台灣地區原住民的健康問題

Issues on Aboriginal Health in Taiwan

葛應欽(Ying-Chin Ko) ； 劉碧華(Bih-Hwa Liu) ； 謝淑芬(Shu-Feng Hsieh)

《The Kaohsiung Journal of Medical Sciences》 10卷7期 (1994/07) Pp. 337-351

https://doi.org/10.6452/KJMS.199407.0337

摘要

原住民的健康問題長期被忽略，近來美國、澳洲逐漸重視少數民族的健康問題，研究得知與強勢民族(白人)有一段差距，台灣原住民的健康狀況，似手和美國、澳洲原住民狀況類似，和台灣地區比較，則原住民無論在平均餘命、死亡率、疾病盛行率、某些疾病(如鼻咽癌、骨癌)發生率等，均比台灣地區一般民眾嚴重，目前的研究顯示在平均餘命約少10歲；男性差12.5歲，女性差6歲，標準化死亡比約為2倍；男性為2.1倍，女性為1.7倍。疾病以意外災害、自殺、肝硬化、結核病、肺炎、支氣管炎、嗜酒、寄生蟲等為最嚴重，一些上消化道癌症也值得注意，而現代漂明帶來的心臟血管病、營養、適應等，漸漸形成新問題。整個評估，原住民健康問題雖然有改善，比台灣地區或離島地區約有25-30年的差距，各族別間也有差異存在。
本文以平均餘命、死亡率、疾病的發生率及盛行率做為應台灣地區原住民健康狀況的指標，並提原住民各族別人口數、社會經濟狀況、健康行為及醫療設施與人力的分布，本文亦比較美、澳及台地區原住民健康狀況的相關指標，以做為相關研究之參考。
最後本文陳述相關研究進行的困難性，也指出未來研究方向，應以實際的健康教育及醫療介入工作為主，以期提昇原住民的健康。

並列摘要

In recent years health professionals have been concerned about the health of aborigines which has been neglected for long time. Health disparities are known to exist among aborigines and non-aborigines in the United State or other countries. In Taiwan, there are nine main aboriginal tribes consisting of appro-ximately 330,000 people. In general, their health status, evaluated by life expectancy, mortality rates and the prevalence and incidence of vari-ous diseases amongst them, is worse than amo-ngst the rest of the Taiwanese (general) popula-tion. Current investigations indicate that life ex-pectancy for aborigines is on average 10 years less than that of the general population; 12.5 years less for men, 6 years less for women; ap-proaching a standardized mortality ratio of 2 fold, that is 2.1 fold in men, 1.7 fold in women. Accidental injures, suicide, tuberculosis, liver cirrhosis, alcoholism, pneumonia, bronchitis, parasite infections are the most important sou-reces of diseases. Hypertension, heart disease, some selected sites of cancer, nutrition and lack of adaption are gradually becoming important new sources of disorders. Although aboriginal health has improved over the decades, the auth-or estimates that their overall health status is 25-30 years behind that of the general population or of off-shore islanders. The extent of their de-velopment varies with tribes.
It is necessary to study the cause of why aborigines die so young. It may be due to in-sufficient medical care for heart disease whose prevalence is relatively low among aborigines but resultant mortality is nevertheless high. However, insufficient medical car cannot ex-plain the high incidence of a number of cancers and resultant mortality. All factors relating to the environment, agents, hosts and diseases should be taken into consideration, such cul-ture, transportation, life style, health behavior etc, and compared to those of non-aborigines. A series of studies are proposed to address the specific, multi-dimensional health demands of the aborigines.
The author suggests the development of prevention and intervention strategies designed to overcome difficulties and barriers to elimi-nate these disparities among the people of Tai-wan.

並列關鍵字

aborigines ； health ； disease