背景：隨著原住民族人口持續移居都市，台灣居住於都市地區之原住民族人口超過半數。然而，相較於原鄉，都市原住民族健康相關研究及健康監測資料仍相當不足，現行行政資料亦難以完整呈現都市原住民族之健康狀況、健康行為及健康社會決定因素。
目的：探討台南市都市原住民族之健康狀況、健康風險行為及健康社會決定因素，並與非原住民族對照組進行比較，以建立都市原住民族基線健康資料，作為未來健康促進與政策規劃之參考。
方法：本研究採橫斷式研究設計，在取得教會同意並遵循文化安全原則下，自三間原住民族教會招募會友為主要研究對象，並自兩間鄰近的非原住民族教會招募會友作為對照組。研究對象為年滿18歲且於台南市居住滿六個月以上之成年人，採結構式問卷蒐集人口學特徵、社會經濟狀況、健康行為、身體質量指數(BMI)、自述經醫師診斷之慢性疾病及心理健康狀況等資料，並以描述性統計、卡方檢定及邏輯斯迴歸分析探討各變項與健康結果之關聯。
結果：原住民族受訪者的教育程度與平均月收入較低，租屋或居住宿舍的比例較高。在18-64歲受訪者中，原住民族的高血壓及糖尿病比例分別為22.7%及10.3%，高於非原住民族受訪者的16.3%及7.6%，亦高於2021年國民健康訪問調查的15.0%及6.7%。在18歲以上受訪者中，原住民族的過重及肥胖比例分別為27.4%及45.1%，高於非原住民族受訪者的18.3%及30.8%，亦高於全國調查的24.7%及23.2%。健康風險行為方面，18-64歲原住民族受訪者近半年吸菸、嚼食檳榔及飲酒比例分別為17.5%、14.4%及49.5%，亦高於非原住民族受訪者及全國調查結果。
結論：都市原住民族仍承受較高比例的健康風險，尤其是過重、肥胖與飲酒問題。此差異可能與其社會經濟條件、居住狀況及生活型態有關。此外，原住民族與非原住民族在多數自述經醫師診斷之慢性疾病及心理健康指標上，未達統計顯著差異；然而，疾病診斷仍可能受到健康檢查與疾病篩檢參與、醫療利用及健康識能等因素影響。未來應由政府、醫療機構、原住民族教會及相關社團建立跨部門夥伴關係，持續辦理符合都市原住民族文化脈絡、工作型態及生活需求的健康促進活動，以提升健康識能及健康檢查與疾病篩檢參與率，促進疾病的早期發現與適時介入。後續研究亦應納入生理量測與客觀醫療資料，以更完整評估都市原住民族的健康狀況與疾病負擔。

Background: As increasing numbers of Indigenous peoples migrating to urban cities, more than half of all Indigenous population in Taiwan now resides in urban cities. However, compared with Indigenous communities in rural areas, research and health surveillance data on urban Indigenous peoples remain limited. Existing administrative databases are also insufficient to comprehensively assess health status, health behaviors, and social determinants of health among urban Indigenous peoples.
Objective To investigate the health status, health risk behaviors, and social determinants of health among urban Indigenous peoples in Tainan City and to compare these characteristics with those of non-Indigenous adults as baseline data for healthcare planning for urban Indigenous peoples.
Methods: This study is a cross-sectional survey study. This study is a cross-sectional survey study. After obtaining approval from the participating churches and in accordance with cultural safety principles, we recruited participants from three urban Indigenous churches as the main study group and from two nearby non-Indigenous churches as the comparison group in Tainan City. Church members aged 18 years and above were invited to fill out the questionnaire. The content of the questionnaire included demographic characteristics, socioeconomic status, health behaviors, body mass index (BMI), having chronic diseases diagnosed by medical doctors, and mental health status. Descriptive statistics, chi-square tests, and logistic regression analyses were performed to examine the associations between study variables and health outcomes.
Results: urban Indigenous participants had lower educational attainment and monthly income and were more likely to live in rented housing or dormitories. Among participants aged 18-64 years, the prevalences of self-reported physician-diagnosed hypertension and diabetes were 22.7% and 10.3%, respectively, exceeding those among non-Indigenous participants (16.3% and 7.6%) and the corresponding estimates from the 2021 National Health Interview Survey(NHIS,18-64 ) (15.0% and 6.7%). Among participants aged ≥18 years, 72.6% had a BMI ≥24 kg/m², including 27.4% classified as overweight and 45.1% as obese; both proportions were higher than those among non-Indigenous participants and in the national survey. Among participants aged 18-64 years, the prevalences of past-six-month smoking, betel-quid chewing, and alcohol use were 17.5%, 14.4%, and 49.5%, respectively, and were also higher than the corresponding estimates among non-Indigenous participants and in the national survey. After adjustment for relevant covariates, Indigenous identity remained significantly associated with BMI ≥ 24 kg/m² and weekly alcohol use. Participants living in rented housing or dormitories had significantly higher odds of BMI ≥ 27 kg/m² than those living in owner-occupied housing.
Conclusions: This study demonstrates that urban Indigenous peoples remain disproportionately affected by health risks, particularly overweight, obesity, and alcohol consumption. These disparities may be associated with socioeconomic conditions, housing circumstances, and lifestyle factors. In addition, no statistically significant differences were observed between Indigenous and non-Indigenous participants in most self-reported physician-diagnosed chronic diseases or mental health indicators. However, the identification of chronic diseases may be influenced by participation in health examinations and disease screening, healthcare utilization, and health literacy.
Future efforts should strengthen partnerships among government agencies, healthcare institutions, Indigenous churches, and community organizations to deliver culturally appropriate health promotion programs. These initiatives may improve health literacy, increase participation in health examinations and disease screening, and promote early detection and timely intervention. Future research should incorporate physiological measurements and objective healthcare data to better assess the health status and disease burden of urban Indigenous peoples.

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