遷徙與區域醫療資源對原住民健康不平等之影響

Effects of Migration and Healthcare Recourse on Health Status of Aborigines

從原住民較低的平均餘命可揭露族群間健康不平等的現象，於此同時，原住民高度流動性也同樣引起關注。為釐清遷徙與健康之關聯，本文運用2007年「原住民社會變遷與政策評估調查資料」，以多元線性迴歸模型檢視遷徙、地區醫療資源與原住民健康狀況間的關聯。研究發現：（1）遷徙雖改變原住民所近用的醫療資源多寡，但區域醫療資源對於個人健康狀況的影響不大；（2）移徙前後環境異質性越高，遷徙者心理壓力越大，對健康越是不利；（3）遷徙對原住民健康的正向作用小於心理壓力所致生的負向作用。是故，（4）醫療資源差等的地區剝奪非為原住民健康不平等的主因，族群間健康不平等仍受社會與經濟因素所決定。

The life expectancy gap between aborigines and main stream reveals the ethnic health disparity, in the mean times, the high migration rate in aborigines comes into noticed as well. Based on the data of the Taiwan Indigenous People Survey (TIPS), this paper applies multiple linear regression model to examine the health status of different migrants and to analyze the changing quantity of areal healthcare resource between original and destination. The main findings are as follows. (1) Although migration can alter the accessibility of healthcare resource, the effect of local healthcare resource on health status is not significant. The better healthcare resource in local areas does not ensure the better healthcare resource utilization for aborigines. (2) The higher cultural environment variation that migrants went through might put them under high mental stress and therefore become harmful to their health status. (3)The migrations are drive by other structure factors rather than regional healthcare resource. (4) The ethnic health disparity results in socioeconomic factors rather than area deprivation of healthcare resource.