 and SPSS Statistics 18.0. The statistics used were percentages, arithmetic means, standard deviations, and t-tests. This research was conducted in accordance with human research ethics practice. The research project was approved by the Human Research Ethics Committee, Faculty of Public Health, Mahidol University [COA. No. MUPH 2018-168; Protocol No. 151/2561; Date of Approval 28 November 2018]. The results showed that 42.1% of households in municipal areas and 40.8% of households in non-municipal areas had 3-4 household members. Municipal households had more children and older-aged people than did non-municipal areas. Households in the municipalities had a higher number of household members suffering from chronic non-communicable diseases than those outside the municipalities (59.6% and 50.5%, respectively). Households in the municipal areas had health promoting factors at a high level as follows: environmental factors 85.1%, social factors 30.7%, sufficiency economy factors 24.6%, and happiness factors 7.0%. Households in non-municipal areas had health promoting factors at a high level in relation to the environmental factors (98.1%), social factors (76.7%), sufficiency economy factors (44.7%), and happiness factors (13.6%). Mean scores for household health promoting factors in non-municipal areas were significantly higher than those in municipal areas (p < 0.01) on overall, social, environmental, and sufficiency economy factors. There was no difference in happiness (p = 0.09). Under 60% of households in municipal areas had health promoting factors in terms of applying unused materials or building vegetable and fruit plots in the household, not buying underground lottery tickets regularly, having confidence or trust in the operation of the local authorities, trusting or accepting community leaders, making a household account, not buying luxury items, planning for more learning, and having enough income. Less than 60% of households in non-municipal areas had health promoting factors in terms of making a household account, having enough income, doing activities together with family members outside the house, and planning for more learning. The findings indicated that household-level factors which are conducive to good health should be promoted or brought about with a focus on sufficiency economy and happiness in both areas and on social aspects in municipal areas.