臺灣老人人口分佈與自覺健康之地區性差異

Geographic Differences in the Distribution of the Population and the Perceived Health Status among the Elderly in Taiwan

本研究旨在探討臺灣老人人口分佈與健康狀況之地區差異及其影響因素。研究資料係以2001年完成之「國民健康訪問調查（NHIS）」中，所有樣本年齡在65歲以上者為研究對象，先以頻率及百分比描述臺灣老人人口的分佈狀況，並以卡方檢定探討樣本之人口學、健康狀況、健康行為與醫療服務利用等變項在不同地區分組中的差異；再以長期資料統計模式的廣義估計方程式（GEE），研究影響樣本自覺健康之因素。分析結果顯示臺灣老人人口分布並不平均，南部與東部地區的老人人口比例（11.0-12.7%）遠較中北部地區為高（7.9-9.0%）；而老年人自覺健康普通或不佳的比例以大台北地區最低（57.6%）（p<0.01）。除了地區別的差異外，顯著影響老年人自覺健康的因素有：教育程度、憂鬱狀況、身體之活動功能、慢性病項數、門診與急診的就診與否，以及是否有規律運動。本研究以實證資料說明了培養老年人的運動習慣、改善老年人休閒空間、加強其社會支持，都是吾人在擬定老年人健康促進計畫時應詳加注意者。

We aimed to analyze geographic differences in the distribution of the population and the perceived health status among the elderly in Taiwan. Of those interviewed during the 2001 National Health Interview Survey (NHIS), people 65 years of age and older were recruited into this study. Because the sampling strategy of probability proportional to size was used in the NHIS, the study sample in this analysis represented senior citizens who resided in Taiwan in 2001. Two statistical techniques, the chi-square test and the generalized estimating equation model (GEE), were used to delineate the study endpoints. The proportion of the elderly population in southern and eastern Taiwan (11.0-12.7%) was higher than in central and northern Taiwan (7.9-9.0%). In the Taipei metropolitan area, the percentage of elderly people who perceived their health status as poor or fair was 57.6% (the lowest percentage compared to other geographic areas). The perceived health of the elderly was significantly influenced by their level of education, mood (i.e., depression), physical functioning, the number of ongoing chronic conditions, previous ambulatory clinic or emergency room visits, regular exercise habits, and geographic location of their residence. Regular exercise significantly influenced the health of the elderly, implying that advocating exercise habits, improving recreation facilities, and mitigating geographic health disparity should be among the priorities in promoting health status for the elderly.