Hung-Hao Chang

Over, Under, or About Right: Misperceptions of Body Weight Among Food Stamp Participants

The purpose of this research was to investigate the associations between misperception of body weight and sociodemographic factors such as food stamp participation status, income, education, and race/ethnicity. National Health and Nutrition Examination Survey (NHANES) data from 1999–2004 and multivariate logistic regression are used to estimate how sociodemographic factors are associated with (i) the probability that overweight adults misperceive themselves as healthy weight; (ii) the probability that healthy‐weight adults misperceive themselves as underweight; and (iii) the probability that healthy‐weight adults misperceive themselves as overweight. NHANES data are representative of the US civilian noninstitutionalized population. The analysis included 4,362 men and 4,057 women. BMI derived from measured weight and height was used to classify individuals as healthy weight or overweight. These classifications were compared with self‐reported categorical weight status. We find that differences across sociodemographic characteristics in the propensity to underestimate or overestimate weight status were more pronounced for women than for men. Overweight female food stamp participants were more likely to underestimate weight status than income‐eligible nonparticipants. Among healthy‐weight and overweight women, non‐Hispanic black and Mexican‐American women, and women with less education were more likely to underestimate actual weight status. We found few differences across sociodemographic characteristics for men. Misperceptions of weight are common among both overweight and healthy‐weight individuals and vary across socioeconomic and demographic groups. The nutrition education component of the Food Stamp Program could increase awareness of healthy body weight among participants.

Association between obesity and depression: Evidence from a longitudinal sample of the elderly in Taiwan

Objectives: Obesity has been identified as an epidemic worldwide. In Taiwan, the highest prevalence of obesity is observed in adults age ≥65. This article investigates the effects of body weight status on the likelihood of depression among the elderly in Taiwan. Method: A longitudinal sample of the elderly (1351 males and 1165 females) interviewed in both the 1999 and 2003 Surveys of Health and Living Status of the Elderly in Taiwan is used. A random effect logit model is estimated to examine the effects of body weight status, lifestyle, and socio-demographic characteristics on the likelihood of depression. Results: About 10.4% of the elderly men are overweight and 13.4% are obese in 2003. A higher prevalence of obesity is found among elderly women, with 19.3% being overweight and 26.4% obese. Elderly men who are underweight are more likely to be depressed (odds ratio; OR = 2.36) than those from other weight categories, while overweight and obese women are less likely to be depressed (ORs = 0.72 and 0.61) than elderly women of the normal weight category. Conclusions: In contrast to most findings for the Western countries, a negative association between obesity and depression of the elderly is evident in Taiwan. The different findings between Western and Asian countries may be due to the cultural differences. Unlike the Western countries that stigmata are attached to excessive overweight, being overweight is not a symbol of unhealthiness because only the wealthy can afford to eat more and put on more weight in the Chinese society.

Does the Universal Health Insurance Program Affect Urban‐Rural Differences in Health Service Utilization Among the Elderly? Evidence From a Longitudinal Study in Taiwan

PURPOSE To assess the impact of the introduction of Taiwans National Health Insurance (NHI) on urban-rural inequality in health service utilization among the elderly. METHODS A longitudinal data set of 1,504 individuals aged 65 and older was constructed from the Survey of Health and Living Status of the Elderly. A difference-in-differences model was employed and estimated by the random-effect probit method. FINDING The introduction of universal NHI in Taiwan heterogeneously affected outpatient and inpatient health service utilization among the elderly in urban and rural areas. The introduction of NHI reduced the disparity of outpatient (inpatient) utilization between the previously uninsured and insured older urban residents by 12.9 (22.0) percentage points. However, there was no significant reduction in the utilization disparity between the previously uninsured and insured elderly among rural residents. CONCLUSIONS Our study on Taiwans experience should provide a valuable lesson to countries that are in an initial stage of proposing a universal health insurance system. Although NHI is designed to ensure the equitable right to access health care, it may result in differential impacts on health service utilization among the elderly across areas. The rural elderly tend to confront more challenges in accessing health care associated with spatial distance, transportation, social isolation, poverty, and a lack of health care providers, especially medical specialists.

Distinguishing between whole-farm vs. partial-farm participation in the conservation reserve program.

By distinguishing between the decision to participate in the conservation reserve program (CRP) and the decision for whole-farm vs. part-farm participation, we model participation as separate binary decisions. Our results suggest the farm characteristics and other factors affect the decision to participate in CRP differently than the decision regarding whole-farm vs. part-farm participation. This model formulation also helps to clarify the conditions under which the effect of CRP payments on the acreage enrolled in the program is positive or negative. (JEL Q15, Q18)

Television viewing, fast-food consumption, and children's obesity.

Childhood obesity is rising in Taiwan and is becoming a major public health issue. This article examines the effect of childrens TV viewing and fast-food consumption on childhood obesity. Using a nationwide survey data in Taiwan and a two-step estimation procedure, our results show that TV viewing hours and fast-food consumption are correlated. After controlling for the endogeneity, we find these two activities positively contribute to childrens body weight and the increased risk of being overweight. Results suggest that public health/childhood obesity programs should educate parents of the critical influence of TV viewing and fast-food consumption on childhood obesity. The government can also encourage the fast-food industry to develop and sell healthier foods for children and provide point of sale nutritional information of these products. (JEL I12, I18)

Are farmers' decisions to work off the farm related to their decisions to participate in the conservation reserve program?

Since both working off the farm and participating in the Conservation Reserve Program (CRP) remove important resources from US agricultural production, we utilize two econometric specifications to test hypotheses regarding whether these two decisions by farmers are independent. We find statistical evidence that decisions to participate in CRP and work off the farm are correlated. Characteristics of farm households and farm operations affect both decisions directly and indirectly, as do local economic conditions and participation in other farm programs. To illustrate their importance, we simulate the combined direct and indirect effects of changes in decoupled payments and farm size on the probabilities of farm households engaging in these two activities. We also illustrate that the probability of engaging in these two activities depends on whether the farm is located in a state, or local agricultural district or participates in a related farmland retention program.

Depressive symptoms, smoking, and cigarette price elasticity: results from a population-based survey in Taiwan

ObjectivesTo understand the association between depressive symptoms and smoking. In addition, we investigate how smokers with and without depressive symptoms may respond to cigarette price change differently.MethodsWe used data drawn from a nationally representative survey in Taiwan. Totally, 13,030 male adults were included in the analysis. Depressive symptoms were measured using the Taiwanese depression questionnaire. A logistic regression model was estimated to examine the odds ratio of smoking for those with depressive symptoms versus those without depressive symptoms. Focused on smokers, the ordinary least squares multivariate regression method was used to estimate the cigarette price elasticity.ResultsCompared to those without depressive symptoms, those with depressive symptoms were more likely to smoke (44.5 vs. 50.1%) and consume more cigarettes per day (18.4 vs. 21.0). The odds ratio of smoking for those with depressive symptoms, adjusted for demographic variables, was 1.3 (95% confidence interval, 1.1–1.6). The cigarette price elasticity was estimated at −0.82 and −0.41 for depressive smokers and non-depressive smokers, respectively.ConclusionsAlthough the association between depression and smoking had been documented, this study contributes to previous literature by investigating the extent to which cigarette price elasticities may differ between smokers with and without depressive symptoms. Results indicate that depressive smokers are more sensitive to the change of cigarette price. Therefore, tax/price increases can also be a very effective means of tobacco control for depressive smokers.

Urban-rural disparity in physical fitness of elementary schoolchildren in Taiwan.

Childhood fitness is generally evaluated by a battery of health‐related estimators to assess pediatric health status. More so than the fitness level at any other stage of life, the level of physical fitness in childhood will have a marked effect on an individuals physical development and overall health in adolescence and adulthood. This paper contributes to this issue by investigating the differences in the distribution of the physical fitness of elementary schoolchildren aged 9–12 by gender, region and ethnicity.

Achieving Environmental Objectives Under Reduced Domestic Agricultural Support and Trade Liberalization: An Empirical Application to Taiwan

We focus on rice policy reform required for Taiwans admission to the WTO, and examine the effects, theoretically and empirically, of the re-instrumentation of domestic policy needed to achieve environmental objectives when both positive and negative environmental externalities exist. Policies that treat non-commodity attributes in agriculture as secondary to existing aims, such as income support, are unlikely to result in the desired supplies of environmental goods. Those supplies can be achieved at lower government and social costs using policy instruments to achieve environmental goals directly. Results are relatively insensitive to the social values assigned to environmental goods.

Factors affecting precautionary savings of self‐employed farm households

Purpose - The purpose of this paper is to empirically investigate the effects of farm income variability, farm size, and other socio-demographic characteristics on the precautionary saving behavior of farm households and to estimate the influences of the identified factors on the amount of savings by self-employed farm households. Design/methodology/approach - Using 2003 Agricultural Resource Management Survey (ARMS) data and a Double-Hurdle procedure, the likelihood and the amount of savings by farm households are estimated. Findings - An important empirical finding of this study is that variability in income plays an important role in explaining precautionary savings of US farm households. Findings suggest that farm households facing higher income risk save more and accumulate more wealth. It is indicated that several farm, operator, household, and demographic attributes contribute to the precautionary savings of farm households. In particular, results show that educational attainment by operator and spouses have positive impact on the decision to save. In addition, results from this study show that farms that specialize in cash grain are likely to have precautionary savings. Practical implications - Farm households today are virtually indistinguishable from non-farm households in their levels of income and diversity of employment. As a result, government policies that influence general economic conditions have much more profound impacts on farm families. Federal support of farm income warrants continued scrutiny. This paper shows that greater income uncertainty increases savings and wealth of farm households. Therefore, farm policies that reduce income variability or uncertainty will have an impact on precautionary savings and wealth of farm households. Originality/value - Several studies have investigated savings of households; however, these studies are limited to entire US population, older Americans, or non-self-employed individuals in the USA. Little is known about the savings behavior of self-employed US farm households owing to a lack of household survey data and because of the complex relationship between the farm household and farm business in terms of resource allocation (both capital and labor).