瘧疾發生對農民福祉之影響

Abstract

隨著時代的演進，人們對傳染病的預防愈來愈重視，而作為二十世紀中期主要傳染病之一的瘧疾，曾經對臺灣造成了重大的影響，為此臺灣推行了瘧疾根除運動，並在1965年正式成為完全根除瘧疾地區。然而至今仍有許多國家為瘧疾感染危險地區，臺灣每年亦有境外移入的個案，故瘧疾的影響仍是一個不容忽視的議題。而瘧疾造成之影響尤其在衛生條件較為不足之地區更為嚴重，農村地區便深受其害，故本研究以臺灣二十世紀中期的瘧疾根除運動作為背景，並將農民出生地依瘧疾影響程度加以分類，探討瘧疾發生對受影響程度不同之農民，在多個面向的長期影響。本研究以2016年至2021年農家戶口抽樣調查的個人資料為樣本，合併政府統計的國小學童瘧疾脾腫檢查資料並進行統計分析。本研究使用改良後之差異中之差異法進行實證分析。研究結果顯示，當瘧疾強度每降低一個百分點，將會對農民家戶農業收入及教育程度上帶來顯著正向影響，而在農民主要從事產業別方面則無顯著改變。若進一步將樣本依照瘧疾強度區分後發現，出生於高度瘧疾區農民，在農業收入及從事主業之產業別上並無顯著變化，僅有教育程度顯著提高；而對於出生於低度瘧疾區之農民而言，瘧疾強度每降低一單位使得農民之農業收入顯著增加，但從事主業為第三級產業之人數卻顯著減少，而其他指標則無顯著影響。故根據本研究的結果發現，對於在不同程度瘧疾地區出生之農民，瘧疾的根除對其產生之衝擊亦不同。

With the progress of times, people have increasingly concerned about the prevention of infectious diseases. Malaria, one of the major infectious diseases in the mid-20th century, had a significant impact on Taiwan. Taiwan implemented a malaria eradication campaign and officially became a malaria-free region in 1965. However, to this day, many countries are still at risk of malaria infection, and Taiwan experiences imported cases annually, making the impact of malaria an issue that cannot be ignored. The impact of malaria is particularly severe in areas with limited sanitation, greatly affecting rural areas. This study takes the mid-20th century malaria eradication campaign in Taiwan to explore the long-term effects of malaria occurrence on farmers with different levels of impact in various aspects. Using the data from the Agricultural Household Survey from 2016 to 2021, this study combines individual-level data and the information of malaria splenomegaly. This study employs the modified Difference-in-Differences method as the empirical approach and analyzes the year 1955, the final year of the malaria eradication campaign, as the year of the event. The research findings indicate that when analyzing the total sample, a one-percentage-point decrease in malaria intensity significantly positively affects farmers' agricultural income and educational attainment, while no significant changes are observed in the primary industries in which farmers are primarily engaged. However, when examining the sample based on malaria intensity classification, the results show that farmers born in high-intensity malaria areas do not experience significant changes in agricultural income and primary industry, except for a significant improvement in educational attainment. On the other hand, analyzing farmers born in low-intensity malaria areas reveals that a one-unit decrease in malaria intensity significantly increases farmers' agricultural income but significantly decreases the number of individuals engaged in tertiary industries as their primary occupation, with no significant impact on other indicators. Therefore, based on the findings of this study, it is evident that the eradication of malaria has different impacts on farmers born in areas with varying degrees of malaria prevalence.