Trajectory patterns of Self-rated health among the elderly in Taiwan: A Comparison across Ethnicity

This study seeks to compare health trajectories across the two major ethnic groups of the elderly in Taiwan, the Taiwanese and the Mainlanders, over 11 years of follow-up. This ethnic division is considered a salient dimension of social stratification in Taiwan, shaping the two groups of elders' pathways through life. Data are from the first four waves of the Taiwan Survey of Health and Living Status of the Elderly (N=3,540). Proportional hazard models with time-dependent covariates and multinomial logistic regression were employed to compare health trajectories across ethnicity. There are three major findings. (1) Self-rated health is shown to be a remarkably strong predictor of mortality despite controlling for other variables, which is consistent with the bulk of studies in this area. (2) By using a national representative sample of the elderly in Taiwan and treating self-rated health as a time-dependent covariate, evidence from this study reveals that self-rated health reflects a person's health trajectory. (3) Considerable differences exist in the ways sociostructural forces are related to the health trajectories of Mainlanders and Taiwanese, respectively, over the 11 years of follow-up. In conclusion, it seems that, among this elderly population, the ethnic inequality in health can be explained away by Mainlanders' higher socio-economic standing, which is different from the racial/ethnic health disparities observed in the United States, where social class accounts for part of the differences, but the health disparities between African Americans and whites remain after adjusting for measures of social class.