社經地位與健康路徑關係之性別差異

Gender Differences in a pathway Linking Socioeconomic Status and Health

李妙純(Miaw-Chwen Lee) ； 張華庭(Hua-Ting Chang)

《台灣公共衛生雜誌》 30卷5期 (2011/10) Pp. 453-467

https://doi.org/10.6288/TJPH2011-30-05-06

摘要

為瞭解性別之健康差異，本文以路徑分析探討性別如何經由社經地位影響性別之健康差異。方法：本研究以「2005年國民健康訪問調查」12-64歲個人問春為資料，以台灣版SF-36自覺健康狀態為健康指標。結果：當調整年齡、社經地位、健康行為、環境風險因子及飲食多樣性後，男性健康皆比女性佳。性別透過社經地位或再由社經地位影響健康行為、環境風險因子及飲食多樣性等間接影響健康；若未考慮間接效果，將低估性別之健康差異。對大部分的健康指標而言，社經地位對女性健康的直接效果比男性小；社經地位透過環境風險因子對女性健康的間接效果較大，男性則為飲食多樣性；社經地位透過健康行為對女性健康的效果相當小，男性則不然。結論：性別為影響健康之重要因素，但也與社經地位相關，並透過其他因素，特別是健康行為、環境風險因子及飲食多樣性而影響兩性健康差異。在社會資源有限及性別主流化趨勢下，應該針對兩性之特異性提出有效政策，以提升整體健康並改善性別之健康差異。

關鍵字

性別不平等 ； 自覺健康 ； 健康不均 ； 路徑分析

並列摘要

This study examined the influence of socioeconomic status on gender disparities in health by using a path analysis. Methods: Data came from the 2005 National Health Interview Survey in Taiwan, which contains data about 18099 non-institutionalized residents aged 12-64. Health was measured with the Short-form 36 health status, Taiwan version. Results: When other factors were controlled, women's health was worse than men's. The direct effect of gender on health contributed the most to the gender disparity. The indirect effect of gender on health (through its effect on socioeconomic status) was positive and significant. For men, higher socioeconomic status and more health-damaging behavior had negative effects on health. If we neglect the indirect effect, the gender disparities in health were under-estimated. For separate samples of women and men, the direct effect of socioeconomic status on health was smaller for women than for men. Most of the indirect effect of socioeconomic status on health was through environmental risk factors for women, but through food varieties for men. These indirect effects of health-related behavior were smaller for women than for men. Conclusions: Our results confirmed that gender differences in health are potentially moderated by socio-economic status through variables such as health-related behavior, environmental risks and food varieties. Understanding the gender differences in health is helpful for policy-makers in order to devise gender-equality in social policy for the improvement of health of both men and women and to address the gender disparity in health.

並列關鍵字

gender inequality ； self-reported health ； health inequality ； path analysis

參考文獻

王香蘋(2000)。死亡率與罹病類型差異：老年女性健康問題之探討。婦女與兩性學刊。11，129-50。

謝小芩(1998)。性別與教育期望。婦女與兩性學刊。9，205-31。

Office for National Statistics (ONS). Life expectancy at birth (years), United Kingdom, males and females, 1991-1993 to 2007-2009. Available at: http://www.statistics.gov.uk/downloads/theme_population/leuk2010. xls#'UK at birth'!A1. Accessed November 26,2010.

行政院主計處：人力資源調查提要分析。http://www.dgbas.gov.tw/public/Attachment/010228463671.pdf。引用2010/11/26。Directorate-General of Budget, Accounting and Statistics, Exective Yuan, R.O.C. (Taiwan). Analysis of human resource survey. Available at: http://www.dgbas.gov.tw/public/Attachment/010228463671.pdf. Accessed November 26, 2010. [In Chinese]

Jarman J, Blackburn RM, Brooks B, Dermott E. Gender differences at work: international variations in occupational segregation. Soc Res Online (serial online) 1999 Mar (cited 2010 Nov 26 );4(1). Available from:URL: http://www.socresonline.org.uk/4/1/jarman.html.