南台灣的公共衛生問題：與北台灣的比較分析

Public Health Problems in Southern Taiwan: Compared with Northern Taiwan

陳美霞(Meei-Shia Chen)

《台灣公共衛生雜誌》 24卷6期 (2005/12) Pp. 504-518

https://doi.org/10.6288/TJPH2005-24-06-05

摘要

目標：以南台灣為關注的焦點，本研究從社會、經濟、與人口，疾病負擔與平均餘命，及公衛資源等三個層面，與北台灣作比較，分析南台灣的公共衛生問題。方法：本研究資料來自行政院主計處、衛生署、內政部、以及環保署的各縣市有關上述三個層面的資料，再經計算得南北台灣的相關數據後做比較分析。南北台灣死亡率差距並以多餘死亡指數測量。結果：本研究發現南台灣的相對劣勢：南台灣人民的年收入比北台灣人民低，而且過去將近20年來不僅未曾改善，甚至南北差距加大；南台灣人民的教育程度較低，而過去將近20年來，南北的教育差距也未曾縮減；南台灣都市化程度較北台灣低，人口老化的速度過去二十年來比北台灣快。南台灣民眾十大死因的死亡率不但比北台灣高，而且這個差距在過去十多年來幾乎都是持續那麼大，甚至有些疾病的差距是越來越大。南台灣的民眾比北台灣平均約少活兩歲左右。在公共衛生資源方面，南台灣除了從事病後醫療的醫事人力及病床數資源與北台灣尚可比擬外，其他均比北台灣貧乏。結論：紓解南台灣如此不利的、長期持續落後北台灣的健康及公共衛生狀況最可能的出路是：公衛醫療專業與社區的結合。

關鍵字

健康不平等 ； 南台灣 ； 疾病負擔 ； 南北差距 ； 公共衛生資源

並列摘要

Objectives: This study analyzes southern Taiwan's public health problems by comparing them with northern Taiwan in three dimensions: socioeconomic status and population characteristics; disease burden and life expectancy; and public health resources. Method: The data are based on the county- and city-level statistics of the above three dimensions collected or compiled by Directorate General of Budget Accounting and Statistics of the Executive Yuan, Ministry of Internal Affairs, Department of Health, and Department of Environmental Protection. The relevant statistics for southern and northern Taiwan were than calculated and compared. For the comparison of mortality rates of the ten leading causes of death, the index of excess mortality was used to measure the gaps between southern and northern Taiwan. Result: The study found that southern Taiwan is much more disadvantaged than northern Taiwan: Its average annual income is much lower than that of northern Taiwan. Furthermore, in the past two decades, this disparity has increased. Southern Taiwan's average educational level is also lower than northern Taiwan's. This disparity has not decreased in the past two decades. Southern Taiwan is less urbanized and its population is aging much faster than northern Taiwan. The mortality rates of the ten leading causes of death are higher in southern Taiwan and the state of these inequalities has either persisted or worsened in the past one or two decades. The life expectancy of the population of southern Taiwan is about two years less than that of northern Taiwan. In terms of public health resources, other than the indicators of the numbers of medical providers and hospital beds, southern Taiwan is more disadvantaged than northern Taiwan. Conclusion: The best solution to southern Taiwan's persistently disadvantaged status is the integration and collaboration between the health and medical profession and the people in the communities in southern Taiwan.

並列關鍵字

Health inequality ； southern Taiwan ； disease burden ； south-north disparity ； public health resources

參考文獻

瞿海源｜章英華(2000)。台灣社會變遷基本調查的運作成效及未來的努力方向。調查研究。8，105-19。

Anderson RA(1976).A framework for cross-national comparisons of health service systems.Cross-national Sociomedical Research: Concepts, Methods, Practice. A seminar under the auspices of the ISA.

Blum H(1973).Planning for Health, Development, and Application of Social Change Theory.

Bronfman M(1992).Infant mortality and crisis in Mexico.Int J Health Serv.22,157-67.

Chen MS,Lyttle CS,Andersen RM(1997).Research issues and methodology.Comparing Oral Health Care Systems.7-25.