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Unintentional injury mortality among indigenous communities of Taiwan: trends from 2002 to 2013 and evaluation of a community-based intervention
  1. Stephen W Pan1,2,
  2. Hiu Ha Chong3,
  3. Hui-Chuan Kao4
  1. 1Department of Indigenous Affairs and Development, National Dong Hwa University, Shoufeng, Taiwan
  2. 2Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  3. 3Undergraduate Program of Indigenous Social Work, Department of Indigenous Affairs and Development, National Dong Hwa University, Shoufeng, Taiwan
  4. 4Department of Public Health, Tzu Chi University, Hualien, Taiwan
  1. Correspondence to Dr Stephen W Pan, Department of Indigenous Affairs and Development, National Dong Hwa University, Shoufeng 974, Taiwan; stephen.w.pan{at}alumni.ubc.ca

Abstract

Introduction Indigenous communities in Taiwan shoulder a disproportionate burden of unintentional injury fatalities. We compare unintentional injury mortality rate trends among Taiwan’s indigenous communities and the general population from 2002 to 2013, and evaluate potential impact of a community-based injury prevention programme on indigenous unintentional injury death rates.

Methods Standardised and crude unintentional injury mortality rates were obtained from Taiwan government reports. Segmented linear regression was used to estimate and compare unintentional injury mortality rate trends before and after the intervention.

Results Between 2002 and 2013, unintentional injury mortality rates among Taiwan’s indigenous population significantly declined by about 4.5 deaths per 100 000 each year (p<0.0001). During that time, the unintentional injury mortality rate ratio between indigenous Taiwanese and the general population significantly decreased by approximately 1% each successive year (p=0.02). However, we were unable to detect evidence that the ‘Healthy and Safe Tribe’ programme was associated with a statistically significant decrease in the unintentional injury mortality rate trend among indigenous persons (p=0.81).

Conclusion Taiwanese indigenous communities remain at significantly higher risk of unintentional injury death, though the gap may be slowly narrowing. We found no evidence that the ‘Healthy and Safe Tribe’ indigenous injury-prevention programme significantly contributed to the nationwide decline in unintentional injury mortality among indigenous Taiwanese communities from 2009 to 2013. Future interventions to address the disproportionate burden of unintentional injury fatalities among indigenous Taiwanese should consider interventions with wider coverage of the indigenous population, and complementing grass roots led community-based interventions with structural policy interventions as well.

  • indigenous
  • time series
  • campaign
  • mortality
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Footnotes

  • Contributors SWP conceptualised and drafted the manuscript. HHC and H-CK provided substantial contribution to interpretation and revising the manuscript for important intellectual content. All authors approved the final version of the manuscript to be published and accept accountability for all aspects of the manuscript.

  • Funding This study was made possible by support from Fulbright-Taiwan and the Republic of China’s Ministry of Foreign Affairs (SWP). The funders had no involvement in the planning or conduct of the study.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data used in this study are in the public domain and freely accessible to anyone using the internet.

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