Ethnicity, use of Chinese medicine physicians, and health status among the elderly in Taiwan.

摘要

This study presents a secondary analysis of the data drawn from two waves of a longitudinal survey (N = 2480). Specifically, this study compares two major ethnic groups of elders, the native Taiwanese and Mainlanders, in order to understand the role of ethnicity in relation to the use of Chinese Medicine Physicians (CMP) and health status among the elderly in Taiwan. The ethnic division between the two groups of elders is considered a salient dimension of social stratification, shaping the elders' pathways through life. The objectives are: (1) to reveal a social profile of the elders who choose a CMP as one of their available options of care and how this profile reflects the ways the two ethnic groups are socially organized; and (2) to examine associations between health disparities and ethnicity in self-reported chronic conditions, disability and functional status, and self-rated health, in conjunction with other key elements in the stratification system.; The results show that Taiwanese are more likely to use a CMP, in addition to Western physicians, and ethnicity remains the strongest predictor of choosing a CMP after all the covariates have been taken into account. Health disparities between Taiwanese and Mainlander elders are found in their disability and functional status and self-rated health, in which Mainlanders are better off. Confirmatory factor analysis reveals that one of the three indicators tapping the elders' subjective health may not measure the construct in a comparable way across ethnicity.; This study concludes with a discussion of the class and cultural distance between the two medical professions and the two groups of elders, which may be associated with the type of care they seek. In addition, the identified health disparities between Taiwanese and Mainlander elders may not be resolved by short-term public health interventions only. It requires public health workers to understand how ethnicity reflects the nature, opportunities, and limitations in health chance that are embedded in social life.