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研究生:張慈桂
研究生(外文):Tzu-Kuei Chang
論文名稱:家庭社會經濟地位與學齡前兒童健康關聯之探討
論文名稱(外文):A Study on the Association between Family’s Socioeconomic Status and Preschool Children’s Health
指導教授:藍忠孚藍忠孚引用關係
指導教授(外文):Chung-Fu Lan
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:公共衛生研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
畢業學年度:92
語文別:中文
論文頁數:146
中文關鍵詞:社會經濟地位集群分析學前兒童健康狀況醫療利用
外文關鍵詞:socioeconomic statuscluster analysispreschool childrenhealth statusmedical care utilization
相關次數:
  • 被引用被引用:17
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  • 收藏至我的研究室書目清單書目收藏:3
兒童是一個國家未來的希望,兒童期的健康對於未來青少年期至成年期的健康均有所影響,奠基孩童健康等於是替國民健康的提升注入穩固的基礎。學齡前兒童健康發展對之後個體健康有莫大的重要性,兒童的無法自主、依賴及需要照護,使得其所處之家庭背景對其健康產生明顯的影響。
本研究以橫斷面的調查資料,收集3~6歲學齡前兒童家戶資料,探討家庭社會經濟地位對其健康狀況、預防保健及醫療利用情形之影響,並嘗試建構探討影響學前兒童健康狀況、預防保健及醫療利用之模式。
一般對於家庭社會經濟地位的探討,常以教育、職業及所得個別進行分析,本研究同時嘗試以集群分析(cluster analysis)的方式,將相關社會經濟地位指標區分為高社經地位,及低社經地位兩類,進一步探討整體家庭社會經濟地位對學前兒童罹病、父母自覺兒童健康、各類醫療利用及就醫便利性的影響。
研究結果發現,社會經濟地位對學前兒童的自覺健康、一項以上疾病情形、牙醫服務利用及就醫便利各項上有顯著的關聯。高社會經濟地位者自覺兒童健康良好的比率較高(42.1% vs.34.8%)、較多一項以上疾病問題(OR=1.3,95%CI:1.1-1.7)、較多的自費疫苗接種(OR=2.1,95%CI:1.6-2.6)、較多的牙醫利用服務(OR=2.1,95%CI:1.5-3.0)及較低的就醫不便利性(OR=0.4,95%CI:0.2-0.6)。
在複邏輯迴歸分析中,也發現兒童就讀幼稚園與否對其健康有顯著的影響。在兒童有一項以上的疾病問題,就讀幼稚園的兒童有1.7倍的勝算比。在牙醫利用服務上,就讀幼稚園有2.0倍的勝算比。另外,在兒童就醫的便利性上,也明顯地看到居住區域的差距,居住於”鄉”有10.9倍的勝算比較”市”感受到就醫不方便。
社會經濟地位對健康的關聯,在學齡前兒童亦是可見。未來研究的探討上,仍需建立縱貫性研究,探討不同時期社會經濟地位對健康及發展之影響情形。並結合衛生、社會福利及教育政策,作為對不同社會經濟狀況家庭其學前兒童健康促進的介入。
The health of children is the basis of the adolescent and adulthood health. Improving the health and well-being of children is a primary goal of health care systems. Childhood is a period of dependency and development. Family socioeconomic status influences the children’s opportunity to access health care and is consistently associated with health outcome. The aim of this study was to illustrate how family socioeconomic status relates to the health status of 3-6 year-old preschool children and the type of health care service provided.
We implemented the cross-sectional study and conducted face-to-face interview for children’s caregiver that contained 1247 samples from different urbanization levels. The urbanization levels were based on the classification in the Taiwan-Fukein Demographic Fact Book, Ministry of Interior. The subjects were asked to complete a set of questionnaire including the children’s health status, family characteristics, and the utilization of medical care service. Despite the descriptive statistic, we build the logistic models to elucidate how the family socioeconomic status affected the preschool children’s health and different health care utilization.
Family socioeconomic status usually illustrated in parent’s education, occupation, and family income. We use the cluster analysis to classify socioeconomic status as high and low level, which came from the combination of these criteria variables including parents’ education, occupation, and family income.
The results demonstrated the socioeconomic status significantly affected the parental-reported children health, children’ morbidity level, dental service utilization, and convenience of seeking medical care. High SES had significantly more percent (42.1% vs. 34.8%) for better parental-reported children health than low SES. In logistic regression analysis, high SES had the 2.1 odds ratio (95%CI 1.5-3.0) in ever using the dental services, more morbidity level (OR=1.3, 95%CI 1.1-1.7), and low inconvenience for seeking medical care (OR=0.4, 95%CI 0.2-0.6). Moreover, Children attending the kindergarten had 1.7 odds ratio to have morbidity level and 2.0 odds ratio dental services. And it still had the area disparities among health care access. Living in “Country” had 10.9 odds ratio than those who in “City” felt inconvenient for seeking health care.
For preschool children, socioeconomic status impacts their health status and utilization of health care. Although this result showed primarily the relationship between the socioeconomic status indictors and preschool children’s health measures, it still suggested to collect the longitudinal data for exploring deliberately the association between the socioeconomic status and preschool children’ health and try to cooperate with public health, social welfare, and education system for reducing the socioeconomic status inequality between preschool children’s health.
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