台灣地區國中小學童屈光狀況與城鄉差距之關係

Abstract

目的 根據衛福部國健署的資料，民國99年國小一年級近視盛行率為17.9％，國小六年級為62％，且隨學童年齡越大，近視的比率有增加趨勢，未上國中即有2/3學童近視[民國103年衛福部國健署報導]，而高度近視常伴隨許多眼科方面疾病，如:視網膜剝離，黃斑部病變等，因此學童近視現況調查一直是政府重要保健政策之一。利用衛生署近二十年來的近視調查報告探討台灣地區近年來影響國中小學童近視度數之原因，是否存在城鄉差距之間的關聯。 方法 利用民國八十五年、八十九年、九十四年、九十九年這四次行政院衛生署委託台大醫院執行的「全國中小學生眼屈折狀況調查」資料，將不同年代的資料重新分層，整合，採用加權複迴歸模式(weighted multiple linear regression)，希望能找到最適合的迴歸模式探討影響台灣中小學學童近視度數之原因與城鄉發展的關係。 結果 不論都市發展程度，年代，性別為何，學童年紀越大則近視度數越深，同一性別同一年紀的學童生活在不同都市發展程度地區其近視度數不同，近視增加的速度也不同，可以說都市發展程度及年紀是影響近視的因子。大致上，不同年代的近視平均度數是不同的，且越靠近近代，近視度數越深。台灣近年來城鄉差距逐漸減少，根據國小女生，國小男生，國中女生，國中男生四組資料同時考慮年紀，都市化程度，年代，對近視度數之影響得到的迴歸模式，大致上能將各區域的點估計值依大小分成三組，代表也許往後視力調查可以不需要分成十層分區，只要分成三層進行抽樣即可。最後將上述所有影響近視度數的因子，包括年紀，城鄉差距，及年代，放入自變項中，其中城鄉差距改用新的三大組別的分組，得到最後的迴歸模式。 結論 此報告整合了四個年代，前後總共十五年來台灣地區中小學生的眼屈光狀況，可以看出，年紀，都市化程度，年代，都是影響近幾年來中小學生近視度數的因子，其中，城鄉差距的影響已不像以往這麼明顯，而國中階段受城鄉差距影響較國小階段大。

Purpose Based on past survey data, this research investigates if there exists relationship between the myopia progression and urban-rural gap in Taiwanese students aged between 7 and 15. Methods Four nation-wide surveys of myopia refraction status of students in Taiwan were conducted in 1996, 2000, 2005, and 2010. Summary statistics about the degree of myopia, including the average and standard error have been provided in those reports. We used the reported statistics and the weighted linear regression model to examine the factors affecting the myopia and the relationship between myopia progression and urban-rural gap in Taiwan. Results Students of higher age and living in city usually have a higher degree of myopia. In addition, the urban-rural gap is associated with the degree of myopia. However, in recent surveys, the urban-rural difference has decreased. According to our regression model, we also found that the Developmental Grading of the city can be divided into three groups, instead of the ten stratifications in previous surveys. Conclusion Age, survey-year, and Developmental Grading of the city are associated with the degree of myopia progression. However, the urban-rural gap is less obvious in recent surveys. In particular, the gap affects the myopia progression more for junior high school students than elementary school students. In addition, for future nation-wide myopia survey, we suggest stratify areas into three than ten groups, since the difference among the original ten areas was not substantial.