研究背景: 異位性疾病是台灣最常見的孩童疾病，它包含了氣喘、過敏性結膜炎、過敏性鼻炎和濕疹等疾病。根據台灣學者們的長期監測研究，調查在1995-1996的44,104位與2001年的11,048的孩童發現，氣喘的盛行率最高可達到7.0%。另外，根據一份調查1995-2001年53,134位台灣青少年異位性溼疹盛行率的研究也發現，青少年異位性濕疹的盛行率增加了1.43倍 [95% C.I. = 1.21-1.70]。過去研究常以環境因素來解釋已開發國家的異位性疾病盛行率，而在近二十年開始加入社會經濟的面向來探討。但主要只著重在提供相關的訊息，並且在同因子的探討上還會出現相反的結果，因此我們認為在探討社會經濟地位與疾病的關係中，傳統的收入、教育與職業別是無法直接與疾病作連結，其中應有真正的中介因子值得我們去探討。因此我們決定鎖定有興趣的社經地位因子的中介因子來研究其與異位性疾病的關係，並嘗試探究其相關性與機制。此外，過去許多研究顯示未成年生育不僅會對母親本身造成影響，也會影響其子女的相關健康。雖然這些相關的文獻也提出了許多解釋，其中也包含了社會經濟因素。但是查詢過去文獻我們也發現沒有任何的研究可以給予解答。
研究目的: (1)在此研究中，我們欲探討異位性疾病之健康狀況與社會經濟地位因子之間的關係是否為單純的線性相關，並試圖尋找可以代表社會經濟地位因子與異位性疾病之健康狀況相關的指標中介因子(2)比較一般成年生育父母與未成年生育之子女的疾病發生與其社會經濟因子是否有所差異性與與相關性。
研究對象與方法: 此研究欲利用國內學者王新台教授等人於西元2002年從台南市安南區12所國民小學一、二年級學童(6-8歲)中，篩選出為母親20歲以下生育者之學童，並於所篩選的同班級中，選取等數同年且同性別之其他學童，作為對照組。兩組人數各約為114人，共約228人。本研究將採取回溯型追蹤研究法，將於2009年2月開始到2009年6月期間，透過質性方法設計問卷與肺功能測試收集孩童之基本資料、健康狀況與社會經濟地位指標(回收率為96.05%)。
結果: 在透過校正孩童的性別、年齡和母親是否為成年生育之後，我們發現在父母親的教育程度與孩童之疾病狀況的部份，母親的教育程度為大學/碩博士與專科的孩童相對於母親之學歷為高中(職)的孩童或母親之學歷為國(初)中與小學的孩童，其氣喘終生盛行率之危險勝算比(OR)為5.78倍[95% CI=1.08-30.98]。而母親之學歷為高中(職)之孩童相對於母親之學歷為國(初)中與小學之孩童的氣喘終生盛行率危險勝算比同樣達到顯著(p<0.05)。另外，在父母親的教育程度與過敏性鼻炎與過敏的部份，在校正了孩童的性別、年齡和母親是否為成年生育之後，我們發現了氣喘、過敏性鼻炎與過敏和教育程度之間的關係呈現了U型的型態，即父母親教育程度最高與最低兩組的孩童，其疾病發生的風險均大於或等於父母親教育程度中等的孩童。而這U型的趨勢我們發現是由其它生活形態所導致。另外，在一般成年生育父母與未成年生育之子女健康狀況與家庭社經地位方面，成年組的父母親平均教育程度、職業社經等別與家庭年收入均顯著性的高於未成年組的父母親，並在統計上達到顯著(p<0.05)。
結論:本研究發現父母教育程度與子女異位性疾病的U型趨勢，這告訴了我們在探討教育程度與子女的異位性疾病之間相關性時，不能只單一的注意教育程度對於異位性疾病的直接影響，而是還必須要注意背後可能連結到的社會文化、社會歷程與生活型態因子。

Background: Atopic disease is the most common disease which included asthma, allergic conjunctivitis, allergic rhinitis and atopic eczema in Taiwan. According to Taiwan scholars’ study, the highest prevalence of asthma could be up to 7.0%. Another study, discussing about the prevalence of atopic eczema in Taiwanese adolescents, also showed that the prevalence has increased by 1.43 times. Usually, the atopic disease prevalence in developed countries could be explained by environmental factors in past study, and the factor of socioeconomic status has been included in these two decades. However, most of them only provided related information, and there were even contradictory results in the discussion of same factors. It indicated that traditional socioeconomic factors, such as income, level of education and occupational prestige, could not be connected directly with the disease. There may be some intermediate factors which play an important role in the relation of socioeconomic status and the diseases. We decide to study some inter-median factors to see the relationship, and also try to discover the mechanism behind this relation. In addition, many studies had indicated that adolescent mothers would not only affect mother herself, also affect children’s health. Even though many explanations has been mentioned in these study, which also included socioeconomic status, there is still no answer to this problem.
Objective: (1) In this study, we want to figure out the relationship between socioeconomic status factors and atopic diseases, and we try to find main inter-median factors, which can present the relationship. (2) We want to compare children of adolescent mother and non-adolescent mother to define the association between prevalence of disease and SES.
Subjects and Methods: The subjects of this study was conducted between February and min April, 2002 in An-Nan school district of Tainan city by Prof. ST, WANG. Children in the first and second grade of total 12 elementary schools in this school born to adolescent mothers were recruited. A group of children born by adult mothers matched by sex and class was also recruited for comparison. There are 228 subjects in this study and there are 114 subjects in each group. Study design is retrospective study. And we conducted demographic, health condition and SES of subjects by questionnaires and lung function test (response rate=96.05%) between February and June in 2009.
Result: After adjustment for children's sex, age, adolescent mother, we found there was a U-trend association between parental level of education and children's atopic diseases (p>0.05). We found that mother who’s education level is college or master degree compared to mother who’s education level is high school, the odds ratio of asthma’s prevalence is 5.78 [95%CI=1.08-30.98]. The odds ratio of high-school-educated mothers compared to elementary-school-educated mothers were also significant (p<0.05). Besides, the parts between parents’ education level, allergic rhinitis and allergy, we find that asthma, allergic rhinitis and allergy, and education level appeared the U type after adjusting child’s sex, age and whether mother birth after adult. It means that the highest and lowest parent’s education level’s child sickness risk is higher than the parent’s middle education level’s child. The U type was lead to it’s life habit. Further, the parts between the health of child being birth while parent’s adult or not and the social economic level of the family, the adult group’s parent education level , work, social economic level and family income per year are significant higher than under adult group (P<0.05).

Conclusion: We find there is a U-trend between parental levels of education and children's atopic diseases. This tell us that while talking about the relationship between level of education and children's atopic disease, we should notice not only the direct effect of level of education on atopic disease, but also the possible connection with social culture, course, and life style factor behind the scenes.

Key words: atopic disease, asthma, allergic rhinitis, socioeconomic states, SES, children of adolescent mothers

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