臺灣博碩士論文加值系統

近年來，越來越多的研究指出，家戶周圍的鄰里環境會影響到一個人的健康。無論是住家周圍菸酒的販賣，治安的狀況或是環境是否整潔，都會直接或間接影響個人的行為和健康。本研究的目的主要是探討2000年台灣地區鄰里特徵和個人健康之間的關係。
研究資料來自台灣地區社會變遷基本調查第四期第一次調查計畫，將其20歲以上的受訪者的家戶地址相連到八十九年台閩地區戶口及住宅普查資料以提供鄰里的資訊。研究對象為台灣地區20歲以上成人。本研究以卡方檢定分析在不同的個人因子和鄰里因子中，其個人健康差異的情形，並使用多層次分析(multi-level analysis)探討鄰里因子對個人健康的影響。
研究結果發現在控制個人因子之後，住在老人活動障礙比率越高的鄰里，居民發生日常生活功能障礙的機會越高且自評健康越差。但是與我們預期不同的是鄰里因子對於個人慢性病的發生沒有關係。
本研究結果部分印證了我們之前的研究假設，即加入個人因子之後，有些鄰里因子仍然和個人健康是有相關的，且台灣地區鄰里之間有環境差異的情況。在政策方面，本研究建議若要增加個人的健康，則鄰里環境的改善是很重要的，特別是針對最弱勢的老人族群的社區，其社區組織和醫療服務都需要重整並加以改善。

A growing number of studies indicated that individual health can be directly or indirectly affected by their neighborhood characteristics, such as neighborhood socioeconomic status and services. However, the influence of neighborhood characteristics on health remains unknown in Taiwan. This study examined whether neighborhood characteristics influence individual health in Taiwan.
The data came from the first wave of 2000 Social Change Study, which is a nationally representative study examining social issues in Taiwan. Participants’ residential addresses were geocoded with the 2000 census for measuring neighborhood characteristics (i.e., neighborhood percentage of people under 15 years of education). We used multi-level models to examine the associations between neighborhood-level characteristics and individual-level health.
Results indicated that there were significant neighborhood effects on self-rated health or functional limitations, but not on chronic condition, after adjusting for individual-level characteristics. Results showed that neighborhoods with a higher percentage of elderly and a higher percentage of people with functional limitation were associated with individual poorer self-rated health and individual functional limitations. These relationships existed after taking into account individual characteristics.
The results of this study support the hypothesis that neighborhood characteristics can influence individual health in Taiwan. These results suggest that improving neighborhood context is critical for individual health, especially in the neighborhoods where most residents are elderly or have functional limitation.

第一章 研究緣起 6
第一節 研究背景 6
第二節 研究目的 7
第二章 文獻探討 8
第一節 鄰里定義 8
第三節 鄰里效應與健康的相關理論架構 10
第四節 鄰里效應與健康的實證研究 15
第五節 台灣的鄰里效應或地區效應相關研究 21
第三章 研究方法 22
第一節 研究架構與研究假設 22
第二節 研究設計與資料處理 25
第四章 研究結果 39
第一節 雙變數分析 39
第二節 多層次分析 42
第五章 討論與建議 46

內政部統計年報. 2000. http://www.moi.gov.tw/stat/index.asp
李宜家、林慧淳、江東亮. 2003. 社區剝奪程度、個人社經地位與台灣男性成人的吸煙行為. 台灣衛誌 22(1): 10-16
林瑞雄等. 2001. 都市化、空氣污染和青少年氣喘：群體篩檢. 臺灣醫學會雜誌 100(10):649-655
洪永泰. 1992. 民意調查的抽樣設計. 研考雙月刊 16(1):22-32
徐慧娟、張明正. 2004. 台灣老人成功老化與活躍老化現況:多層次分析. 臺灣社會福利學刊 3(2):1-36
章英華. 1988. 都市化與機會結構及人際關係態度. 變遷中的台灣社會:159-194.中央研究院民族研究所專刊
章英華、傅仰止主編. 2000. 台灣社會變遷基本調查計劃第四期第一次調查計劃執行報告. 中央研究院社會學研究所
章英華、林季平. 2001. 都市化、階層化和資訊化之關聯. 第四屆資訊科技與社會轉型研討會論文集: 365-397
傅仰止. 1995. 都市人的社會心理特質:公私場域之分. 中國社會學刊 18:17-73
楊明仁、施春華、鄭夙芬. 1997. 社區效應與心理健康. 社區發展季刊 97:134-140
謝亞倫. 1996. 臺灣地區都市化程度與癌症死亡率關係之研究. 高雄醫學院公共衛生學研究所碩士論文
鄭健雄. 1994. 臺灣鄉村高齡化社會面臨之問題探討. 台灣農業 30(2):139-147
鄭惠玲、江東亮 2002. 台灣的社會資本與自評健康. 台灣衛誌, 21(4): 285-295.
Anderson RT, Sorlie P, Backlund E et al. 1997. Mortality effects of community socioeconomic status. Epidemiology 8:42-7
Berkman LF, Breslow L. 1983. Health and Ways of Living. New York: Oxford University Press.
Blakely TA, Woodward AJ. 2000. Ecological effects in multi-level studies. J Epidemiol Community Health 54(5):367-74.
Boardman JD. 2004. Stress and Physical health: the role of neighborhoods as mediating and moderating mechanisms. Social Science & Medicine 58:2473-2483
Browning CR and Cagney, KA. 2003. Moving Beyond Poverty: Neighborhood Structure, Social Processes, and Health. Journal of Health and Social Behavior 44(4):552-57
Bullard RD. 1990. Dumping in Dixie: Race, Class, and Environmental Quality. Boulder, CO: Westview Press
Chiang T-L. 1999. Economic transition and changing relation between income inequality and mortality in Taiwan: regression analysis. British Medical Journal 319(7218):1162-1165
Chuang Y-C, Cubbin C, Winkleby MA, Ahn D. 2005. Effects of Neighborhood Socioeconomic Status and Convenient Store Concentration on Smoking. Journal of Epidemiology and Community Health 59:568-573
Coleman JS. 1988. Social capital in the creation of human capital. American Journal of Sociology 94: S95-S120.
Curry SJ, Wagner EH, Cheadle A, et al.1993. Assessment of community-level influences on individual’s attitudes about cigarette smoking, alcohol use, and consumption of dietary fat. Am J Prev. Med. 9:78-84
Crane J. 1991. The epidemic theory of ghettos and neighborhood effects on dropping out and teenage childbearing. Am. J. Sociol. 96:1236-59
Diez-Roux AV, Merkin SS, Arnett D, Chambless L, Massing M, Nieto J, Sorlie P, Szklo M, Tyroler HA, Waston RL. 2001. Neighborhood of residence and incidence of coronary heart disease. The New England Journal of Medicine 345:99-106
Drukker M, van Os J. 2003. Mediators of neighborhood socioeconomic deprivation and quality of life. Soc Psychiatry Psychiatric Epidemiol 38:698-706
General Accounting Office of the United States. 1983. Sitting of Hazardous Waste Landfills and Their Correlations with Racial and Economic Status of Surrounding Communities. Washington. DC.
Gibson RC. 1991. Race and the Self-Reported Health of Elderly Persons. Journal of Gerontology 46(5):S235-42
Jones K, Duncan C. 1995. Individuals and their ecologies: analyzing the geography of chronic illness within a multilevel modeling framework. Health & Place 1(1):27-40
Kawchi I, Kennedy BP, Lochner K, Prothrow-Stith D.1997. Social capital, income inequality, and mortality. Am J Public Health 87:1491-8
Kawachi I, Kennedy BP, Glass R. 1999. Social capital and self-rated health: a contextual analysis. Am J Public Health 89:1187-1193
Leventhal T, Brooks Gunn J. 2000. The neighborhoods they live in: the effects of neighborhood residence on child and adolescent outcomes. Psychol Bull 26:309-337
Liang J. 1986. Self-reported Physical Health Among Aged Adults. Journal of Gerontology 41(2):248-60
Macintyre S, Ellaway A, Cummins S. 2002. Place effects on health: how can we conceptualise, operationalise and measure? Soc Sci Med 55:125-139
Macintyre S, Maciver S, Sooman A. 1993. Area, class and health: Should we be focusing on places or people? J. Soc. Policy 22(2):213-34
Malmstrom M, Sundquist J, Johansson SE. 1999. Neighborhood Environment and Self-Reported Health Status: A Multilevel Analysis. Am J Public Health 89:1181-1186
Marmot M. 2001. Inequalities in health. New England Journal of Medicine 345:134-6
Park R. 1916. Suggestions for the investigations of human behavior in the urban environment. Am. J. Sociol. 20(5):577-60
Reijneveld SA. 2002. Neighborhood socioeconomic context and self reported health and smoking: a secondary analysis of data on seven cities. J Epidemiol Community Health 56:935-942
Pickett KE and Pearl M. 2001. Multilevel analyses of neighborhood socioeconomic context and health outcomes: a critical review. J Epidemiol Community Health 55:111-122
Pillimore P. 1993. How do places shape health? Rethinking locality and lifestyle in North-cast England. Locating Health: Sociological and Historical Implications. Aldershot:Avesbury.
Rapoport A. 1997. The nature and role of neighborhoods. Urban Design Studies 3:93-118
Robert SA. 1998. Community-Level Socioeconomic Status Effects on Adult Health. Journal of Health and Social Behavior 39: 18-37
Robert SA. 1999. SOCIOECONOMIC POSITION AND HEALTH: The Independent Contribution of Community Socioeconomic Context. Annu. Rev. Social. 25:489-516
Roberts E. 1997. Neighborhood social environments and the distribution of low birthweight in Chicago. Am. J. Public Health 87:597-603
Sampson, RJ, Raudenbush SW, Earls F. 1997. Neighborhoods and Violent Crime: A Multilevel Study of Collective Efficacy. Scinece 227:918-23
Sooman A, Macintyre S. 1995. Health and perceptions of the local environment in socially contrasting neighborhoods in Glasgow. Health & Place 1(1):15-26
Subramanian SV, Kim DJ, Kawachi I. 2002. Social trust and self-rated health in US communities: a multilevel analysis. J Urban Health:S21-34
Taylor SE, Repetti RL, Seeman T. 1997. Health psychology: what is an unhealthy environment and how does it get under the skin? Annual Review of Psychology 48:411-47
Wainwright NWJ, Surtees PG. 2003. Places, people, and their physical and mental functional health. Journal of Epidemiology Community Health 58:333-339
Wallace R, Wallace D. 1990. Origins of Public Health Collapse in New York City: The Dynamics of Planned Shrinkage, Contagious Urban Decay and Social Disintegration. Bulletin of the New York Academy of Medicine 66(5):391-434
Wellman B. 1979. The community question: The intimate networks of east Yorkers. American Journal of Sociology 84:1201-31
Wilson K, Elliott S, Law M, Eyles J, Jerrett M, Keller-Olaman S. 2004. Linking perceptions of neighborhood to health in Hamilton, Canada. J Epidemiol Community Health 58:192-198
Wilson WJ. 1987. The truly disadvantaged: The inner-city, the underclass and public policy. Chicago: The University of Chicago Press.
Yang M-J. 2000. Neighborhood experience and mental health. Chang Guang Medical Journal 23:747-754
Yang M-J, Yang M-S, Shih C-H, and Kawachi I. 2002. Development and validation of an instrument to measure perceived neighborhood quality in Taiwan. J. Epidemiol. Community Health 56:492-496
Yen IH, Kaplan GA. 1999. Neighborhood social environment and risk of death: multilevel evidence from the Alameda County Study. American journal of Epidemiology 149(10):898-907