- 期刊
原住民非故意性及故意性意外災害之死亡型態分析
Mortality Patterns of Taiwan Aborigines due to Accidents
摘要
高意外災害死亡率一直是台灣30個山地鄉的重要問題，為了探討近20年來山地鄉居民意外災害死亡的狀況、死因結構及各族別間的差異，本研究利用行政院衛生署登錄之台灣地區死亡資料電腦檔案，以台灣地區居民的死因別死亡率為標準率進行標準化死亡比(Standardized mortality ratio,SMR)分析，比較山地鄉意外災害死亡率與台灣地區之差異，並分析比較各族別意外災害的死因型態。本研究所指的意外災害包含非故意性意外災害，即傳統所謂的意外災害，及故意性意外災害(以自殺、他殺為主)。1971-1990年台灣地區的總觀察人年數為353,728,718人年(男：184,458,396，女：169,270,322)，其中有255,282人(男：188,437，女：66,845)死於意外災害。30個山地鄉的總觀察人年數為3,984,472人年(男：2,184,220，女：1,800,252)，其中死於意外災害的有7,764人(男：5,987，女：1,777)。山地鄉意外災害的死因排行在男性為：機動車及道路意外、自殺、溺水、意外墜落、非藥物意外中毒(以農藥為主)；在女性為：自殺、機動車及道路意外、非藥物意外中慣、溺水、意外墜落。與台灣地區比較，工地鄉不論在總意外災害、及各死因別意外災害的標準化死已比皆為台灣地區的2-3倍以上，其中又以男性的非藥物意外中毒、自殺、意外墜落，女性的自殺、非藥物意外中毒最為嚴重，其死亡狀況皆為台彎地區的3-9倍以上。在族別方面：雖然各族有相近自然生活環境、經濟及醫療水準，但意外災害死亡型態卻互有不同，意外災害總死因別標準化死亡比以泰雅、布農族最高，此二族的自殺及非藥物意外中毒的標準化死亡比又較其他氏族為嚴重。此現象顯示造成山地鄉高意外災害死亡的原因，除了生活及醫療環境外，亦要考慮文化社會層面的影響。
關鍵字
無資料並列摘要
The purpose of this investigation was to study ethnic differences in mortality patterns due to accidents in the various aboriginal areas of Taiwan. Mortality data was collected from the National Health Department. To compare the accident mortality of aborigines with of the general population of Taiwan, and then cal-culated standardized mortality ratios for acci-dents in the various aboriginal groups by using the cause specific accident mortality of the ge-neral population as standardized mortality and found that mortality in Taiwan between 1971 and 1990was 60.1 per hundred thousand due all causes of injuries 72.2 (102.2 for males and 39.5 for females). The same figures for the aborigines were 194.9 (274.1 for males and 98.7 for females), respectively. The leading causes of accidental death among the aborigines motor vehicle accidents, suicide, drowning, acci-dental falls for males and suicide, motor vehicle accidents and non-drug poisoning for females. Our investigations show that the standardized mortality ration due to accidents in the aborigin-al areas is two to three times higher than that in the general population of Taiwan. These fi-gures were differences among the aboriginal tri-bes, despite similarities in medical care, environ-mental and economic circumstances. Mortality due to accidents, especially due to suicide and poisoning, in the Atayal and Bunun tribes were particularly higher than in other tribes. Thus, the risk of an accident in these regions may be associated not only with the environment and the lack of medical resources, but with some so-cio-cultural factors.