Epidemiological Transition and Trends of Inequality in Mortality in Aboriginal Areas in Taiwan, 1974-1998

台灣山地鄉流行病轉型以及死亡率不平等現象和趨勢，1974-1998年

呂宗學(Tsung-Hsueh Lu) ； 何黎星(Li-Hsing Ho) ； 李孟智(Meng-Chih Lee) ； 顏啟華(Chi-Hua Yen)

《中山醫學雜誌》 14卷4期 (2003/12) Pp. 545-555

https://doi.org/10.30096/CSMJ.200312.0007

摘要

背景：過去研究已指出台灣山地鄉死亡率比起台灣整體高，但是並沒有研究分析死亡率差距的趨勢變化。本研究目的要檢視台灣山地鄉死因別死亡率之流行病轉型型態與不平趨勢。
方法：蒐集1974年至1998年的死因統計資料以分析死因型態的改變。另將山地鄉與台灣整體的年齡別死亡率及年齡調整死亡率依死因別予以分析。為探討山地鄉與台灣整體死亡率的差異，則採取死亡率比（山地鄉／台灣整體）來作為不平等的指標。
結果：在1974年，山地鄉有三分之一的死亡可歸因於傳染性疾病；到了1998年，此比例降至十分之一。在同一期間，山地鄉的非傳染性疾病所導致的死亡百分比由54％上升至70％。以1974-7年和1995-8年的年齡別死亡率統計來說，山地鄉和台灣整體的差異最顯著的是0-9歲以及25-49歲這二個年齡層。山地鄉居民死於肺癌、子宮頸癌、糖尿病、缺血性心臟病、肝硬化以及交通事故的比率急遽增加。除了自殺外，幾乎所有的死因比率都呈現增加差異及不平現象的趨勢。
結論：山地鄉流行病轉變型態與台灣整體存在著差異。雖然山地鄉某些死因已有減少，但是山地鄉與台灣整體死亡率的差異及不平現象則呈現增加的趨勢。

關鍵字

健康轉型 ； 死亡率趨勢 ； 死因 ； 山地鄉 ； 台灣

並列摘要

Background: Residents of Aboriginal areas are known to experience a higher mortality than the general population, but little is known about the trends in this gap. We therefore examined the patterns of epidemiological transition and the trends of inequality in cause-specific mortality in Aboriginal areas in Taiwan.
Methods: Mortality data from 1974 through 1998 were collected to analyze changes in mortality patterns. Age-specific and age-adjusted mortality rates for selected causes of death in Aboriginal areas and those in Taiwan as a whole were calculated. Mortality rate ratios (Aboriginal areas/Taiwan) were used as the indicator of inequality.
Results: In 1974, one-third of deaths in Aboriginal areas were due to communicable diseases; this proportion had decreased to one-tenth by 1998. The proportion of deaths from non-communicable diseases increased from 54% to 70% during the same period. The increase in age-specific mortality rate ratios between Aboriginal areas and Taiwan as a whole between 1974-7 and 1995-8 was most prominent in the 0-9 year and 25-49year age groups. Mortality from lung cancer, cervical cancer, diabetes, ischemic heart disease, liver cirrhosis, and traffic accidents showed steeply increasing trends in Aboriginal areas. Except for suicide all causes of death showed increasing trend of inequality.
Conclusions: The pattern of epidemiological transition in Aboriginal areas was different from those in Taiwan. Despite the decreasing of some causes of death, the inequality between Aboriginal areas and Taiwan was increasing.

並列關鍵字

Health transition ； mortality trends ； cause of death ； Aborigines ； Taiwan