A scoping review of determinants of indigenous health and health disparities in Taiwan: present evidence and paradigms

The literature on indigenous health and health disparities primarily focuses on Western countries such as Australia, Canada, New Zealand, and the United States. Nonetheless, an emerging but dispersed corpus of research exists on the determinants of health and health disparities among indigenous populations in Taiwan, a developed nation with sizable indigenous communities. Despite these developments, an understanding of current scholarship on the determinants of indigenous health and health disparities remains lacking. To bridge this gap, we systematically searched PubMed/Medline, Web of Science databases, and the Airiti Library, the most comprehensive Chinese database in Taiwan. By December 31, 2022, we identified 54 relevant studies, including 48 peer-reviewed articles in English and 6 in Chinese. These studies reveal significant disparities in mortality rates and the burden of infectious and chronic diseases between indigenous and non-indigenous populations. Factors contributing to the comparatively poorer health of indigenous communities include genetic predispositions, sociodemographic marginalization, and lifestyle choices. The studies employ diverse methodologies, ranging from small convenience samples to nationally representative data. Our analysis identified four paradigms (biomedical, epidemiological, anthropological, and historical/critical), with most focusing on biomedical and epidemiological perspectives. This review also underscores the scarcity of social-behavioral health research dedicated to indigenous health in Taiwan, highlighting the need for future studies to develop robust conceptual models, collect longitudinal data, and focus more on mental health and psychological well-being. These efforts are crucial for gaining a clearer understanding of indigenous health complexities in Taiwan and informing effective policies.