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研究生:黃昱勳
研究生(外文):Yu-Shun Huang
論文名稱:臺灣縣市層次因子與鄉鎮層次因子對個人健康
論文名稱(外文):The Effects of County-level and Township-level Characteristics on Individual Health in Taiwan
指導教授:莊媖智莊媖智引用關係
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:公共衛生學研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2008
畢業學年度:96
語文別:中文
論文頁數:67
中文關鍵詞:縣市特徵鄉鎮特徵多層次分析個人社經地位個人健康
外文關鍵詞:County-level characteristicsTownship-level characteristicsMultilevel AnalysisIndividual SESIndividual Health
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本篇主要是想要了解臺灣地區鄉鎮特徵以及縣市特徵是否與個人健康有關。研究主要是將民國91年臺灣地區國民健康促進知識、態度、行為調查的資料地理串連至1. 民國89年中華民國統計資訊網;2. 民國89年的普查;3. 各縣市主計處出版的縣市統計要覽;4. 全國家庭收支調查;5. 財政部財稅資料中心的資料,探討不同鄉鎮縣市特徵對個人健康的影響。研究對象主要為臺灣地區各縣市年滿十五歲以上人口,共26755人。縣市樣本數為23個,鄉鎮共224個。本研究會利用雙變項分析及多層次分析(multi-level analysis)來進行統計分析。結果發現當控制個人人口學變項之後縣市層次的人口密度愈高會則該縣市人民得到慢性病的風險上升。鄉鎮的收入不平等愈嚴重、人口密度愈多、平均個人收入愈低,人民的自評健康不佳的風險會較高。鄉鎮的人口密度愈高,人民得到慢性病的風險也會上升。但是在鄉鎮層次發現當扶養比愈高,人民的自覺日常生活功能障礙風險會較低。在交互作用可看到,縣市層次的平均收入與自評健康不佳的關係、鄉鎮層次的平均收入與自評健康不佳的關係、鄉鎮層次的原住民人口比率與慢性病之間的關係、鄉鎮層次的每萬人醫師數與慢性病之間的關係、鄉鎮層次的收入不平等與日常生活功能障礙的關係、鄉鎮層次的社會福利支出與日常生活功能障礙的關係對於不同個人社經地位的人會有不一樣的影響。研究結果可幫助地方政府釐清在不同行政層次(縣市層次或鄉鎮層次)的政策執行應有的規劃方式。
The purpose of this study is to understand how county-level characteristics and township-level characteristics influence people’s health. The data came from the 2002 Taiwan Health Knowledge, Attitude, and Behavior Survey (KAP). Participants’ addresses were geocoded with the 2000 census data, the 2000 Taiwan family income and expenditure survey, and other government-based statistics for measuring area characteristics. A multi-stage cluster sampling method was used to select adults aged over 15 for the survey. The final sample size is 26755 people living in 224 townships and 23 counties. This study used multilevel modeling as the analytical method.
This study found that after controlling individual demographic factors, people who lived in a county with higher population density increased the risk of getting more chronic diseases. In addition, people who lived in the township with higher income inequality, higher population density, and lower average income increased the opportunities of having poor self-rated health. However, people who lived in the township with higher dependency ratio decreased the risk of having functional limitations. Regarding interaction effects, we found significant interactions between individual socioeconomic status and county-level average income, township-level average income, township-level percentages of aborigines, township-level availability of physicians, township-level income inequality, and township-level social welfare expenditures.
The findings of this study can inform the government of Taiwan to design different interventions to address area influences on individual’s health according to different geographical levels.
第一章 前言 1
第二章 文獻探討 3
第一節 區域因子與個人健康的關係 3
第二節 研究架構與假設 13
第三章 研究方法 15
第一節 研究設計與樣本資料來源 15
第二節 研究變項測量 19
第三節 資料分析 25
第四章 結果 29
第一節 樣本描述 29
第二節 相關性分析 31
第三節 雙變項分析 33
第四節 多層次分析 36
第五章 結論及建議 42
第一節 討論 42
第二節 研究限制 45
第三節 建議 48
第六章 參考文獻 49
第七章 圖表 53
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