貧窮與健康－社經地位與原住民族健康問題探析

Poverty and Health: A Study of Socialeconomic Status and Aborignal Health Problem

張朝琴(Chao-Chin Chang)

《嘉義大學通識學報》 6期 (2008/11) Pp. 461-486

https://doi.org/10.7042/JYDXTSXB.200811.0461

摘要

種族之社會不平等或為社會階層分層上的重要分界，例如美國黑人、印地安人等少數民族普遍受到社會歧視，其社經地位偏低，是社會上的弱勢人口群，同時其健康問題也明顯地展現於死亡率之比較。近年來，隨著富裕國家與貧窮國家經濟、健康上的差距擴大，健康不平等與貧窮之議題再度受到關注。山地鄉原住民之社經地位與醫療照護關連，因其弱勢地位將連帶影響著社經狀況及教育管道，進而使得「接受健康的管道」(Accessibility)受阻。健康的管道包含醫療之可近性，可進性會進一步影響本身之健康和醫療行為。至於文化因素及族群認同，則對於自身健康與疾病之認知會有極大的影響，並與接受治療及篩檢、接受疾病照護等行為，均有其相關性。
因此，筆者認為，應該以弱勢族群的立場和健康狀況的差距來爭取社會福利的保障才較適宜，如從弱勢族群要求辦理社會福利以達到免費就醫的目標即成為一較可行的途徑。而如何結合山地鄉原住民之真正醫療照護需求所規劃之醫療福利政策，將是提升他們健康地位的適切方式。基於對社會弱勢族群與健康不平等議題的研究興趣，而以台灣原住民族之貧窮與健康問題作為研究的題目，本文之研究對於台灣目前社會不均及健康不平等問題做一探析，希望能獲得關懷弱勢團體者之迴響。

關鍵字

台灣原住民族 ； 山地鄉原住民 ； 社經地位 ； 社會階層化 ； 健康不平等

並列摘要

Ethnic social inequality or divide the important boundary on layer for the social stratification, for example Afro-American, Indian, its society is on the low side through the position, is a weak tendency population cluster in the society, at the same time its health problem represents the comparison in death rate obviously too. In recent years, as the disparity on the rich country and poor country's economy, health is expanded, the health is paid close attention to the topic of the poverty once again unequally.
The society of the aboriginal of township of mountain region is looked after and closed connecting with by the position and medical treatment, because its weak tendency position will pass the state and educational channel influencing the society relation, then make that accept the channel of the health (Accessibility) Obstructed. Channel of health include medical treatment very getting near, can person who enter can influence one's own healthy and medical behavior further. As for the cultural factor and ethnic identity, there is great influence with the cognition of the disease on oneself healthily, and the behavior of looking after etc. with receiving treatment and sifting examining, accepting the disease, there is its dependence.
So, I think, should try to guarantee of the social welfare to relatively suitable with the disparity of the position of the weak tendency ethnicity and health status, such as handling the social welfare and becoming a more feasible way from ethnicity's demand of the weak tendency promptly by reaching the goal that seeks medical advice. And how accord with mountain region real medical treatment, township of aboriginal look after the medical policy of planning of the demand, it will be the appropriate way to improve their health status. On the basis of to the social weak tendency ethnicity and research interest of the health inequality topic, the national poverty and health problem that and live originally with Taiwan are as the topic of studying, research of this text uneven society at present Taiwan have and health inequality problem make a analysis, the echoing of the persons who hope to be shown loving care for the weak tendency group.

並列關鍵字

Taiwan lives originally nationality ； mountain region township aboriginal ； social economic status ； socal stratification ； healthy inequality

參考文獻

內政部(2001)。中華民國八十九年台閩地區人口統計。台北:行政院內政部。

孔吉文(1984)。全民健康保險與原住民健康相關問題之探討。山海文化雙月刊。3，36。

行政院原民會(2001)。九十年下半年原住民就業狀況調查。台北:行政院原民會。

行政院原民會(2002)。九十一年度原住民就業狀況調查。台北:行政院原民會。

行政院主計處人力資源調查網站