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E91068
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健康訊息,主觀存活機率與健康行為之關係
Health Information, Subjective Probability of Survival and Health Behavior
1.鄒孟文
2.劉錦添
1.Meng-wen Tsou
2.Jin-tan Liu
1.淡江大學國際貿易學系
1.Department of International Trade, Tamkang University
001,002,003,004
1.淡江大學國際貿易學系
1.Department of International Trade, Tamkang University
002
1.行政院國家科學委員會
1.National Science Council
A.14 計畫執行期間(起):2002-08-01
A.14 計畫執行期間(訖):2003-10-31
2002-07-012002-12-312003-04-192003-05-31
A.16 收到日期:2004-01-19
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大台北地區40歲以上成人

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第一次:932 第二次:470


932
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C.2 聯絡日期:2004-01-27
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1.淡江大學國際貿易學系
1.Department of International Trade, Tamkang University
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C.7 資料公開日期:2008-11-01
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1.主觀存活機率
2.健康行為
3.健康衝擊
1.Health Behavior
2.Health Shock
3.Subjective Survival Probability
儘 管「預期」(主觀機率)(subjective probability) 在許多不確定下的決策模式中扮演了相當重要的角色,實際上受到資訊取得不易的影響,經濟學者多半採用一些強烈但無法證實的假設。例如總體經濟模型中常假設 理性預期,而個體經濟模型則大多利用可觀察到的人口機率分配–生命表(life tables)來分析人們的消費行為。然而,生命表所提供的僅是民眾平均壽命的估算值,若能根據個人不同的主觀存活機率進行分析,將可更正確地預測個人行 為。

Hamermesh(1985)最早嘗試比較個人主觀存活機率和生命表平均壽命預期之差異。他利用兩套樣本資料,發現主觀存活機率分配比實際存活機率分配 平坦且變異較大,二者並非完全吻合。Hamermesh並指出人們主觀的存活機率會受到親屬壽命的影響。近年來,陸續有許多經濟學者利用美國Health and Retirement Study(HRS)和Asset and Health Dynamics among the Oldest-Old Study(AHEAD)的多期panel資料觀察民眾壽命預期的變化。Hurd及其合作者一系列的研究即認為主觀存活機率具有預測實際死亡率的能力。 Hurd and McGarry(1995)發現擁有高社經地位(例如教育程度、所得和財富)的人,主觀存活機率明顯較高;至於有吸煙習慣的人則傾向持有較為悲觀的看法。 Hurd and McGarry(1997)利用兩期的HRS資料,發現父母親過世以及本身罹患癌症這項新的健康衝擊(health shock)會顯著降低個人的主觀存活機率。Hurd, McFadden and Merrill(1999)隨後針對70歲以上的老年人為研究對象,再度證實包括癌症、高血壓、糖尿病或憂鬱症等健康警訊的出現會降低老人們的壽命預期。 Smith et al.(2001)則是採用風險認知的調適模型進行探討。這幾位學者發現吸煙者風險認知的調 整過程有別於非吸煙者。不吸煙或已戒煙的人對壽命的預期會廣泛受到各種健康衝擊的影響,但是有吸煙習慣的人僅感受到罹患與吸煙相關的疾病會降低其存活機 率。Smith, Taylor and Sloan(2000)以共4期完整的HRS panel資料進行實證,仍然發現嚴重的健康衝擊和活動受限程度的加重皆會降低人們的主觀壽命預期。這項實證結論與先前的研究發現頗為一致。

本研究共有三項研究主題:一為探討影響個人主觀存活機率的決定因素;二為分析新的健康衝擊對主觀存活機率變動的影響;三則是檢測健康衝擊、健康知識與健康 行為之關係。在資料蒐集方面,我們將與台北市立馬偕紀念醫院家庭醫學科合作,取得2002年7月至12月至該院接受成人免費健康檢查民眾健檢前自我評估的 健康狀況和健康行為資料,以及健檢評估報告中有關受檢者罹患的疾病與各項檢驗結果。根據這份名單,我們將進行健檢後健康行為追蹤和壽命預期的面訪工作。

Although “expectations” plays a prominent role in many kinds of economic models, in most applications, however, the economists make some unverifiable assumptions due to the lack of data on probability distributions. Inmacroeconomic models it is common to assume that expectations are rational. This is a rather strong assumption and it is untestable without data or actual expectations. In micro estimation it is often specified that individuals base their behavior on observable population probabilities. For example, estimation of life cycle consumption models has been based from the survival probabilities found in a life table. Since the survival probabilities from the life tables may not be correct even on average, an improvement to using population probabilities in microeconomic models is to base estimation on individuals’ subjective probabilities. Hamermesh(1985)provided the first study about whether people’s longevity expectations conform to life tables. Using two different samples, he found that subjective longevity perceptions do not accurately correspond to actuarialdistributions. The subjective distributions were flatter and exhibited greater variance. Moreover, respondents tend to base their beliefs disproportionatelyon relatives’ longevity. In recent years, several studies examine the evolutionof subjective longevity expectations over time based on the panel data from the Health and Retirement Study(HRS)and the Asset and Health Dynamics among theOldest-Old Study (AHEAD). Hurd and his colleagues provide a consistent evidence on the predictability of the subjective survival probabilities on actual mortality. Hurd and McGarry(1995)found that respondents with higher socioeconomic status(education, income and wealth)give higher probabilities of survival, whereas respondents who smoke give lower probabilities. Hurd and McGarry(1997)use two waves of e HRS and suggested that subjective beliefs decline with the death of a parent and respond to only one type of new health shock–cancer. Hurd, McFadden and Merrill(1999)focus on an older population(i.e., aged 70 or older)by using the panel structure of the AHEAD. These author also confirmed that subjective beliefs do respond to the onset of health conditions (cancer, high blood pressure, diabetes and depressions).On the other hand, Smith et al.(2001)use a risk-updating framework to investigate how exogenous health shocks impact people’s longevity expectations. Their result supports the conclusion that smokers have a different risk perception process. Smokerswere only sensitive to their own smoking related illness while former smokersand those who never smoked react to a wider range of health signals. Further,Smith, Taylor and Sloan(2000)use the most complete version of the HRS available (four waves)and found that serious health shocks and new activity limitations do reduce longevity expectations, which is consistent with the previous findings. We will address three issues in this study. First, we investigate the determinants of subjective probability of living to 75 or 85. Second, we examine how longevity expectations respond to new health shocks. Third, using a simultaneous framework, we explore the roles of health information(including health shocks and health knowledge)in determining health behaviors. To obtain detailed information on health behaviors and expectations, we will conduct a survey of adults who take the physical checkup by free-of-charge at Mackary Memorial Hospital. Our analysis is based on the information of pre-physical checkup and post-physical checkup interview as well as the reports on health evaluations. The measures of health shocks will be constructed as the incidence of health conditions according to the evaluation reports. Prior work have found that unrealistic stated subjective survival probabilities are associated with low cognitive ability. To control for the focal-point responses, we examine the determinants of subjective survival probabilities by using the probit model with sample selection. Our second test recognizes that all the determinants of subjective probabilities must be considered in estimating the risk equivalent associated with new information.Following the approach developed by Viscusi (1990), we can evaluate how new information, acquired through exogenous health shocks, affects people’s longevity expectations. The impact of health shocks on health behaviors can be examined after treating health knowledge as an endogenous explanatory variable in the health behavior equations.

D.16 完成檢誤日期:2004-09-13
D.17 預定釋出日期:2008-11-01
D.18 初次釋出日期:2008-11-01
D.19_1 最新版釋出日期:2008-11-01
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10.6141/TW-SRDA-E91068-1
追蹤清單
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