社經發展與死亡 : 以臺北縣市為例

Abstract

目的 ： 研究臺灣近40年來的社會變遷之下，臺北縣市的社會經濟發展與死亡的關係。 研究設計 ： 以縣市及鄉鎮市區兩層次分別進行橫斷性與縱慣性分析，並以迴歸模式探討地區社經發展程度對死亡率的影響。 主要結果變項 : 總死因死亡率。 結果：臺北縣的標準化死亡率這四十年來總是臺北市的1.14-1.22倍左右。就各鄉鎮市區層次來看，臺北縣各鄉鎮市四十年最壞的地區比最好的地區是1.92(14.38/7.5)倍，四十年後是1.94(7.92/4.49)倍；臺北市各區標準化死亡率之最高值與最低值之比，1965-1974年代的1.68倍，降至1995-2004年的1.45倍。迴歸分析結果顯示:無論縣市層次或鄉鎮市區層次，社經發展程度越高，死亡率越低；就個別發展指標而言，受高等教育比率對死亡率的解釋力與相關性非常重要。 結論：臺北縣市的死亡率與社經發展息息相關，尤其是教育程度與家戶所得最為顯著，為減少城鄉健康不平等，增進地區發展的平衡，重視各鄉鎮市的發展需要，是政府可以著手的議題，尤其是發展落後地區的受教育人口比率的提升，更是刻不容緩的重點發展。

Objectives: To examine the relationship between socioeconomic development and mortality in Taipei area during 1965-2004. Design: Cross-sectional and longitudinal analyses were performed at city -county level and township level. Regression analysis was applied to examine the effects of socioeconomic development on mortality. Main Outcome Measures: All-cause mortality Results: During 1965-2004, the age-standardized mortality rate in Taipei county and city was around the ratio from 1.14 to 1.22.Under the township level, the age-standardized mortality of the worst to the best in Taipei County was around the ratio from 1.92 to 1.94; on the other side, about Taipei city was around ratio from 1.68 to 1.45.Findings from regression analysis, the higher level of socioeconomic development, the lower mortality in the areas. We also found that education was more important in explaining mortality than other socioeconomic indicators. Conclusions: Socioeconomic development is important to the decrease of mortality in Taipei area. To reduce the geographic inequality of health, the government needs to tackle the development problems in deprived areas.