隨著全球快速都市化的結果，導致許多都市為容納更多人口，因都市設計規劃時未多方考量，反而產生一些後遺症，例如：大量增加建築而犧牲綠地等，反不利民眾之健康。因此世界衛生組織就提出「健康城市」之概念與目標，其指標包括「綠覆率」及「綠地可及性」。近年來也有越來越多研究發現民眾居住環境周圍之綠地對民眾健康具有重要影響力，包括：心血管疾病、中風、精神疾病，但對於民眾新發糖尿病是否有關性之研究相當缺乏，因此本論文針對該議題作較深入之研究，希望其成果可作為未來都市設計規劃之重要參考。本研究以全國美兆健檢47萬人分布全台本島之完整且適當去識別化資料庫，包括：個人之基本資料、問卷及檢驗資料。搭配美國NASA提供植被指數資料(Normalized Difference Vegetation Index, NDVI)、台灣商用電子地圖中的公園資訊、政府公開之村里教育程度、村里所得、鄉鎮發展類型等資料做綜合性研究分析。
研究結果發現就個人層面而言，研究對象之年齡與新發糖尿病呈現正相關。教育程度部分，相較不識字或國小，國中、高中職、專科及大學族群於三組NDVI與新發糖尿病呈現正相關，但研究所以上族群未見相關性。運動狀況(以代謝當量高低代表) 與新發糖尿病呈現負相關趨勢，但只有在NDVI1000組有達統計上意義。身體肥胖狀況(body mass index，BMI) 與新發糖尿病呈現正相關。就研究對象居住處環境與社經狀況而言，村里受高等教育比例及所得收入高低與研究對象新發糖尿病未呈現相關性。城鄉型態方面，相對於“低度開發或偏遠鄉鎮”，除“高齡化鄉鎮”呈現負相關外，都會工商區、新興市鎮及傳統產業市鎮與其新發糖尿病未呈現相關性。本研究發現研究對象居住處臨近NDVI與其新發糖尿病呈現負相關性，並提出建議讓政府於未來都市規劃時，能更重視民眾住家鄰近綠地之保留與規畫，以減少民眾新發糖尿病，打造健康城市。

Rapid urbanization worldwide lets more than half of people to live in the less than 3% area of planet, which leads many negative impacts on human health. The decreasing of green space, air pollution, urban heat island due to rapid urbanization are not good for public health. The World Health Organization raised the goad to build “Healthy Cities”. There are 32 items to evaluate a healthy city, including green space and living space (including the reach to green space). Recently, many studies showed the importance of residential greenness of people housing would be more important than the area of green space on the human health and the prevention of human diseases, such as cardiovascular diseases, strokes, mental disorders. However, the association of residential greenness with developing diabetes has not been fully investigated. This thesis focuses on this issue to study this association. We hope the results to be as important references for housing level policy of governments.
This study used a longitudinal health examination data bank from “MJ health data and biobank” from 2000 to 2014 with a total of 1,354,164 data. The biobank includes the personal information (such as age, gender, education, resident location, physical activity) and laboratory data (such as fasting blood sugar). In addition, the MODIS satellite from NASA, U.S. provided the residential greenness (NDVI) information. We also include the data from the government, including the income levels, education status, and residential area characters. We used ordinal logistic regression to analyze these data.
Our study showed the positive association of age with developing diabetes. Compared with the population with education less than elementary school, there were positive associations in the people with education levels of junior, senior high school, college and university with developing diabetes. However, there is no association in the population of more than graduate level with education less than elementary school. About the physical activity, there was positive association only in NDVI1000 group.
On the environmental elements, NDVI was negatively associated with the developing diabetes, which is the most important finding in this study. However, no association was found between the income and education level of residential counties with developing diabetes of study cases. The counties with high age the cases living was positive association with developing diabetes, compared with living under-developed area and remove village.
The findings from this study found the residential greenness of housing is important to prevent developing diabetes, which would be important evidence for housing-level policy of governments.

論文審定書 i
序言與致謝 ii
中文摘要 iii
Abstract iv
目錄 v
圖次 vii
表次 viii
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究問題與目的 2
第二章 文獻回顧 3
第一節 都市化與民眾健康 3
第二節 健康城市 5
第三節 糖尿病 (Diabetes) 8
第四節 綠地與民眾健康 9
第五節 民眾鄰近環境綠地(Residential greenness)與其指標 10
第六節 民眾鄰近環境綠地與民眾健康之關係 11
第三章 研究材料與方法 12
第一節 研究架構 12
第二節 研究範圍與對象 13
第三節 研究項目之操作型定義 14
第四節 分析方法 18
第四章 研究結果 19
第一節 研究對象篩選結果 19
第二節 研究變數的敘述統計 20
第三節 新發糖尿病之危險因子分析 23
第五章 研究結論與建議 27
第一節 討論 27
第二節 限制 30
第三節 結論與建議 31
參考文獻 32
附錄一 全島公園分布圖 43
附錄二 研究對象分布圖 44

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