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台灣地區1991~2007年男女性之健康差距:以平均餘命、死亡率及潛在生命年數損失為指標

Gender Differences in Health in Taiwan, 1991~2007: Life Expectancy, Mortality and Years of Potential Life Lost as Indicators

摘要


目標:國人健康狀況逐年改善,然性別健康差距卻日漸擴大。本研究就平均餘命、死亡率及潛在生命年數損失三項指標探討性別的健康差距狀況,並討論可能的解釋原因。方法:研究資料下載自行政院內政部及衛生署所發布之官方統計數字,並以台灣地區2000年年中人口做為標準人口,計算1991~2007年間的男女性主要死因別標準化死亡率和標準化每千人口潛在生命年數損失(SYPLL)。結果:台灣地區零歲平均餘命之性別差距由5.31歲擴大為6.26歲。惡性腫瘤與自殺之標準化死亡率不論男女均逐年上升,且性別差距擴大;心臟疾病及腦血管疾病的標準化死亡率都逐年下降,但性別差距卻略增。男性事故傷害標準化死亡率之下降幅度大於女性且性別差距逐年縮小。兩性全死因之SYPLL逐年下降且性別差距由38.60年縮小為33.32年,然若將因事故傷害所造成之SYPLL扣除,則兩性之性別差距是擴大的,由19.48%增為25.79%。但惡性腫瘤之SYPLL的性別差距則上升,且佔全死因性別差距之比例也由9.82%升為19.47%。結論:台灣地區之性別健康差距逐年擴大,推論係因男性高吸菸率之故。是否會因男性吸菸率下降而縮小,尚需密切觀察。

並列摘要


Objectives: The health status of the Taiwanese people has improved; however, the gender difference in life expenctancy is widening. Three indicators, life expectancy at birth, standardized mortality rate and standardized years of potential life lost, were applied to understand the potential causes of gender gap. Methods: Data were obtained from the statistics published by the Department of Interior and the Department of Health, Executive Yuan, Taiwan. The standardized mortality rate (SMR) and standardized years of potential life lost (SYPLL) between 1991 and 2007 were calculated by the applied direct standardization method and adjusted to the 2000 Taiwan mid-year population. Results: The gender difference in life expectancy at birth widened from 5.31 years to 6.26 years. The SMR for malignant neoplasms and suicide in both genders increased year by year and the gender differences widened. The gender differences in SMR for cardiovascular diseases and cerebrovascular diseases also widened slightly although the SMRs themselves decreased each year. The SMR for accidents in both males and females decreased dramatically and the gender difference also narrowed. The SYPLL from all causes decreased yearly and the gender difference narrowed from 38.60 to 33.32; however, the gender gap for SYPLL widened if the SYPLL caused by accidents were deducted from the SYPLL from all causes. The gender difference in malignant neoplasm-specific SYPLL increased and its proportion to SYPLL from all causes increased from 9.82% in 1991 to 19.47% in 2007. Conclusions: In Taiwan, the gender differences in health were widening. It was inferred that this was related to the high smoking rate among male adults. Whether the gender difference will be narrowed by lowering the male smoking rate remains to be determined.

參考文獻


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