Progress and Challenges for China’s Public Health

Two new reports published in The Lancet look at recent progress in China’s public health conditions while also looking at problems that remain. From Dennis Normile at Science Magazine:

Researchers from the Chinese Center for Disease Control and Prevention, China’s National Office for Maternal and Child Health Surveillance, and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, Seattle, used provincial and county-level data to produce a detailed picture of health throughout the country. Wealthy urban centers such as Shanghai enjoy a health status comparable to that of developed Western European nations, but the situation in the rest of the country is complex and potentially challenging for improvement efforts.

One key finding is that mortality rates for children under 5 dropped 78% nationwide between 1990 and 2013. Children in richer urban areas fared far better than those in the poorer countryside. In 2012, Shanghai’s wealthy Huangpu district had the lowest rate, 3.3 deaths among children under 5 per 1000 live births. By contrast, that same year the rate across the Tibetan plateau ranged as high as 104.4.

[…] “The progress is well beyond what you would expect on the basis of simply education and income,” says Christopher Murray, an IHME public health specialist and co-author. “This is a country that has a very strong commitment to maternal and child health,” he adds. As part of a “concerted public health strategy,” China has invested heavily in hospitals and clinics as well as in widespread vaccination programs and breastfeeding awareness campaigns. [Source]

A recent article by Cesar Chalala in CounterPunch gave an overview of public health in China and looked at the regional disparities in care:

Despite this progress, however, many health problems remain unresolved. While the wealthier portion of the Chinese population has benefited from advanced health care technologies, many among the poor particularly those living in rural areas do not have adequate access to even the most essential services. For example, it is estimated that 80 percent of rural households do not have access to a sanitary lavatory and 20 percent of rural households lack safe drinking water.

In China, approximately 80 percent of health and medical services are concentrated in the main cities which mean that medical care is not available to more than 100 million people in remote rural areas. Although almost half of the population lives in the countryside, government expenditures in health tend to heavily favor those living in urban areas.

Although some progress has been made in underdeveloped rural areas, there is still widespread under-nutrition, vitamin and mineral deficiencies and indoor air pollution, all of which affect the health of people of all ages but children’s health in particular. Malnutrition among rural children is still a concern. The rate of stunted growth among children in China is estimated at 22 percent, and is as high as 46 percent in poor areas. [Source]