| Summary: | 碩士 === 國立臺灣大學 === 公共衛生碩士學位學程 === 105 === Objectives: Along with the socioeconomic development and health reform in Taiwan, the GDP and life expectancy are both improved. However, the geographical inequality of health in Taiwan hasn’t been intensively researched before, especially among Changhua, Nantou and Yunlin in central Taiwan. Therefore, this study explores this issue through (1) Reveal the socioeconomic development trends in county and township level within Changhua, Nantou and Yunlin during 2000-2015. (2) Analyze the correlation between regional socioeconomic development and health. (3) Investigate the existence of geographical health inequality.
Methods: This study belongs to the secondary data analysis, with data from official government publications. The independent variables include 4 economic development indicators: (1) average annual income per individual income tax return unit, (2) average disposable income per house, (3) gross domestic production per capita of secondary and tertiary industry (4) low income ratio, and 3 social development indicators: (1) the higher education rate above 15 year-old, (2) tap water penetration rate and (3) number of doctors per 10,000 people. The main outcome measure is the age-standardized mortality rate. Descriptive statistical analysis and panel data analysis were applied to examine the relationship and effect. The geographic information system was also used for visualized presentation of the regional mortality changes.
Results: The results showed that: (1) The standardized mortality rate of Yunlin County, and Nantou County were both higher than Changhua County, and the difference was statistically significant (p = 0.002). Take the year 2015 as an example, the rate of Yunlin, Nantou and Changhua are 5.07‰, 5.01‰ and 4.46‰ respectively. (2) The difference of standardized mortality rate among townships was not only significant but also increased year by year. The highest and lowest ratio of Changhua, Nantou, and Yunlin were from 1.25, 1.97, and 1.27 to 1.31, 2.10, and 1.36 respectively, and (3) Findings from the panel regression analysis suggested the higher the degree of socioeconomic development, the lower the mortality rate regardless of the county level or township level and education was the most important factor.
Conclusions: The standardized mortality rate differs obviously from either county or township level. The higher socioeconomic development is, the lower mortality rate it is. The most important factor in terms of mortality rate is education. Socioeconomic development is important to decrease the mortality in Changhua, Nantou, and Yunling, showing that there is health inequality among these regions.
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