本文使用地區擴散取向討論鄉鎮地區別兩性死亡率下降，並修正Montgomery and Casterline（1993）使用鄉鎮內擴散與跨鄉鎮擴散之時間序列模型方法。分析資料來源取臺灣地區1980年、1990年、2000年三波戶口及住宅普查資料，及1980、1981、1990、1991、2000、2001等六年的死亡人口登記資料，討論臺灣兩性之標準化死亡率下降過程與影響之結構因子。結果發現，兩性地區別標準化死亡率呈下降集中的趨勢，城鄉差異明顯。進一步使用二階段迴歸方程式分析鄉鎮內死亡率下降之空間擴散現象，發現前一年死亡率會顯著影響後一年的死亡率高低；其次，進行跨鄉鎮擴散分析，也發現相鄰鄉鎮死亡率高低，亦呈現顯著正向的影響。最後，死亡率持續下降且呈現朝鄰近鄉鎮擴散之現象，表示臺灣整體生活水準與醫療技術逐年進步，而於1995年實施全民健康保險後，死亡率不均之地區差異，仍無法有效改善，值得相關單位重視。 In this paper, we applied the spatial diffusion approach to investigate factors that are associated with the decline of the standardized death rate (SDR) at the township level. The approach is based upon the time series within-and cross-township diffusion models proposed by Montgomery and Casterline in 1993. The data were derived from two sources, including socio-economic indicators from the Population and Housing Census and the SDR from Taiwan-Fukien Demographic Fact Book, Republic of China. The results show that for males and females the SDR is in decline at the township level and that there exists a discrepancy between urban and rural areas. A further analysis of two-stage regression models suggests that a decline in mortality within the township is associated with a decline in the previous year. In addition, spatial autocorrelation exists at the town level. Finally, the continuous decline in mortality may imply an improvement in living standard and medical services. However, the introduction of national health insurance in 1995 has not ameliorated the spatial discrepancy of mortality, which demands further scrutiny by health policies.
