健康風險認知、減重需求與其願付價值

Health Risk Perception, Demand, and Willingness to Pay for Weight Reduction

傅祖壇(Tsu-Tan Fu)；林億明(Yih-Ming Lin)

肥胖 ； 假設市場評估法 ； 身體質量指數 ； 雙界二分選擇模型 ； Obesity ； Contingent Valuation Method ； BMI ； Doubled-Bound Dichotomous Choice Model

經濟研究

50卷1期（2014 / 01 / 31）

69 - 99

繁體中文

本文旨在建立一兩階段模型探討影響國人肥胖減重需求之因素，並衡量在三個月內減重五公斤之新減重療程的願付價值。在第一階段模型，將個人健康風險認知納入模型內，並探討影響國人減重需求之因素。本文利用「台灣地區心臟血管疾病風險因子研究之社區型追蹤整合調查」（CVDFACTS）資料進行實證研究，並利用聯立模型加以估計，估計結果顯示，肥胖的風險認知對減重之需求有顯著影響，就社會經濟變數方面，性別、年齡、所得與工作狀態對減重之需求有顯著影響。除此之外，肥胖程度增加會使得對減重的需求機率將增加，而家族裏有人曾罹患與肥胖相關之疾病，亦會增加對減重的需求。其次，利用雙界二分選擇模型估計減重之願付價值，結果指出每人願意支付價格大約為3,388至4,689元，女性之願付價值高於男性，其中願付價值之影響因子為年齡，所得多寡，肥胖程度外，還受肥胖是否影響工作之升遷之認知、是否曾經控制過體重所影響。模擬分析的結果指出，女性、身體質量指數（body mass index，BMI）高者、高所得與高肥胖風險認知等願付較高價格減重。

This study investigates factors that affect sample respondents' demand for weight reduction, incorporating the obesity health risk perception, and further develops a means to estimate their willingness to pay (WTP) for a therapy of obesity prevention using survey data of CVDFACTS. As for the decision to participate in an obesity prevention therapy, we find that gender, age, income and job status, BMI, and family illness history are important and significant determinants for respondents. In addition, the results also present that the concerns on social and martial relations as affected by obesity are important and significant determinants. The doubled-bound dichotomous choice model estimates the respondents' WTP. The model estimates that the average willingness to pay for an obesity prevention therapy, which could reduce weight by 5 kilograms in 3 months, is NT$3,388 for the male and NT$4,689 for the female sample respondents, respectively. Furthermore, this study notes that age, income, the concern that work achievement is affected by obesity, and those who have tried to control their weight are important and significant determinants of the WTP. The results of the profile analysis suggest that obese females with high income, high health risk perception, and who have tried to control their weight are the most likely to be willing to pay the greatest amount for the weight-reduction therapy.

1. 傅祖壇、劉錦添、簡錦漢、賴文龍(2001)。健康風險認知與香煙消費行為—台灣的實證研究。經濟論文，29(1)，91-118。
   連結：
2. 詹滿色、傅祖壇(2007)。臺灣漁產品HACCP 安全認證的價值評估—雙界二分假設市場評估法之應用。農業經濟叢刊，13(2)，168-188。
   連結：
3. 鄒孟婷、鄒孟文(2009)。臺灣成人肥胖因素之分析—2001 年國民健康訪問調查。台灣家庭醫學雜誌，19(1)，13-23。
   連結：
4. 中央研究院Academia Sinica (2002)，「CVDFACTS 加值型資料庫」“CVDFACTS Data Warehouse”，http://cvdfacts.ibms.sinica.edu.tw/。http://cvdfacts.ibms.sinica.edu.tw/
5. 行政院衛生署 Department of Health, Executive Yuan (2010)，「2005-2008 國民營養健康狀況變遷調查」“Nutrition and Health Survey in Taiwan, 2005-2008”，http://nahsit.nhri.org.tw/
6. Baum, C. L.,Ford, W. F.(2004).The Wage Effects of Obesity: A Longitudinal Study.Health Economics,13(9),885-899.
7. Bray, G.,Bouchard, C.,James, W.(1998).Handbook of Obesity.New York:Marcel Dekker.
8. Cawley, J.(2008).Contingent Valuation Analysis of Willingness to Pay to Reduce Childhood Obesity.Economics & Human Biology,6(2),281-292.
9. Chang, V. W.,Lauderdale, D. S.(2005).Income Disparities in Body Mass Index and Obesity in the United States, 1971-2002.Archives of Internal Medicine,165(18),2122-2128.
10. Chang, W. C.,Hsiao, C. F.,Chang, H. Y.,Lan, T. Y.,Hsiang, C. A.,Shih, Y. T.,Tai, T. Y.(2006).Betel Nut Chewing and Other Risk Factors Associated with Obesity among Taiwanese Male Adults.International Journal of Obesity,30(2),359-363.
11. Chu, N. F.(2005).Prevalence of Obesity in Taiwan.Obesity Reviews,6(4),271-274.
12. Fu, T.,Wen, T.,Yeh, P.,Chang, H.(2008).Costs of Metabolic Syndrome Related Diseases Induced by Obesity in Taiwan.Obesity Reviews,9(S1),68-73.
13. Gortmaker, S. L.,Must, A.,Perrin, J. M.,Sobal, A. M.,Dietz, W. H.(1993).Social and Economic Consequences of Overweight in Adolescence and Young Adulthood.The New England Journal of Medicine,329(14),1008-1012.
14. Hanemann, M.,Loomis, J.,Kanninen, B.(1991).Statistical Efficiency of Double-Bounded Dichotomous Choice Contingent Valuation.American Journal of Agricultural Economics,73(4),1255-1263.
15. Himes, C. L.(2000).Obesity, Disease, and Functional Limitation in Later Life.Demography,37(1),73-82.
16. Hu, F.(2008).Obesity Epidemiology.New York:Oxford University Press.
17. Johannesson, M.,Johansson, P. O.,Kriström, B.,Gerdtham, U. G.(1993).Willngness to Pay for Antihypertensive Therapy: Further Results.Journal of Health Economics,12(1),95-108.
18. Johannesson, M.,Jönsson, B.,Borgquist, L.(1991).Willingness to Pay for Antihypertensive Therapy: Results of a Swedish Pilot Study.Journal of Health Economics,10(4),461-474.
19. Jones, A. M.(1994).Health, Addiction, Social Interaction and the Decision to Quit Smoking.Journal Health Economics,13(1),93-110.
20. Jones, A. M.,Kirigia, J. M.(1999).Health Knowledge and Smoking among South African Women.Health Economics,8(2),165-169.
21. Kan, K.,Tsai, W. D.(2004).Obesity and Risk Knowledge.Journal of Health Economics,23(5),907-934.
22. Kenkel, D. S.(1991).Health Behavior, Health Knowledge, and Schooling.Journal Political Economy,99(2),287-305.
23. Liu, J. T.,Tsou, M. W.,Hammitt, J. K.(2009).Willingness to Pay for Weight-Control Treatment.Health Policy,91(2),211-218.
24. Maddala, G. S.(1983).Limited-Dependent and Qualitative Variables in Econometrics.New York:Cambridge University Press.
25. McLaren, L.(2007).Socioeconomic Status and Obesity.Epidemiologic Reviews,29(1),29-48.
26. Pagan, J. A.,Davilla, A.(1997).Obesity, Occupational Attainment, and Earnings: Consequences of Obesity.Social Science Quarterly,78(3),756-770.
27. Philipson, T.(2001).The World-Wide Growth in Obesity: An Economic Research Agenda.Health Economics,10(1),1-7.
28. Sargent, J. D.,Blanchflower, D. G.(1994).Obesity and Stature in Adolescence and Earnings in Young Adulthood: Analysis of a British Birth Cohort.Archives of Pediatrics & Adolescent Medicine,148(7),681-687.
29. Shaw, D.,Chien, Y. L.,Lin, Y. M.(1999).An Alternative Approach to Combining Revealed and Stated Preference Data: Valuing Water Quality of the River System in Taipei.Environmental Economics and Policy Studies,2(2),97-112.
30. Sobal, J.(1994).Social and Economic Consequences of Overweight in Adolescence.The New England Journal of Medicine,330(9),647.
31. Sobal, J.,Stunkard, A. J.(1989).Socioeconomic Status and Obesity: A Review of Literature.Psychological Bulletin,105(2),260-275.
32. Viscusi, W. K.(1985).Are Individual Bayesian Decision Maker?.American Economic Review,75(2),381-385.
33. Viscusi, W. K.(1991).Age Variations in Risk Perceptions and Smoking Decisions.The Review of Economics and Statistics,73(4),577-588.
34. Viscusi, W. K.(1992).Smoking: Making the Risky Decision.New York:Oxford University Press.
35. WHO(1998).Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation.Geneva:World Health Organization.
36. Young, T. K.(1996).Sociocultural and Behavioural Determinants of Obesity among Inuit in the Central Canadian Arctic.Social Science & Medicine,43(11),1665-1671.
37. Zethraeus, N.(1998).Willingness to Pay for Hormone Replacement Therapy.Health Economics,7(1),31-38.
38. 林文元、季瑋珠(2003)。預防醫學與肥胖。台灣醫界雜誌，46(3)，98-100。
39. 傅祖壇、葉寶文(2005)。應用CVM 在健康效益之評估—高血壓疾病預防之願付價值。經濟論文叢刊，33(1)，1-32。

1. 楊竣宇(2016)。社會與經濟因素對於回收行為影響之分析— 以提升臺灣廢筆記型電腦回收率為例。淡江大學管理科學學系碩士班學位論文。2016。1-128。