本研究在比較城鄉地區老人的社會支持體系與健康狀況之差異，並探討社會支持體系對城鄉地區老人健康狀況的影響。資料來源為臺灣大學衛生政策與管理研究所吳淑瓊教授主持之「老人健康及長期照護調查研究」在民國85年收集之第三波資料。本研究係以台北市萬華區及台北縣石碇鄉、平溪鄉分別為城鄉地區之對象母群，共抽出1,634人（城區736人，鄉區898人），完成有效樣本1,448位（城區640位，鄉區808位），問卷完成率88.6％；所得研究資料以SPSS套裝軟體進行描述性統計、卡方分析、t檢定、賀德臨T2分析、多元迴歸分析等方法進行分析，所得重要結果如下：
一、 城鄉地區健康狀況的差異
城區老人的疾病程度顯著較鄉區老人為佳。各項目差異方面，在呼吸疾病、關節炎/風溼症/痛風、腰/背痛等項目上，城區老人較鄉區老人佳，但在高血壓、糖尿病、巴金森氏症等項目上，鄉區老人較城區老人佳。
城區老人的身體功能顯著較鄉區老人為佳。各項目差異方面，在費力活動、所爬樓梯層數、爬一層樓樓梯、走路超過一公里、走過街口數、走過一個街口等項目上，城區老人較鄉區老人為佳，但在中等程度活動、提起或攜帶食品雜貨等項目上，鄉區老人較城區老人為佳。
城區老人的心理健康顯著較鄉區老人為佳。各項目差異方面，在不想吃東西/胃口不好、覺得心情不好、覺得事情不順利、覺得很孤單/寂寞、覺得很悲哀、提不起勁做事等項目上，城區老人較鄉區老人為佳。
二、 城鄉地區社會支持體系的差異
城區老人的社會網絡顯著較鄉區老人為好。在與配偶同住、與子女接觸、與親友聯絡、社團活動參與變項上，城區老人顯著高於鄉區老人。與子女接觸變項中的與子女多常見面、與子女多常通電話項目上，城區老人顯著高於鄉區老人。
在社會支持方面，城區老人的自覺獲得支持顯著高於鄉區老人，且在有沒有人了解個性、能不能找得到人傾聽項目，皆是城區老人高於鄉區老人。城鄉地區在支持滿意度則未達顯著差異。城區老人的負向互動顯著高於鄉區老人，且在常常抱怨項目是城區老人高於鄉區老人。
三、 城鄉地區社會支持體系與健康狀況的關係：
城區方面，社會支持、社會網絡對疾病程度沒有預測力。社團活動參與愈多者，其身體功能狀況愈好。社團活動參與愈多、負向互動愈少者，其心理健康愈好。
鄉區方面，社團活動參與愈多、支持滿意度愈高者，其疾病程度愈少。與配偶同住、與子女接觸愈多、與親友聯絡愈多、支持滿意度愈高者，其身體功能狀況愈好。與配偶同住、與子女接觸愈多、支持滿意度愈高者，其心理健康愈好。
本研究發現城鄉地區在社會支持體系、健康狀況確實有顯著差異。

The purposes of this research are to compare the elderly social support system and health status differences between the urban and rural areas and to explore the social support system impact on health status of the elderly in urban/rural areas. The data were collected by Dr. Shwu-Chong Wu, a faculty of the Graduate Institute of Health Policy and Management of National Taiwan University and also the primary investigator of "the survey of health and long-term care in elderly" in 1996 and were the third data collection of that study. Researcher selected Wan-Hua area of Taipei City and Shin-Ting Hsiang, Pin-His Hsiang of Taipei Hsien to represent the geographic characteristics, i.e. urban and rural areas. This study randomly selected 1,634 cases (736 in the urban area,898 in the rural area). The valid sample was 1,448 cases ,with completing rate of 88.6%. Descriptive statistics, Chi-square, t-test, Hotelling's T2, multiple regression were used to analyze the data.
The major findings of the study are as follows:
1.The difference of health status in the urban and rural area
The perceived disease influence of elderly in the urban area was better than the rural area. The urban elderly had better conditions than the rural elderly in respiratory system diseases, arthritis / rheumatism / gout, lumbago / back pain, but worse conditions in hypertension, diabetes, and Parkinson's Disease.
The urban elderly had better physical function than the rural elderly had. The urban elderly had better conditions than the rural elderly had in vigorous activities, climbing several flights of stairs, climbing one flight of stairs, walking more than a kilometer, walking several street blocks, walking one street block, but worse conditions in moderate activities and lifting or carrying groceries.
The urban elderly had better mental health than the rural elderly. The urban elderly had more positive response than the rural elderly in questions such as "did not feel like eating; my appetite was poor", "felt could not shake off the blues", "felt depressed", "had trouble keeping my mind on what I was doing", "felt lonely", "felt sad", "could not get myself 'going'".
2.The difference of social support system between the urban and rural area
The urban elderly had better social network than the rural elderly. The urban elderly had higher rate than the rural elderly in living with spouse, contacting with son and daughter, communicating with relatives and friends, and involving in social activities. In the responses of "how often do you visit your son and daughter", "how often do you talk with your son and daughter by phone", the urban elderly had significant more positive responses than the rural elderly.
Regarding social support, the urban elderly had more support than the rural elderly. The urban elderly had significant higher score than the rural elderly in "somebody understood him / her " and "somebody listen to him /her ". There was no significant difference in support satisfaction between the urban and rural elderly. The frequency of negative interaction of the urban elderly was higher than frequency of the rural elderly. The urban elderly also had significant higher score than the rural elderly in "complaining frequency".
3.The correlation of social support system and health status in the urban and rural area
In the urban area: the social support and social network could not predict the perceived disease influence. Those who were more involved in the social activities tended to have less physical functions disabled. Those who were more involved in the social activities, with less negative interaction had better mental health.
In the rural area: those who were more involved in the social activities, higher support satisfaction, had less perceived disease influence. Those who were living with spouse, more contact with son and daughter, more connection with relatives and friends, higher support satisfaction were likely to have less physical function disabled. Those who were living with spouse, more contact with son and daughter, higher support satisfaction had better mental health.
To sum up, the study results show significant differences of the social support system and health status between the urban and rural area.

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