氣候災害對農村公共衛生與心理健康之影響－－以颱風災害為例

Impacts of Climate Disaster on Public Health and Mental Health in Rural Taiwan

世界銀行將臺灣列為最易受天災衝擊的全球災害熱點。本研究旨在探討農村居民對氣候災害帶來公共衛生衝擊的感受情形，及對災後心理健康狀況的可能影響。本研究對象為莫拉克與凡那比颱風災區居民，採用結構性問卷調查方式，以間隔抽樣方法，總計調查400位18歲以上農村居民，共獲有效樣本381份。問卷設計主要調查農村居民對氣候災害後的公共衛生與心理健康之感受，採用Likert五點尺度量表，分為環境衛生汙染、傳染病、非傳染病與災後心理感受等四大面向進行調查。研究發現農村居民對於農村環境公共衛生受災嚴重程度之平均感受，前兩項為災後環境衛生汙染與災後心理健康受創。在整體公共衛生受災感受程度的多元迴歸分析上，發現經歷房屋受損者、年齡為65歲以上者、耕種面積為0.5甲至1甲者，相較於其對照組，其受災嚴重程度的感受也較高，尤以曾有房屋受損影響效果最大（β=3.874）。第二階段的災後心理健康感受之迴歸分析，經控制受災經驗、社會人口變項與農業經營情形的影響效果後，發現受訪者感受到災後環境衛生汙染與非傳染性疾病災情愈為嚴重者，對心理健康狀況的影響愈高。綜合上述發現，建議有關單位未來在協助災民因應氣候災害對農村公共衛生與心理健康之影響時，應優先妥善處理環境衛生污染問題，及協助災民進行受損房屋的清理與復原，始能有效降低災民災後心理創傷的問題。另政府宜依據不同受災群體提供客製化的公共衛生與健康支持措施，特別需照顧房屋受損者與高齡災民的居家環境衛生與心理健康。

Taiwan is annually afflicted by climate disasters, mainly typhoons and recognized as a relatively high-risk global hotspot by the World Bank. The aim of this study is to examine how the climate disaster affects perceptions of public health and mental health status among the victims of Typhoon Morakot and Typhoon Fanapi in rural areas. Using a representative survey of Typhoon victims in south Taiwan, an interval sampling design and two-stage multiple regression model was employed in the survey, we find compelling evidence that the effect of damaged experience of Typhoon disasters on the perception of environmental health risk is higher than those who dose not have property loss due to Typhoon disasters. In addition, those who were victims of Typhoon disaster, aged 65 and over, with farm size between 0.5-1 hectare, and with damaged houses significantly increases the feelings of disaster severity, compared with their counterparts. Futhermore,the empricial results show that the the feeling of severity of environmental pollution and non-communicable physical injuries and illness is positively associated with post-disaster mental health status. The main policy implications of this study can be suggested that properly measures handling with environmental sanitation and pollution problems, and recovery damaged houses should be top priority for post-disaster public health and mental health issues.