地區剝奪、父母親社經地位對新移民女性子女健康之影響

Area Deprivation, Parents’ Socioeconomic Position and New Female Immigrant Children Health Status in Taiwan

林育秀(Yu-Hsiu Lin)

指導教授 ： 梁亞文

中臺科技大學/管理學院/醫護管理研究所/碩士(2008年)

https://doi.org/10.6822/CTUST.2008.00002

摘要

背景：2007年台灣婚姻移民者已達398,720人，其中新移民女性占9成以上，為台灣第5大族群，且自1998年迄今已有241,360名新移民女性子女出生，佔同時期出生人數之10.03%。這一群「新台灣之子」的健康狀況及其可能影響因素雖逐漸受到重視，但國內研究多侷限於單一區域或某一國籍新移民女性子女之健康，鮮少以全國性資料探討此一議題，亦未見研究探討地區剝奪與新移民女性子女健康的相關性。

研究目的：藉由全國性資料瞭解新移民女性（包含大陸、港澳地區、東南亞國家與其他國家之女性配偶）子女之健康狀況，並探討地區剝奪、父母親社經地位對新移民女性子女健康之影響。

研究方法：本研究為一橫斷性研究，以內政部「九十二年外籍與大陸配偶生活狀況調查」資料庫進行次級資料分析。地區剝奪採用林慧淳之台灣地區剝奪指標，將2003年之「15至17歲不在學率」與「初級行業人口比例」標準化後相加，計算出地區剝奪指數，指數愈高表示地區剝奪程度愈高，並依四分位法區分地區剝奪程度後與資料庫進行串檔。統計方法包含描述性分析、雙變項分析、邏輯斯迴歸分析，並以機率來解釋自變數對事件發生機率的偏作用（partial effect）。

研究結果：已生育子女之新移民女性共99,594人，以東南亞國家者最多（54.20%），大陸地區者居次（43.84%），其他國家者（1.13%）與港澳地區者（0.83%）最少。已生育之新移民女性平均年齡為28.45歲（SD=6.30），其本國籍男性配偶平均年齡為39.28（SD=7.88）；共生育147,784名子女，平均3.48歲（SD=4.55），多為健康狀況良好者（99.64%），發展遲緩者佔0.08%、身心障礙者佔0.16%、重大傷病者佔0.12%。邏輯斯迴歸分析發現，父親之工作狀況、教育程度、健康狀況、收入狀況、母親之工作狀況、結婚年數與地區剝奪均顯著影響新移民女性子女健康狀況。邊際效果顯示使新移民女性子女健康機率顯著增加的變項包含：子女性別（女性增加0.07%）、父親教育程度（高中以上者增加0.11%）、健康狀況（非身心障礙者增加0.13%）、收入（非低收戶者增加0.37％）及父母親之工作狀況（有工作的父親增加0.23%；有工作的母親增加0.15%）；使新移民女性子女健康機率顯著減少的變項則為子女年齡（5歲以上者減少0.09%）、母親在台居住時間（超過4年者減少0.19%）與低地區剝奪（較居住在高剝奪地區者減少0.11%）。

研究結論：新移民女性之國籍別對其子女健康狀況未有顯著性影響，然父親之社經地位及地區剝奪對新移民女性子女之健康狀況則有顯著性影響。衛生主管機關在制定婚姻移民者相關醫療政策時，除考量地區差異及注重醫療服務的提供與改善外，若直接將資源投注在新移民女性家庭，其成效可能會較從區域層次的作法更為有效。

關鍵字

子女健康狀況 ； 地區剝奪 ； 社經地位 ； 新移民女性

並列摘要

Background:
International or cross-cultural marriages have become prevalent in Taiwan. In 2007, there were 398,720 transnational marriage couples registered in Taiwan; 90% of which were marriages to alien brides, mostly from Mainland China and the Southeastern Asian countries. The fertility rate of these registered alien brides from 1998 to 2007 was 10%. However, little is known about the health status of the children born to these women. For proper health planning, it is essential to have detailed information on the health status of this group of children as they constitute a significant portion of Taiwan’s future generation.

Purpose:
The purpose of this study was to examine the effects of parents’ socioeconomic position and local area deprivation on the health of children born to transnational married couples residing in Taiwan.

Methods:
This is a cross-sectional study using data from 2003 “The survey on Living Status of Immigrant Women” administered by the Ministry of the Interior. There were 287,059 new female immigrants included in this study. New female immigrants were classified as arriving from Mainland China, Hong Kong and Macao regions, Southeastern Asia, and other countries. Taiwan was divided into 25 administrative areas based on the 2003 “Taiwan-Fukien Demographic Fact Book.” Area deprivation was defined as a composite index of two items: (1) proportion of primary care occupational population; (2) prevalence of non-schooling among the population aged 15-17 years. A composite rank score from 1.25 (least deprived) to -1.30 (most deprived) was calculated and quintilised for the 25 areas in this analysis.
Chi-square tests were used to examine the significance of bivariate relationships between parents’ socioeconomic position, area deprivation and children’s health. Multivariate logistic regression analyses were used to estimate odds ratios for the independent association of parents’ characteristics to their children’s health. Also, transformation of logistic models were used to report the marginal effects of the independent variables.

Results:
Logistic regression models, controlling for other maternal characteristics and socioeconomic factors, revealed that fathers’ job, education level, health status, income level as well as mothers’ job, migration status, and area deprivation were significant predictors of the children’s health. Families with lower socioeconomic positions and those residing in economically deprived areas were significantly more likely to have children with poorer health.
Marginal effects showed that the children’s sex, fathers’ education, employment status, health status, and income level, as well as the mothers’ employment status, migration status, were the most important factors determining the health status of the children.

Conclusion:
Maternal nativity status was not associated with children’s health status. Alternatively, socioeconomic position of the family, health status of the parents, and local area deprivation were found to be determinants of the health status of children born to transnational couples. Policies focusing on the optimization of these determinants could benefit the health of a large portion of Taiwan’s children.

並列關鍵字

Children health outcome ； New female immigrant ； Socioeconomic position ； Area deprivation

參考文獻

Chen, P. C., Pai, L., Wang, J. D., & Doyle, P. E. (1999). Parental Socioeconomic Status and Low Birthweight, Preterm Delivery, and Small for Gestational Age in Taiwan. Chinese Journal of Public Health, 18(2), 105-115.

蕭文萱（2007）。母親國籍與嬰幼兒健康。未出版之碩士論文。國立台灣大學，台北。

陳志柔、于德林（2005）。台灣民眾對外來配偶移民政策的態度。台灣社會學，（10），95-148。

王桂芸（2007）。氣喘病患健康知能與自我管理行為之關係及介入措施之成效（國科會專題研究計畫成果報告編號：NSC96-2314-B016-049-MY2）。台北：行政院國家科學委員會。

李素幸（2003）。外籍新娘所產新生兒低體重及其他健康問題之探討（2/2）（國科會專題研究計畫成果報告編號：NSC91-2320-B-309-001）。台北：行政院國家科學委員會。