TY - JOUR
T1 - Mortality, morbidity, and risk factors in Taiwan, 1990–2017: findings from the Global Burden of Disease Study 2017
AU - Wu, Yun-Chun
AU - Lo, Wei-Cheng
AU - Lu, Tsung-Hsueh
AU - Chang, Shu-Sen
AU - Lin, Hsien-Ho
AU - Chan, Chang-Chuan
N1 - Funding Information:
We acknowledge funding supports from Taiwan Ministry of Science and Technology (grant number: MOST 106-2917-I-002-042 and MOST 108-3017-F-002-003 ), Taiwan Ministry of Education (grant number: 107L891601-107L891607 , 108L891601-108L891607 ), and Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Taiwan Ministry of Education (grant number: NTU-108L9003 ). We express our appreciation to Mohsen Naghavi for sharing his expertise on methods for estimating global burden of disease and giving his guidance on the manuscript, and to Sofia Redford for her assistance on manuscript preparation. We thank all of IHME staffs and GBD collaborators who have contributed to the data collection, analysis, vetting for GBD 2017.
Funding Information:
We acknowledge funding supports from Taiwan Ministry of Science and Technology(grant number: MOST 106-2917-I-002-042 and MOST 108-3017-F-002-003), Taiwan Ministry of Education(grant number: 107L891601-107L891607, 108L891601-108L891607), and Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Taiwan Ministry of Education(grant number: NTU-108L9003). We express our appreciation to Mohsen Naghavi for sharing his expertise on methods for estimating global burden of disease and giving his guidance on the manuscript, and to Sofia Redford for her assistance on manuscript preparation. We thank all of IHME staffs and GBD collaborators who have contributed to the data collection, analysis, vetting for GBD 2017.
Publisher Copyright:
© 2020 Formosan Medical Association
PY - 2021/6
Y1 - 2021/6
N2 - Background Taiwan has implemented a national health insurance system since 1995 with high coverage and utilization rate. However, the health care system in Taiwan is facing immense challenges due to rapid population ageing. We have evaluated the landscape of population health by revisiting the results of GBD 2017 study. Methods Taiwan vital registration data (1980–2016) and Taiwan national health insurance database (2016) were used. We also conducted benchmarking comparisons with selected countries in East Asia from 1990 to 2017. Results The age-standardized disability-adjusted life-year (DALY) rates decreased by one-quarter from 1990 to 2017; however, progress was relatively slow compared to the comparator countries and has been stagnant recently. The Social-demographic Index (SDI) level in Taiwan in 2017 was 0.86, which is similar to Japan, Singapore, and South Korea in 2017, while the SDI level of China in 2017 was similar to that of Taiwan (0.69) in 1990. Although Taiwan's SDI reached the same level as those in Japan, Singapore, and South Korea in 2017, modifiable risk factors still contributed to nearly half of Taiwan's total disease burden. Five leading risk factors (high fasting plasma glucose, high body-mass index, alcohol use, illicit drug use, and impaired kidney function) accounted for a higher DALY rate in Taiwan than comparator countries in 2017. Conclusion Taiwan made marked progress in health from 1990 to 2017. However, interventions targeted on major modifiable disease risk factors should be prioritized to realize the full potential of heath improvement in the process of rapid socioeconomic development.
AB - Background Taiwan has implemented a national health insurance system since 1995 with high coverage and utilization rate. However, the health care system in Taiwan is facing immense challenges due to rapid population ageing. We have evaluated the landscape of population health by revisiting the results of GBD 2017 study. Methods Taiwan vital registration data (1980–2016) and Taiwan national health insurance database (2016) were used. We also conducted benchmarking comparisons with selected countries in East Asia from 1990 to 2017. Results The age-standardized disability-adjusted life-year (DALY) rates decreased by one-quarter from 1990 to 2017; however, progress was relatively slow compared to the comparator countries and has been stagnant recently. The Social-demographic Index (SDI) level in Taiwan in 2017 was 0.86, which is similar to Japan, Singapore, and South Korea in 2017, while the SDI level of China in 2017 was similar to that of Taiwan (0.69) in 1990. Although Taiwan's SDI reached the same level as those in Japan, Singapore, and South Korea in 2017, modifiable risk factors still contributed to nearly half of Taiwan's total disease burden. Five leading risk factors (high fasting plasma glucose, high body-mass index, alcohol use, illicit drug use, and impaired kidney function) accounted for a higher DALY rate in Taiwan than comparator countries in 2017. Conclusion Taiwan made marked progress in health from 1990 to 2017. However, interventions targeted on major modifiable disease risk factors should be prioritized to realize the full potential of heath improvement in the process of rapid socioeconomic development.
KW - Disease burden
KW - Epidemiological transition
KW - Health policy
KW - Modifiable risk factors
KW - Public health
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U2 - 10.1016/j.jfma.2020.11.014
DO - 10.1016/j.jfma.2020.11.014
M3 - Article
SN - 0929-6646
VL - 120
SP - 1340
EP - 1349
JO - Journal of the Formosan Medical Association
JF - Journal of the Formosan Medical Association
IS - 6
ER -
