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研究生:童崇嘉
研究生(外文):Chung-ChiaTung
論文名稱:台南市健康城市計畫之結果指標評價
論文名稱(外文):The Evaluation of Outcome Indicators of Tainan Healthy City Program
指導教授:胡淑貞胡淑貞引用關係
指導教授(外文):Shu-Jhen Hu
學位類別:碩士
校院名稱:國立成功大學
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
論文出版年:2012
畢業學年度:100
語文別:中文
論文頁數:112
中文關鍵詞:健康城市評價健康城市指標
外文關鍵詞:Healthy City evaluationHealthy City indicators
相關次數:
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背景:
WHO為解決都市健康問題,於1986年提出了「健康城市計畫」。然而推行至今,關於執行成效的評價研究卻極少,且多集中於質性評價,少數量性評價研究只包括相關過程指標,無法與WHO當初建立健康城市指標的目的相互呼應。
目的:
本研究應用其他永續環境相關領域之技術,利用指標數據的變化來評價台南市健康城市計畫推行之成效。為使結果更為客觀,本研究另外選擇未推行健康城市計畫的台中市及較晚推行健康城市計畫的高雄市作為參考組。
方法:
本研究收集2002年至2010年,台南、台中、高雄三座城市,24項健康城市指標之數據,並將其分為「環境、社會、健康行為、醫療資源、健康結果」五大面向。利用全排列多邊形圖示指標法(FPPSI)進行指標數據之標準化,並繪製雷達圖、直方圖及折線圖等相關圖表呈現之。城市間相互之比較,則進一步計算其差距和變化百分比,讓結果更為明確。
結果:
隨著健康城市計劃的推行,台南市除了健康結果指標外,其他四類指標皆呈現進步的趨勢,尤以社會指標的表現最突出;若和台中市相比較,台南市在環境指標、社會指標、健康行為及醫療資源指標,乃至於整體表現,其進步幅度都大於台中市;但和高雄市比較時,兩者在環境指標的進步幅度大致相同,在社會指標和健康行為醫療資源方面,則是台南市明顯優於高雄市,在整體表現上台南市和高雄市的差距並不明顯。總體來說,健康城市計畫的推行,確實對指標的改善有一定之成效。值得注意的是,雖然台南市的進步幅度最大,但在各類指標的原始客觀數據的表現上,台南市仍遠遠落後於台中市,表示台南市的城市環境在實質上仍有極大的努力空間。
結論:
有推行健康城市計畫之城市,皆呈現穩定且持續的進步,而施行一般施政計畫的城市,其指標的表現的則較不穩定。健康城市計畫的推動對社經指標的改善影響最大,對健康結果指標影響最小,可能是因為健康結果指標牽涉到的因果關係較為複雜,且和城市人口組成及社經結構關係較大,故健康城市計畫的推行對於這方面的影響可能較為有限。本研究建議政府未來應持續、定期收集相關指標,以作為評價政策介入成效的依據。此外,政府將來在城市政策制定或介入計畫推行時,應納入健康城市之思維,方能使其有效的達成宜居環境之目標。
Background:
In order to solve urban health problems, WHO has initiated “Healthy City Program” since 1986. However, studies on evaluating the implementing effects are rare. Most of them focused on qualitative evaluation, and quantitative evaluation studies only use process indicators, which can’t reflect the purpose of establishing healthy city indicators at the outset.
Objective:
This study applied the techniques using in urban sustainable development to evaluate the change of indicators data of the Tainan Healthy City Program. To make the results more objective, this study chooses Taichung City and Kaohsiung City to be references groups.
Methods:
We collected 24 healthy city indicators from 2002-2010 in above-mentioned three cities, and divided these indicators into five categories:- “environmental, social, health behavior, medical resource and health outcome”. FPPSI (Full Permutation Polygon Synthetic Indicator) skill was used to standardize these data, and presented the results by radar chart, histogram and line chart. Also, DiD (differences-in-differences) and DiC (differences-in-changes) was used to compare the changes with each other city.
Results:
With the implementation of the Healthy City Project, Tainan City, except for the health outcome indicators, the other four dimensions showed the trend of progress, especially the social indicators. Comparing with Taichung City, Tainan City made great progress changes in environmental indicators, social indicators, health behavior indicators, medical resource indicators and overall performance. As comparing with Kaohsiung City, both cities had similar process change in environmental indicators, whereas in social, health behavior and medical resource dimensions, Tainan City were obviously better than Kaohsiung City. Overall, the implementation of the Healthy City Program did have positive effect. Noticeably, even though Tainan City made the best progress, it still lagged far behind Taichung city in the original data. Namely, there was a great gap that Tainan City should make more efforts to improve the urban environment substantially.
Conclusions:
The cities implementing the Healthy City Program would make stable and continuous improvement. The greatest impact was on the improvement of social indicators and the minimal impact was on health outcome indicators. This is because health outcome indicators involved complex causal relationship, and the demographic composition and social-economic structure of the city played a more important role. As sources of evaluating the effects of policies, this study suggested that the government should continue to collect relevant indicators regularly. In addition, the government should incorporate into the concepts of the Healthy Cities in policy-making, which can help achieve the goal of livable environment.
第一章 緒論 1
第一節 研究動機 1
第二節 研究目的 2
第二章 文獻探討 4
第一節 城市指標的意義 4
第二節 利用指標進行城市比較的方法 5
第三節 利用城市指標進行評價之案例 12
第四節 健康城市的指標 18
第五節 各國健康城市評價方法 23
第六節 小結 31
第三章 研究方法 32
第一節 研究對象 32
第二節 研究設計 33
第三節 指標來源與內容 34
第四節 研究步驟 39
第四章 研究結果 44
第一節 台南市健康城市指標各階段變動情形 44
第二節 台南市及台中市指標數據變化比較 52
第三節 台南市及高雄市指標數據變化比較 63
第四節 台南市、台中市、高雄市指標數據變化比較 74
第五章 討論 81
第一節 主要結果與研究貢獻 81
第二節 與過去研究之對話 82
第三節 研究限制 87
第四節 結論與建議 88
參考文獻 90
附錄 95
附錄一、台南市健康城市指標原始資料 96
附錄二、台中市健康城市指標原始資料 97
附錄三、高雄市健康城市指標原始資料 98
附錄四、台南、台中、高雄二十四項指標變動情形 99
附錄五、台中市雷達圖 111
附錄六、高雄市雷達圖 112
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