Health Knowledge and Health Behavior: Empirical Study of Obesity in Taiwan

Examples include the consumption of cigarettes and alcohol and the propensity towards exercise (Kenkel, 1991), smoking (Hsieh et al., 1996), and dietary fiber or other nutritional intake (Ramezani and Roeder, 1995; Variyam et al., 1996). After treating health knowledge as an endogenous variable, Kenkel (1991) found that both schooling and health knowledge reduced the uptake of smoking and heavy drinking, whilst increasing the amount of exercise a person takes.

Similar results are also found in several studies. Focusing on the important issue of obesity, Nayga (2000a, 2000b, 20001) revisited the issue of the effects of schooling on health, by examining the relationship between obesity, schooling and health knowledge. In contrast to Kenkel’s (1991) findings, Nayga (2000a) concluded that the association between schooling and obesity was mainly attributed to differences in health knowledge amongst individuals.

Obesity is defined as a medical disorder of an excessive accumulation of body fat, which is linked to many of the major causes of death, including heart disease, strokes, diabetes, and some types of cancer. According to 1996 Taiwan Nutrition Survey, 11 percent of the respondents were considered to be overweight, and 13 percent were considered to be obese. It is noteworthy that more than 85 percent of respondents with a BMI greater than 27 had metabolic diseases.

We will address three issues in this study. First, we examine the relationship between health knowledge, schooling and obesity. Second, we investigate the magnitude of the measurement error in self-reported measure of obesity.

Third, using difference-in-difference estimation, we explore the role of physician advice in weight control practices. One of the data sets we use in this study is drawn from the 1993-1996 Taiwan Nutrition Survey conducted by Dr. Wen-Harn Pan.

To obtain detailed information on health knowledge, perception of obesity, and health behaviors, we will conduct another survey of adults who take the physical examination at Mackay Memorial Hospital. Our analysis is based on the health information of pre- and post- physical examinations as well as the medical records on physical examination reports.