- 學位論文
鄰里生活空間與憂鬱情緒之關聯的多層次分析： 健康生活型態的調節效果
A Multilevel Approach to the Association Between Neighborhood Living Space and Depressive Mood: The Moderating Role of Healthy Lifestyle
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摘要
背景：世界衛生組織於多次的會議、建言中提到：要改善人類的健康、為健康創造一個支持性的環境，顯示環境對於人類的健康有極大的影響。當人們所居住的鄰里生活空間對其健康產生負面影響時，自身的健康生活型態所扮演的調節效果為何，為目前國內相關研究較少探討的部分。此外，一個地區的經濟狀況會影響居民的憂鬱情緒，因此透過個人層次與縣市層次對居民健康的影響，將有助於改善環境與居民健康之間關係的知識缺口。 目的：探討台灣居民的鄰里生活空間、健康生活型態與憂鬱情緒的關係，以及憂鬱情緒是否因不同縣市之社會經濟發展程度而有所差異。 方法：本研究以「台灣社會變遷基本調查計畫」之2011年公開資料進行次級資料分析，總研究樣本數共納入2090人。本研究利用多階層線性模式(Hierarchical Linear Models)，將資料統合出個人層次鄰里生活空間(包含主觀的環境汙染、治安)、健康生活型態與憂鬱情緒，並利用人均所得作為縣市層次變項，探討個人與縣市層次中，鄰里生活空間、健康生活型態與憂鬱情緒之關係。 結果：在個人層次分析中，在鄰里生活空間方面，主觀汙染程度、主觀汙染環境、主觀治安不良的程度越高，會導致居民的憂鬱情緒越高；雖然不是健康生活型態者有較高的憂鬱情緒，在鄰里生活空間的影響下，雖然鄰里生活空間與健康生活型態不具有交互作用，但保有健康生活型態依然可以抵銷部分環境造成的危害；在健康生活型態之中，尤其不喝酒、運動、吃蔬果能夠降低憂鬱情緒。在縣市層次分析發現，不同縣市居民的憂鬱情緒有顯著差異，但不能被人均所得所解釋，亦不存在交互作用效果。 結論：本研究證實鄰里生活空間中，環境汙染、治安不良對居民的心理健康有負面影響，但個人的健康生活型態可以幫助減輕其危害。研究結果可供政府執行健康促進政策時之參考。
並列摘要
Background: World Health Organization (WHO) has suggested several times in conferences that improving human health and creating a health supporting environment are necessary because environment plays a critical role in influencing human health. When the neighborhood living spaces have negative effect on human health, the role self-healthy lifestyle plays in moderating depressive mood is poorly studied in Taiwan. In addition, local economic development would impact depressive mood level in residents. Therefore, understanding the effects from individual-level and county-level in residents’ health may improve knowledge gaps between environment and residents’ health. Objective: Investigating the correlation among residents’ neighborhood living space, healthy lifestyle and depressive mood in Taiwan, and whether different depressive mood level is due to different social economy development across counties. Methods: Data was analyzed from The Survey Research Data Archive (SRDA) by 2011 with 2,090 subjects in total. Hierarchical Linear Models (HLM) was used in this study to determine the association among neighborhood living space (including perceived environmental pollution and public security), healthy lifestyle and depressive mood on individual-level and county-level with per capita income as county-level variables. Results: In neighborhood living space, upregulation of perceived environmental pollution and public security failure would induce residents’ depressive mood. Although there were not any interactions between neighborhood living space and healthy lifestyle, people who maintained healthy lifestyle can avoid negative impacts from neighborhood living space. Moreover, level of depressive mood was not perfectly correlated to lifestyle, but no alcohol intake, more exercise and more vegetable intake may successfully reduce depressive mood. At last, there were significant differences in residents’ depressive mood across counties; however, these differences were not correlated to per capita income. Conclusion: In neighborhood living space, pollution and public security failure may cause negative effects in residential mental health; however, these negative effects can be reduced by supported healthy lifestyle. These results have implication of government to execute the policy of health promotion.
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