原住民與台灣地區其他族群慢性病盛行率及相關因素之探討

A study on Prevalence of Chronic Diseases and Related Factors among originals and other Ethnic Groups in Taiwan

陳萱(CHEN HSUAH)

指導教授 ： 廖宏恩

亞洲大學/健康學院/健康管理研究所/碩士(2005年)

摘要

為瞭解三十個山地鄉之山地原住民與台灣地區之閩南、客家、外省族群及平地原住民高血壓、糖尿病盛行狀況的差異，本研究嘗試比較不同族群、不同年齡層、不同性別與不同城鄉民眾之高血壓及糖尿病盛行率，並企圖找出影響各族群在疾病盛行率不同之相關因素，希冀能提出可行之減少疾病盛行率降低，並促進其健康狀態之方案。
本研究的資料來源為國民健康局於民國九十年所調查之國民健康訪問調查，受訪對象為十二歲以上之民眾。本研究定義之台灣地區樣本為扣除離島地區及三十個山地鄉之樣本，樣本數為18040人，完訪率為94.2%;山地地區樣本為三十個山地鄉擴大抽出之樣本，樣本數為1574人，完訪率為90.7%。本研究資料處理乃利用統計軟體spss10.0版統計套裝軟體進行描述性統計分析與雙變項羅吉斯迴歸分析。

研究結果如下：
1.就高血壓盛行率分析，若以地區別來區分，山地地區高血壓盛行率高於台灣地區(18.0%,10.7%)，若加上族群別來考量，則山地原住民的盛行率為最高(19.2%)，依次為居住地在台灣地區的外省族群(14.7%)、漢族群(12.3%)、平地原住民(11.1%)、閩南人(10.5%)、客家人(9.3%)，若以性別來區分，則台灣地區男性高血壓盛行率高於女性(11.0%v.s.10.7%)，而山地地區則呈現相反情況(i.e.男性16.0%v.s.女性20.1%)，若以年齡別論，65 歲(含)以上之老年人口的高血壓盛行率最高。迴歸分析結果顯示，在控制人口及社會經濟因素下，台灣地區無偶者高血壓盛行狀況為有偶者之1.344倍;過去一年內沒有使用全身性健康檢查者之高血壓盛行狀況為有使用全身性健康檢查者之1.364倍;過去六個月內曾因身體不舒服，而有去看醫生的民眾，其高血壓盛行狀況為沒有去看醫生民眾之1.277倍;居住於鎮與鄉之民眾高血壓盛行狀況為居住於縣轄市民眾之1.191與1.211倍。而就山地地區高血壓盛行率而論，過去一年內沒有接受全身性健康檢查者高血壓盛行狀況為有接受全身性健康檢查者之1.460倍。以族群別而論，山地原住民高血壓盛行狀況較漢族群為低，為其之0.362倍。比較兩地區高血壓盛行狀況的差異，僅發現山地地區中，族群差異是影響高血壓盛行狀況之影響因子，台灣地區則無。
2.針對糖尿病的盛行率而論，若以地區別來區分，台灣地區糖尿病病盛行率則高於山地地(4.4% v.s.4.1%)，若加上族群別來考量，則外省族群的盛行率為最高(5.4%)，依次為居住地在山地地區的漢族群(4.7%)、閩南人(4.5%)、山地原住民(3.9%)、客家人(3.1% )，若以性別來區分，則台灣地區男性糖尿病盛行率高於女性(4.5v.s.4.3%)，而山地地區則呈現相反情況(i.e.男性3.3%
v.s.女性4.9%)，若以年齡別論，65 歲(含)以上之老年人口的糖尿病盛行率仍然最高。迴歸分析結果顯示，在控制人口及社會經濟因素下，台灣地區普通收入者(月收入在一萬元以上及四萬元以下者)糖尿病盛行狀況為低收入(無收入及月收入在一萬元以下者)的1.251倍。而山地地區，僅年齡變項對糖尿病盛行狀況有影響，比較兩地區糖尿病盛行狀況，發現族群差異並非盛行差異的影響因子。

研究建議如下：
一、策略：依據研究發現，顯示出過去一年內未做全身性健康檢查者，有較高的高血壓、糖尿病盛行率，本研究建議衛生當局應持續加強對民眾衛生教育之宣導，並提升民眾使用全身性健康檢查的使用率。
二、對象：因為衛生資源有限，本研究歸納出兩地區易患有高血壓及糖尿病之標的團體如下所述，建議衛生機關可針對標的團體，加強其疾病篩檢率。
1.預防高血壓標的團體為：
(1)台灣地區：『年齡較長者』、『無偶者』、『過去一年內，沒有接受過全身性健康檢查者』及『過去六個月，曾身體不舒服，但有就醫者』、『居住於鄉或鎮者』。
(2)山地地區：『年齡較長者』、『過去一年內，沒有接受過全身性健康檢查者』及『漢族群』。
2.預防糖尿病標的團體為：
(1)台灣地區：『年齡較長者』、『普通收入者』。
(2)山地地區：『年齡較長者』。

關鍵字

原住民 ； 高血壓 ； 糖尿病 ； 族群

並列摘要

The purpose of this survey is to compare the prevalence of hypertension and diabetes among different ethnic groups, age levels, gender, and geographic areas. In addition, we try to find the factors influencing the prevalence of hypertension and diabetes among different ethnic groups. Hopefully, our findings can provide strategies and mark high-risk groups to promote health.
The data sources, which were collected by Bureau of Health Promotion, were interviewees aged 12 and older drawn from National Health Interview Survey in Year 2001. The sample sizes of Taiwan area, deducting people who live in off-shore island areas and mountain areas, are 18,040 people, with 94.2% completed interviews. Meanwhile, enlarged samples drawn from remote mountains areas are 1,574 people, with complete interviews rate of 90.7%. This study also employed SPSS software (Ver.10.0) to precede descriptive analyses and binary logistic regression. The research findings were shown as follows.

1. Regarding the prevalence of hypertension, the prevalence rate in mountains areas (18.0%) is higher than that in Taiwan areas (10.7%). Adding ethnic factors, the data showed that hypertension prevalence of the indigenous People in mountainous region is highest (19.2%), followed by the mainlanders (14.7%), Han Chinese (12.3%), Indigenous People in the Plain (11.1%), Taiwanese (10.5%), and Ha-kka (9.3%). The prevalence of male (11.0%) is higher than that of female (10.7%) in Taiwan area, while the reverse situation showed in mountains areas (i.e. male 16.0% vs. female 20.1%). In terms of age, people with aged 65 and above have higher prevalence than other age groups. In addition, after controlling demographic factors for Taiwan areas, regression analysis showed the hypertension prevalence among people living without partners, people without preventive physical exams for the past one year, people with full access to health care while in need for the past six months, and people who living in a town or village were respective 1.344times, 1.364times, 1.277 times, 1.191 times, and 1.211 times, than that among people living with partners, people with any preventive physical exam for the past one year, people without seeking health care while in need for the past six months, and people who living in a county. For the mountains areas, after controlling demographic factors, regression analysis showed the hypertension prevalence among aboriginal group, and people without preventive physical exams for the past one year, were 0.362 times and 1.46 times than that among Han Chinese group, and people with any preventive physical exam for the past one year.
The ethnic factor associated with hypertension prevalence, in our study, is only founded in the mountains areas.
2. Regarding the prevalence of diabetes, the prevalence rate in Taiwan areas (4.4%) is higher than that in mountains areas (4.1%).Adding ethnic factors, the data showed that diabetes prevalence of the mainlander is highest (5.4%), followed by the Han Chinese (4.7%), Taiwanese (4.5%), indigenous People in mountainous region Indigenous (3.9%),People in the Plain (3.1%) and Ha-kka (3.1%).The prevalence of male (4.5%) is higher than that of female (4.3%) in Taiwan area, while the reverse situation showed in mountain areas (i.e. male 3.3% vs. female 4.9%). In terms of age, people with age 65 and above have higher prevalence than other age groups. In addition, after controlling demographic factors for Taiwan areas, regression analysis showed the diabetes prevalence of people who have middle level of monthly income (i.e., NTD$10,000≦income＜NTD$40,000) is 1.251 times of the people who have monthly low income (i.e., income＜NTD$10,000). In mountains areas, only the age factor was associated with diabetes prevalence from the regression analysis. At last, the ethnic factor is not associated with diabetes prevalence either in Taiwan areas or the mountains areas.
The suggestions are as follow：
1. What strategy: based on the finding that people without preventive physical exams for the past one year have higher prevalence of either hypertension or diabetes, we suggest the health authority continuously propagates health education to promote preventive physical exams.
2. Who: based on the scarcity of health resources, the study helps to identify the high risk groups with either hypertension or diabetes shown in the following:
(1).High risk groups for hypertension:
a. In Taiwan areas, people who live in a town or a village , people who are aged, people who have no living partners, people who have no any preventive physical exam for the past one year, and people who have full access to health care while in need for the past six months, are our target population.
b. In remote mountains areas, people who are aged, people who are Han Chinese group, and people who have no any preventive physical exam for the past one year, are our target population.
(2) High risk groups for diabetes:
a.: In Taiwan areas, people who live in a town or a village, people who are aged, and people who have middle levels of monthly income, are our target population.
b.: In remote mountains areas, people who are aged are our target population.

並列關鍵字

Aboriginals ； hypertension ； diabetes ； ethnic groups

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