The importance of improving health in China
- By Colin Speakman
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E-mail China.org.cn, November 25, 2016
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| Chinese Premier Li Keqiang addresses the opening ceremony of the Ninth Global Conference on Health Promotion (GCHP) in Shanghai, east China, Nov. 21, 2016. (Xinhua/Rao Aimin) |
The Chinese Dream should include not just a moderately prosperous Chinese population but an increasingly healthy one. Life expectancy has notably increased – residents of Shanghai, where the 9th Annual WHO Global Conference on Health Promotion has recently ended, boast the longest life expectancy at birth (82.51 years versus 74.84 nationally) of any Chinese city (Shanghai Health Bureau). However there remain many challenges from obesity, diabetes, smoking and pollution-related illnesses and food safety concerns. There is also the matter of providing adequate nutrition for the poorest citizens. The latter involves a combination of income levels, price levels of staple foods and food security for a population of approaching 1.4 billion.
The Shanghai Conference was co-organized by the National Health and Family Planning Commission of the People's Republic of China and it led to two important agreements that will bear Shanghai's name.
The Shanghai Declaration on Health Promotion, which commits to make bold political choices for health, stressing the links between health and wellbeing and the United Nations 2030 Agenda for Sustainable Development and its Sustainable Development Goals.
The Shanghai Consensus on Healthy Cities, which contains a commitment by more than 100 mayors to advance health through improved management of urban environments.
The second agreement is important for all of us who, like me in Shanghai, live in one of China's many large urban areas. While there are obvious opportunities for improved medical care in big cities over rural areas – easier access to well-resourced hospitals and specialist physicians, generally quicker transportation to get treatment and 24 hour pharmacies – there are still health challenges from rapid urbanisation.
Strategies for handling these will be increasingly important as China plans to move another 250 million citizens from rural areas into cities in the next ten years (National New-type Urbanization Plan 2014-2020) as part of economic policies to drive up household consumption to replace falling contributions of demand from exports in a sluggish global economy. Many cities will be newly developed or satellite cities of existing mega cities, but those now global cities will also expand.
Sadly, air pollution remains one of the effects of urbanization with traditional heating systems, high private car use in congested areas and the impact of old industries'energy output. Construction itself produces much local dust and disrupts daily life on the way to the urban paradises we eventually hope to see. Almost ten years ago, the combined effects of outdoor and indoor pollution were estimated to be causing around 700,000 premature deaths a year in China (World Bank Report, 2007). Although this has spurred on new policies, starting with air quality improvements in Beijing for the 2008 Olympics which include a system to limit car use by last digit of license plate, taking 20 percent of cars off the road. As a resident of Beijing for several years after that, I clearly saw (or perhaps not clearly) that car use had significantly increased, and air pollution had not been significantly improved. Renewed efforts are urgently needed, including further expansion of and encouragement of the use of public transport, greater restrictions on private car use and fast development of eco-friendly vehicles and the supporting network of charging stations that they require.
It was only at the start of this decade that China moved to having more citizens living in urban areas than in rural areas. An urban life changes lifestyles – improved transport and office based employment means less physical activity in our typical day and combined with a wider variety of eating options including junk food. Urban dwellers commuting necessary long distances across large cities between home and work are not finding it easy to incorporate exercise naturally into their routine. They are also likely to experience more stress from the daily urban battle around the city.
These realities have combined to leave China with the highest number of citizens either with diabetes or at a pre-diabetic stage in the world (Journal of American Medical Association). Research has shown that two thirds of all people with diabetes globally live in cities rather than rural areas (Novo Nordisk – Cities Changing Diabetes).
In China, lung diseases from air pollution and smoking have risen. China, while being home to roughly 20 percent of the world's population, is accounting for 33 percent of global deaths from lung cancer, reflecting a sharp increase from a decade ago (WHO World Cancer Report, 2014). Again, although these concerns have been identified in general ten years ago, China's continued fast economic growth in contrast with the economic woes in the advanced Western economies, has until recently been maintained at levels that have continued to produce economic "bads" in health terms. Since the new normal of notably slower growth of the last couple of years, there seems more recognition of the impact of sustained rapid growth on the quality of life.
A detailed discussion on recommended anti-smoking and diabetes prevention policies needs coverage of its own but looking at this from the experience of developed Western societies, China, while taking great strides forward, still has some way to go in reducing smoking and smoke-related deaths and in the dietary and lifestyle changes needs to reverse the huge strain likely to be put on national health care systems in the future. Citizens need more health education to make informed changes and take responsibility for their own wellbeing.
Thus, the WHO Conference in Shanghai could not have been timelier – the need to recognize the health issues in urbanization and to seek best practice drawing on global experiences is paramount. Prevention is always better than cure. Education to promote a healthy lifestyle is far less costly than treating the consequences of an unhealthy one.
Increased life expectancy, partly by significant strides in poverty alleviation, is wonderful, but citizens need to be able to live out their advanced years in good health, both for their own happiness and to minimize the burden on national medical care. For certain, a healthy, longer life should be part of the Chinese Dream.
Colin Speakman is a China Specialist Consultant on international education.
Opinion articles reflect the views of their authors only, not necessarily those of China.org.cn.
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