本研究使用衛生署國民健康局1999年的「台灣地區中老年身心社會生活狀況長期追蹤調查」資料,利用日常活動量表,整理中老年健康的性別差異,配合功能狀態、健康自評與慢性病的盛行情況,共同勾勒中老年的健康狀況,並進行性別差異比較。分析除比較三種健康狀況彼此之關係,同時也分析主要的死亡病因。另外,基於關心中老年健康狀況對日常生活的影響,本研究並以功能行動能力作為中老年健康狀況的分析標的,了解其與社會背景因素、罹病類型與自評健康狀況之關係,藉以輔助說明影響中老年人健康狀況的因素。中老人健康的整體趨勢是女性、75歲以上、教育程度偏低者、本省籍、及居住鄉村地區等受訪樣本的健康較差。在老人的死亡原因方面,在老年最盛行的幾種慢性疾病(關節炎、高血壓、腸胃潰瘍、呼吸道疾病、心臟病、以及白內障、與糖尿病等)中,除了關節炎與白內障之外,其他均是重要的死亡關連因素。分性別來看的話,男性死於急性(如腦血管疾病、肝病、肺疾病及急性心肌梗塞)與短期致命病變(如各系統的惡性腫瘤)的比率高於女性;而女性老人則在慢性衰竭病症(如糖尿病)方面高於男性。總結來說,不論是就自評健康狀況、離病狀況、或是功能行動障礙來看,性別、教育程度與年齡是影響老年健康狀況的重要變項。中老年女性的健康狀況比較不好,又經常扮演照顧者的角色,而無偶者的健康狀況比較不好,且無偶者大部分是女性,因此長期照護政策需要慎重考慮女性健康特性。另外,中老年男性覺得自己的健康比較好,但住院的比率卻比女性高;不論是男性粗心大意或刻意逞強,避免讓其疏忽小病而釀成大病,應該加強重症前兆的宣導。在老年慢性疾病方面,對日常生活影響最大的疾病為關節炎(或風濕症)和中風,產生相當影響的還有脊椎骨刺、癌症或惡性腫瘤、及糖尿病。罹患中風、糖尿病、與癌症者的死亡率最高。在人口老化的趨勢下,應特別重視這些疾病的預防、治療、控制與病痛緩解。
This paper uses the 1999 Survey of Health and Living Status of the Middle Aged and Elderly in Taiwan, which was conducted by the National Health Bureau of Taiwan and Population Studies Center, University of Michigan, to investigate the health status of the middle aged and elderly in Taiwan. Selfassessment on health, capacities of daily activities, and morbidity are used as indicators of health status. Relationships between these three indicators are discussed as well. For all aspects of health issues, sex differential is especially emphasized. The result shows that sex, age and education are the main factors relating to health status no matter in which kind of indicator. Those who are female, aged 75 and above, low education have lower quality of health. About the relationships between these three indicators with mortality, there is no significant evidence linking higher prevalence rates of disease with higher mortality rates. Self-assessment on health has a positive relationship with capacities of daily activities. Nevertheless, it is diminishing with age. It seems that duration of disability is the key factor. Among the main prevalent chronic diseases, that is, arthritis, high blood pressure, G-I diseases, respiratory diseases, heart diseases, cataract, and diabetes, most of them have high risk on death except cataract and arthritis. For sex differential, men are more likely to die of acute and fatal diseases than women do. Meanwhile, women are more likely to die of chronic disease.