Online Program

Differences in Age-Standardized Mortality Rates for Avoidable Deaths Based on Township Income Quartiles in Taiwan, 1971-2008

Wednesday, November 4, 2015 : 10:30 a.m. - 10:43 a.m.

Brian Chen, JD, PhD, Arnold School of Public Health, University of South Carolina, Columbia, SC
Chun-Yuh Yang, College of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
Objectives. To document the temporal trend in avoidable mortality based on township income in Taiwan between 1971 and 2008, and analyze whether universal access implemented in 1995 eliminated any income-related mortality disparities.

Methods. Data were obtained from Taiwan’s National Death Certification Registry and the National Statistics Bureau. Cause-specific age-standardized mortality rates (ASMRs) for avoidable mortality were calculated by gender and township income quartiles. Segmented regression analyses were performed to assess the impact of universal access on amenable mortality.

Results. From 1971 to 2008, ASMRs for deaths amenable to medical care fell by greater magnitudes for the richer townships, which had the lowest ASMRs by 2006-2008 for almost all avoidable causes of death. Universal access to care slowed the growth of ischemic heart disease and aggregate amenable mortality for men living in the poorest townships, but did not eliminate the disparities.

Conclusions. All Taiwanese nationals experienced lower amenable ASMRs by 2006-2008. However, an income gradient persisted throughout the study period. Guaranteed access to medical care may have helped reduce but did not eliminate the income gradient in mortality disparities.

Learning Areas:

Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Describe the disparities in causes of death that can be delayed through timely and appropriate medical care ("avoidable mortality"), based on neighborhood income Assess whether universal access to health care eliminated any observed disparities in avoidable mortality

Keyword(s): Health Disparities/Inequities, Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have published multiple manuscripts on avoidable mortality in peer-reviewed journals, and am trained as a social scientist/economist in a doctoral program based at the University of California at Berkeley.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.