Changes of Health Outcomes, Healthy Behaviors, Generalized Trust, and Accessibility to Health Promotion Resources in Taiwan Before and During COVID-19 Pandemic: Comparing 2011 and 2021 Taiwan Social Change Survey (TSCS) Cohorts

Abstract

Yu-Ching Lin,1,2,* Chung-Ying Lin,3– 6,* Chia-Wei Fan,7 Chieh-Hsiu Liu,8 Daniel Kwasi Ahorsu,9 Duan-Rung Chen,10 Hui-Ching Weng,3,11 Mark D Griffiths12 1Department of Physical Medicine and Rehabilitation, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 2Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 3Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 4Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 5Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 6Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 7Department of Occupational Therapy, AdventHealth University, Orlando, FL, USA; 8Department of Geriatrics and Gerontology, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 9Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong; 10Institute of Health Behaviors and Community Sciences, National Taiwan University, Taipei, Taiwan; 11Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 12International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK*These authors contributed equally to this workCorrespondence: Hui-Ching Weng, Institute of Allied Health Sciences and Institute of Gerontology, College of Medicine, National Cheng Kung University, 1 University Road, East District, Tainan City, 70101, Taiwan, Tel [phone] ext. 5986, Fax [phone], Email [email protected]: The present study compared two nationally representative cohort datasets concerning Taiwan residents’ healthy behaviors, subjective health outcomes, generalized trust, and accessibility to health promotion resources.Patients and Methods: The Taiwan Social Change Survey (TSCS) was conducted in two waves ten years apart: 2011 cohort (n = 1021; 48.4% males) and 2021 cohort (n = 1425; 47.4%) cohorts. Descriptive statistics were calculated to compare the two TSCS datasets. Then, multiple regression models were constructed with health outcome as the dependent variable, and demographics and other key components as independent variables.Results: The 2011 TSCS cohort showed higher prevalence for cigarette smoking (30.8% vs 25.2%; p=0.002), alcohol drinking (52.5% vs 24.3%; p< 0.001), exercise habits (52.7% vs 48.0%; p=0.02), and better fruit and vegetable accessibility (Mean=3.91 vs 3.82; p=0.04). The 2021 TSCS cohort reported higher body mass index (Mean=24.20 vs 23.63; p< 0.001), less residency in urban areas (22.4% vs 31.1%; p< 0.001), better jogging accessibility (4.14 vs 4.05; p=0.006), higher generalized trust (2.26 vs 2.17; p=0.001), and greater internet usage (3.43 vs 2.89; p< 0.001). The regression model showed that exercise habits (standardized coefficient=0.20 and 0.10; p< 0.001) and generalized trust (standardized coefficient=0.11 and 0.11; p=0.004 and < 0.001) were consistently associated with health outcomes in both cohorts. Additionally, internet use (standardized coefficient=− 0.07; p=0.026) and alcohol drinking behaviors (standardized coefficient=− 0.07; p=0.0022) were negatively associated with health outcomes in the 2021 cohort.Conclusion: The present study demonstrated the trends and changes over 10 years regarding multiple health-related components among Taiwan residents. The study’s findings provide insight into education promotion programs to reduce unhealthy behaviors as well as enhancing generalized trust building and developing healthy behaviors for Taiwan residents.Keywords: health behavior, health promotion, COVID-19, Taiwan, trust

Keywords

• health behavior
• unhealthy behavior
• health promotion
• taiwan
• generalized trust