鄰里層次社會資本與個人層次特質對嚼檳榔行為之多層次分析

A Multilevel Analysis of neighborhood-level Social Capital and individual-level Characteristics in Relation to Betel Quid Chewing Behavior in Taiwan

10.6288/TJPH2011-30-05-07

張芳華(Fang-Hua Jhang)

台灣社會變遷調查 ； 社會資本 ； 嚼食檳榔 ； 多層次分析 ； Taiwan Social Change Survey TSCS ； social capital ； betel quid chewing ； multilevel analysis

台灣公共衛生雜誌

30卷5期（2011 / 10 / 15）

468 - 480

繁體中文

本研究目的在了解2000年至2005年檳榔嚼食率變化，並分析探討兩年度鄰里層次社會資本與個人層次特徵對嚼檳榔行為的影響。方法：運用「台灣社會變遷調查」20歲以上資料，有效樣本分別為1,774與1,995人，村里數分別為87與88個，以雙變項分析、比例Z檢定與多層次邏輯迴歸來分析資料。結果：檳榔嚼食率在5年間未顯著下降，整體嚼食率仍在9%上下，男性檳榔嚼食率更達15%以上。以多層次邏輯迴歸分析發現鄰里層次社會資本持續發揮影響力，在兩個年度社會互動與嚼食檳榔風險皆顯著相關(OR=1.60, 95%CI: 1.01-2.54; OR=2.50, 95%CI: 1.16-5.39)。性別、年齡、教育程度、吸菸與喝酒行為等個人層次變項對嚼檳榔行為亦為影響因素。結論：嚼食檳榔不僅與個人特質有關，也與社會資本有關。在社會互動脈絡下，檳榔成為與他人建立某種關係的媒介物，而非被視為致癌物。建議除應在鄰里間加強檳榔危害宣導外，培養國人健康社交活動的認知也是有效對策，以弱化檳榔在文化與社會互動上的角色。

The aims of this study were to compare the rates of betel quid chewing between 2000 and 2005, and to explore the effects of neighborhood-level social capital and individual-level characteristics on betel quid chewing behavior over that time period. Methods: Nationally representative data from the Taiwan Social Change Survey were obtained from 1774 respondents in 87 neighborhoods in 2000 and 1995 respondents in 88 neighborhoods in 2005. Bivariate analysis, two-sample tests for proportions, and multilevel logistic regression were used to analyze the data. Results: The rates of betel quid chewing were not significantly reduced in 5 years. Between 2000 and 2005, the rate of overall chewing was about 9%, and, for men, it was over 15%. In multilevel logistic regression, neighborhood-level social capital's influence on the risk of betel quid chewing was durable. This study demonstrated that the risk of betel quid chewing was significantly related to social interaction in 2000 and in 2005 (OR=1.60, 95%CI: 1.01-2.54; OR=2.50, 95%CI: 1.16-5.39). Individual-level characteristics associated with betel quid chewing were gender, age, education, and smoking and drinking behavior. Conclusions: Betel quid chewing was associated not only with individual characteristics but also with social capital. In the context of social interactions, betel quid was treated as a medium for establishing relationships with others instead of as a carcinogen. The results suggest that educating the public about the dangers of betel quid in neighborhoods and developing healthy cognitions about social interactions are effective strategies to weaken the role of betel quid.

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