35卷5期

• Link 綜論 Review Article
• 醫師適用勞動基準法的爭議－以會計師、律師經驗為鏡Dispute about physicians being covered by the Labor Standards Act - the experience of accountants and lawyers
• 張濱璿、張耀懋
  Brian Pin-Hsuan Chang, Yao-Mao Chang
• 勞基法 ； 醫師工時 ； 醫師勞動權益 ； 醫師過勞
  Labor Standards Act ; working hours of physicians ; labor rights of physicians ; physician overworking
• 醫師工作過勞已是社會議題，醫師勞動權益的保障，已不能忽視。「勞動基準法」所定的規範，是勞動權益的最低標準，受僱醫師希望能獲得渴望已久的保障。其他行業適用勞基法過程上也面臨類似問題。但從社會公義角度，醫師納入勞基法究竟是對民眾醫療權益的保障或是減損？當其他排班的醫療人員均納入勞基法保障，以及當類似具有長時間工作性質的會計師、律師陸續納入勞基法保障後，醫師尚未納入的正當性為何？到底醫師適用勞基法可能遇到的問題以及解決的方法是什麼？本文將從勞動基準法上規範的勞動權益保障分析出發，並藉由會計師、律師適用的進程，觀察此二自由職業的適用經驗，進一步提出醫師適用勞基法可能的方式以及需要的配套措施，以提供未來政策規劃之參考。
  Overwork has caused strokes or death for many physicians, and is currently a widespread social controversy. The protection of working rights of physicians is an issue that cannot be neglected. The Labor Standards Act (the Act) was enacted to provide minimum standards for working conditions. Employed physicians hope to get this long-awaited protection. Problems occurred when the Act was applied to to other businesses. From the perspective of social justice, however, will having physicians covered by the Act protect public health and prevent impairment? Other medical staff are covered by the the Act, as are accountants and lawyers who have similar long working hours, so should physicians not also be covered by the Act? In the end, what problems and their solutions may we encounter when physicians are included under the Act? This article will analyze the issue in terms of the protection of labor rights by the Act, and from the observation of the application process to accountants and lawyers; finally, we propose a way for physicians to be covered by the Act along with necessary supporting measures.
• 459 - 476
• 10.6288/TJPH201635105055

• Link 原著 Original Article
• 台灣死亡率與平均餘命變動速率關係趨勢－生命表熵的應用Trends in the relationship between the proportional rate of change in force of mortality and life expectancy: an application of life-table entropy
• 林正祥、謝尚儒
  Cheng-Hsiang Lin, Shang-Ju Hsieh
• 死亡率 ； 平均餘命 ； 生命表熵 ； 惡性腫瘤熵
  mortality rate ; life expectancy ; life table entropy ; cancer entropy
• 目標：熵在熱力學的領域中，指的是失去的熱量或無法利用的能量的量測，應用於人口學中，其可視為生命表中損失之人年數相對於平均餘命之比率，若喪失的人年數的比率(熵)愈小，則人們所能生存的平均餘命(功)就會愈大，反之則會愈小。本文旨在探討出生及中、老年時期生命表熵及惡性腫瘤熵之變化趨勢。方法：闡述說明生命表中平均餘命，死亡率變化速率與熵的關係及其特性，並利用台灣生命表相關資料探討生命表熵及疾病熵(惡性腫瘤)變化趨勢。結果：研究結果顯示1952年至2014年生命表熵H_0(0歲熵)男、女性皆呈平穩曲線下降，H_(40)(40歲熵)男、女性則有震盪起伏現象，H_(65)(65歲熵)是震盪起伏上升，幅度較H_(40)為大；HE係指因死亡率減少所能增加的平均餘命，其變動趨勢顯示HE_0呈現下降趨勢，而在HE_(40)與HE_(65)則是上升的；1975年至2014年惡性腫瘤熵，男、女性均呈上升趨勢，其對平均餘命的影響亦然。以2014年平均餘命推算，若當年所有死亡率悉數去除(免死一次)，則男、女性平均壽命分別為89.8年及94.92年。結論：本研究初步檢視生命表中熵的變動趨勢，發現中、老年人熵值高(特別是中年人)，意謂較少的系統能量可以轉化為功(存活的生命年數)，因此延遲老化應是未來努力的目標；惡性腫瘤熵男、女均呈上升趨勢，且男性高於女性。另外，2014年資料顯示，惡性腫瘤熵影響中年時期的減損甚鉅，顯然中年時期的預防應重於一切，至於其對老年男、女性平均餘命的影響分別為18%及10.7%，亦不容小覷。延遲衰老及癌症預防應列為政府健康促進政策要務。
  Objectives: In thermodynamics, entropy is heat loss or lack of availability of thermal energy needed for activity within a given operating system. It is viewed as the percentage of the average years of future lost by the observed deaths to the life expectancy in Demograph. If loss of person-years is less, then people will survive longer, and vice versa. This study aimed to evaluate the long-term trends in entropy and cancer entropy at birth, middle age and advanced age in Taiwan. Methods: Interpret how the life table entropy derived from the relationship between the proportional rate of progress in force of mortality and life expectancy. The Taiwan life table and cancer data set was used to explore long-term trends in entropy and cancer entropy based on number of deaths recorded at birth, middle age and older age (age 65 years and older). Results: From 1952 to 2014, trends in birth entropy for males and females declined steadily; at middle age, trends in entropy for males and females fluctuated up and down; trends in entropy among older adults was similar to middle age fluctuated up and down but with a wider margin. Mortality rates are declining in all age groups, while life expectancy is increasing for both sexes. From 1975 to 2014, trends in cancer entropy and life expectancy affected by cancer were increasing for both sexes. In 2014, life expectancy was estimated to be 89.8 and 94.92 years at birth for males and females, respectively, when the mortality rate is reduced completely (saved from death once) for the whole first year. Conclusions: This study found a high percentage of entropy in middle aged and older adults, showing that loss of person years is higher for middle-aged men and women especially. Trends in cancer entropy are rising and are higher among males than females. In 2014, cancer entropy was the major effect on middle age life expectancy. However, the effects of cancer on life expectancy among older adults (18% for males, 10.7% for females) should still not be overlooked. Results suggest that reducing senescence and cancer prevention should be the main purpose of long-term health promotion by the government in the future.
• 477 - 486
• 10.6288/TJPH201635105040

• Link 原著 Original Article
• 台灣膳食暴露評估模型之電腦系統開發與應用：以有機磷農藥殘留為例Developments and applications of a computerized system for Taiwan diet exposure assessment model: demonstrated for organophosphate pesticides residues in food matrices
• 蔡經綸、余雅芳、陳建志、周詠勝、倪詩蓓、張嘉津、江舟峰
  Ching-Lun Tsai, Ya-Fang Yu, Chien-Chih Chen, Yung-Sheng Chou, Shih-Pei Ni, Chia-Chin Chang, Chow-Feng Chiang
• 膳食暴露評估 ； 有機磷農藥 ； 健康風險 ； 毒理資料 ； 暴露情境
  dietary exposure assessment ; organophosphate ; health risk ; toxicology ; exposure scenario
• 目標：開發台灣膳食暴露評估模型，評估有機磷農藥殘留之健康風險。方法：查詢56項有機磷毒理資料，收集2014年總膳食調查及後市監測殘留資料1,235筆，聚類台灣飲食回憶資料401,551筆。採用SQL (structural query language)語言，建立毒理、濃度及攝食量三種關聯式資料庫。攝食量估算採用OIM (observed individual mean)演算法，操作介面採用GUI (graphical userinterface)技術，根據標的器官系統估算累積風險。結果：開發四種GUI雲端模組，毒理模組查詢各類危害物之毒理資料；濃度模組比較各類食品之後市監測與膳食調查濃度；攝食量及風險模組可根據族群及食品類別，估算攝食量及健康風險之各項統計值。以一般族群全部個體平均攝食為指標，顯示有機磷之累積風險為8.94%，其中普硫松之貢獻達73%，含普硫松之前三高風險食品為：芥菜類、芭樂類及莧菜類。結論：平均而言，台灣一般族群有機磷殘留之膳食暴露無潛在風險(＜10%)，建議後續開發高端風險演算模組之第二層級評估。
  Objectives: To develop a computerized system for assessing dietary exposure to residual organophosphate pesticides and to evaluate the associated potential health risk. Methods: We inquired toxicological parameters of 56 organophosphate pesticides regulated by Taiwan Food and Drug Administration, collected residue data of 1,235 samples analyzed in the total diet study and post-market surveillance of 2014, and aggregated 401,551 records obtained from the Nutritional and Health Survey. Using structural query language (SQL), we developed 3 relational databases including toxicology (TOX), residual concentration (CON), and core food consumption rate (CCR). The CCR was calculated using observed individual mean (OIM) algorithm. The user interface adopted the graphical user interface (GUI) technique. The cumulative risks were estimated by target organ systems. Results: Four internet GUI modules were developed, including TOX inquired toxicological data by exposure routes and target organ systems; CON compared residual concentrations monitored in post-market surveillance and total diet study; CCR and RSK modules calculated intake rates and risk with acceptable daily intake (ADI) by exposure group and food category. Using whole group average consumption rates of organophosphates in general population as the risk index, the cumulative %ADI was 8.94%, with 73% contributed by prothiofos, in which the food items with the highest %ADI were leaf mustard, guava, and amaranth. Conclusions: On average, the risk of exposing to dietary organophosphate residues in general population is <10%. An upper bound estimate module should be developed as the 2nd tier assessment.
• 487 - 497
• 10.6288/TJPH201635105024

• Link 原著 Original Article
• 穀類研磨場所空氣細菌及真菌之分布特性Characteristics of the distribution of airborne bacteria and fungi in grain processing plants
• 徐櫻芳、楊心豪、黃筱茜、黃小林、 莊啟佑、洪粕宸
  Ying-Fang Hsu, Shin-Hao Yang, Hsiao-Chien Huang, Hsiao-Lin Huang, Chi-Yu Chuang, Po-Chen Hung
• 穀類研磨 ； 職業衛生 ； 生物氣膠 ； 菌種
  grain grinding ; occupational hygiene ; bioaerosol ; genera
• 目標：針對穀類研磨場所空氣中之細菌及真菌等微生物進行調查，以瞭解其濃度與菌種等特性，並且評估製程與環境對其所產生之影響。方法：3家穀類研磨依照製程劃分為原料存放區、前置作業區、加工調理區及包裝區，於各區實施空氣中細菌與真菌每日三次採樣及環境條件量測與人員計數，而後進行濃度量測與菌種鑑定。結果：在3家穀類研磨作業場所中，場1細菌平均濃度為15,879 ± 6,515 CFU/m^3；場2為21,243 ± 5,258 CFU/m^3；場3為3,672±1,741CFU/m^3。場1真菌平均濃度為8,801 ± 1,566 CFU/m^3；場2為15,909±6,406 CFU/m^3；場3為3,954±1,903 CFU/m^3。3家穀類研磨場之空氣中真菌與細菌濃度場內/場外比例則介於5-10倍之間，顯示場內確有污染來源貢獻，惟三階段採樣時段與不同製程之細菌與真菌濃度，均未有觀察到統計顯著差異。整合3場細菌中優勢菌種則發現，研磨場1以Pseudoxanthomonas (61.50%)與Brevibacterium (17.74%)；研磨場2之Thermomonas (45.24%)與Micrococcus (26.81%)；場3則以Pseudoxanthomonas (57.59%)與Micrococcus (23.19%)等細菌菌種佔大多數。另真菌菌種於3間穀類研磨作業場均以Aspergillus真菌屬佔大多數。結論：穀類研磨場所空氣中之細菌與真菌濃度顯著高於場外，建議可加強通風換氣與個人防護等職業衛生措施，以確保作業人員健康。
  Objectives: The aim of this study was to investigate the characteristics of the distribution of airborne microbes in three grain processing plants. Methods: Airborne bacteria and fungi were collected three times each day in four processing areas and outdoor locations at each plant during the study period. Results: In the three grain processing plants, the average bacterial concentrations were 15,879 ± 6,515 CFU/m^3, 21,243 ± 5,258 CFU/m^3 and 3,672 ± 1,741 CFU/m^3, respectively. The average fungal concentrations were 8,801 ± 1,566 CFU/m^3, 15,909 ± 6,406 CFU/m^3 and 3,954 ± 1,903 CFU/m^3, respectively. The ratio of indoor/outdoor microbial concentration was 5-10. In grain processing plant Number1, Pseudoxanthomonas (61.50%) and Brevibacterium (17.74%) were the predominant airborne bacteria. Thermomonas (45.24%) and Micrococcus (26.81%) and Pseudoxanthomonas (57.59%) and Micrococcus (23.19%) were the predominant bacteria in plants Number 2. and 3, respectively. Aspergillus (39.47%~79.72%) was the sole dominant airborne fungus found in all three plants. Conclusions: Grain processing plants may have high concentrations of airborne microbes inside them. Improvements in the rate of ventilation and local exhaust equipment should be considered in order to control biological contamination. We also suggest that workers should wear personal protective equipment to ensure occupational health.
• 498 - 510
• 10.6288/TJPH201635105047

• Link 原著 Original Article
• 從單雙環學習模式看醫療團隊執行新實務的學習成效Investigating the learning performance of teams adopting a new medical practice by the Single-Loop and Double-Loop Learning Models
• 黃經洲
  Jin-Jun Huang
• 學習曲線 ； 新實務 ； 單雙環學習模式 ； 學習成效
  learning curves ; new practice ; Single-Loop and Double-Loop Learning Models ; learning performance
• 目標：健康—照護產業近年來的發展已由醫護個人經驗或獨特秘技主導的局面轉向依靠臨床驗證有效而公開發表的最佳實務。此一趨勢導致醫院必須不斷學習新實務，方能避免落後他院，進而提升醫療水準。儘管醫學文獻對於最佳實務的規範嚴謹清楚，但是醫院導入新實務後，在結果面上仍會發生醫療品質不佳的問題。對此關鍵議題，本文主張雙環學習模式有助新實務學習成效的提升。方法：本文選取兩個分屬不同醫院的同質開刀團隊，執行相同新實務，作為研究對象。以開刀團隊的學習曲線，作為衡量學習成效的指標。結果：透過對兩開刀團隊成員問卷施測及統計分析，發現兩團隊在使用單、雙環學習模式的程度上存在顯著差異，影響開刀團隊執行新實務的學習成效。結論：此研究結果顯示團隊行動效能的提升確實可透過雙環學習模式來達成，且其提升效果遠勝於單環學習模式。在實務面，建議醫院經營者不應只倚賴醫學文獻的管理和專業實務者的知識，可考慮營造有利雙環學習模式運作的情境，才是提升醫療品質理想的作法。
  Objectives: The health-care industry has recently been transformed from one emphasizing medical practitioners' personal experiences or unique skills into one that depends on new medical practices that are evidence-based. This trend has resulted in hospital staffs continuously learning and implementing new medical practices to improve the quality of health-care. In spite of the fact that the medical literature has provided clear standards for best practices, when new medical practices have been introduced in hospitals, the quality of treatment results has often been poor. The aim of this study was to determine if double-loop learning models could effectively decrease the number of problems with poor quality treatment. Methods: As subjects, the study selected two homogeneous operation teams which were required to implement new medical practices in different hospitals. Learning curves served as indicators of performance in implementing the new medical practices. Results: Based on the statistical analysis of questionnaire completed by members of the two teams, a significant difference was found between single-loop and double-loop learning models. Conclusions: In order to improve the quality of care, hospital managers should introduce double-loop learning models to stimulate interaction among team members rather than relying on documentary files and individual knowledge.
• 511 - 523
• 10.6288/TJPH201635105002

• Link 原著 Original Article
• 遠距健康照護對可避免住院與醫療利用之影響The effect of tele-healthcare intervention on preventable hospitalizations and healthcare utilization in Taiwan
• 陳文意、梁亞文、謝輝龍、蔡味娟、莊碧焜、林玉惠
  Wen-Yi Chen, Yia-Wun Liang, Hui-Lung Hsieh, Wei-Chuan Tsai, Bi-Kun Chuang, Yu-Hui Lin
• 遠距健康照護 ； 可避免住院 ； 差異中取差異 ； 傾向分數配對
  tel-healthcare ; preventable hospitalizations ; difference-in-differences ; propensity score matching
• 目標：本研究旨在探討遠距健康照護能否減少可避免住院及抑制醫療費用成長？方法：研究對象為中部某醫院遠距健康照護計畫「銀髮族U-Care計劃」之收案個案(實驗組)以及該地區未參與計畫的居民(對照組)。我們以傾向分數配對模型自健保資料庫2009-2011年的醫療利用檔擷取對照組，以住院總次數的成長平均數為中點，區分「高醫療利用成長」與「低醫療利用成長」兩族群，再以差異中取差異迴歸探討遠距健康照護對可避免住院與醫療利用之影響。結果：遠距健康照護使得高醫療利用成長族群的門診次數增加約2次、可避免住院次數減少0.052次，每次住院費用、每次門診費用與門診住院總費用分別約減少8,743、225與15,917點；遠距健康照護使得低醫療利用成長族群住院總次數減少0.036次、門診次數增加約1次。結論：遠距健康照護對高醫療利用成長族群的可避免住院次數與醫療利用有顯著的抑制效果。然而，研究個案參與此計畫無須支付任何費用，對於遠距健康照護有助於健保財務管理的正向效益推論仍須持著謹慎保留的態度。
  Objectives: The aim of this study was to investigate whether tel-healthcare intervention could reduce preventable hospitalizations and healthcare expenditures. Methods: The case group was made up of those who participated in the Senior U-Care program (a tel-healthcare intervention) administrated by a hospital in central Taiwan. We utilized the Propensity Score Matching model to create a control group from the National Health Insurance Research Database over the period from 2009 to 2011. All patients in both groups were divided into high growth utilization and low growth utilization groups based on the mean growth in the total number of hospital admissions. The difference-in-differences model was used to investigate the impact of the tel-healthcare intervention on preventable hospitalizations and healthcare utilization. Results: The tel-healthcare intervention increased outpatient visits by approximately 2 but decreased preventable hospital admissions by 0.052 in the high growth utilization group. Additionally, inpatient expenditure (per admission), outpatient expenditure (per visit), and total healthcare expenditure in the high growth utilization group decreased by 8,743, 225, and 15,917 point values respectively due to the tel-healthcare intervention. The tel-healthcare intervention decreased approximately 0.036 inpatient admissions but it increased 1 outpatient visit for the low growth utilization group. Conclusions: Tel-healthcare intervention effectively decreased preventable hospitalization and healthcare expenditures in the high growth utilization group. Nevertheless, the services provided by the tel-healthcare intervention under study were free of charge to participants. We should therefore be cautious about concluding that tel-healthcare intervention would generate a positive effect on the financial management of the national insurance system.
• 524 - 541
• 10.6288/TJPH201635105059

• Link 原著 Original Article
• 老年人肺結核知識、態度和預防行為之探討：以鳳林鎮為例Knowledge, attitude and preventive behaviors relative to tuberculosis in the elderly - a study in Fenglin Township, Taiwan
• 黃美芳、張慈桂
  Mei-Fang Huang, Tzu-Kuei Chang
• 肺結核 ； 知識 ； 態度 ； 預防行為
  tuberculosis ; knowledge ; attitude ; preventive behavior
• 目標：結核病是台灣法定傳染病中死亡數最多的疾病。被感染後一生中有5~10%會發病，現在65歲以上老年人，在台灣結核病高盛行年代感染機率高，隨著年紀增長抵抗力下降，對老年人的健康威脅值得注視。本研究目的在瞭解鳳林鎮老年人肺結核知識、態度及預防行為情形及其相關因素，提供疾病防治建議。方法：以鳳林鎮各關懷據點65歲以上老年人為研究對象，採問卷調查進行。結果：肺結核知識答對率64.5%。在態度層面，民眾最害怕被別人知道罹患肺結核(40.9%)；並期望已經在治療且醫師也說不會傳染的肺結核病人戴口罩(73.1%)。受訪民眾的預防行為，以到醫院時戴口罩的情況最低(56.5%)。同時控制相關因素後，衛福部社家署補助之關懷據點的民眾採取預防行為勝算比是原住民委員會等單位補助的2.55倍，達統計顯著意義。結論：肺結核知識中，老年人最欠缺傳染途徑的訊息。不同關懷據點之民眾在預防行為上有所不同，未來應分別就不同關懷據點，加強老年人的肺結核知識、態度，以改善其預防行為。
  Objectives: Tuberculosis (TB) is the leading cause of death among communicable diseases in Taiwan. People infected with TB bacteria have a lifetime risk of falling ill with TB of 5-10%. The elderly have a high prevalence of TB accompanied by an increase in chronic health problems. They should be concerned about the threat from TB. The aim of this study was to understand the knowledge, attitude, and preventive behaviors with regard to TB by the elderly in Fenglin. Methods: A cross-sectional study with a structured questionnaire was designed to collect data. Results: A total of 193 seniors were included in the study; 64.5% of them knew the right answers to questions about TB. Their attitude about prejudice showed that 40.9% feared that other people would know that they or a family member was diagnosed with TB. On the preventive dimension, 73.1% expected that TB patients should wear masks. Only 56.5% believed that people visiting the hospital should wear a mask. After controlling for all associated factors, we found that those who came from care centers subsidized by the Ministry of Health and Welfare had a 2.25 times odds ratio of taking preventive measures than did those in the center subsidized by the Council of Indigenous Peoples. Conclusions: Knowledge about TB transmission was low among the participants. The elderly from different care centers displayed a significant difference in preventive behaviors. It is necessary to consider the care center as an important factor when advocating for measures to control TB in the future.
• 542 - 551
• 10.6288/TJPH201635105045

• Link 評論 Commentary
• 評論：結核病防治與人權教育Commentary: tuberculosis control and human rights education
• 周碧瑟
  Pesus Chou
• 無
  none
• 無
  none
• 552 - 552
• 10.6288/TJPH20163510504501

• Link 實務 Public Health Practice
• 利用政府開放性資料建構台灣線上互動式疾病死因地圖Using government open data to construct a Taiwan online interactive map of disease causes of death
• 鄧詠竹、郭巧玲、陳建州、葉耀鮮、高瑞鴻、林柏丞、范毅軍、詹大千
  Yung-Chu Teng, Chiao-Ling Kuo, Chien-Chou Chen, Yao-Hsien Yeh, Jui-Hung Kao, Bo-Cheng Lin, I-Chun Fan, Ta-Chien Chan
• 地理資訊系統 ； 年齡標準化死亡率 ； 動畫 ； 十大死因 ； 空間聚集分析
  geographic information system (GIS) ; age-adjusted mortality ; animation ; 10 leading causes of death ; spatial clustering analysis
• 目標：死因統計是評量健康城市、探討地區疾病負擔的重要指標，隨著開放資料的浪潮，鄉鎮死因統計數據已開放給全民使用，本研究建構線上互動式死因地圖，期能讓各界更方便探索長時期鄉鎮死因的時空變化。方法：使用輕量程式語言JavaScript進行網站功能的開發，死因資料來源為政府開放平台中1991至2013年全死因統計與癌症死因統計，人口統計資料來自內政部，用以計算年齡標準化死亡率，空間統計功能使用Local Moran's I方法進行死亡率空間聚集的偵測。結果：在線上地圖中(http://mortality.geohealth.tw)使用者可以探索縣市或鄉鎮、不同年度、性別、死因的空間分佈，透過動畫方式可一次瀏覽多年度死因資料，並可透過空間統計功能找出特定死因聚集的熱區。若選定某一特定縣市或鄉鎮，互動式統計圖將會顯示該縣市或鄉鎮死亡率位於全國的排名、分性別死亡率、時間趨勢圖，亦可顯示各縣市或鄉鎮的十大死因。結論：藉此網站同時可以查詢死因統計在各地區的時空變化與各種死因的組成方式，將有利於衛生政策制訂與探討健康不平等議題。
  Objectives: Statistics on causes of death are an important indicator to measure healthy cities and their disease burdens. With the trend of increasingly accessible government data, township statistics on causes of deaths have already been made available to the public. This study constructs an online interactive map of causes of death to facilitate exploring the long-term spatiotemporal trends. Methods: We used a light programming language - JavaScript - to develop the website. The data of causes of death including all causes and cancer-specific ones during 1991- 2013 are from the platform of publicly accessible government data. The population data are from the Ministry of Interior. We utilized them to compute age-adjusted mortality rates. The spatial statistic, Local Moran's I, was used to detect spatial clusters of mortality. Results: In the online map (http://mortality.geohealth.tw/), users can explore the spatial distribution of mortality at the city or township level, for different years, genders, and causes. Through an animation function, we can compare the same cause of death in many years, and we can also use the spatial statistic to identify the hotspots of some causes. If we select one city or township, the interactive statistical chart displays the ranking of mortality among all cities or townships, gender-specific mortality, temporal trends and the top 10 leading causes of death. Conclusions: With this website, users can simultaneously elucidate spatio-temporal changes of causes of death and major components of causes at the city or township level, which can be beneficial for formulating health policy and studying the issues of health disparity.
• 553 - 566
• 10.6288/TJPH201635105012