Ethnic density and mortality: Aboriginal population health in Taiwan

Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: 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.