女性勞動參與率與孕產婦死亡率及嬰兒死亡率之關聯性：OECD國家的實證

Abstract

背景：本研究聚焦於全球在孕產婦與兒童死亡率方面所面臨的健康挑戰。儘管全球在改善健康成果方面已取得顯著進展，但健康結果的不平等現象仍持續存在，特別是在中低所得國家之中。本文旨在分析 OECD 國家中不同年齡層女性勞動參與率之角色及其對孕產婦與嬰兒死亡率的影響。藉此，本研究期望釐清社會不平等——以女性勞動參與差異為代表——如何影響母嬰健康結果，並提供洞見以協助制定更具公平性的全球健康政策。 目的：本研究旨在探討女性勞動參與率是否對孕產婦死亡率與嬰兒死亡率造成顯著影響，並進一步分析此關係是否因年齡層不同而產生異質性效果。特別地，本研究將女性勞動參與視為衡量社會不平等的關鍵指標之一，從15–24歲、25–54歲與55–64歲三個年齡層切入，觀察其對健康結果的影響是否隨社會與經濟結構而變化。此外，本研究亦關注在不同國家發展程度與社會政策制度下，女性勞動參與與死亡率間的關聯是否展現出不同的模式，藉此提出更具針對性的政策建議，以回應全球永續發展目標中對母嬰健康與性別平等的倡議。 方法：本研究使用OECD跨國面板資料，首先除了進行傳統迴歸之分析，包括:階層迴歸模型(Hierarchical Regression)、趨勢調整迴歸（Trend-Adjusted Regression），也考慮了醫療保險制度與COVID-19期間之延伸模型外。接著更採用分量迴歸（Quantile Regression）分析不同死亡率分布區間之效果差異，並進行分組迴歸（Grouped Regression）以檢視不同收入國家中女性勞參率對死亡率的異質性影響。 結果：女性勞動參與率對孕產婦與嬰兒死亡率的影響為多層次與多面向的社會機制結果，與國家社會政策、經濟發展程度及福利制度密切相關。研究結果顯示，女性勞動參與率與孕產婦及嬰兒死亡率之間存在年齡層與國家間的異質性關係。在高所得國家，25–54歲女性勞參率對死亡率呈負向關聯，而低所得國家則可能因缺乏托育與社會支援制度，導致正向關聯。此外，55–64歲女性的參與率也間接影響家庭育兒支持，對嬰兒健康具有潛在效應。 結論：整體而言，不同年齡層女性勞動參與對健康的影響具有顯著異質性，反映社會政策與制度環境在其中的重要調節角色。因此，政策應整合性別平等、家庭福利及職場環境，以降低女性在不同生命階段所面臨的健康風險。

Research Background：The study focuses on the global health challenges surrounding maternal and child mortality. Despite significant progress in improving health outcomes worldwide, disparities persist, particularly among lower-income countries. This study aims to analyze the role of female labor force participation rates across different age groups in OECD countries and their effects on maternal and infant mortality rates. By doing so, it seeks to understand how social inequality—reflected through variations in female labor force participation—affects maternal and child health outcomes, and to provide insights that may inform the development of more equitable global health policies.

Research Objectives：This study aims to investigate whether female labor force participation has a significant impact on maternal and infant mortality rates, and to examine how these effects vary across different age cohorts. Female labor participation is used as a proxy indicator for social inequality, with analysis focusing on three age groups: 15–24, 25–54, and 55–64. By disaggregating labor participation by age, the study seeks to capture the heterogeneous effects of women’s economic engagement on health outcomes, particularly within varying socio-economic and policy contexts. Furthermore, the research explores whether the relationship between labor participation and mortality differs according to countries' levels of development and social policy structures. The goal is to offer evidence-based insights to inform more targeted and effective policy responses in alignment with the Sustainable Development Goals (SDGs), particularly those related to maternal and child health and gender equity. Research Methodology：This study employs multiple research methods to analyze the relationship between female labor force participation rates and maternal and infant mortality rates. The data sources include the World Health Organization, World Development Indicators, and OECD statistics, covering data from 2010 to 2020. First, First, in addition to conducting traditional regression analyses, including a hierarchical regression model and a trend-adjusted regression model, extended models incorporating health insurance systems and the COVID-19 period are also considered. Subsequently, quantile regression is employed to analyze the heterogeneous effects across different distributions of mortality rates, and grouped regression is further applied to examine the differential impacts of female labor force participation on mortality across countries with varying income levels.

Research Results：The effects of female labor force participation on maternal and infant mortality are shaped by complex socio-economic mechanisms, including national policy environments, economic development levels, and welfare infrastructures. The findings reveal that the relationship between female labor force participation and mortality rates varies by age group and national context. In high-income countries, participation among women aged 25–54 is negatively associated with both maternal and infant mortality. Conversely, in lower-income countries lacking adequate childcare and welfare systems, the association may be positive. Moreover, participation among older women (55–64) may indirectly influence infant health through reduced caregiving support for younger generations.