Improvements in China’s public health over two decades

Source: en.nhfpc.gov.cn

Updated: 2015-10-30

The latest reports from the prominent English medical journal The Lancet indicate that public health conditions in China have improved significantly over the past two decades, based on a survey of life expectancy and mortality rates among those under five in 31 provinces on the mainland and in Hong Kong and Macao.

The study, from a global disease study that involved US and Chinese scholars, found life expectancy in China increasing over the years and mortality rates among those below five generally dropping, while regional difference remain. Participants were the University of Washington’s Institute for Health Metrics and Evaluation, the Chinese Center for Disease Control and Prevention, and the National Maternal and Child Health Surveillance Office.

One area of analysis was the mortality rate of 240 diseases in China in the 1990-2013 period, which found male life expectancy in the city of Shanghai at just over 80 years and for females, just over 85 years, ranking first in China. Both figures were in line with international standards and showed that China's life expectancy has increased by six years over the years, with experts saying that they believe increasing GDP and improved education for pregnant and lying-in women lie behind the increase in life expectancy.

But there is still a huge gap between provinces, with life expectancy in some western areas roughly ten years lower than the highest level and on a par with some underdeveloped countries, such as Bangladesh. It also shows causes of death varying a lot among provinces, but with cerebro-vascular disease common nationwide. However, some provinces, such as Yunnan, have a very low mortality rate from it, but chronic obstructive pulmonary disease there, mostly from smoking and air pollution, has claimed a lot of lives which is also the case with many other southern and western provinces and cities. These include the city of Chongqing and the provinces of Sichuan, Gansu, Qinghai and Guizhou. In northern provinces, heart disease is the major killer, especially in Heilongjiang, where the mortality rate is three times that of Zhejiang province.

One member of the Chinese CDC's chronic non-infectious disease prevention and control center, Zhou Maigeng, commented, "Our research shows the importance of controlling major death risks, including cerebro-vascular and heart diseases and smoking," then went on to say that the government is committed to healthcare system reforms, especially to make it more equal and that regional health policies will play an important role in this.

Another area of analysis, the first of its kind, showed changes in health conditions in the infant mortality rate, covering children under five in almost 3,000 districts and counties for the 1996-2012 period, where mortality rates were 8.8 percent lower. It showed that children's health has improved, with mortality rates in the Northwest and Southwest and among minority groups falling sharply. But, again, the rates vary a lot by province, with the lowest mortality rate among children under five at less than 5 out of 1,000 in certain provinces, a figure that is even better than that of Canada, New Zealand and the US.

At least 29 of China’s provinces meet the UN Millennium Development Goals, with only two left to catch up. However, the rate in some provinces is on a par with disadvantaged countries, such as Cameroon in Africa. There are 20 regions with the worst mortality rate spread across the Tibet and Xinjiang Uygur regions, and Gansu and Sichuan provinces, with one county in Sichuan at the very bottom, showing just over 104 children, below the age of five, out of 1,000 dying.

One person involved in the study, Zhu Jun, says that it found China's child mortality down greatly in certain ways, but emphasized the point that future studies should concentrate on experiences that can help underdeveloped regions increase the child survival rate. One foreign doctor involved pointed to the fact that there are hardly any documents that show the health differences between provinces and counties, but that these new studies offer some insight into health conditions in the world's most populous country and could help policy makers on national health development.