Juan Shao-Chiu, Awerbuch-Friedlander Tamara, Levins Richard
1School of Criminal Justice, State University of New York at Albany, 135 Western Avenue, Albany, 12222 NY USA.
2Department of Global Health and Population, Harvard School of Public Health, 655 Huntington Avenue, Boston, 02115 MA USA.
Public Health Rev. 2016 Oct 3;37:11. doi: 10.1186/s40985-016-0028-1. eCollection 2016.
Ethnic density (the proportion of ethnic minority populations in a geographic area) has emerged as an important factor determining population health. By examining the relationship between mortality rates and the proportion of aboriginal population in Taiwan, this ecological approach highlights the pressing need to understand why aboriginal health remains relatively disadvantaged affecting the population as a whole, especially given the provision of universal health coverage.
Using combined data from various government departments in Taiwan, we first compare overall mortality rates between aboriginal people and the general population in Taiwan's 21 administrative locations during the years 2010 and 2011. Then we describe the associations between ethnic density and the relative risk of 40 different causes of death.
Aboriginal people in Taiwan on average have higher overall mortality rates than the general population. The proportion of aboriginal population is associated with a higher risk of death for overall mortality, homicide, vehicle crashes, tuberculosis, and several alcohol-related diseases such as peptic ulcer, chronic liver disease, and cirrhosis. These affect the health of the general population in counties where aborigines are abundant.
The proportion of aboriginal population may play an essential role in determining Taiwan's population health. When universal health coverage is in place, the root causes (for example, alcoholism, culture, and socioeconomic disadvantages) of health disparities between aboriginal populations and general populations need to be addressed.
种族密度(某一地理区域内少数民族人口的比例)已成为决定人口健康的一个重要因素。通过研究台湾原住民人口比例与死亡率之间的关系,这种生态学方法凸显了迫切需要理解为何原住民健康状况仍相对不利,这影响到整个人口,特别是考虑到台湾已提供全民健康保险。
利用台湾各政府部门的综合数据,我们首先比较了2010年和2011年台湾21个行政区原住民与普通民众的总体死亡率。然后我们描述了种族密度与40种不同死因的相对风险之间的关联。
台湾原住民的总体死亡率平均高于普通民众。原住民人口比例与总体死亡率、凶杀、车祸、结核病以及几种与酒精相关的疾病(如消化性溃疡、慢性肝病和肝硬化)的较高死亡风险相关。这些影响了原住民人口众多的县的普通民众的健康。
原住民人口比例可能在决定台湾人口健康方面发挥重要作用。在实行全民健康保险的情况下,需要解决原住民与普通民众之间健康差距的根本原因(例如酗酒、文化和社会经济劣势)。