死亡率與罹病類型差異：老年女性健康問題之探討

Mortality and Disease-morbidity Characteristics on Health Problems of Elderly's in Taiwan

10.6255/JWGS.2000.11.129

王香蘋(Hsiang-Pyng Wang)

老年健康 ； 罹病類型 ； 疾病發生 ； 性別差異 ； health of the elderly ； pattern of diseases ； incidence ； gender gap

婦女與兩性學刊

11期（2000 / 04 / 01）

129 - 150

繁體中文

研究老年死亡率和健康狀況的變化時，發現兩性平均餘命的差距隨工業化程度的上升而增加，女性於老年人口群所佔的人數比例亦因年齡增長而遞增，特別是年節越高的老老人，「老年女性化(feminization of later life)」的現象更普遍。「老年女性化」是老年女性較男性長壽所造成的結果，但長壽的生命是否擁有健康的生活卻是一個疑問，兩性老人死亡率與健康狀態的差別，可能是疾病發生率、罹病類型不同所造成。女性老人易於罹患慢性病不易痊癒的特性加上女性長壽的因素，可能累積造成女性老人多數處於殘障與多病的不健康狀態。 本文嘗試呈現兩性老人健康差異的現象，利用「傷害調查資料」、「死因檔案資料」和「台灣地區老人狀況調查」，探討老年罹病率與死亡率的性別差異矛盾現象。分析發現女性老人罹患腦血管疾病所導致的死亡率較男性為低，且其罹患之骨骼肌肉疾病與死因無關卻屬於影響日常生活期間較長的慢性、溫和性疾病。關於死因的性別差異，各年齡組老人的死亡率在80歲之前女性的死亡比例均少於男性，但80歲之後則相反。且因急性或短期致命性疾病死亡的比例是男性高於女性，證實女性的罹病率是以罹患慢性、罹病時間長且易導致功能殘障的疾病為主。此種溫和性的健康問題長時間困擾女性老人，配合長壽的因素，造就了比男性老人較低死亡的機率且較差的健康自評。

In the study regarding mortality and health status, it was found that the gender gap in terms of life expectancies pronounced as industrialization deepened in a society. It is one thing that women live longer than men, yet it is another whether women live healthier in their later lives. Explanations for the differences in mortality and health status between the elder men and women can be traced back to the incidences and patterns of the diseases falling on them: it is more likely for elder women to contract chronic illness; the elder women, though live longer, tend to exhibit lower health status, and may come down with disabilities or other unfavorable physical conditions. This study is to investigate the factors that have contributed to the aforementioned differences. Based on surveys on the elder’s health status between 1986 and 1996, it was found that the morbidity rates for the elder women were higher than the elder men, yet the mortality rates were the opposite. My study suggests some explanations: for both sexes who came down with cardiovascular diseases, women’s mortality rates were lower; yet, women are apt to contract skeleton-musclar diseases which led to disabilities. For those below age 80, mortality rates for women were lower, while the case was reversed for those older than age of 80. This study also found that, men more often contracted acute diseases that led to death quickly, while women tend to contract chronic illness, which did not lead to quick death These factors along with longer life expectancy, elder women demonstrated lower mortality rates and lower self-assessed health status.

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