臺灣高齡友善環境縣市層級資料庫之應用：以WHO都市健康公平性評估工具（Urban HEART）為例

目的：本研究以WHO發展的Urban HEART評估工具，應用已建立之高齡友善環境縣市層級資料庫，挑選相關對應的指標來評估並了解臺灣各縣市健康不平等的情形。方法：WHO Urban HEART指標分為六大類包含：總結指標、特定疾病指標、物理環境與基礎設施指標、社會與人力發展指標、經濟指標及治理指標。本研究挑選臺灣高齡友善環境資料庫對應的33個指標，並以2010年與2015年為主，計算各縣市指標之數值變化百分比，進行各縣市指標變化的比較。結果：總結指標中，五歲以下兒童死亡率下降13.2%及零歲平均餘命上升1.3%，皆略顯進步。特定疾病指標中，除心臟疾病標準化死亡率上升1.4%外，其餘指標在全國皆有下降。物理環境與基礎設施指標中，除自來水普及率變化不大外，其餘指標的變化百分比在全國皆也有進步。社會與人力發展指標中，成人吸菸率顯著下降13.3%，但是18歲以上BMI＞25之百分比(7%)及青少年懷孕率(23.7%)卻有退步的情形。經濟指標中，低收入戶人口比率增加了23.7%。最後，治理指標中的醫療保健支出占政府支出比率增加12.9%，但在選舉投票率以及教育科學文化歲出支出百分比，皆有退步的情形。除此，綜合各縣市之變化百分比，發現有城鄉差異。結論：以Urban HEART指標評估臺灣地區在2010年及2015年的健康與環境狀況，可了解大多數指標在全台各縣市皆有進步或維持，然而仍然有部分指標顯示有不一致的情形。因此，建議應針對各縣市較落後的指標探究其影響因素，以協助研擬相關政策，改善城鄉不平等的現象。

關鍵字

都市健康公平性評估工具；高齡友善環境資料庫；縣市層級

並列摘要

Purposes: To apply the Urban Health Equity Assessment and Response Tool (Urban HEART) developed by WHO, we selected the matched indicators from the Age-Friendly Environment Dataset at city-county level to evaluate whether the health inequity problems exist in cities and counties in Taiwan. Methods: Indicators of Urban HEART include six dimensions: summary indicators, disease-specific indicator, physical environment and infrastructure, social and human development, economics and governance. We selected 33 corresponding indicators from the Age-Friendly Environment Dataset at city-county level, and compared the changes of these indicators in cities and counties between 2010 and 2015. Results: In summary indicators, the under-five mortality decreasing 13.2% and life expectancy at birth increasing 1.3% showed a slight improvement. In disease-specific indicators, except for heart disease mortality increasing 1.4%, all other diseases have decreased. In physical environment and infrastructure, most of indicators have been improved, except for the safe water unchanged. In social and human development, the adults’ smoking rate has significantly decreased 13.3%, but adults’ overweight and obesity (7%) and teenage pregnancy (23.7%) got worst. In economic indicators, the percent of low-income households increased 23.7% in whole country. Finally, in the indicators of governance, the percent change of government spending on health in whole country has improved by 12.9%. However, indicators of voter participation and government spending on education regressed. Conclusions: We assessed health and environment situations of Taiwan between 2010 and 2015 with urban HEART indicators, and results showed most of indicators in cities and counties have been improves or maintained. However, some indicators have shown the urban-rural difference. Therefore, we suggest further examine the determinants of those indicators and develop related policies to improve the health inequality between cities and counties.

並列關鍵字

Urban Health Equity Assessment and Response Tool (Urban HEART) ； Age-friendly environment dataset ； City-county level

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臺灣高齡友善環境縣市層級資料庫之應用：以WHO都市健康公平性評估工具（Urban HEART）為例

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