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

Abstract

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.