| Summary: | 碩士 === 國立陽明大學 === 臨床暨社區護理研究所 === 102 === Background: The global obesity rates increased year by year, obesity has been shown to cause multiple chronic diseases, increased medical expenses. However, the environment is a modifiable factor in obesity prevention; counties have executive power, as well as health organization and full-time health professional. Therefore need to explore the relationship between county municipal and citizen’s obesity rates, and investment value of the obesity rate caused by obesogenic envioronment after the transformation.
Objective: To analyze the relations of obesogenic environment and obesity rate of county residents in 2011 and 2012 years, as well as understanding of environmental changes impact on obesity rates.
Methods: A longitudinal design, using obesity rates of counties from the Health Promotion Administration, Ministry of Health and Welfare in 2011 and 2012 years, and using the "Community environmental assessment tool of obesity prevention and mangement" to collect the obesogenic environment of township, merged into the county data. The investigators collected counties variables associated with obesity from the Directorate General of Budget, Accounting and Statistics. Investigators used the method of data envelopment analysis to explore the impact of investment of obesity rate caused by obesogenic environment of counties in Taiwan.
Result: 1. A single investment analysis of obesogenic environment in counties caused obese in the amount of output that: Aboriginal ratio and diet expenses ratio is an important environmental factor of obesity in Yunlin County (technical efficiency 1). 2. Predict trends of counties’ obesity rate of caused by diverse environment in the future, such as: security (criminal occurred, crime population) increased in 19 counties, and all will lead to increased obesity rates (increasing returns to scale). 3. Obesity rates of counties and cities caused by diverse obesogenic environment investment returns: When variable return to scale (VRS) represents the reciprocal of 1 worst investment returns. Environment of eat healthy food (nutrition standards of diet, calorie labeling of diet, counseling of health food, and sanitary inspection, etc.) to improve, Chia-Yi County (1/VRS = 6.29), Kao- Hsiung City (1/VRS = 5.62) and Tai-Nan City (1/VRS = 5.46) compared with the degree of obesity ratio improved better.
Conclusion: Counties may accouding to the analysis results of obesogenic environment, take the more effective project, or special obesity prevention strategy for the county and to develop relevant policies. Insecurity may affect the willingness of residents moving out, the most counties may therefore lead to rising obesity rates.
Suggestion: New-Taipei City should pay attention to the elderly obesity problem, and increase the development of public activity area. Kee-Lung City should educate the public to walk, reducing car or motorcycle riding. Tao-Yuan County to assist low income families cope with high-quality food made. Yun-Lin County should note Aboriginal obesity, diet expenditure to be able to choose healthy foods. Tai-Tung City should obesity prevention advocacy in high population density, to give nutrition health education for new residents, increase household income and education level, to prevent criminal cases occurrence or criminal population. Kin-Men County should increase the proportion of medical personnel. Lian-Jiang County traffic accidents to be avoided to maintain the safety of pedestrians.
Key words: obesity, obesogenic environment, data envelopment analysis
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