在過去十年當中，我國心血管疾病及其相關危險因子(例如:肥胖、高血壓、高血糖和高血脂)的盛行率皆呈現持續上升的趨勢，這些慢性的健康問題不僅對醫療保健制度形成了巨額負擔，也將可能對社會生產力造成嚴重的負面影響。有鑑於此，本研究採用2005年國民健康訪問調查(NHIS)的資料，探討代謝症候群如何影響心血管疾病(心臟病和中風)以及其如何透過心血管疾病影響就業，考量到慢性病的潛在內生性以及疾病之間的相關性，因此使用帶有工具變數的trivariate probit模型來估計疾病與就業之間的關聯性，而我們所使用的工具變數包含有疾病的區域盛行率以及父母親的遺傳因素。實證研究之結果顯示:無論對於男性或女性，罹患心血管疾病對於個人就業的機率皆存在顯著的負面影響，一旦罹患心血管疾病將會使男性和女性的勞動參與率分別降低44.31% 與26.98%；同時，我們也發現代謝症候群對於心血管疾病存在正向顯著的影響，會使男性和女性心血管疾病的發生率分別提高17.01% 以及30.37%，證實了罹患代謝症候群將提高發生心血管疾病的可能性；而若能避免代謝症候群的發生，將可緩和5.8%(男性)與7.73%(女性)間接因心血管疾病而導致的失業率。因此，在代謝症候群的發生率持續大幅增長的情況下，採取多方辦法去對抗這項趨勢仍有其必要性，例如:透過教育水準的提升，可降低女性代謝症候群與心血管疾病的發生率，進而促進社會生產力；除此之外，心血管疾病的預防與治療也應當要能夠改善個人成功求職以及持續就業的機率。 The prevalence of cardiovascular diseases and its risk factors (including overweight/obesity, diabetes, hypertension and hyperlipidemia) has been on the rise in the past decade in developing countries. These chronic health problems not only place a huge burden on health care and welfare systems, but may also affect labor market performance. We hence examine the negative impact of metabolic syndrome on the probability of cardiovascular disease and also on the probability of employment through increase of the risk of cardiovascular disease by analyzing the 2005 National Health Interview Survey (NHIS) of Taiwan. It uses an endogenous trivariate probit model with a recursive structure, and the instrumental variables include prevalence rate of disease and genetic factors. The empirical results indicate that cardiovascular disease has a significantly negative effect on both male’s and female’s employment probability. For men, the effect of cardiovascular disease is to reduce labor force participation by 44.31% while for women the effect is 26.98%. On the other hand, the results confirm that metabolic syndrome increases the risk for cardiovascular disease significantly. Metabolic syndrome will increase the incidence rate of cardiovascular disease by 17.01% for men and 30.37% for women. If metabolic syndrome can be avoided, the employment rates will rise by 5.8% and 7.73% for men and women, respectively. Therefore, given the significant increase in the incidence of metabolic syndrome, it is imperative that a multifaceted approach to combat this trend be undertaken. For example, enhance the education level will reduce the risk for metabolic syndrome and cardiovascular disease for women, and hence it would improve the social productivity. In addition, the prevention and treatment of cardiovascular disease should improve the probability of individuals finding and retaining employment.
