臺灣博碩士論文加值系統

研究目的：探討社經地位、地區剝奪與老人存活狀況的關係。
研究設計：老人社經地位資料來自「1989年台灣地區老人保健與生活問題調查」，地區剝奪資料則來自林慧淳之碩士論文。存活狀況資料則來自衛生署家庭計畫研究所對該調查的老人樣本1989至1996年追蹤結果。
研究對象： 1989年時年滿60歲的老人隨機樣本4,049名。
研究結果：（1）社經地位較低的老人，有較高的死亡率；（2）地區剝奪與老人存活狀況的關係不顯著；（3）老人的社經地位對其存活狀況的影響較地區剝奪的強烈。
結 論：社經地位與台灣老人存活的機率相關，但地區剝奪則否。

Objective─To examine the relationship between survival status, and socioeconomic status, and area deprivation among elderly adults in Taiwan.
Design─Data on socioeconomic status came from 񓟥 Survey of Health and Living Status of the Elderly in Taiwan", and data on area deprivation from Huey-chwen Lin’s master themes. Data on survival status came from a follow-up study conducted by the Taiwan Provincial Institute of Family Planning between 1989 and 1996.
Subjects─Random sample of 4,049 people aged above 60 in 1989.
Results─（1）Elderly adults with lower socioeconomic status tended to have a high mortality rate. （2）Area deprivation was not significantly associated with the survival status of elderly adults. （3）The socioeconomic status of elderly adults is more powerful than area deprivation in determining their survival status.
Conclusion─Socioeconomic status is associated with the survival probability of elderly adults in Taiwan whereas area deprivation is not.

第一章 前言 1
第一節 研究緣起 1
第二節 研究目的 3
第三節 論文結構 3
第二章 文獻探討 4
第一節 社經地位的概念與測量 4
一、 社經地位的概念 5
二、 社經地位的測量 9
第二節 地區剝奪的概念與測量 12
一、 地區剝奪的概念 14
二、 地區剝奪的測量 15
第三節 社經地位、地區剝奪與健康狀況的關係 17
一、 社經地位與健康狀況的關係 17
二、 地區剝奪與健康狀況的關係 23
三、社經地位與地區剝奪的相對重要性 26
第三章 研究方法與材料 28
第一節 研究架構與研究假說 28
第二節 變項定義與測量 30
一、 依變項 30
二、 自變項 30
三、 控制變項 32
第三節 研究材料 33
一、 抽樣設計 33
二、 資料蒐集與訪查結果 33
三、 社會人口學資料的校正 34
四、 存活狀況資料 35
五、 缺失值特性 35
第四節 資料分析方法 36
一、 描述性統計 36
二、 分析性統計 36
第四章 結果 38
第一節 老人樣本特性 38
一、 老人存活狀況 38
二、 老人社經地位變項分佈 39
三、 老人居住地區剝奪程度變項分佈 39
四、 其他控制變項分佈 40
第二節 影響老人存活狀況的因素：雙變項分析 41
一、 社經地位變項 41
二、 居住地區剝奪程度變項 42
三、 同一地區剝奪程度，社經地位是否與老人存活狀況有關 42
四、 其他控制變項 43
第三節 影響老人存活狀況的因素：多變項分析 44
一、 社經地位對老人存活狀況的影響 44
二、 地區剝奪對老人存活狀況的影響 45
三、 社經地位對老人存活狀況的影響是否大於地區剝奪 46
第五章 討論 48
第一節 假說的驗證與討論 48
一、 社經地位較低的老人，死亡率較高 48
二、 地區剝奪程度對老人存活狀況的影響不顯著 49
三、 社經地位是較重要的老人存活狀況之影響因素 49
第二節 建議 49
一、 提供低收入老人維持適當生活水準的生活津貼 50
二、 進行其他健康指標的研究 50
參考文獻 51
附錄一 「台灣地區老人保現與生活問題調查表」有關社經地位的問卷77
附錄二 老人樣本居住地區之地區剝奪程度，依地區剝奪指數分 78
附錄三 老人樣本社會人口學資料校正結果 79

一、 中文部份：
1. Abbott P, Wallace C. 女性主義觀點的社會學（俞智敏、陳光達、陳素梅、張君玫譯）。巨流出版社，1995。
2. Giddens A. 社會學（上）（張家銘等譯）。唐山出版社，1997。
3. Light D, Keller S. 社會學（林義男譯）。巨流出版社，1995。
4. Smelser NJ. 社會學（陳光中、秦文力、周愫嫻譯）。桂冠圖書公司，1991。
5. Turner JH. 社會學（張君玫譯）。巨流出版社，1996。
6. 呂宗學：台灣地區區域經濟發展與死亡率的相關研究。台灣大學公共衛生研究所碩士論文，1990。
7. 林福田：社經狀況與結核病發生之區域變異及其相關研究。國立陽明大學公共衛生研究所碩士論文，1998。
8. 李宜家：社區剝奪程度與個人社經地位對吸菸行為之影響。國立台灣大學公共衛生學院衛生政策與管理研究所碩士論文，2000。
9. 胡幼慧：社會流行病學。巨流圖書公司，1995。
10. 胡幼慧、林芸芸、吳肖琪：台灣地區社會流行病學之分佈：六項死因之小區域分析。人口學刊 1990; 13: 83-106。
11. 莊義利：台灣老人的社會人口特徵與四年死亡率之相關分析。東海大學社會學系碩士論文，1993。
12. 張華葆：社會階層。三民書局，1987。
13. 許嘉猷：社會階層化與社會流動。三民書局，1992。
14. 廖正宏：差別死亡率及病態之研究。思與言 1976; 13: 353-66。
15. 劉坤仁：台灣地區的社會階層與健康不平等。國立台灣大學公共衛生學研究所碩士論文，1996。
二、英文部份：
1. Adler NE, Boyce W, Chesney MA, Cohen S, Folkman S, Kahn RL, et al. Socioeconomic status and health: the challenge of the gradient. Am Psychol 1994; 49: 15-24
2. Antonovsky A. Social class, life expectancy and overall mortality. Milbank Q. 1967; 45: 31-73
3. Arber S, Cooper H. Gender differences in health in later life: the new paradox? Soc. Sci. Med. 1999; 48: 61-76
4. Backlund E, Sorlie PD, Johnson NJ. The shape of the relationship between income and mortality in the United States: evidence from the National Longitudinal Mortality Study. Ann Epidemiol 1996; 6:12-20
5. Beckett M. Converging health inequalities in later life----an artifact of mortality selection? J. health and Social Behavior 2000; 41: 106-119
6. Black D, Marris JN, Smith C, Townsend P. The Black Report. In: Townsend P, Davidson N, Whitehead M, eds. Inequalities in Health. London: Penguin, 1988; 31-213.
7. Breeze E, Sloggett A, Fletcher AE. Socioeconomic status and transitions in status in old age in relation to limiting long-term illness measured at the 1991 Census. Euro. J. Public Health 1999; 9: 265-70.
8. Carstairs V, Morris R. Deprivation: explaining differences in mortality between Scotland and England and Wales. BMJ 1989; 299: 886-9.
9. Carstairs V. Deprivation indices: their interpretation and use in relation to health. Journal of Epidemiology and Community Health 1995; 49(suppl 2): S3-S8.
10. Curtis S, Jones IR. Is there a place for geography in the analysis of health inequality? In: Bartley M, Blane D, Davey Smith G, eds. The Sociology of Health Inequalities. UK: Blackwell Publishers, 1998; 85-112
11. Davey Smith G, Egger M. Socioeconomic differences in mortality in Britain and the United States. AJPH 1992; 82: 1079-1081
12. Davey Smith G, Shipley MJ, Rose G. Magnitude and causes of socioeconomic differentials in mortality: further evidence from the Whitehall Study. J Epidemiol Community Health 1990; 44: 265-70
13. Der G, Macintyre S, Ford G, Hunt K, West P. The ewlationship of household income to a range of health measures in three age cohorts from the West of Scotland. European Journal of Public Health 1999; 9: 271-7
14. Eachus J, Williams M, Chan P, Davey Smith G, Grainge M et al. Deprivation and cause specific morbidity: evidence from the Somerset and Avon survey of health. BMJ 1996; 312: 287-92
15. Eames M, Ben-Shlomo Y, Marmot MG. Social deprivation and premature mortality: regional comparison across England. BMJ 1993; 307: 1097-1102
16. Ecob R, Simth GD: Income and health: what is nature of the relationship? Soc. Sci. Med. 1999; 48(1): 693-705
17. Elo IT, Preston SH. Educational differentials in mortality: United States, 1979-1985. Soc. Sci. Med. 1996; 42: 47-57.
18. Ettner SL. Newevidence on the relationship between income and health. J Health Economics 1996; 15: 67-85.
19. Feinstein. The relationship between socioeconomic status and health: a review of the literature. Milbank Q. 1993; 71: 279-322
20. Fox AJ, Goldblatt PO, Jones DR. Social class mortality differentials: artefact, selection or life circumstances? J Epidemiol and Community Health 1985; 39: 1-8.
21. Geyer S, Peter R. Income, occupational position, qualification and health inequalities — competing risk? ( Comparing indicators of social status) J Epidemiol Community Health 2000; 54: 299-305.
22. Gunnell D, Peters TJ, Kammerling RM, Brooks J. Relation between parasuicide, suicide, psychiatric admissions, and socioeconomic deprivation. BMJ 1995; 311: 226-30.
23. Haan MN, Kaplan GA, Camacho T. Poverty and health: prospective evidence from the Alameda County Study. Am J. Epidemiol. 1987; 125: 989-998
24. Hayward MD, Pienta AM, McLaughlin. Inequality in men’s mortality: the socioeconomic status gradient and geographic context. J. Health and Social Behavior 1997; 38: 313-330
25. House JS, Kessler RC, Herzog AR, et al. Age, socioeconomic status, and health. Milbank Q. 1990; 68: 383-411
26. Kaplan GA, Camacho T. Perceived health and mortality: a nine-year follow-up of the human population laboratory cohort. Am J Epidemiol 1983; 117: 292-304.
27. Kaplan GA, Seeman TE, Cohen RD, Knudsen LP, Guralnik J. Mortality among the elderly in the Alameda County study: behavioral and demographic risk factors. AJPH 1987; 77: 307-312
28. Kitigawa EM, Hauser PM. Differential mortality in the United States: a study in socioeconomic epidemiology. Cambridge: Harvard University Press, 1973
29. Krieger N, Williams DR, Moss NE. Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu. Rev Public Health 1997; 18: 341-378
30. Lynch JW, Kaplan GA, Shema SJ. Cumulative impact of sustained economic hardship on physical, cognitive, psychological, and social functioning. N Engl J Med 1997; 337: 1889-95
31. Macintyre S, Maciver S, Sooman A. Area, class and health: should we be focusing on place or people? Inl Soc. Pol. 1993; 22: 213-234
32. Macintyre S. The black report and beyond what are the issues? Social Science and Medicine 1997; 44: 723-45.
33. Marmot M. Epidemiology of socioeconomic status and health: are determinants within countries the same as between countries? Ann. N. Y. Acad. Sci. 1999; 896: 16-29.
34. Marmot MG, Kogevinas M, Elston MA. Social/economic status and disease. Ann. Rev. Public Health 1987; 8: 111-35.
35. McCarron PG, Davey Smith G, Womersley JJ. Deprivation and Mortality in Glasgow: changes from 1980 to 1992. BMJ 1994; 309: 1481-2.
36. McDonough P, Duncan GJ, Williams D, House J. Income dynamics and adult mortality in the US, 1972 through 1989. Am. J. Public Health 1997; 87: 1476-1483
37. McLoone P, Boddy FA. Deprivation and mortality in Scotland, 1981 and 1991. BMJ 1994; 309: 1465-70.
38. Mitchell EA, Stewart AW, Crampton P, Salmond C. Deprivation and sudden infant death syndrome. Social Science and Medicine 2000; 51: 147-50.
39. Payne G, Payne J, Hyde M. ‘Refuse of all classes’? Social indicators and social deprivation. Sociological Research Online 1996; 1,1, http://www.socresonline.org.uk/socresonline/1/1/3.html
40. Phillimore P, Beattie A, Toensend P. Widening inequality of health in northern England, 1981-1991. BMJ 1994; 308: 1125-1128.
41. Popay J, Williams G, Thomas C, Gatrell T. Theorising inequalities in health: the place of lay knowledge. Sociology of Health & Illness 1998; 20: 619-644.
42. Robert SA, House JS. Socioeconomic inequalities in health: integrating individual-, community-, and societal-level theory and research. In: Albrecht GL, Fitzpatrick R, Scrimshaw SC, eds. Handbook of Social Studies in Health and Medicine. London: SAGA Publication, 2000; 116-35.
43. Robert SA. Community-level socioeconomic status effects on adult health. J Health and Social Behavior 1998; 39: 18-37.
44. Robert SA. Socioeconomic position and health: the independent contribution of community socioeconomic context. Annu. Rev. Sociol. 1999; 25:489-516.
45. Ross CE, Wu CL. Education, age, and the cumulative advantage in health. J Health and Social Behavior 1996; 37: 104-120.
46. Salmond C, Crampton P, Hales S, Lewis S, Pearce N. Asthma prevalence and deprivation: a small area analysis. Journal of Epidemiol Community Health 1999; 53: 476-80.
47. Shaw M, Gordon D, Dorling D, Mitchell R, Davey-Smith G. Increasing mortality differentials by residential area level of poverty: Britain 1981-1997. Social Science and Medicine 2000; 51: 151-3.
48. Sloggett A, Joshi H. Higher mortality in deprived areas: community or personal disadvantage? BMJ 1994; 309: 1407-4.
49. Solie PD, Backlund E, Keller JB: US mortality by economic demographic and social characteristics: the National longitudinal Mortality Study. Am. J. Public Health 1995; 85: 949-956.
50. Taiwan Provincial Institute of Family Planning. 1989 Survey of Health and Living Status of the Elderly in Taiwan: Questionnaire and Survey Design. 1989.
51. Townsend P. The International Analysis of Poverty. Maylands: Harvester Wheatsheaf, 1993.Chapter 2: Conceptualising Poverty.
52. Waitzman NJ, Smith KR. Phantom of the area: poverty-area residence and mortality in the United States. AJPH 1998; 88: 973-6.
53. Whitehead M. Diffusion of ideas on social inequalities in health: a European perspective. Milbank Q. 1998; 76: 469-492
54. Williams DR & Collins C. US socioeconomic and racial differences in health: patterns and explanations. Annu. Rev. Sociol. 1995; 21: 349-86
55. Williams DR. Socioeconomic differentials in health: a review and redirection. Social Psychology Quarterly 1990; 53: 81-99
56. Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: hoe wducation, income, and occupation contributte to risk factors for cardiovascular disease. AJPH 1992; 82: 816-20.
57. Yen IH, Kaplan GA. Poverty area residence and changes in physical activity level: evidence from the Alameda County Study. AJPH 1998; 88: 1709-12.