Abstracts & Papers in Stream 3

As the development of health technologies and the extension of life expectancy, the absolute and relative number of the aged have been increasing in many countries. The aged are those who are vulnerable in health, so their health status is an imperative matter of quality of life. Also, regarding the use of medical or rehabilitation services, the aged must be faced with economic difficulties in real, without personal or societal assistance. On the other hand, inequality of health status exists between the aged. On the contrary to young people who have an income and can keep them under control, the aged should depend on social security systems such as health insurance or pension, whose health status varies by persons. One important factor of health inequalities has known as the differences in socioeconomic status (SES). Therefore, this study using Korean Longitudinal Study of Ageing (KLoSA) examines subjective and objective health status of the aged by SES in Korea. Also, since the KLoSA has been lain out for international comparisons, this study compares differences of aspects or patterns in health inequality by SES between Korean and other countries, such as the US, UK, and European Unions. This study is expected to give Asian countries important political implications; those are entering developed countries and facing with the increase of the aged and their health inequality, as Korea has been experienced.

The purpose of this study was to examine the influence of socio-demographic factors, health behaviors, physical functional abilities and commercial insurance on self-rated health among the middle aged and elderly in Taiwan. The data, applying a panel data design, investigated whether health behaviors, physical functional abilities and commercial insurance were associated with self-rated health for the middle aged and elderly. The studied subjects were derived from the Survey of Health and Living Status of the Middle Aged and Elderly in Taiwan, which comprised 2,462 observations, aged 50 and over in 1996, and conducted follow-up surveys in 1999, 2003 respectively. Random effects ordered probit regression was performed to assess the panel data and the self-rated health of ordinal, discrete. The empirical results confirm that, when potentially confounding variables were controlled, the elderly with better education, Hakka, Mainlander, people who exercise regularly, and those with commercial insurance had a significantly better level of self-rated health. In contrast, the variables of age, living in rural areas, chronic disease, activities of daily living (ADL), instrumental activities of daily living (IADL), depression, and betel nut chewing all revealed a significant negative influence on estimated self-rated health. Some findings replicated results from previous literature; others were new. In particular, when other factors were excluded, this paper highlights that the significant effects of gender and living in town on self-rated health were attenuated after including some indicators of functional abilities. Functional ability revealed more important influence on self-rated health than gender and living areas factors. In addition, ADL and IADL were overall strongly associated with self-rated health than reports of other health related characteristics among the middle aged and elderly in Taiwan.

Full paper download: Ho S_elderly in Taiwan.pdf

This paper reports on a study of the health and social care of aboriginal adults in Taiwan with a specific focus on the Paiwan group. This is an undeveloped area of research and the researcher is himself Paiwanese. The study aims to explain which approaches are most appropriate for the delivery of health and social care services to a minority group. The context of the study is secondary data which shows the wide range of inequalities experienced by the Paiwan and the lack of available resources. The study then uses an ethnographic approach to understand the Paiwan's experiences and perspectives. Purposive and snowball sampling were used to identify interviews in both a rural village and a major city. Forty seven people were interviewed including 11 policy makers, 4 Paiwanese cultural workers/researchers and 32 Paiwanese older and disabled people. An additional three focus groups provided data from older and disabled Paiwanese people and three more from service providers. Interviews were analysed thematically. The findings confirm that the Paiwan's traditional model of care has come under threat, not only from Japanese and Chinese invaders but also from modernization, western medicine and movement of young people to cities. It is argued that there are on the agenda two approaches to remedying this situation. One involves seeking to ensure that full citizenship rights are achieved for the community, the other the devolution of control over services to the community itself. It will be argued that an appropriate policy needs to combine both of these approaches to secure multicultural citizenship.

Full paper download: Hsu C_citizenship approach for aboriginal adults.pdf