生態系統理論於社區健康評估之運用

Using Ecological Systems Theory in Community Health Assessment

隨著全球生態逐漸惡化、氣候極端改變、經濟普遍蕭條，以及人口結構改變（譬如：高齡化、單身化、少子化及新移民）現況，使得社區健康倍感重要。國內外學者雖曾以生態理論探討促進現代社會人民健康之議題，卻尚未應用該理論評估國內外社區健康問題。因此，本文以臺北市信義區某社區為例，採觀察、深度訪談、問卷調查、文獻考察等方法，探究生態學系統理論應用於評估臺灣都市社區健康之可行性，並分析外在環境因素對社區居民健康可能的影響。本社區健康評估結果顯示該社區健康問題在於居民促進健康之能力與行動普遍不足；也發現部份居民與鄰居之人際關係疏離。作者根據結果提出以四大生態系統為基礎之具體方案（如整合社區人力資源及凝聚社區居民共識），以解決該社區之健康問題。

The health of urban community residents is an issue of growing concern due to ecological degredation, increasingly extreme changes in weather, the growing prevalence of economic downturns, and chronic population structure imbalances (e.g., rising elderly and unmarried populations, low birth rates, and rising immigrant populations) around the globe. Although the theory of ecology is commonly used by domestic and international researchers to explore health promotion issues in modern society, it has not been applied in assessing the problems of community health in Taiwan or elsewhere. This paper focused on one community in Taipei City's Xinyi District to investigate the feasibility of applying the ecological system theory to urban community health assessments in Taiwan and analyzed the influence of external environments on residents' health. Researchers used observation, in-depth interviews, a questionnaire survey and literature review to frame research and collect data. Community health assessment results show one of the main health problems in the target community resulted from inadequate resident abilities and actions related to health promotion. Some residents also maintained only distant interpersonal relationships with people in their immediate neighborhood. Findings suggest the need for implementing concrete schemes based on four ecological systems to resolve identified health problems that included inadequate community human resource integration and community consensus building.