報告人: 李 蘭 教授
會議名稱: The Ameri can Publ i c Heal t h Associ at i on’ s 1 3 4
t hA n n u a l M e e t i n g a n d E x p o s i t i o n
會議地點: Boston, Massachusetts, U.S.A.
會議期間：2006 年 11 月 4 日至 8 日
壹、出席國際學術會議心得報告 一、參加會議經過
美國公共衛生學會第 134 屆年會和學術研討會，安排在 2006 年的 11 月初於 麻州波士頓市舉行。本人與五位博士班學生（一位在學；四位畢業數年已在大專 院校任教）一同前往。其中三位學生為初次參加國際會議，既興奮又緊張。
我們一行人於 11 月 2 日深夜自台灣啟程，抵達波士頓時間為 3 日中午，即 刻前往預定好的旅館住宿。次日上午前往會場辦理報到後，各人依自己興趣選擇 合適的場次參加。更重要的是，我們每人皆需在大會安排的時段，前往特定會場 以口頭或海報方式發表研究成果及心得。
除了參加學術性的專題演講及各種研討會外，另有一處值得仔細瀏覽的地 方，是由超過 680 個書商、大學、儀器商、機構團體等所提供的產品展售和專業 服務之攤位。特別是在各家書攤上，可以看到最新及最豐富的書籍，是挑選授課 時使用之教科書和補充教材的好機會。
參加國際會議的另一項收獲是，在會場上可以遇到過去在美求學時的老師或 同學；也會遇到自己曾教過而正在美國進修的學生。透過交談除能瞭解各自的近 況外，針對各自進行中的研究計畫，也可交換意見並提供建議，算是另一種形式 的學術交流。
此次會議結束時間為 11 月 8 日，我們一行人於 8 日當晚即前往機場搭機，
因為時差關係抵台時間為 10 日清晨。
三、 參加會議心得
由於公共衛生涵蓋多重面向及數個專業領域，大會安排的學術活動超過 900 場次以上。透過專題演講、論文報告、學術討論、圓桌會議、海報展示、及陪席 座談等各種方式，提供與會者極為豐盛的學術饗宴。
今年大會是以 ”PublicHealth and Human Right”為主題，因此許多場次不論 是專題演講或陪席式座談，均繞著此主題進行，可見公共衛生離不開人，更不容 忽視人權及平等的問題。
開幕式邀請的貴賓之一，Paul E. Farmer, MD, PhD 為國際慈善組織 ”Partners In Health”的理事長，具有二十年以上的傳染病防治經驗，更是世界知名的愛滋 病和結核病防治專家。他長期關懷貧困國家及健康不平等議題。另一位貴賓，
Helene D. Gayle, MD, MPH 是 CARE, USA 的主席。她是倡導人權和消除貧窮的 有力人士，也是愛滋病、結核病和生育健康的專家。他們二人受邀在開幕式中做 專題演講，分享各自在國內及世界各地推展疾病預防的經驗和成就，令人感動。
閉幕式的貴賓之一，Vincent DeMarco 是 Maryland Citizen’sHealth Initiative 的主席。他長期扮演著領導及結盟的角色，以確保並提升照護品質為目標。特別 值得一提的是，他曾成功地結合了上百個組織與團體，在美國境內推動槍械管制 立法及相關計畫。另一位貴賓，John E. McDonough 是 Health Care for All 的執行 長，也是麻州消費者健康倡議組織的領導人。1996 年，他在麻州成功地推動以 菸稅照顧無保險之兒童健康法案的通過，成為其他州仿效的對象。他們兩位都針 對 ”Expanding Health CareCoverage” 進行專題演講，為大會主題做很好的整理 與呼應。
此次與會的重要任務之一，乃發表近期完成之研究成果。本人及與會學生們
共發表了四篇論文，其中 ”Socioeconomicstatusdisparity in household passive smoking in Taiwan ”是以圓桌會議方式發表。在同一場地大會安排了五組人馬，
每組都有一個特定的題目。全程 90 分鐘被分成三個時段，每個時段由主持人宣 布開始之後，與會者可依據自己的興趣前往不同桌次，聆聽報告者說明相關內容 之後參與討論。二手菸議題在台灣雖受重視，但是從家庭觀點切入，探討二手菸 暴露問題卻是少有的。國外人士參加該小組者，不但詢問許多問題，討論時也非 常熱烈。
另一篇論文，”Influence ofurban-rural disparity and perceived stressors on children’ssuicideideation”，是以口頭報告方式發表的。因為我們從社會不平等觀 點出發，針對兒童的自殺意念探討地區差異，也是一個很吸引人的議題。當場有 人對測量工具的製作過程有興趣；也有人對統計方法和結果解釋有興趣，顯見兒 童自殺意念代表著豐富的意涵，值得深入探討。
”Effectivenessofinternetadvertisementsfocusing on anti-smoking for
Taiwanesewomen ”和 ”Maternalfirstbirth age,family socioeconomicstatusand children’shealth”兩篇論文，是以海報方式發表。在安排時段作者必須站在海報 旁，說明研究內容並接受詢問。通常，作者經過解釋和答辯的過程，可以重新思 考研究方法及執行過程的缺失，還可接收到各種意見及建議，對於論文改寫和日 後投稿是有實質幫助的。
三、結語
利用剛抵達美國的週末及會議期間的晚上，我們一行人曾去參觀哈佛大學及 MIT。從建築上看到他們對古物的珍視和保護；也欣賞到他們的創新與突破。校 園既是幫助學生成長的地方，也是孕育學生氣質的所在，因為哈佛校園充滿了人 文氣息，讓每一位參觀者都忍不住駐足與嚮往。此次有機會拜會正在哈佛從事研 究的同事，聽他述說聽課和生活的情形，激起同行學生想到美國再進修的想法，
又是此行的另一種收穫。
身處全球化與國際化的洪流中，大專教師參加國際會議具有實質意義。唯有 努力不斷並持續成長的教師，方能教導出具有未來感的學生。因此，鼓勵並支持 大專教師和研究人員參加國際性的學術會議，絕對是一項有價值的投資。
貳、於國際學術會議中所發表之論文摘要
A. Socioeconomic status disparity in household passive smoking in Taiwan
Dih-Ling Luh, Department of Public Health, Chung Shan Medical University, No.110,Sec.
1,Chien-Kuo N. Road, Taichung, 402, Taiwan , R.O.C., Taiwan, 886-4-24730022,
[email protected], Lee-Lan Yen, ScD, Institute of Health Policy and Management, College of Public Health, National Taiwan University, Room 623, 6F, No. 17, Xuzhou Rd., Taipei, Taiwan, Fu-Li Chen, Department of Public Health, Fu Jen Catholic University, 510 Chung Cheng Rd.,Hsin Chuang, Taipei Hsien, Taiwan, Ling-Yen Pan, Division of Health Policy Reserach, National Health Research Institute, No.35,Keyan Road,Zhunan Town, Miaoli County, Taiwan, and Baai-Shyun Hurng, Bureau of Health Promotion, Department of Health, Taiwan, 5F., No.503, Sec. 2, Liming Rd., Taichung City, Taiwan.
The purpose of this paper was to describe the disparity of socioeconomic status (SES) in household passive smoking (HPS) in Taiwan. This study is based on the data from 2002 National Survey on Knowledge, Attitude, Practice of Health Promotion
(HPKAP), provided by the Bureau of Health Promotion, Department of Health, Taiwan. 16,813 non-smokers of HPKAP reported their household passive smoking status. The indicators of SES included education, occupation, and personal income per month. Logistic regression was applied to estimate the disparity of SES in HPS, stratified by gender and age. The four age groups were 15 to 24, 25 to 39, 40 to 64, and 65 and above. Main findings: The prevalence of HPS in Taiwan was 45.94%.
Female had a higher prevalence of HPS. By age, younger group had a higher prevalence of HPS. In female, all age group showed that lower education level and lower personal income had a higher prevalence of HPS, but not in male. The occupational disparity in HPS varied with age and gender, and without consistent pattern. According the findings, low SES female were the main victim of HPS, we strongly suggested that they should be the main target of future smoking prevention program.
Keywords: Smoking, Social Class
B. Influences of urban-rural disparity and perceived stressors on children's suicide ideation
Yi-Chen Chiang, MPH and Lee-Lan Yen, ScD. Institute of Health Policy and Management, College of Public Health, National Taiwan University, Room 623, 6F, No. 17, Xuzhou Rd., Taipei, Taiwan, 886-921194872,[email protected]
The purpose of this study was to investigate the influence of urban-rural disparity and perceived stressors on children's suicide ideation. Data were obtained from the cohort of the 4th graders followed in northern Taiwan by the CABLE study (Child and Adolescent Behaviors in Long-term Evolution) from 2001 to 2004. The 1593 students who reported having suicide ideation only in 2004 (grade 7) were defined as new cases. Self-report stressors including academic performance, interpersonal
relationship, family economic status, appearance, romantic relationship, etc. were measured. It was found that the cumulative incidence rates of ever having suicide ideation among children from 2001 to 2004 were 19.0%, 28.0%, 35.8%, and 44.7%
respectively. Besides, the incidence rate of having suicide ideation in 2004 was 9.0%.
The incidence rate of children living in Hsin-chu County (rural area) was 11.2%. The significantly higher rate than that of children living in Taipei City (urban area), 6.9%, showed the urban-rural disparity. The result of logistic regression analysis indicated that“academicperformance”wastheonly stressorsignificantly affecting new cases to have suicide ideation except their resident area. It was suggested that parents should find out children's stressors as early as possible, especially their expectation toward children's academic performance. The 7th graders need to learn the coping skills for overcoming their new stressors. The influence of urban-rural disparity on the 7th graders' suicide ideation needs to be extensively explored.
Keywords: Suicide, Children and Adolescents
C. Effectiveness of Internet advertisements focusing on anti-smoking for Taiwanese women
Fu-Li Chen, PhD1, Lee-Lan Yen, ScD2, Chin-Hua Chang, PhD3, and Hsueh-Fang Lee1. (1) Department of Public Health, Fu Jen Catholic University, 510 Chung Cheng Rd.,Hsin Chuang, Taipei Hsien, Taiwan, 886-2-29053431,[email protected], (2) Institute of Health Policy and Management, College of Public Health, National Taiwan University, Room 623, 6F, No. 17, Xuzhou Rd., Taipei, Taiwan, (3) Institute of Journalism, National Taiwan University, No.1, Sec. 4, Roosevelt Road, 106, Taipei, Taiwan
Objectives:The purpose of this study was to design and evaluate the internet advertisements for encouraging women against cigarette smoking. Methods:Three anti-smoking internet ads had been designed for clarifying young women's belief on cigarette smoking. For the sake of pursuing independence, self-confidence,
sophisticated, and light cigarette never damage health, many women became smokers.
Pros and cons message combined with highly emotional involvement was used as the strategies. The anti-smoking internet ads were broadcasted through Yahoo website in Taiwan. When internet users clicked the banner ads, the internet ads and web
questionnaire were liked. Overall, 4,157 women answered the web questionnaire.
Results:Findings indicated that 85% of female visitors reported that they were favorite the three internet ads. One advertisement against smoking representing independence and confidence acquired positive evaluation by most female visitors. Our results showed the effectiveness of anti-smoking internet ads for those who were adult, non-smokers, white-colored workers, and being an internet ads supporter.
Conclusion:Anti-smoking ads being disseminated by internet was proved to be effective to prevent women's smoking.
Keywords: Health Communications, Smoking
D. Relationship of maternal first birth age and family socioeconomic status with health status of first graders
Dih-Ling Luh, Department of Public Health, Chung Shan Medical University, No.110,Sec.
1,Chien-Kuo N. Road, Taichung, 402, Taiwan , R.O.C., Taiwan, 886-4-24730022,
[email protected], Lee-Lan Yen, ScD, Institute of Health Policy and Management, College of Public Health, National Taiwan University, Room 623, 6F, No. 17, Xuzhou Rd., Taipei, Taiwan, Ling-Yen Pan, Division of Health Policy Reserach, National Health Research Institute,
No.35,Keyan Road,Zhunan Town, Miaoli County, Taiwan, and Fu-Li Chen, Department of Public Health, Fu Jen Catholic University, 510 Chung Cheng Rd.,Hsin Chuang, Taipei Hsien, Taiwan.
There were two purposes of this study. One was to describe the relationship between maternal first birth age and later career development and socioeconomic status. The other was to explore a little further into the relationship of maternal first birth age and family socioeconomic status with child health. Data was taken from the first year of the CABLE study (Child and Adolescent Behaviors in Long-Term Evaluation), including child and parent questionnaires and student health examination records.
Family socioeconomic status was based on self-reported level of maternal education and monthly family income. The indicators of children's health included disease history, dental caries, and fillings of first graders. Analysis of data was adjusted for the gender, birth order and area of residence of the children. The study population consisted of 1,464 individuals for which data was complete for the above variables.
Results: 1. Those with a younger maternal first birth age had currently lower levels of education and lower family income. 2. Children of mothers with a higher level of education were more likely to have had disease history. 3. Children with mothers of higher first birth age and higher level of education were less likely to have dental caries but more likely to have fillings. Conclusions: The first birth age of mothers of elementary school children has an obvious relationship with current family
socioeconomic status. In addition both of these factors are related to the health status of first grade students.
Keywords: Family Planning, Children's Health