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題名：洪災風險降低之健康效益評估
作者：李俊鴻
作者(外文)：Lee, Chun Hung
校院名稱：國立中興大學
系所名稱：應用經濟學研究所
指導教授：蕭景楷
學位類別：博士
出版日期：2005
主題關鍵詞：洪災風險；健康效益；風險知覺；條件評價法；Flood Disaster Risk；Health Benefits；Risk Perception；Contingent Valuation Method
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為減少洪災對人民健康與財產的危害，政府部門往往透過氣象觀測的技術來追蹤和預測颱風豪雨的動態，並配合各種工程和非工程防洪措施作為因應，希冀降低洪災所可能產生的各項有形與無形的損害。許多過去防洪措施的相關研究，並未評估這些措施在生命安全、心理與生理健康等方面的效益，因而低估了整體的防洪效益並降低資源的配置效率，而決策當局所規劃的防災管理策略也無法發揮最大的效能。
過去健康效益評價的相關研究，大都只選擇罹病減輕或是死亡風險降低其中一種來分析，並未同時考量這兩種情況；此外，個人承擔風險的能力以及所面對風險程度的大小皆會影響其對風險降低的評價，然而以往文獻甚少同時比較不同群體在健康效益評價上之差異。
綜合上述問題，本研究將在洪災風險降低的情境下建立評估健康效益之理論與實證模型，利用條件評價法中的雙界二元選擇模型，探討個人願付數額與洪災影響認知因素、預防性支出、罹病狀況、洪災損失與社經背景等影響變數之關係；進一步從不同層面(如居民的社經條件、受災程度及面對風險的狀況)探討健康效益評價上之差異，並推估洪災風險降低之健康效益總值。
本研究之主要結果如下：
1. 從健康效益實證模型估計結果得知，若受訪者罹患疾病且無法工作天數增加，則其對生理健康的願付金額將隨之提高；高風險地區的受訪者的心理健康效益的願付數額高於低風險地區的受訪者；而受訪者所得越高，對於死亡風險降低的願付數額將越高。
2. 女性的健康效益願付數額大於男性，顯示出風險趨避者中女性的比例大於男性，所以其願付數額也較高；男性與女性在心理健康效益的願付數額上並無顯著差異，則顯示出居民面對洪災時的恐懼程度是一致的。而已婚者在三種健康效益的願付數額皆大於未婚者，顯示出已婚者因為與家人同住有較多牽絆，因而有較高之健康效益願付數額。
3. 有罹患疾病受訪者的生理健康效益願付數額高於未罹患生理疾病之受訪者，顯示出有罹患生理疾病的受訪者有曾經因洪災而罹病之經驗，因而有較高之生理健康效益願付數額；此外，隨著疾病持續天數越高生理健康效益願付數額亦越大，顯示出受訪者罹患疾病天數越高，若能夠透過防洪措施降低或避免洪災對其生理健康之危害，其對生理健康效益的願付數額將越大。
4. 由所得群體、風險群體及受洪災影響群體的分析結果皆顯示，死亡風險降低的願付數額最高，心理健康效益願付數額次之，生理健康效益願付數額最低，顯示出由於汐止地區居民長年來受到洪災的影響，居民對洪災健康影響認知以死亡所產生的威脅為最大，其次則為因洪災所引發的恐懼與不安的心理上的情緒，最後才是因洪災對民眾生理上(如因洪災所產生的皮膚病、感冒及腹瀉)的影響。
5. 本研究依據集群分析所劃分的受洪災影響高、低群體，在受洪災影響高、低群體內的全體受訪者面對風險的認知與態度對其所得邊際效用相等的假設所推估出的每戶的願付數額來代表洪災風險減少的三項健康效益願付數額都相當大，將這些平均數值利用汐止地區的受洪災影響高、低群體的戶數轉化成健康效益總值，則整個地區因為防洪措施帶來的效益非常可觀，然此僅為所有無形效益中的三項。因此，決策當局在制定相關防災政策以及考量分配防洪經費時，應當將無形效益納入整體的防洪效益中，才不會產生嚴重低估情形。
Public Sector often used meteorological observation technologies to predict movement of typhoons, and adopted structural and nonstructural measures to mitigate various tangible and intangible damage. In the past, many studies of flood -control measures revealed lack of evaluation for value of life, mental and physiology health benefits, and underestimated the total benefits of flood control and reduced the efficiency of resources allocation. Therefore, the inefficiency of flood-control plans was induced.
Formerly, many researches of evaluating health benefits only analyzed morbidity mitigation or mortality risk reduction individually, and rarely combined them simultaneously. Besides, individual evaluation of risk reduction would be affected by their ability to undertake the risks and the level of risk. However, there are few studies consider different evaluation of health benefits between distinct groups.
To sum up, the purpose of this research is to establish a theoretical and empirical model of evaluation of health benefits from flood disaster risk reduction, using double bound dichotomous choice model under contingent valuation method, and analyze the affecting factors of willingness to pay(WTP) such as influential factors of flood disaster perception, preventive expenditure, morbidity situation, loss of flood disaster and social economics background. Furthermore, this research will evaluate the difference of different groups from evaluation of health benefits and estimate the total health benefits from flood disaster risk reduction.
The main results of this research as follows:
1. The empirical result of the model indicates that respondents’ WTP of physiology health would be increasing, as soon as the arising morbidity time when they can’t work. The respondents live in high risk areas have larger WTP of mental health than those live in low risk areas. Besides, the respondents with higher income have higher WTP of mortality risk reduction.
2. Women’s WTP are larger than men’s and it reveals that women in the proportion of the risk averser are larger than the men. There is no obvious difference about the WTP of mental health benefits between men and women, means that the consistency in the resident of the scare degree. The WTP of married people are larger than singles’ as a result of married people who are living with their families.
3. The physiological WTP of morbidity reduction of residents who had a sick are larger than the others’ and revealed that the morbidity experiences during flood disasters make them willing to pay more physiological WTP. Otherwise, the physiological WTP of residents are larger because of longer morbidity periods.
4. As a consistent results between groups of income, risk, and influence of flood disasters, WTP of mortality risk is the highest, WTP of mental health benefits is the next, the WTP of physiological health benefits is the lowest. The results reveal that threats of death is the highest, mental emotion of fear is the next, and consequence of physiology(such as dermatosis, cold, and diarrhea causes of flood disaster) is the lowest for the perception of healthy consequence of flood disasters of residents who live in Hsichih area for a long time.
5. The three WTPs, which are presented by per household, of healthy benefits from flood disaster reduction are vary large, and the total benefits, which are summing up by average WTP from households in Hsichih, of whole area from flood-control measures are very considerable. However, the benefits of health are only three items of all intangible benefits. Therefore, decision makers should take account of intangible benefits into whole benefits of flood-control measures during the process of policy making, such as disaster prevention policy and budget distribution, and underestimated benefits of flood-control measures wouldn’t happen.
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