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系統識別號 U0026-0812200911182583
論文名稱(中文) 澎湖地區健康不平等之發展分析
論文名稱(英文) The analysis of the development of health inequality in Penghu
校院名稱 成功大學
系所名稱(中) 公共衛生研究所
系所名稱(英) Graduate Institute of Public Health
學年度 92
學期 2
出版年 93
研究生(中文) 陳惠茵
研究生(英文) Huei-Yin Chen
學號 t8690101
學位類別 碩士
語文別 中文
論文頁數 119頁
口試委員 指導教授-陳美霞
口試委員-鄭雅文
口試委員-許甘霖
中文關鍵字 澎湖  健康不平等  社經地位 
英文關鍵字 health inequality  socioeconomic status  Penghu 
學科別分類
中文摘要 論文摘要
台灣近年來的貧富差距加大,而不同社經族群間健康不平等的現象必然也會跟著加大,除了台灣,其他國家也有類似的變化趨勢。這當然是公共衛生所應關心的重要問題。健康不平等在1980年前後,開始成為一個國際間炙手可熱的議題,探討在各國家之間、或國家內各區域間種種可能造成健康不平等的因素。在台灣研究這個領域的學者並不多,也很少研究針對特殊的地方區域探討健康不平等的問題。本研究企圖綜合時間性的縱貫面及橫斷面的資料分析層面,更深入地針對澎湖地區探討健康不平等的趨勢分析。
本研究的研究目的有四點:了解澎湖地區内部不同族群與區域的健康狀況、健康差距;了解澎湖與本島─以台北市為例─之間健康不平等長期的發展情形;了解澎湖内部區域中馬公市與其他鄉長期以來在健康方面差距的長期發展趨勢以及探討澎湖不同族群及區域之間健康不平等的長期發展機制及內容。
根據研究結果發現,澎湖地區不同族群之間的健康狀態與行為是有健康不平等的狀況,而區域層次的比較—澎湖與台灣以及澎湖內部鄉市的差距,長時間以來都有加大的趨勢,顯現出在台灣核心地區與邊陲地區的發展速度不僅不同而且差距越來越大。利用深度訪談22位個案的研究結果發現,影響健康的因素─生活機會、物質環境、健康行為與社會資本─是多元且相互影響的,而所謂的健康不平等並不是一個靜止的狀態,而是生活種種因素及條件與環境不停拉扯與角力的動態發展結果。
此研究的焦點是在於放入時間的因素考量與發展的狀況,分析影響健康的因素以及可能的進行模式,探討特定的地方區域來解答健康不平等的問題。研究結果建議國家的健康相關政策在醫療保健等方面致力於縮小城鄉或核心與邊陲的差距時,所依據的資料內容除了官方二手資料或橫斷面調查資料之外,也要考慮長期累積的發展過程角度;越了解問題的發展趨勢,越有利於擬定出有效解決健康不平等問題之方針。


英文摘要 Abstract
The gap between the poor and the rich in Taiwan has increased in recent years. As expected, the health inequality between various socioeconomic groups has also become more serious. This trend of social and health inequality is happening not only in Taiwan, but also in many other countries. The problem of social and health inequalities is indeed an important public health issue. Consequently, during 1980s , the issue of health inequality has gained wide international attention among researchers. These researchers studied all kinds of possible factors that lead to health inequality – the health inequality between various social groups within a country or that between countries or between regions or communities within a country.
However, few researchers studied the problem of health inequality in Taiwan. Further, few studies focused on the problem of health inequality of a particular region or county. This research aims at the in-depth study of the trend and the development of Penhu’s health inequality, combining cross-sectional and time-series data.
This study has four research objectives. The first is to investigate Penghu’s health status and its health inequalities between different groups. The second is to study the long-term development of health inequality between Penghu and Taiwan, using Taipei as the reference. The third objective is to examine the trends in health inequality between Magong city and other areas in Penghu. The last objective is to analyze the mechanisms and the contents of the long-term development in health inequality between various socioeconomic groups and between areas in Penghu.
The result of the study shows that, there are inequalities in health status and behaviors among groups. And both the health inequality between Penghu and Taiwan and between Magong and other townships in Penghu are widening for the past thirty years. This shows that not the gap between the core (i.e., Taipei or Magong) and the periphery (i.e., Penghu or other townships than Magong in Penghu) are increasing. The result of the 22 in-depth interviews shows that the factors that affect one’s health status include those regarding life opportunities, material conditions, health behaviors and social capital. These multiple factors act interactively. This study illustrates that the development of health inequality is not a static process – it is very dynamic, resulting from the complex interactions of the environment, conditions and every parts of life.
This research brings in the time factor in the development of health inequality, focusing on Penghu and its people. This study demonstrates that health policy-makers, in their endeavor to reduce the gap in health status between socioeconomic groups, between urban and rural areas or between the core and periphery areas, should not only depend on official secondary or cross-sectional data. They should also consider the long-term development perspective. The more we understand the mechanisms in development of the health inequality problems, the better we are able to come up with effective ways to reduce health inequalities.



論文目次 章節目錄
第一章 緒論
第一節 研究背景 1
第二節 研究問題與研究目的 3
第三節 研究場域簡介 4
第二章 文獻探討
第一節 健康不平等、社經地位與健康的關係 6
第二節 發展的視角與健康不平等 11
第三節 研究主張 (Research claim and argument) 14
第三章 材料與方法
第一節 研究設計與資料來源 15
第二節 資料分析方法 21
第四章 研究結果分析與討論
第一節 澎湖地區現存不同區域與族群的健康不平等 22
第二節 澎湖地區與台灣本島健康不平等之長期發展狀況 43
第三節 澎湖地區內部區域健康不平等之長期發展狀況 57
第四節 澎湖地區內部區域及族群健康不平等之長期發展過程 64
第五節 綜合討論 81
第五章 研究結論
第一節 研究結論 87
第二節 研究限制 88
第三節 未來研究與政策建議 89
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