臺灣博碩士論文加值系統

本研究主要想瞭解台灣地區不同鄰里類型、居民個人社經地位及個人健康三者間的關係，研究的假設是，一、在控制了個人因子的情況下，居住在狀況不好的鄰里類型的居民（例如鄰里社經地位低），個人的健康狀況（慢性病、日常生活功能障礙、自評健康）也會比較差。二、鄰里特徵會和個人特徵產生交互作用來影響個人的健康，也就是說，鄰里類型與個人健康狀況的關係會因個人社經地位的不同而有所差異。
資料來源是以1990年與2000年「台灣地區社會變遷基本調查」中第二期第一次及第四期第一次調查計畫為個人層次的資料，分別連結七十九年和八十九年「台閩地區戶口及住宅普查」的鄰里資料。在1990年的樣本中共有1934人，230個鄰里，2000年有1895人，88個鄰里。
鄰里類型是將普查資料中的八個鄰里特徵，利用集束分析（cluster analysis）的方式進行分類，這些特徵包含國中未畢業比率、大學畢業以上比率、未工作人口比率、單親家庭比率、離婚或分居比率、老年人口比率、未成年人口比率及鄰里都市化程度等八個因子，最後形成一個鄰里的類型（Typology），再以多層次分析法（multi-level analysis, MLA），分析在控制了個人因子的情況下，居住在狀況不好的鄰里類型的居民，個人的健康狀況是否也會比較差，以及鄰里類型與個人因子之間是否存在著交互作用（cross-level effect）的關係，所有的統計分析皆分成1990與2000年進行，以比較在1990與2000年鄰里類型與個人健康是否會因為時代的不同而有所差異。
結果發現，2000年的資料中鄰里類型對於個人健康會有影響，而且有交互作用存在，換句話說，鄰里類型對於健康結果的影響會因為個人社經地位的不同而有差異，進一步分層分析發現，在慢性病方面，在高社經地位者的身上作用較為明顯，如果高社經地位者居住在低社經地位、低度都市化的鄉村會比居住在其他類型鄰里有較高的機率罹患慢性病，而在日常生活功能障礙方面，則是在低社經地位者的身上較為明顯，低社經地位者居住在低社經地位、低度都市化的鄉村有越高的機率發生日常生活功能障礙。鄰里類型對於健康的影響，在1990年的結果中，在控制個人層次的變項後，鄰里類型只對日常生活功能障礙有影響，位在高社經地位、高度都市化程度的城市會比位在低社經地位、低度都市化的鄉村有比較少的機率發生日常生活功能障礙，而交互作用上則不顯著。

The purpose of this study is to understand the relationships among neighborhood type, individual SES, and individual health in Taiwan. The hypotheses are (1) after controlling individual characteristics, those who live in disadventaged neighborhoods (i.e., Low SES neighborhoods) have a higher probability to have chronic diseases, functional limitation, and poor self-rated health compared to those who live in adventaged neighborhoods; (2) the relationship between neighborhood type and individual health status is moderated by individual SES.
The data came from the first wave of 1990 Social Change Study and the first wave of 2000 Social Change Study. Social Change Study is a nationally representative study examining social issues in Taiwan. Participants’ residential addresses were geocoded with the 1990 and 2000 census for measuring neighborhood characteristics, respectively. The 1990 sample included 1934 cases in 230 neighborhoods and the 2000 sample included 1985 cases in 88 neighborhoods.
I used cluster analysis to create a neighborhood typology based on eight neighborhood characteristics: rates of less than junior high school, rates of more than college degree, rates of single-parent families, rates of divorce or living apart, rates of elderly, rates of teens under 18, and rurality/urbanity. Individual health status was measured by three indicators including chronic disease, functional limitation, and self-rated health.
I used multi-level analysis to examine whether individuals who live in disadventaged neighborhood types have worse health status compared to those who live in adventaged neighborhood types. In addition, I examined the moderating relationships of neighborhood types and individual SES on individual health. All of the analyses were conducted separately for 1990 and 2000.
The findings of this study are as follows:
1. In 2000, there are significant interaction effects of neighborhood types and individual SES on individual health status. For high SES people, living in rural low SES neighborhoods is more likely to have chronic diseases than in other neighborhood types. However, the same effects were not found among low SES residents. On the contrary, neighborhood types are more likely to influence individual functional limitation among low SES residents, but not high SES residents. For people with low socioeconomic status, living in rural low SES neighborhoods is more likely to have functional limitation than in other neighborhood types.
2. In the year of 1990, the relationship between neighborhood type and functional limitation is significant after controlling for individual characteristics. Residents who live in the rural low SES neighborhood type are more likely to report functional limitation than those who live in the urban high SES neighborhood type.

第一章 緒論 1

第二章 文獻探討 3
第一節 鄰里與個人健康效應研究的發展 3
第二節 鄰里的定義與測量 7
第三節 鄰里分類的方法學與其相關的實證研究 10
第四節 鄰里效應與健康的實證研究 15
第五節 台灣地區地域環境差異及其與個人健康的相關性研究 28

第三章 研究方法 34
第一節 研究架構與假設 34
第二節 研究設計與樣本資料來源 36
第三節 變項測量 39
第四節 統計分析方法 43

第四章 研究結果 46
第一節 雙變數分析 46
第二節 鄰里型態集束分析 50
第三節 多層次分析 55

第五章 結論與建議 62
第一節 結論 62
第二節 研究限制與建議 64

第六章 參考文獻 67

第七章 附錄 75

英文文獻

1.Aldenderfer, Mark S. and Roger K. Blashfield. 1984. Cluster Analysis. Newbury Park, CA: Sage Publications. A Sage University Paper 44.
2.Aneshensel, Carol S. and Clea A. Sucoff. 1996. The neighborhood context of adolescent mental health. Journal of Health and Social Behavior 37(4):239-310
3.Balfour, Jennifer and George A. Kaplan. 2002. Neighborhood environment and loss of physical function in older adults: Evidence from the Alameda County Study. American Journal of Epidemiology 155(6):507-515
4.Blakely, Tony A. and Alistair J. Woodward. 2000. Ecological effects in multi-level studies. Journal of Epidemiology and Community Health 54(5):367-374
5.Boardman, Jason D. 2004. Stress and physical health: The role of neighborhoods as mediating and moderating mechanisms. Social Science & Medicine 58(12):2743-2483
6.Bond Huie, Stephanie A. 2001. The concept of neighborhood in health and mortality research. Sociological Spectrum 21(3):341-358
7.Borrell, Luisa N., Ana V. Diez-Roux, Kathryn Rose, Diane Catellier and Bobby L. Clark. 2004. Neighborhood characteristics and mortality in the Atherosclerosis Risk in communities study. International Journal of Epidemiology 33(2):398-407
8.Boyle, Michael H. and J. Douglas Willms. 1999. Place effects for areas defined by administrative boundaries. American Journal of Epidemiology 149(6):577-585
9.Browning, Christopher R. and Kathleen A. Cagney. 2002. Neighborhood structural disadvantage, collective efficacy and self-rated physical health in an urban setting. Journal of Health and Social Behavior 43(4):383-399
10.Chaskin, Robert J. 1997. Perspectives on neighborhood and community: A review of the literature. Social Service Review 71(4):521-547
11.Chaskin, Robert J. 1998. Neighborhood as unit of planning and action: A heuristic approach. Journal of Planning Literature 13(1):11-30
12.Cheng, Tai-An. 1989. Urbanisation, migration and minor psychiatric morbidity. Chinese Psychiatry 3:159-169
11.Chiang, Tung-Liang. 1999. Economic transition and changing relation between income inequality and mortality in Taiwan: Regression analysis. British Medical Journal 319(7218):1162-1165
13.Chow, Julian. 1998. Differentiating urban neighborhoods: A multivariate structural model analysis. Social Work Research 22(3):131-142
14.Chuang, Ying-Chih. 2001. Neighborhood Influences on Adolescent Cigarette and Alcohol Use. Doctoral Dissertation. University of North Carolina at Chapel Hill Press.
15.Cubbin, Catherine and Marilyn A. Winkleby. 2005. Protective and harmful effects of neighborhood-level deprivation on individual-level health knowledge, behavior change, and risk of coronary heart disease. American Journal of Epidemiology 162(6):559-568
16.Diez-Roux, Ana V. 2001. Investigating neighborhood and area effects on health. American Journal of Public Health 91(11) :1783-1789
17.Diez-Roux, Ana V., Sharon S. Merkin, Donna Arnett, Lloyd Chambless, Mark Massing, F. Javier Nieto, Paul Sorlie, Moyses Szklo, Herman A. Tyroler and Robert L. Watson. 2001. Neighborhood of residence and incidence of coronary heart disease. New England Journal of Medicine 345(2):99-106
18.Elliott, Delbert S., Scott Menard, Amanda C. Elliott, Bruce Rankin, William J. Wilson and David Huizinga. 2000. Good Kids from Bad Neighborhoods. Chicago, Il: The University of Chicago Press.
19.Esbensen, Finn-aage and David Huizinga. 1990. Community structure and drug use: From a social disorganization perspective. Justice Quarterly 7(4):691-709
20.Fotso, Jean-Christophe and Barthelemy Kuate-Defo. 2005. Socioeconomic inequalities in early childhood malnutrition and morbidity: Modification of household-level effects by the community SES. Health & Place 11(3):205-225
21.Furstenberg, Frank F. Jr and Mary E. Hughes. 1997. “The influence of neighborhoods on childern’s development: A theoretical perspective and a research agenda.” Pp. 23-47 in Neighborhood Poverty: Policy Implications in Studying Neighborhoods, vol. 2, edited by Jeanne Brooks-Gunn, Greg J. Duncan, and J. Lawrence Aber. New York, NY: Russell Sage Fundation.
22.Gates, Hill. 1981. ” Ethnicity and social class.” Pp.241-281 in The Anthropology of Taiwanese Society, edited by Emily M. Ahern and Hill Gates. Stanford, CA: Stanford University Press.
23.Gibson, Rose C. 1991. Race and self-reported health of elderly persons. Journal of Gerontology 46(5):S235-S242
24.Guest, Avery M. and Barrett A. Lee. 1983. Consensus on locality names within the Metropolis. Sociology and Social Research 67(4):375-391
25.Guest, Avery M. and Barrett A. Lee. 1984. How urbanities define their neighborhoods. Population and Environment 7(1):32-56
26.Hallman, Howard W. 1984. Neighborhoods: Their Place in Urban life. Beverly Hills, CA: California Sage.
27.Haney, Wava G. and Eric S. Knowles. 1978. Perception of neighborhoods by city and suburban residents. Human Ecology 6(2):201-214
28.Hawley, Amos H. 1950. Human Ecology. New York, NY: Ronald Press.
29.Hill, Terrence D., Catherine E. Ross and Ronald J. Angel. 2005. Neighborhood disorder, psychophysiological distress, and health. Journal of Health and Social Behavior 46(2):170-186
30.Horowitz, Carol R., Kathryn A. Colson, Paul L. Hebert, and Kristie Lancaster. 2004. Barriers to buying healthy foods for people with diabetes: Evidence of environmental disparities. American Journal of Public Health 94(9):1549-1554
31.Hwu, Hai-Gow, Eng-Kung Yeh and Lan-Yang Chang. 1989. Prevalence of psychiatric disorder in Taiwan defined by the Chinese diagnostic interview schedule. Acta Psychiatrica Scandinavica 79(2):136-152
32.Jackson, Kenneth T. 1985. Crabgrass Frontier: the Suburbanization of the United States. New York, NY: Oxford University Press.
33.Jencks, Christopher and Susan E. Mayer. 1990. “The social consequences of growing up in a poor neighborhood.” in Inner-City Poverty in the United States, edited by Lynn L. E. and M. F. H. McGeary. Washington D.C.: National Academy Press.
34.Keller, Suzanne I. 1968. The Urban Neighborhood: A Sociological Perspective. New York, NY: Random House.
35.Kobetz, Erin, Mark Daniel and Jo A. Earp. 2003. Neighborhood poverty and self-related health among low-income, rural woman, 50 years and older. Health & Place 9(3):263-271
36.Kubzansky, Laura D., S. V. Subramanian, Ichiro Kawachi, Martha E. Fay, Mah-J Soobader and Lisa F. Berkman. 2005. Neighborhood contextual influences on depressive symptoms in the elderly. American Journal of Epidemiology 162(3): 253-260
37.Lee, Barrett A. and Karen E. Campbell. 1997. Common ground? Urban neighborhoods as survey respondents see them. Social Science Quarterly 78(4):922-936
38.Levin, Kate A. and Alastair H. Leyland 2006. A comparison of health inequalities in urban and rural Scotland. Social Science & Medicine 62(2):1457-1464
39.Leyland, Alastair H. and Peter P. Groenewegen. 2003. Multilevel modelling and public health policy. Scandinavian Journal of Public Health 31(4):267-274
40.Lieberson, Stanley L. 1985. Making It Count: The Improvement of Social Research and Theory. Berkeley, CA: University of California Press
41.Macintyre, Sally, Anne Ellaway and Steven Cummins. 2002. Place effects on health: How can we conceptualise, operationalise and measure them? Social Science and Medicine 55(1):125-139
42.Macintyre, Sally. 1997. “What are spatial effects and hoe can we measure them? “ Pp.1-17 in Exploiting National Survey Data: The Role of Locality and Spatial Effects, edited by Angela Dale. Manchester: Faculty of Economic and Social Studies, University of Manchester.
43.Malmström, Marianne, Jan Sundquist and Sven-Erik Johansson. 1999. Neighborhood environment and self-reported health status: A multilevel analysis. American Journal of Public Health 89(8):1181-1186
44.Mayer, Susan E. and Cristopher Jencks. 1989. Growing up in poor neighborhoods: How much it matter ? Science 243(4897):1441-1445
45.Morenoff, Jeffery D. and Marta Tienda. 1997. Underclass neighborhoods in temporal and ecological perspective. The Annals of the American Academy 551:59-72
46.Patel, Kushang V., Karl Eschbach, Laura L. Rudkin, M. Kristen Peek and Kyriakos S. Markides. 2003. Neighborhood context and self-rated health in older Mexican Americans. Annals of Epidemiology 13(9):620-628
47.Perry, Clarence A. 1929. The Neighborhood Unit: A Scheme of Arrangement for the Family-Life Community. New York, NY: Russell Sage Foundation.
48.Pickett, Kate E. and Michelle Pearl. 2001. Multilevel analyses of neighborhood socioeconomic context and health outcomes: A critical review. Journal of Epidemiology and Community Health 55(2):111-122
49.Punj, Girish and David W. Stewart. 1983. Cluster analysis in marketing research: Review and suggestions for application. Journal of Marketing Research 20:134-148
50.Rapkin, Bruce D. and Douglas A. Luke. 1993. Cluster analysis in community research: Epistemology and practice. American Journal of Community Psychology 21(2):247-277
51.Rapoport, Amos. 1997. The nature and role of neighborhoods. Urban Design Studies 3:93-118
52.Raudenbush, Stephen W. and Robert J. Sampson. 1999. ‘Ecometrics’: Toward a science of assessing ecological settings, with application to the systematic social observation of neighborhoods. Sociological Methodology 29:1–41
53.Reijneveld, Sijmen A. 2002. Neighborhood socioeconomic context and self reported health and smoking: A secondary analysis of data on seven cities. Journal of Epidemiology and Community Health 56(12):935-942
54.Robert, Stephanie A. 1998. Community-level socioeconomic status effects on adult health. Journal of Health and Social Behavior 39(1):18-37
55.Robert, Stephanie A. 1999. Socioeconomic position and health: The independent contribution of community socioeconomic context. Annual Review of Sociology 25: 489-516
56.Robet, Stephanie A. and James S. House. 2000. “Socioeconomic inequalities in health: Integrating individual-, community- and societal-level theory and research.” in The Handbook of Social Studies in Health and Medicine, edited by Gary L. Albrecht, Ray Fitzpatrick and Susan C. Scrimshaw. London: Sage Publications.
57.Sampson, Robert J., Jeffery D. Morenoff and Thomas Gannon-Rowley. 2002. Assessing “Neighborhood effects“: Social processes and new directions in research. Annual Review of Sociology 28:443-478
58.Sampson, Robert J., Stephen W. Raudenbush and Felton Earls. 1997. Neighborhoods and violent crime: A multilevel study of collective efficacy. Science 277(5328):918-924
59.Sloggett, Andrew and Heather Joshi. 1994. Higher mortality in deprived areas: Community or personal disadvantage? British Medical Journal 309(6967):1470-1474
60.Subramanian, S. V., Jarvis T. Chen, David H. Rehkopf, Pamela D. Waterman and Nancy Krieger. 2005. Racial disparities in context: A multilevel analysis of neighborhood variations in poverty and excess mortality among black populations in Massachusetts. American Journal of Public Health 95(2):260-265
61.Sucoff, Clea A. and Dawn M. Upchurch. 1998. Neighborhood context and the risk of childbearing among metropolitan-area block adolescent. American Sociological Review 63:571-585
62.Tienda, Marta. 1991. “ Poor people and poor places: deciphering neighborhood effects on poverty outcomes.” in Macro-Micro Linkages in Sociology, edited by Joan Huber. Newbury Park, CA: Sage Publications.
63.Tumin, Melvin M. 1985. Social Stratification. Englewood Cliffs, NJ: Prentice-Hall.
64.Veugelers, Paul J., Alexandra M. Yip and George Kephart. 2001. Proximate and contextual socioeconomic determinants of mortality: Multilevel approaches in a setting with universal health care coverage. American Journal of Epidemiology 154(6):725-732
65.Wainwright, Nicholas W. J. and Paul G. Surtees. 2004. Places, people, and their physical and mental functional health. Journal of Epidemiology and Community Health 58(4):333-339
66.Wellman, Barry. 1979. The community question: The intimate networks of East Yorkers. American Journal of Sociology 84(5):1201-1231
67.Wen, Ming and Nicholas A. Christakis. 2005. Neighborhood effects on potshotspitalization mortality: A population-based cohort study of elderly in Chicago. Health Services Research 40(4):1108-1127
68.Wilson, Kathi, Susan Elliott, Michael Law, John Eyles, Michael Jerrett and Sue Keller-Olaman. Linking perceptions of neighborhood to health in Hamilton, Canada. Journal of Epidemiology and Community Health 58(3):192-198
69.Winkelstein, Warren Jr. 1972. Epidemiological considerations underlying the allocation of health and disease care resources. International Journal of Epidemiology 1(1):69-74
70.Yang, Ming-Jen, Mei-Sang Yang, Chun-Hua Shih and Ichiro Kawachi. 2002. Development and validation of an instrument to measure perceived neighborhood quality in Taiwan. Journal of Epidemiology and Community Health 56(7):492-496
71.Yang, Ming-Jen. 2000. Neighborhood experience and mental health. Chang Gung Medical Journal 23(12):747-754
72.Yen, Irene H. and George A. Kaplan. 1999. Neighborhood social environment and risk of death: Multilevel evidence from the Alameda County study. American Journal of Epidemiology 149(10):898-907

中文文獻

1.內政部1990年統計年報
2.內政部2000年統計年報
3.王振寰，2002。台灣社會。臺北：巨流圖書公司。
4.江東亮，1997。第一章：健康與公共衛生的歷史。載於陳拱北預防醫學基金會（主編），公共衛生學（1-41頁）。臺北：巨流圖書公司。
5.李宜家、林慧淳、江東亮，2003。地區剝奪程度、個人社經地位與台灣男性成人的吸菸行為。台灣公共衛生雜誌，22(1)：10-16。
6.洪銓娸，2005。鄰里特徵對個人健康的影響。台北醫學大學公共衛生研究所碩士論文。
7.徐慧娟、張明正，2004。台灣老人成功老化與活躍老化現況：多層次分析。台灣社會福利學刊，3(2)：1-36。
8.章英華，1994。遷徙意願與理想居住地：從都市化、個人背景與居住環境評價的探討。載於伊慶春（主編），臺灣社會的民眾意向：社會科學的分析（65-89頁）。臺北：中央研究院中山人文社會科學研究所。
9.章英華，1995。台灣都市的內部結構：社會生態的與歷史的探討。臺北：巨流圖書公司。
10.章英華、傅仰止，2000。台灣社會變遷基本調查計畫第四期第一次調查計畫執行報告。臺北：中央研究院社會學研究所。
11.楊明仁、施春華、鄭夙芬，1997。社區效應與心理健康。社區發展季刊，97：134。
12.劉進慶，1992。台灣戰後經濟分析。臺北：人間出版社。
13.蔡明璋，1996。台灣的貧窮：下層階級的結構分析。臺北：巨流圖書公司。
14.蔡瑞明，1999。台灣、美國與日本社會流動的結構分析。台灣社會學刊，22：83-125。
15.鄭惠玲、江東亮，2002。台灣的社會資本與自評健康。台灣公共衛生雜誌，21(4)：289-295。
16.瞿海源，1990。台灣社會變遷基本調查計畫第二期第一次調查計畫執行報告。臺北：中央研究院社會學研究所。
17.瞿海源，1996。台灣社會變遷基本調查計畫第三期第二次調查計畫執行報告。臺北：中央研究院社會學研究所。