已開發國家之男女死亡差異之探討

Sex Mortality Differentials in Developed Countries

胡幼慧(Yow-Hwey Hu)

《中華民國公共衛生學會雜誌》 7卷3期 (1987/12) Pp. 125-140

https://doi.org/10.6288/JNPHARC1987-07-03-02

摘要

男女死亡差異之增大乃爲本世紀已開發國家之普遍經驗，人口學、生物學及社會學家曾就不同死因別死亡現象提出生物決定論與環境決定論兩大爭論。本文才根據各個研究結果之整理，認爲生物遺傳因素能影響到男女在一般性感染疾病的抵抗力，然而在慢性病與人爲死亡方面的解釋卻有限。有些學者認爲生物遺傳因素可經由行爲（如抽菸）及人格待質（如A型人格）之途徑與環境產生交亙作用而影響到男女死亡經臉。由於生物影響模式本身之限制，加上國際間與各國內之男女死亡差異幅度之變異相當大，使得社會學者建議由文化社會之角度（例如男女角色、社會支持）來探討男女死亡差異之成因，並提出了多項因素交互作用之模式。台灣地區之死亡業已達已開發國家之水率，其男女死亡差異的趨勢之初步分折卻顯示出偏異於西方之型態。自國際比較之意義而言，台灣地區之文化特質（例如家庭中心文化與生活型態、人格特質）及種族之生物特性將成爲進一步比較男女死亡差異之成因之重要資料。

並列摘要

The widening of sex mortality differentials accompanied with mortality decline is a well-known mortality experience in Western countries during this century. Biological and behavioral/environmental perspectives on these sex differences are two main explanatory approaches. This paper reviews supporting evidences as well as their limitations of these two approaches. It appears that biological reasons are more important in explaining sex differences in infectious diseases, particularly for the very young age groups. For other major causes of death which cuase the mortality discrepancies between men and women (such as CHD, lung cancer, and accident), behavioral factors seem to be the determinants. In this paper, more recent sociological models which integrate social, psychological and biological factors are introduced for future investigations. Also, pattern of sex mortality differentials in Taiwan is also briefly summarized in the boader international context.

並列關鍵字

mortality ； sex differentials