臺灣博碩士論文加值系統

背景及研究目的
　　本研究要探討的是個人身心狀況的決定因素，由於健康之於人類的重要性是不可被否認的，且隨著時代的改變，個人身心健康狀況的決定因素也會有所不同，因此雖然過去已有許多討論個人健康決定因素的文獻，但本文認為此議題是該與時俱進、且持續被探討的。

研究方法
　　本文採用中央研究院2011年至2012年間執行的「台灣社會變遷基本調查-健康組」問卷做為資料來源，並在文中使用四個模型分析台灣的居住環境、健康識能與醫療滿意度對身體及心理健康狀況所造成的影響。以下是本文中的四個被解釋變數及模型設定：(1)自評健康之Ordered Probit模型；(2)慢性病之Probit模型；(3)BMI之Multinomial Logit模型；(4)心理健康之OLS模型。

結果
　　根據此橫斷面分析結果顯示，醫療滿意度的提升可促進自評健康及心理健康，另外，健康識能較高者心理健康狀況也會較佳，但健康識能在生理健康方面僅對BMI模型呈顯著，對自評健康、慢性病則不具顯著影響。由居住環境變數中則可發現主觀的物理環境因素對身心健康較無顯著影響，但客觀物理環境變數如城鄉差異、工廠及攤販等則會顯著影響身心狀況表現，最後，若由社會環境面因素分析，則可發現社會支持也是影響生理及心理健康的要素之一。

結論
　　衛生當局可經由加強醫療品質、提升人民健康識能、縮減城鄉醫療落差、制定攤販規章、及提倡社會資本等措施來提升大眾的身心健康表現，當然，個人擁有良好的健康習慣，如睡眠充足、頻繁運動等也是基本的保健之道。

Background and Objectives: The purpose of this study is to investigate the determinants of individual health status. There have been many literatures discussing personal health determinants in the past, but according to the importance of health to humans and the health determinants keeping changing with times, we continue to study this issue because the individual health determinants might be different in different period and it is still need to be explored.
Methods: The data come from a Taiwan Social Change Survey executed in 2011 to 2012 by Academia Sinica. Four models have been used to estimate the influence of Living Environment, Health Literacy, and Medical Satisfaction on individual physical and mental health in Taiwan. Including (1) an Ordered Probit model for Self-Reported Health, (2) a Probit model for Chronic Disease, (3) a Multinomial Logit model for BMI, and (4) an OLS model for Mental Health.
Results: The cross-sectional analyses showed that the higher medical satisfaction can improve self-reported health and mental health. Besides, we found that the individuals with higher health literacy have better mental conditions, but health literacy does not have significant effect in the physical health models except for the BMI one. By estimating the living environment variables, we can find that the objective physical environment does not have much influence on health status but the perceived physical environment and the social environment does.
Conclusions: Government can try to improve public health by enforcing the quality of medical care, increasing people’s health literacy, reducing the medical gap between urban and rural area, setting vendors regulations, and encouraging social capital. Of course, keeping the right health habits is still the most basic way to stay healthy.

第一章　緒論 1
第一節　研究背景與動機 1
第二節　研究方法 4
第三節　論文架構 4
第二章　文獻回顧 5
第一節　居住環境與健康的關係 6
第二節　健康識能與健康的關係 9
第三節　醫療滿意度與健康的關係 10
第四節　控制變數 11
第三章　資料來源與樣本分析 12
第一節　資料來源與說明 12
第二節　變數說明 13
第三節　樣本分析 20
第四章　實證結果分析 26
第一節　自評健康之估計結果 26
第二節　慢性病之估計結果 29
第三節　BMI之估計結果 31
第四節　心理健康之估計結果 35
第五章　結論與研究限制 38
第一節　結論 38
第二節　研究限制與後續建議 40
參考文獻 42

Baker, D. W., Parker, R. M., Williams, M. V., Clark, W. S., & Nurss, J. (1997). The relationship of patient reading ability to self-reported health and use of health services. American Journal of Public Health, 87(6), 1027-1030.
Bilgic, A., Florkowski, W. J., Yen, S. T., & Akbay, C. (2013). Tobacco spending patterns and their health-related implications in Turkey. Journal of Policy Modeling, 35(1), 1-15.
Bunker, J. P., Frazier, H. S., & Mosteller, F. (1994). Improving Health: Measuring Effects of Medical Care. The Milbank Quarterly, 72(2), 225-258.
Carpenter, L. M. (1997). Examining Associations between Occupation and Health by Using Routinely Collected Data. Journal of the Royal Statistical Society: Series A (Statistics in Society), 160(3), 507-521.
Chaska, N. L., Krishan, I., Smoldt, R. K., Ilstrup, D., Weidman, K. A., & Nobrega, F. T. (1980). Use of medical services and satisfaction with ambulatory care among a rural Minnesota population. Public Health Reports, 95(1), 44.
Cho, Y. I., Lee, S.-Y. D., Arozullah, A. M., & Crittenden, K. S. (2008). Effects of health literacy on health status and health service utilization amongst the elderly. Social Science & Medicine, 66(8), 1809-1816.
Connelly, L. B., & Doessel, D. P. (2004). Medical Expenditures and Health Status in Australia: A Story of Increasing or Decreasing Returns? Australian Economic Review, 37(1), 12-30.
Cutler, D. M., & Lleras-Muney, A. (2006). Education and health: evaluating theories and evidence: National Bureau of Economic Research.
Datta Gupta, N., & Kristensen, N. (2008). Work Environment Satisfaction and Employee Health: Panel Evidence from Denmark, France and Spain, 1994-2001. European Journal of Health Economics, 9(1), 51-61.
de Jong, K., Albin, M., Skärbäck, E., Grahn, P., & Björk, J. (2012). Perceived green qualities were associated with neighborhood satisfaction, physical activity, and general health: Results from a cross-sectional study in suburban and rural Scania, southern Sweden. Health & Place, 18(6), 1374-1380.
de Vries, S., Verheij, R. A., Groenewegen, P. P., & Spreeuwenberg, P. (2003). Natural environments -- healthy environments? An exploratory analysis of the relationship between greenspace and health. Environment and Planning A, 35(10), 1717-1731.
DeWalt, D. A., Berkman, N. D., Sheridan, S., Lohr, K. N., & Pignone, M. P. (2004). Literacy and Health Outcomes. Journal of General Internal Medicine, 19(12), 1228-1239.
Doll, R., Peto, R., Boreham, J., & Sutherland, I. (2004). Mortality in relation to smoking: 50 years' observations on male British doctors. Bmj, 328(7455), 1519.
Dujardin, C., Lorant, V., & Thomas, I. (2013). Self-assessed health of elderly people in Brussels: does the built environment matter? Self, 48.
Eckersley, R. (2006). Is modern Western culture a health hazard? International Journal of Epidemiology, 35(2), 252-258.
Gazmararian, J. A., Baker, D. W., Williams, M. V., & et al. (1999). HEalth literacy among medicare enrollees in a managed care organization. JAMA, 281(6), 545-551.
Gidlow, C., Cochrane, T., Davey, R. C., Smith, G., & Fairburn, J. (2010). Relative importance of physical and social aspects of perceived neighbourhood environment for self-reported health. Preventive Medicine, 51(2), 157-163.
Graff Zivin, J., & Neidell, M. (2013). Environment, Health, and Human Capital. 51(3), 689-730.
Grossman, M. (1972). The demand for health: a theoretical and empirical investigation. NBER Books.
Guldvog, B. (1999). Can patient satisfaction improve health among patients with angina pectoris? International Journal for Quality in Health Care, 11(3), 233-240.
Gupta, M. R., & Barman, T. R. (2010). Health, infrastructure, environment and endogenous growth. Journal of Macroeconomics, 32(2), 657-673.
Hall, J. A., Milburn, M. A., & Epstein, A. M. (1993). A Causal Model of Health Status and Satisfaction with Medical Care. Medical Care, 31(1), 84-94.
Kroneman, M., Verheij, R., Tacken, M., & van der Zee, J. (2010). Urban–rural health differences: primary care data and self reported data render different results. Health & Place, 16(5), 893-902.
Lechner, M. (2009). Long-Run Labour Market and Health Effects of Individual Sports Activities. Journal of Health Economics, 28(4), 839-854.
Lee, S. J., Sudore, R. L., Williams, B. A., Lindquist, K., Chen, H. L., & Covinsky, K. E. (2009). Functional Limitations, Socioeconomic Status, and All-Cause Mortality in Moderate Alcohol Drinkers. Journal of the American Geriatrics Society, 57(6), 955-962.
Leslie, E., & Cerin, E. (2008). Are perceptions of the local environment related to neighbourhood satisfaction and mental health in adults? Preventive Medicine, 47(3), 273-278.
Li, J. (2014). The influence of state policy and proximity to medical services on health outcomes. Journal of Urban Economics, 80(0), 97-109.
Maas, J., van Dillen, S. M. E., Verheij, R. A., & Groenewegen, P. P. (2009). Social contacts as a possible mechanism behind the relation between green space and health. Health & Place, 15(2), 586-595.
Marmot, M. (2002). The influence of income on health: views of an epidemiologist. Health Affairs, 21(2), 31-46.
Mitchell, R., & Popham, F. (2007). Greenspace, urbanity and health: relationships in England. Journal of Epidemiology and Community Health, 61(8), 681-683.
Mohnen, S. M., Groenewegen, P. P., Völker, B., & Flap, H. (2011). Neighborhood social capital and individual health. Social Science & Medicine, 72(5), 660-667.
Monnat, S. M., & Beeler Pickett, C. (2011). Rural/urban differences in self-rated health: Examining the roles of county size and metropolitan adjacency. Health & Place, 17(1), 311-319.
Nummela, O., Sulander, T., Rahkonen, O., Karisto, A., & Uutela, A. (2008). Social participation, trust and self-rated health: A study among ageing people in urban, semi-urban and rural settings. Health & Place, 14(2), 243-253.
Pampalon, R., Martinez, J., & Hamel, D. (2006). Does living in rural areas make a difference for health in Québec? Health & Place, 12(4), 421-435.
Patel, S. R., Ayas, N. T., Malhotra, M. R., White, D. P., Schernhammer, E. S., Speizer, F. E., . . . Hu, F. B. (2004). A prospective study of sleep duration and mortality risk in women. SLEEP-NEW YORK THEN WESTCHESTER-, 27(3), 440-444.
Pope, C. R. (1978). Consumer Satisfaction in a Health Maintenance Organization. Journal of Health and Social Behavior, 19(3), 291-303.
Rasciute, S., & Downward, P. (2010). Health or Happiness? What Is the Impact of Physical Activity on the Individual? Kyklos, 63(2), 256-270.
Ross, C. E., & Wu, C.-l. (1995). The Links Between Education and Health. American Sociological Review, 60(5), 719-745.
Shaper, A. G., Wannamethee, G., & Walker, M. (1988). ALCOHOL AND MORTALITY IN BRITISH MEN: EXPLAINING THE U-SHAPED CURVE. The Lancet, 332(8623), 1267-1273.
Smith, J. P. (1999). Healthy Bodies and Thick Wallets: The Dual Relation between Health and Economic Status. The Journal of Economic Perspectives, 13(2), 145-166.
Subramanian, S. V., & Kawachi, I. (2004). Income Inequality and Health: What Have We Learned So Far? Epidemiologic Reviews, 26(1), 78-91.
Tehrani, A. B., Feldman, S. R., Camacho, F. T., & Balkrishnan, R. (2011). Patient Satisfaction with Outpatient Medical Care in the United States. Health Outcomes Research in Medicine, 2(4), e197-e202.
Tomey, K., Diez Roux, A. V., Clarke, P., & Seeman, T. Associations between neighborhood characteristics and self-rated health: A cross-sectional investigation in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Health & Place(0).
Tsai, T.-I., Lee, S.-Y. D., Tsai, Y.-W., & Kuo, K. N. (2010). Methodology and Validation of Health Literacy Scale Development in Taiwan. Journal of Health Communication, 16(1), 50-61.
Vandelanotte, C., Sugiyama, T., Gardiner, P., & Owen, N. (2009). Associations of leisure-time internet and computer use with overweight and obesity, physical activity and sedentary behaviors: cross-sectional study. Journal of medical Internet research, 11(3).
Verhaeghe, P.-P., & Tampubolon, G. (2012). Individual social capital, neighbourhood deprivation, and self-rated health in England. Social Science & Medicine, 75(2), 349-357.
Vlahov, D., Freudenberg, N., Proietti, F., Ompad, D., Quinn, A., Nandi, V., & Galea, S. (2007). Urban as a Determinant of Health. Journal of Urban Health, 84(1), 16-26.
Weiss, G. L. (1988). Patient Satisfaction with Primary Medical Care: Evaluation of Sociodemographic and Predispositional Factors. Medical Care, 26(4), 383-392.
Whitehead, M., & Dahlgren, G. (1991). What can be done about inequalities in health? The Lancet, 338(8774), 1059-1063.
Wolf, M. S., Feinglass, J., Thompson, J., & Baker, D. W. (2010). In search of ‘low health literacy’: Threshold vs. gradient effect of literacy on health status and mortality Social Science & Medicine (Vol. 70, pp. 1335-1341).
Wolf, M. S., Gazmararian, J. A., & Baker, D. W. (2005). HEalth literacy and functional health status among older adults. Archives of Internal Medicine, 165(17), 1946-1952.
Xiao, H., & Barber, J. P. (2008). The Effect of Perceived Health Status on Patient Satisfaction. Value in Health, 11(4), 719-725.
Yen, C.-F., Hsiao, R. C., Ko, C.-H., Yen, J.-Y., Huang, C.-F., Liu, S.-C., & Wang, S.-Y. (2010). The relationships between body mass index and television viewing, internet use and cellular phone use: The moderating effects of socio-demographic characteristics and exercise. International Journal of Eating Disorders, 43(6), 565-571.
Ziersch, A. M., Baum, F. E., MacDougall, C., & Putland, C. (2005). Neighbourhood life and social capital: the implications for health. Social Science & Medicine, 60(1), 71-86.