背景：許多研究指出社區的健康與社區的支持性環境有密切關係。1986年WHO發起健康城市計畫並建立健康城市指標，期望透過健康的公共政策，創造支持健康的環境。然而城市層級之評估指標，通常不易為社區所理解，也與社區生活和需求無關，因此無法協助社區能力之發展。本研究目的即是建構社區層次的支持性環境之指標，以為健康社區之評估量表，並以台南市為例，實地收集和評估台南市健康社區之發展情形。

方法：包括健康社區之理論回顧及整理台南市居民對健康城市的需求調查，首先建構54個健康社區指標，接者邀請台南市里長和協會理事長進行焦點團體，及專家學者進行問卷之校度檢視後，進行台南市232個里之健康社區發展評估。

結果：共篩選出25題為健康社區指標。經因素分析後指出健康社區的發展差異以「休閒組織與活動」及「乾淨環境」最重要，其次為「健康促進與社區照護」、「社區表現」及「生活空間」。進一步分析各指標與健康社區發展之關係發現，當某個指標達成率越高時，不同發展程度的社區其差距不大；反之，若該指標達成率不到一半時，不同發展程度的社區在該指標的差異則極大。

結論：不同發展程度的社區在各指標的差異可能是因為社區的關切點不同、或是這些指標在社區發展上有優先次序、或是社區在實際推動上有難易程度。未來各社區在選定議題時，應透過社區參與的方式，規劃適合社區的計畫，與社區共同建立促進健康的環境，創造符合其生活所需的健康社區。

Background: Many researches have indicated that the health of a community is associated with its supportive environment for health. Through building healthy public policies, WHO launched healthy city projects and set up healthy city indicators in 1986 to help establish a supportive environment for communities. However, city-level indicators are not easy to understand for community residents and are also irrelevant to their life and needs. Neither does these incators could facilitate building up community capacity. The purpose of the study was to develop community-level supportive environment indicators to serve as a healthy community assessment scale. We used this scale to evaluate the current status of healthy community development in Tainan, as a case example.

Methods: We first reviewed theories related to healthy community and summarized residents’ expectations and needs assessment conducted in Tainan in 2003. Fifty-four contructs related healthy community indicators were built up and 15 community leaders were invited to participate in a focus group to discuss the appropriateness of these indicators. After all indicators were reviewed by associated professions, we started to collect the data of healthy community development of 232 neighborhoods in Tainan in 2004.

Results: Only 25 healthy community indicators were selected out according to the homological principle. The result of factor analysis showed that “leisure organization and activity” and “cleaning environment”are the most significant factors in the development of healthy communities, then factors of “health promotion and community caring”, “community performance ”, and “living spaces”. In further analyzing the relation between each indicator and the status of community development, we found that when the overall achievement rate of an indicator was high, the difference of development between communities was small; however, when the achievement rate was low, the difference became larger and wider.

Conclusion: The differences of achievement rate among indicators of communities in different developmental status may be because communities have their concerns or have their own priority among indicators, or have difficulties to practice some indicators. This study suggested that when setting an issue, communities should consider these factors though increasing community participation in order to build up a more comfortable and health promoting environment in the community.

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