1
3
E92049
3
010
健康知識與健康行為:台灣肥胖之實證
Health Knowledge and Health Behavior: Empirical Study of Obesity in Taiwan
1.鄒孟文
1.Meng-wen Tsou
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):2003-08-01
A.14 計畫執行期間(訖):2004-10-31
2004-09-292004-10-16
A.16 收到日期:2005-01-17
1
年滿20-60歲之有工作的女性

1

1441


1441
002
01
C.2 聯絡日期:2005-01-14
2
1.淡江大學國際貿易學系
1.Department of International Trade, Tamkang University
1
C.7 資料公開日期:2009-11-01
2
008
2
1
1
1
2
3
3
001
1,2
1.肥胖
2.健康行為
3.健康知識
1.Health Behavior
2.Health Knowledge
3.Obesity
 在健康經濟和公共衛生的領域中,教育與健康行為的議題學者們著墨甚多。Grossman(1972, 1975)最早認為教育投資有助於人們從事健康活動的效率性。然而,Farrell and Fucks (1982), Becker and Murphy (1988)和Chaloupka (1991)卻持不同的看法。這幾位學者指出教育與健康間的正向關係可能僅是反映個人的自我選擇,某些無法觀測到的個人特質,例如時間偏好(time preferences),可能同時影響一個人受教育的年限和健康行為。

自1990年代開始,有關探討健康知識、教育程度和健康行為的研究陸續出現,討論的健康行為包括吸菸、喝酒、運動以及營養攝取等。Kenkel (1991)提出健康知識是促使教育能增進健康投入效率的假說。他在控制健康知識的內生性質後,發現教育程度愈高的人,吸菸和酗酒的機率明顯降低,從事的 運動量則較多。而擁有健康知識的民眾,也比較會從事健康活動。這項發現普遍獲得文獻上的證實(Ramezani and Roeder, 1995; Hsieh et al., 1996; Variyam et al., 1996)。

Nayga (2000a, 2000b, 2001)一系列的研究則首度將討論重點轉移至近年來國內外相當受到矚目的肥胖議題上。Nayga (2000a)利用美國的Diet and Health Knowledge Survey (DHKS)資料,發現教育程度與肥胖間的負向關係主要是經由健康知識這項中介變數傳導而來。不同於Kenkel的是,當控制住個人瞭解肥胖易引發的疾病 知識後,教育對肥胖的影響即轉趨不明顯。

所謂「肥胖」指的是體內脂肪堆積過多產生的疾病。儘管肥胖不會帶來立即的生命威脅,但醫學研究發現,肥胖與罹患心血管疾病、中風、糖尿病和部份惡性腫 瘤有密切的關聯性(Himes, 2000)。根據1996年國民營養調查顯示,國人屬於過重體態(overweight)約佔11%,屬於肥胖體態(obesity)則佔了13%的比 例。值得注意的是,BMI (body mass index)超過27以上的成人,平均有八成五會出現與肥胖相關的代謝疾病。因此,宣導民眾正確的體重認知和控制方式將有助於減少肥胖造成的醫療負擔。

有鑑於國內探討肥胖的研究仍相當少見,而隨著台灣社會生活型態的改變,體重過重或肥胖的人口有逐漸上升的趨勢,因而引發我們對本項議題的研究興趣。本研究共有三項研究主題:一為探討健康知識、教育程度與肥胖之關係;二為衡量主觀肥胖認知和客觀肥胖指標間的偏誤來源;三則是檢測健檢後的醫師忠告對民眾體 重控制行為之影響。

在資料蒐集方面,我們除了將使用1993-1996年國民營養健康狀況變遷調查外,另將與台北市立馬偕紀念醫院家庭醫學科合作,針對2003年7月至 12月至該院接受成人免費健康檢查的民眾進行問卷調查,藉此可取得受檢者的健康知識,主觀健康認知和健康行為資料,以及健檢評估報告中受檢者經測量的身 高、體重數值和各項檢驗結果。待受檢者至醫院取回健檢報告並聽取醫師的諮詢與建議後,我們將進行健康行為追蹤的面訪工作。

There has been a growing awareness amongst economists and health commentators of the importance of schooling on health behavior, with the positive correlation between health and schooling having been explained in several ways. Grossman (1972, 1975) has argued that schooling increases an individual’s ability to produce health, while others have asserted that schooling could be correlated with unobservable factors relating to health. Farrell and Fuchs (1982), Becker and Murphy (1988) and Chaloupka (1991) argued, for example, that by lowering the rate of time preference, schooling might encourage healthy habits.

Since the 1990s, a number of studies have hypothesized that by improving an individual’s health knowledge, schooling improves allocative efficiency. These studies explored the effects of schooling and health knowledge on a variety of health behaviors and outcomes. Examples include the consumption of cigarettes and alcohol and the propensity towards exercise (Kenkel, 1991), smoking (Hsieh et al., 1996), and dietary fiber or other nutritional intake (Ramezani and Roeder, 1995; Variyam et al., 1996). After treating health knowledge as an endogenous variable, Kenkel (1991) found that both schooling and health knowledge reduced the uptake of smoking and heavy drinking, whilst increasing the amount of exercise a person takes. Similar results are also found in several studies.

Focusing on the important issue of obesity, Nayga (2000a, 2000b, 20001) revisited the issue of the effects of schooling on health, by examining the relationship between obesity, schooling and health knowledge. In contrast to Kenkel’s (1991) findings, Nayga (2000a) concluded that the association between schooling and obesity was mainly attributed to differences in health knowledge amongst individuals.

Obesity is defined as a medical disorder of an excessive accumulation of body fat, which is linked to many of the major causes of death, including heart disease, strokes, diabetes, and some types of cancer. According to 1996 Taiwan Nutrition Survey, 11 percent of the respondents were considered to be overweight, and 13 percent were considered to be obese. It is noteworthy that more than 85 percent of respondents with a BMI greater than 27 had metabolic diseases.

We will address three issues in this study. First, we examine the relationship between health knowledge, schooling and obesity. Second, we investigate the magnitude of the measurement error in self-reported measure of obesity. Third, using difference-in-difference estimation, we explore the role of physician advice in weight control practices.

One of the data sets we use in this study is drawn from the 1993-1996 Taiwan Nutrition Survey conducted by Dr. Wen-Harn Pan. To obtain detailed information on health knowledge, perception of obesity, and health behaviors, we will conduct another survey of adults who take the physical examination at Mackay Memorial Hospital. Our analysis is based on the health information of pre- and post- physical examinations as well as the medical records on physical examination reports.

D.16 完成檢誤日期:2006-06-27
D.17 預定釋出日期:2009-11-01
D.18 初次釋出日期:2010-02-05
D.19_1 最新版釋出日期:2010-02-05
1
1
1
2
1,3
10.6141/TW-SRDA-E92049-1
https://efenci.srda.sinica.edu.tw/webview/index.jsp?object=https://efenci.srda.sinica.edu.tw:80/obj/fStudy/E92049
追蹤清單
下載(0)
申請(0)
遠距(0)