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Title: | 台灣家庭社經地位與家庭吸菸狀態關係:趨勢研究,1980—2016 The Relationship between Socioeconomic Status and Smoking Status at Household-level in Taiwan: a Trend Study, 1980-2016 |
Authors: | Yi-Hsuan Lin 林依宣 |
Advisor: | 江東亮(Tung-Liang Chiang) |
Keyword: | 家庭社經地位,不平等,吸菸趨勢,家庭吸菸狀態,趨勢研究, household socioeconomic status,inequality,smoking trend,household smoking status,trend study, |
Publication Year : | 2019 |
Degree: | 碩士 |
Abstract: | 背景與目的:菸品對於健康的危害從全世界到個人各個層次都有影響,而台灣在菸害監測與防制上主要是針對個人層次,鮮少關注於家庭層次,但是家中有吸菸者是會透過二手菸、三手菸、菸品消費排擠其他消費的方式,影響家庭其他成員的健康。要提升全民健康便是公共衛生所關注的影響健康的因素中,與醫療同等重要的社經因素在台灣卻鮮少被注重,然吸菸不平等的現象時常在國外研究中所發現,故要解決台灣菸害問題,應從社會經濟的角度切入。本研究目的有三,(一) 描述吸菸家庭趨勢;(二)探討家庭社經地位與吸菸家庭關係之變遷;(三)探討菸害重要全國性事件對不同家庭社經地位之吸菸家庭率影響之變遷。
方法:本研究針對多年度的全國性重複橫斷性資料作次級資料分析,依變項為家庭吸菸狀態,自變項為家庭社經地位,其三個指標為家戶收入分位、戶長教育程度與戶長職業。單變項先描述各個變項歷年的趨勢,並檢定全國歷年吸菸家庭率之趨勢;雙變項以卡方檢定各變項與家庭吸菸狀態之間的關係,再使用連結點分析瞭解家庭社經地位各組之趨勢轉折點已及組間的平行檢定,進一步以戶長性別與年齡分層,瞭解分層後各家庭社經地位組別之趨勢;最後多變項分析以對數複回歸模式用九個粗略模型以及三個模型將變項分別以不同組合的方式放入,以瞭解變項對於吸菸家庭率的影響。 結果:(一)吸菸家庭率逐年下降,自1980年開始由78.42%下降至 27.78%;(二)戶長教育程度各組間的吸菸家庭率差距逐年擴大;(三)家戶收入分位各組間的吸菸家庭率差距逐年縮小;(四)戶長職業各組間的吸菸家庭率差距先縮小再擴大;(五)無法證明菸害重要全國性是建是否對吸菸家庭率有效果。 結論:台灣吸菸家庭率的趨勢會因為不同家庭社經地位指標而有所不同,考量了家庭特性後,戶長教育程度與戶長職業在每一年確實多出現了社會不平等現象,因此政府應該要關注吸菸家庭指標,並且要關心社會不平等的現象,針對較低的戶長教育程度與戶長職業制訂政策以解決菸害問題。 Background: The health-harming effects of tobacco is not only at the individual level, but also at the family level, even at the worldwide population level. Mostly, Taiwan’ s department of Health puts efforts at the individual level, but not at the family level. However, this issue on househould-level is important as well, because tobacco has negative influences on family members through environmental tobacco smoke, thirdhand smoke and supplanting other expenditures. To solve this problem, we should focus on socioeconomic status, which is found to be the root cause of most of health issues and smoking inequalities. Objectives: This thesis was aimed to examine (1) Trend in smoking families prevalence, (2) trend in the relationships between household socioeconomic status and household smoking status, (3) the influences of national tobacco related events on trends in smoking families proportion of different household socioeconomic status groups, in Taiwan. Methods: Data for Survey of Family Income and Expenditure in Taiwan (19800-2016) were analysed to explore the prevalence of household smoking status and socioeconomic characteristics. Joinpoint regression analysis was applied to test the trend, and multivariable logistic regression was used to explore the association of household smoking status and household socioeconomic status, controlling for potential confounders. Results: (1) Smoking families prevalence have declined from 78.42% to 27.78% since1980, (2)widening educational gap in smoking families proportion was found, (3) narrowing trends in household income-related smoking inequalities, (4) the difference between the head of occupation groups got broader marginally in the beginning, then got smaller slightly, (5) the impact of national tobacco related events was not detected on any trend. Conclusions: Using different indicators of household socioeconomic status may result in different trends of smoking families prevalence. After controlling for family characteristics, the social disparities of smoking families exist in most of years, therefore, the government should concern smoking families rate as an important index and tackle inequality. One of solutions for smoking problems could be putting the family with lower education and occupation of family head as a first priority when formulate policy. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/71434 |
DOI: | 10.6342/NTU201900400 |
Fulltext Rights: | 有償授權 |
Appears in Collections: | 健康政策與管理研究所 |
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