缩小台湾原住民的预期寿命差距。

Bridging the gap in life expectancy of the aborigines in Taiwan.

作者信息

Wen Chi Pang, Tsai Shan P, Shih Yaw-Tang, Chung Wen-Shen Isabella

机构信息

National Health Research Institutes, Division of Health Policy Research, Taipei, Taiwan, ROC.

出版信息

Int J Epidemiol. 2004 Apr;33(2):320-7. doi: 10.1093/ije/dyh009.

DOI:10.1093/ije/dyh009

PMID:15082634

Abstract

BACKGROUND

Similar to the general population in Taiwan, the health of aborigines has steadily improved over the last 30 years, but the gap remains wide, especially in males, despite an infusion of substantial medical resources. The objectives of this study are to quantify the contribution of major causes of death to the gap in life expectancy and to propose initiatives to bridge the health gap between aborigines and the general population.

METHODS

This study included residents (slightly over 200000) from 30 'aboriginal townships' in Taiwan. The gap in life expectancy between aborigines and the general population was analysed by decomposing these gaps according to major causes of deaths. This analysis quantifies the contribution of different causes of deaths to the gap in life expectancy between the two populations.

RESULTS

The overall mortality of aborigines in these townships was approximately 70% higher than the respective male and female general populations over the past 30 years. Mortality from infectious disease, cirrhosis of the liver, accidents, and suicide are substantially higher than the general population. The gap in life expectancy at birth in males was 8.5 years during 1971-1973, increasing to 13.5 years by 1998-2000, however, the gap in females remained relatively stable (8.0 years and 8.4 years, respectively). Of the 13.5-year difference in life expectancy in males, the differential mortality from diseases of the digestive system (mainly due to cirrhosis of the liver), accidents (from both motor vehicle and non-motor vehicle accidents), and infectious and parasitic disease contributed half (50%) of the gap in life expectancy. In females, the above primarily preventable causes of deaths accounted for 41% of the life expectancy gap.

CONCLUSIONS

Based on the findings of this study, we suggest that future focus should be in the area of primary prevention in order to reduce the incidence of infectious and parasitic diseases, liver cirrhosis, and accidents.

摘要

背景

与台湾的普通民众一样，原住民的健康状况在过去30年中稳步改善，但尽管投入了大量医疗资源，差距仍然很大，尤其是在男性中。本研究的目的是量化主要死因对预期寿命差距的影响，并提出缩小原住民与普通民众之间健康差距的举措。

方法

本研究纳入了台湾30个“原住民乡镇”的居民（略超过20万）。通过根据主要死因分解这些差距，分析了原住民与普通民众之间的预期寿命差距。该分析量化了不同死因对这两个人口群体预期寿命差距的影响。

结果

在过去30年中，这些乡镇原住民的总体死亡率比相应的普通男性和女性高出约70%。传染病、肝硬化、事故和自杀导致的死亡率显著高于普通人群。1971 - 1973年男性出生时的预期寿命差距为8.5岁，到1998 - 2000年增加到13.5岁，然而，女性的差距相对稳定（分别为8.0岁和8.4岁）。在男性预期寿命13.5年的差异中，消化系统疾病（主要由于肝硬化）、事故（包括机动车和非机动车事故）以及传染病和寄生虫病导致的死亡率差异占预期寿命差距的一半（50%）。在女性中，上述主要可预防的死因占预期寿命差距的41%。