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  1. Measurement and analysis of equity in health: a case study conducted in Zhejiang Province, China.

    Science.gov (United States)

    Sun, Xueshan; Zhang, Hao; Hu, Xiaoqian; Gu, Shuyan; Zhen, Xuemei; Gu, Yuxuan; Huang, Minzhuo; Wei, Jingming; Dong, Hengjin

    2018-03-22

    Equity is the core of primary care. The issue of equity in health has become urgent, and China has attached increasing attention to it. With rapid economic development and great changes in medical insurance policy, the pattern of equity in health has changed tremendously. The reform of healthcare in Zhejiang Province is at the forefront in China, and studies on Zhejiang Province are of great significance to the entire country. This paper aimed to measure health equity from the perspectives of health needs and health-seeking behavior and to provide suggestions for the next policy formulations, with respect to timeliness. The investigator's household survey was conducted in August 2016. A sample of 1000 households, which included2807 individuals in Zhejiang, China, was obtained with the multi-stage stratified cluster sampling method. Descriptive analysis and chi-square tests were adopted in the analysis. The value of the concentration index was used to measure the equity. This study found that the poor have more urgent health needs and poorer health situations than the rich. Through studies on health-seeking behavior, the utilization of outpatient services was almost equitable, while the utilization of hospitalization showed a pro-rich inequity (i.e., the rich use more services). Individuals with employer-based medical insurance used more outpatient services than those with rural and urban medical insurance. More people in the poorer income groups did not use inpatient services due to financial difficulties. Absolute medical prices and medical insurance may explain the equity in the utilization of outpatient services and the inequity in the utilization of hospitalization. In view of the pro-rich inequity of hospitalization, more financial protection should be provided for the poor.

  2. Health care in China: improvement, challenges, and reform.

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    Wang, Chen; Rao, Keqin; Wu, Sinan; Liu, Qian

    2013-02-01

    Over the past 2 decades, significant progress has been made in improving the health-care system and people's health conditions in China. Following rapid economic growth and social development, China's health-care system is facing new challenges, such as increased health-care demands and expenditure, inefficient use of health-care resources, unsatisfying implementation of disease management guidelines, and inadequate health-care insurance. Facing these challenges, the Chinese government carried out a national health-care reform in 2009. A series of policies were developed and implemented to improve the health-care insurance system, the medical care system, the public health service system, the pharmaceutical supply system, and the health-care institution management system in China. Although these measures have shown promising results, further efforts are needed to achieve the ultimate goal of providing affordable and high-quality care for both urban and rural residents in China. This article not only covers the improvement, challenges, and reform of health care in general in China, but also highlights the status of respiratory medicine-related issues.

  3. The Intergenerational Inequality of Health in China

    DEFF Research Database (Denmark)

    Eriksson, Tor; Pan, Jay; Qin, Xuezheng

    This paper estimates the intergenerational health transmission in China using the 1991-2009 China Health and Nutrition Survey (CHNS) data. Three decades of persistent economic growth in China has been accompanied by high income inequality, which may in turn be caused by the inequality...... measures and various model specifications, and is robust when unobserved household heterogeneity is removed. We also find that the parents’ (especially the mothers’) socio-economic characteristics and environmental / health care choices are strongly correlated with their own and their children’s health......, supporting the “nature-nurture interaction” hypothesis. The Blinder-Oaxaca decomposition further indicates that 15% to 27% of the rural-urban inequality of child health is attributable to the endowed inequality from their parents’ health. An important policy implication of our study is that the increasing...

  4. Income inequality and health in China: A panel data analysis.

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    Bakkeli, Nan Zou

    2016-05-01

    During the last decades, the level of income inequality in China has increased dramatically. Despite rapid economic growth and improved living conditions, the health performance in China has dropped compared to the period before the economic reform. The "Wilkinson hypothesis" suggests that increased income inequality in a society is correlated to worse health performance. China is a particular interesting case due to the rapid socioeconomic change in the country. This study uses the China Health and Nutrition Survey (CHNS) to address the question of whether income inequality has an impact on individuals' risks of having health problems in China. Unlike previous studies with health measures such as self-reported health or mortality rate, our study uses physical functions to measure individual health. By analysing panel data using county/city-level dummies and year fixed-effects, we found that income inequality does not have a significant impact on individuals' risks of having health problems. This result is robust when changing between different indicators for income inequality. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. One Health in China

    Directory of Open Access Journals (Sweden)

    Jianyong Wu

    2016-11-01

    Full Text Available As a result of rapid economic growth over the previous three decades, China has become the second largest economy worldwide since 2010. However, as a developing country with the largest population, this rapid economic growth primarily based on excessive consumption and waste of resources. Thus, China has been facing particularly severe ecological and environmental problems in speeding up industrialization and urbanization. The impact of the health risk factors is complex and difficult to accurately predict. Therefore, it is critical to investigate potential threats in the context of the human-animal-environment interface to protect human and animal health. The “One Health” concept recognizes that human health is connected to animal and environmental health. This review primarily discusses specific health problems in China, particularly zoonoses, and explains the origin and development of the One Health approach, as well as the importance of a holistic approach in China.

  6. mHealth Series: Measuring maternal newborn and child health coverage by text messaging – a county–level model for China

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    Zhang, Yanfeng; Chen, Li; van Velthoven, Michelle H. M. M. T.; Wang, Wei; Liu, Li; Du, Xiaozhen; Wu, Qiong; Li, Ye; Car, Josip

    2013-01-01

    Background Effective interventions in maternal, newborn and child health (MNCH), if achieving high level of population coverage, could prevent most of deaths in children under five years of age. High–quality measurements of MNCH coverage are essential for tracking progress and making evidence–based decisions. Methods MNCH coverage data are mainly collected through fieldworkers’ interview with preselected households in standard programs of Demographic and Health Surveys (DHS) or Multiple Indicator Cluster Surveys (MICS) in most low– and middle–income countries. Household surveys will continue to be the major data source for MNCH coverage in the foreseeable future. However, face–to–face data collection broadly used in household surveys is labor–intensive, time–consuming and expensive. Mobile phones are drawing more and more interest in medical research with the rapid increase in usage and text messaging could be an innovative way of data collection, that is, we could collect DHS data through mHealth method. We refer to it as “mDHS”. Finding We propose in this paper a conceptual model for measuring MNCH coverage by text messaging in China. In developing this model, we considered resource constraints, sample representativeness, sample size and survey bias. The components of the model are text messaging platform, routine health information system, health facilities, communities and households. Conclusions Measuring MNCH interventions coverage by text messaging could be advantageous in many ways and establish a much larger evidence–base for MNCH health policies in China. Before mDHS could indeed be launched, research priorities would include a systematic assessment of routine health information systems and exploring feasibility to collect name lists, mobile phone numbers and general demographic and socio–economic data; qualitative interviews with health workers and caregivers; assessment of data validity of all indicators to be collected by text

  7. The old age health security in rural China: where to go?

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    Dai, Baozhen

    2015-11-04

    The huge number of rural elders and the deepening health problems (e.g. growing threats of infectious diseases and chronic diseases etc.) place enormous pressure on old age health security in rural China. This study aims to provide information for policy-makers to develop effective measures for promoting rural elders' health care service access by examining the current developments and challenges confronted by the old age health security in rural China. Search resources are electronic databases, web pages of the National Bureau of Statistics of China and the National Health and Family Planning Commission of China on the internet, China Population and Employment Statistics Yearbook, China Civil Affairs' Statistical Yearbook and China Health Statistics Yearbooks etc. Articles were identified from Elsevier, Wiley, EBSCO, EMBASE, PubMed, SCI Expanded, ProQuest, and National Knowledge Infrastructure of China (CNKI) which is the most informative database in Chinese. Search terms were "rural", "China", "health security", "cooperative medical scheme", "social medical assistance", "medical insurance" or "community based medical insurance", "old", or "elder", "elderly", or "aged", "aging". Google scholar was searched with the same combination of keywords. The results showed that old age health security in rural China had expanded to all rural elders and substantially improved health care service utilization among rural elders. Increasing chronic disease prevalence rates, pressing public health issues, inefficient rural health care service provision system and lack of sufficient financing challenged the old age health security in rural China. Increasing funds from the central and regional governments for old age health security in rural China will contribute to reducing urban-rural disparities in provision of old age health security and increasing health equity among rural elders between different regions. Meanwhile, initiating provider payment reform may contribute to

  8. Controlling cost escalation of healthcare: making universal health coverage sustainable in China

    Science.gov (United States)

    2012-01-01

    An increasingly number of low- and middle-income countries have developed and implemented a national policy towards universal coverage of healthcare for their citizens over the past decade. Among them is China which has expanded its population coverage by health insurance from around 29.7% in 2003 to over 90% at the end of 2010. While both central and local governments in China have significantly increased financial inputs into the two newly established health insurance schemes: new cooperative medical scheme (NCMS) for the rural population, and urban resident basic health insurance (URBMI), the cost of healthcare in China has also been rising rapidly at the annual rate of 17.0%% over the period of the past two decades years. The total health expenditure increased from 74.7 billion Chinese yuan in 1990 to 1998 billion Chinese yuan in 2010, while average health expenditure per capital reached the level of 1490.1 Chinese yuan per person in 2010, rising from 65.4 Chinese yuan per person in 1990. The repaid increased population coverage by government supported health insurance schemes has stimulated a rising use of healthcare, and thus given rise to more pressure on cost control in China. There are many effective measures of supply-side and demand-side cost control in healthcare available. Over the past three decades China had introduced many measures to control demand for health care, via a series of co-payment mechanisms. The paper introduces and discusses new initiatives and measures employed to control cost escalation of healthcare in China, including alternative provider payment methods, reforming drug procurement systems, and strengthening the application of standard clinical paths in treating patients at hospitals, and analyses the impacts of these initiatives and measures. The paper finally proposes ways forward to make universal health coverage in China more sustainable. PMID:22992484

  9. China's rural public health system performance: a cross-sectional study.

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    Tian, Miaomiao; Feng, Da; Chen, Xi; Chen, Yingchun; Sun, Xi; Xiang, Yuanxi; Yuan, Fang; Feng, Zhanchun

    2013-01-01

    In the past three years, the Government of China initiated health reform with rural public health system construction to achieve equal access to public health services for rural residents. The study assessed trends of public health services accessibility in rural China from 2008 to 2010, as well as the current situation about the China's rural public health system performance. The data were collected from a cross-sectional survey conducted in 2011, which used a multistage stratified random sampling method to select 12 counties and 118 villages from China. Three sets of indicators were chosen to measure the trends in access to coverage, equality and effectiveness of rural public health services. Data were disaggregated by provinces and by participants: hypertension patients, children, elderly and women. We examined the changes in equality across and within region. China's rural public health system did well in safe drinking water, children vaccinations and women hospital delivery. But more hypertension patients with low income could not receive regular healthcare from primary health institutions than those with middle and high income. In 2010, hypertension treatment rate of Qinghai in Western China was just 53.22% which was much lower than that of Zhejiang in Eastern China (97.27%). Meanwhile, low performance was showed in effectiveness of rural public health services. The rate of effective treatment for controlling their blood pressure within normal range was just 39.7%. The implementation of health reform since 2009 has led the public health development towards the right direction. Physical access to public health services had increased from 2008 to 2010. But, inter- and intra-regional inequalities in public health system coverage still exist. Strategies to improve the quality and equality of public health services in rural China need to be considered.

  10. Occupational health services in PR China

    International Nuclear Information System (INIS)

    Liang Youxin; Xiang Quanyong

    2004-01-01

    In China, the origin of occupational health started in the mid 1950s soon after the founding of the People's Republic of China. However, more complete concept and practice of occupational health was defined after the early 1980s, when China started her full-scale drive for economic reform and policy of openness. The integrity intends to cover occupational health, occupational medicine, industrial toxicology, industrial hygiene, occupational ergonomics, and occupational psychology as theoretical and practical components of occupational health. As a result, occupational health in China has undergone many changes and has improved over the past decades. These changes and improvements came about, most likely due to a new scheme, where a holistic approach of the recognition, regulation, and provision of occupational health services in a wider coverage is gradually formed and brought into effect. This presentation provides the current status of occupational health and safety problems, the latest legislative to occupational health and safety, and a general scenario of the organizational structure and function of occupational health services in China. It attempts to share with participants both our experience and lessons learned towards creating a more open and effective channel of ideas and information sharing

  11. Health impact assessment of ambient fine particulate matter exposure in impacts by different vehicle control measures in China

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    LI, S.; Wang, H.; Jiang, F.; Zhang, S.

    2017-12-01

    Road transportation is the one of the largest emission sources contributing to ambient PM2.5 pollution in China. Since the 1990s, China has adopted comprehensive control measures to mitigate vehicle emissions. However, the effects of these measures on reducing emissions, improving air quality and avoiding negative health impacts have not been systematically evaluated. In this study, we combine emissions inventory, air quality modeling, and IER model to evaluate the effect of various vehicle control measures on premature deaths attributable to ambient PM2.5 at a spatial resolution of 36 km × 36 km across China. Our results show that, comparing to no control scenarios, the total vehicular emissions with the actual vehicle emission controls implemented have reduced the emissions of NOX, HC, CO, PM2.5 by 57%, 69%, 75%, 71% respectively; and reduced the national annual mean PM2.5 concentration by 2.5ug/m³ across China by 2010. The number of avoidable deaths associated with reducing PM2.5 level is 150 thousands (95% Confidence interval: 66 thousand - 212 thousand). The geographic distribution of the absolute number of avoidable deaths presents a distinct regional feature and is particularly evident in several regions. The most influential areas are mainly concentrated in Beijing and its south part, which formed a large area of continuous high value. Our results have important policy implications on prioritizing vehicular emission control strategy in China.

  12. Evaluation on equality and efficiency of health resources allocation and health services utilization in China.

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    Sun, Jian; Luo, Hongye

    2017-07-14

    China is faced with a daunting challenge to equality and efficiency in health resources allocation and health services utilization in the context of rapid economic growth. This study sought to evaluate the equality and efficiency of health resources allocation and health services utilization in China. Demographic, economic, and geographic area data was sourced from China Statistical Yearbook 2012-2016. Data related to health resources and health services was obtained from China Health Statistics Yearbook 2012-2016. Furthermore, we evaluated the equality of health resources allocation based on Gini coefficient. Concentration index was used to measure the equality in utilization of health services. Data envelopment analysis (DEA) was employed to assess the efficiency of health resources allocation. From 2011 to 2015, the Gini coefficients for health resources by population ranged between 0.0644 and 0.1879, while the Gini coefficients for the resources by geographic area ranged from 0.6136 to 0.6568. Meanwhile, the concentration index values for health services utilization ranged from -0.0392 to 0.2110. Moreover, in 2015, 10 provinces (32.26%) were relatively efficient in terms of health resources allocation, while 7 provinces (22.58%) and 14 provinces (45.16%) were weakly efficient and inefficient, respectively. There exist distinct regional disparities in the distribution of health resources in China, which are mainly reflected in the geographic distribution of health resources. Furthermore, the people living in the eastern developed areas are more likely to use outpatient care, while the people living in western underdeveloped areas are more likely to use inpatient care. Moreover, the efficiency of health resources allocation in 21 provinces (67.74%) of China was low and needs to be improved. Thus, the government should pay more attention to the equality based on geographic area, guide patients to choose medical treatment rationally, and optimize the resource

  13. The intergenerational Inequality of Health in China

    DEFF Research Database (Denmark)

    Eriksson, Tor; Pan, Jay; Qin, Xuezheng

    2014-01-01

    This paper estimates the intergenerational health transmission in China using the 1991–2009 China Health and Nutrition Survey (CHNS) data. Three decades of persistent economic growth in China has been accompanied by high income inequality, which may in turn be caused by the inequality...... of opportunity in education and health. In this paper, we find that there is a strong correlation of health status between parent and their offspring in both the urban and rural sectors, suggesting the existence of intergenerational health inequality in China. The correlation is robust to various model....... The Blinder–Oaxaca decomposition further indicates that 15% to 27% of the rural–urban inequality of child health is attributable to the endowed inequality from their parents' health. An important policy implication of our study is that the increasing inequality of income and opportunity in China can...

  14. Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam

    Directory of Open Access Journals (Sweden)

    Liu Xiaoyun

    2012-02-01

    Full Text Available Abstract Introduction Health care financing reforms in both China and Vietnam have resulted in greater financial difficulties in accessing health care, especially for the rural poor. Both countries have been developing rural health insurance for decades. This study aims to evaluate and compare equity in access to health care in rural health insurance system in the two countries. Methods Household survey and qualitative study were conducted in 6 counties in China and 4 districts in Vietnam. Health insurance policy and its impact on utilization of outpatient and inpatient service were analyzed and compared to measure equity in access to health care. Results In China, Health insurance membership had no significant impact on outpatient service utilization, while was associated with higher utilization of inpatient services, especially for the higher income group. Health insurance members in Vietnam had higher utilization rates of both outpatient and inpatient services than the non-members, with higher use among the lower than higher income groups. Qualitative results show that bureaucratic obstacles, low reimbursement rates, and poor service quality were the main barriers for members to use health insurance. Conclusions China has achieved high population coverage rate over a short time period, starting with a limited benefit package. However, poor people have less benefit from NCMS in terms of health service utilization. Compared to China, Vietnam health insurance system is doing better in equity in health service utilization within the health insurance members. However with low population coverage, a large proportion of population cannot enjoy the health insurance benefit. Mutual learning would help China and Vietnam address these challenges, and improve their policy design to promote equitable and sustainable health insurance.

  15. Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam

    Science.gov (United States)

    2012-01-01

    Introduction Health care financing reforms in both China and Vietnam have resulted in greater financial difficulties in accessing health care, especially for the rural poor. Both countries have been developing rural health insurance for decades. This study aims to evaluate and compare equity in access to health care in rural health insurance system in the two countries. Methods Household survey and qualitative study were conducted in 6 counties in China and 4 districts in Vietnam. Health insurance policy and its impact on utilization of outpatient and inpatient service were analyzed and compared to measure equity in access to health care. Results In China, Health insurance membership had no significant impact on outpatient service utilization, while was associated with higher utilization of inpatient services, especially for the higher income group. Health insurance members in Vietnam had higher utilization rates of both outpatient and inpatient services than the non-members, with higher use among the lower than higher income groups. Qualitative results show that bureaucratic obstacles, low reimbursement rates, and poor service quality were the main barriers for members to use health insurance. Conclusions China has achieved high population coverage rate over a short time period, starting with a limited benefit package. However, poor people have less benefit from NCMS in terms of health service utilization. Compared to China, Vietnam health insurance system is doing better in equity in health service utilization within the health insurance members. However with low population coverage, a large proportion of population cannot enjoy the health insurance benefit. Mutual learning would help China and Vietnam address these challenges, and improve their policy design to promote equitable and sustainable health insurance. PMID:22376290

  16. The lower effectiveness of text-only health warnings in China compared to pictorial health warnings in Malaysia.

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    Elton-Marshall, Tara; Xu, Steve Shaowei; Meng, Gang; Quah, Anne C K; Sansone, Genevieve C; Feng, Guoze; Jiang, Yuan; Driezen, Pete; Omar, Maizurah; Awang, Rahmat; Fong, Geoffrey T

    2015-11-01

    In 2009, China changed its health warnings on cigarette packs from side-only text warnings to two text-only warnings on 30% of the bottom of the front and back of the pack. Also in 2009, Malaysia changed from similar text warnings to pictorial health warnings consistent with Framework Convention on Tobacco Control (FCTC) Article 11 Guidelines. To measure the impact of the change in health warnings in China and to compare the text-only health warnings to the impact of the pictorial health warnings introduced in Malaysia. We measured changes in key indicators of warning effectiveness among a longitudinal cohort sample of smokers from Waves 1 to 3 (2006-2009) of the International Tobacco Control (ITC) China Survey and from Waves 3 to 4 (2008-2009) of the ITC Malaysia Survey. Each cohort consisted of representative samples of adult (≥18 years) smokers from six cities in China (n=6575) and from a national sample in Malaysia (n=2883). Generalised Estimating Equations (GEE) were used to examine the impact of the health warnings on subsequent changes in salience of warnings, cognitive and behavioural outcomes. Compared to Malaysia, the weak text-only warning labels in China led to a significant change in only two of six key indicators of health warning effectiveness: forgoing cigarettes and reading the warning labels. The change to pictorial health warnings in Malaysia led to significant and substantial increases in five of six indicators (noticing, reading, forgoing, avoiding, thinking about quitting). The delay in implementing pictorial health warnings in China constitutes a lost opportunity for increasing knowledge and awareness of the harms of cigarettes, and for motivating smokers to quit. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Evaluation of Rural Primary Health Care in Western China: A Cross-Sectional Study.

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    Wang, Manli; Fang, Haiqing; Bishwajit, Ghose; Xiang, Yuanxi; Fu, Hang; Feng, Zhanchun

    2015-10-29

    China's Ministry of Health has enacted Rural Primary Health Care Program (2001-2010) (HCP) guidelines to improve the quality of people's health. However, the program's success in Western China remains unevaluated. Thus, this study aims to begin to fill that gap by analyzing the provision and utilization of Rural Primary Health Care (RPHC) in Western China. A cross-sectional study was conducted to collect secondary data on the socio-economic characteristics, system construction, services use and implementation of RPHC, and the residents' health status of the sampled areas. Four hundred counties from 31 provinces in China were selected via stratified random sampling, including 171 counties from 12 Western provinces. Twenty-seven analysis indicators, covering system construction, services use and implementation of RPHC were chosen to assess Western China's primary health quality. Analysis of Variance (ANOVA) and Least Significant Difference (LSD) methods were used to measure the RPHC disparities between Western and Eastern and Central China. Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was used to rank Western, Eastern and Central internal provinces regarding quality of their RPHC. Of the 27 indicators, 13 (48.15%) were below the standard in Western China. These focused on rural health service system construction, Chinese medicine services, and public health. In the comparison between Western, Central and Eastern China, 12 indicators had statistical significance (p China, all indicators were statistically significant (p China overall. Western China's RPHC has proceeded well, but remains weaker than that of Eastern and Central China. Differences within Western internal provinces threaten the successful implementation of RPHC.

  18. Advancing primary care to promote equitable health: implications for China

    Directory of Open Access Journals (Sweden)

    Hung Li-Mei

    2012-01-01

    Full Text Available Abstract China is a country with vast regional differences and uneven economic development, which have led to widening gaps between the rich and poor in terms of access to healthcare, quality of care, and health outcomes. China's healthcare reform efforts must be tailored to the needs and resources of each region and community. Building and strengthening primary care within the Chinese health care system is one way to effectively address health challenges. This paper begins by outlining the concept of primary care, including key definitions and measurements. Next, results from a number of studies will demonstrate that primary care characteristics are associated with savings in medical costs, improvements in health outcomes and reductions in health disparities. This paper concludes with recommendations for China on successfully incorporating a primary care model into its national health policy, including bolstering the primary care workforce, addressing medical financing structures, recognizing the importance of evidence-based medicine, and looking to case studies from countries that have successfully implemented health reform.

  19. [Occupational health status of electronics manufacturing female employees in China].

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    Wei, T T; Mei, L Y

    2018-02-06

    Electronics industry is a typical labor-intensive industry in China. There are a lot of female workers and various occupational hazard factors in the workplace. This article reviewed the characteristics of employment of women in electronics industry, occupational hazards of exposure, protective measures, occupational disease situation, influence of reproductive health and mental health, and occupational health management. Electronics female emplyees have the priority in reproductive health and mental health. Besides, this group has poor protective measures, occupational health management and policy should be taken to enhance the level of women health in electronics industry.

  20. Measuring financial protection for health in families with chronic conditions in Rural China.

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    Jiang, Chunhong; Ma, Jingdong; Zhang, Xiang; Luo, Wujin

    2012-11-16

    As the world's largest developing country, China has entered into the epidemiological phase characterized by high life expectancy and high morbidity and mortality from chronic diseases. Cardiovascular diseases, chronic obstructive pulmonary diseases, and malignant tumors have become the leading causes of death since the 1990s. Constant payments for maintaining the health status of a family member who has chronic diseases could exhaust household resources, undermining fiscal support for other necessities and eventually resulting in poverty. The purpose of this study is to probe to what degree health expenditure for chronic diseases can impoverish rural families and whether the New Cooperative Medical Scheme can effectively protect families with chronic patients against catastrophic health expenditures. We used data from the 4th National Health Services Survey conducted in July 2008 in China. The rural sample we included in the analysis comprised 39,054 households. We used both households suffering from medical impoverishment and households with catastrophic health expenditures to compare the financial protection for families having a chronic patient with different insurance coverage statuses. We used a logistic regression model to estimate the impact of different benefit packages on health financial protection for families having a chronic patient. An additional 10.53% of the families with a chronic patient were impoverished because of healthcare expenditure, which is more than twice the proportion in families without a chronic patient. There is a higher catastrophic health expenditure incidence in the families with a chronic patient. The results of logistic regression show that simply adding extra benefits did not reduce the financial risks. There is a lack of effective financial protection for healthcare expenditures for families with a chronic patient in rural China, even though there is a high coverage rate with the New Cooperative Medical Schemes. Given the

  1. The impact of mental health on labour market outcomes in China.

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    Lu, Chunling; Frank, Richard G; Liu, Yuanli; Shen, Jian

    2009-09-01

    Mental illnesses account for 20% of the total burden of disease in China. Yet, health policy in China has not devoted much attention to mental health problems and their impact on Chinese society. The objective of this paper is to investigate the impact of mental health status on labour market outcomes, such as employment and income, and provide evidence about some of the economic consequences of mental illnesses. Using the China Health Surveillance Baseline 2001 Survey and an instrumental variables estimation approach, we address possible reverse causation between work and mental health. To estimate the impact of self-reported mental health status, we use the two-part model, the first part estimating a logit equation for the probability of being employed and the second-part estimating an ordinary least squares (OLS) model on the log of individual income condition on being employed. We use a list of symptoms of mental disorders to constitute a measure of mental health status. Our identification strategy relies on instruments that measure average mental health status by zip code other than the observed individual to implement an instrumental variables model. Both men and women suffer a significant reduction in the employment rate and annual income if the average mental health deteriorates at a population level. The mental health index has a positive and significant effect on the likelihood of being employed. Our findings are consistent with what has been found in industrialised countries. This is the first empirical study that reveals that poor mental health status can be disruptive of labour market activities in China. A rapid rise of mental and behavioural problems in population reflects the transition to a market economy and indicates pressing problems that have gone unrecognised and unaddressed. The negative economic consequences in labour market outcomes suggest a potential gain from preventing and curing the mental disorder. Our study about the impact of mental

  2. China's health care system reform: Progress and prospects.

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    Li, Ling; Fu, Hongqiao

    2017-07-01

    This paper discusses the progress and prospects of China's complex health care reform beginning in 2009. The Chinese government's undertaking of systemic reform has achieved laudable achievements, including the expansion of social health insurance, the reform of public hospitals, and the strengthening of primary care. An innovative policy tool in China, policy experimentation under hierarchy, played an important role in facilitating these achievements. However, China still faces gaps and challenges in creating a single payer system, restructuring the public hospitals, and establishing an integrated delivery system. Recently, China issued the 13th 5-year plan for medical reform, setting forth the goals, policy priorities, and strategies for health reform in the following 5 years. Moreover, the Chinese government announced the "Healthy China 2030" blueprint in October 2016, which has the goals of providing universal health security for all citizens by 2030. By examining these policy priorities against the existing gaps and challenges, we conclude that China's health care reform is heading in the right direction. To effectively implement these policies, we recommend that China should take advantage of policy experimentation to mobilize bottom-up initiatives and encourage innovations. Copyright © 2017 John Wiley & Sons, Ltd.

  3. The China Health and Nutrition Survey, 1989-2011.

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    Zhang, B; Zhai, F Y; Du, S F; Popkin, B M

    2014-01-01

    The China Health and Nutrition Survey (CHNS) began in 1989 with the goal of creating a multilevel method of data collection from individuals and households and their communities to understand how the wide-ranging social and economic changes in China affect a wide array of nutrition and health-related outcomes. Initiated with a partial sample in 1989, the full survey runs from 1991 to 2011, and this issue documents the CHNS history. The CHNS cohort includes new household formation and replacement communities and households; all household members are studied. Furthermore, in-depth community data are collected. The sample began with eight provinces and added a ninth, Heilongjiang, in 1997 and three autonomous cities, Beijing, Shanghai, and Chongqing, in 2011. The in-depth community contextual measures have allowed us to create a unique measure of urbanicity that captures major dimensions of modernization across all 288 communities currently in the CHNS sample. The standardized, validated urbanicity measure captures the changes in 12 dimensions: population density; economic activity; traditional markets; modern markets; transportation infrastructure; sanitation; communications; housing; education; diversity; health infrastructure; and social services. Each is based on numerous measures applicable to each dimension. They are used jointly and separately in hundreds of studies. © 2014 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

  4. Changes in health expenditures in China in 2000s: has the health system reform improved affordability.

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    Long, Qian; Xu, Ling; Bekedam, Henk; Tang, Shenglan

    2013-06-13

    China's health system reform launched in early 2000s has achieved better coverage of health insurance and significantly increased the use of healthcare for vast majority of Chinese population. This study was to examine changes in the structure of total health expenditures in China in 2000-2011, and to investigate the financial burden of healthcare placed on its population, particularly between urban and rural areas and across different socio-economic development regions. Health expenditures data came from the China National Health Accounts study in 1990-2011, and other data used to calculate the financial burden of healthcare were from China Statistical Yearbook and China Population Statistical Yearbook. Total health expenditures were divided into government and social expenditure, and out-of-pocket payment. The financial burden of healthcare was estimated as out-of-pocket payment per capita as a percentage of annual household living consumption expenditure per capita. Between 2000 and 2011, total health expenditures in China increased from Chinese yuan 319 to 1888 (United States dollars 51 to 305), with average annual increase of 17.4%. Government and social health expenditure increased rapidly being 22.9% and 18.8% of average annual growth rate, respectively. The share of out-of-pocket payment in total health expenditure for the urban population declined from 53% in 2005 to 36% in 2011, but had only a slight decrease for the rural population from 53% to 50%. Out-of-pocket payment, as a percentage of annual household living consumption, has continued to rise, particularly in the rural population from the less developed region (6.1% in 2000 to 8.8% in 2011). The rapid increase of public funding to subsidize health insurance in China, as part of the reform strategy, did not mitigate the out-of-pocket payment for healthcare over the past decade. Financial burden of healthcare on the rural population increased. Affordability among the rural households with sick

  5. Neglected environmental health impacts of China's supply-side structural reform.

    Science.gov (United States)

    Zhang, Wei; Zhang, Lei; Li, Ying; Tian, Yuling; Li, Xiaoran; Zhang, Xue; Mol, Arthur P J; Sonnenfeld, David A; Liu, Jianguo; Ping, Zeyu; Chen, Long

    2018-03-15

    "Supply-side structural reform" (SSSR) has been the most important ongoing economic reform in China since 2015, but its important environmental health effects have not been properly assessed. The present study addresses that gap by focusing on reduction of overcapacity in the coal, steel, and iron sectors, combined with reduction of emissions of sulfur dioxide (SO 2 ), nitrogen oxide (NO x ), and fine particulate matter (PM 2.5 ), and projecting resultant effects on air quality and public health across cities and regions in China. Modeling results indicate that effects on air quality and public health are visible and distributed unevenly across the country. This assessment provides quantitative evidence supporting projections of the transregional distribution of such effects. Such uneven transregional distribution complicates management of air quality and health risks in China. The results challenge approaches that rely solely on cities to improve air quality. The article concludes with suggestions on how to integrate SSSR measures with cities' air quality improvement attainment planning and management performance evaluation. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. The Effect of Childhood Health Status on Adult Health in China.

    Science.gov (United States)

    Wang, Qing; Zhang, Huyang; Rizzo, John A; Fang, Hai

    2018-01-26

    Childhood health in China was poor in the 1950s and 1960s because of limited nutrition. In the last three decades, China has distinguished itself through its tremendous economic growth and improvements in health and nutrition. However, prior to such growth, access to good nutrition was more variable, with potentially important implications, not only for childhood health, but also for adult health, because of its long-term effects lasting into adulthood. To shed light on these issues, this study examined the long-run association between childhood health and adult health outcomes among a middle-aged Chinese population and addresses the endogeneity of childhood health. A nationwide database from the 2011 China Health and Retirement Longitudinal Study (CHARLS) was employed. Three adult health outcomes variables were used: self-reported health status, cognition, and physical function. The local variation in grain production in the subjects' fetal period and the first 24 months following birth was employed as an instrument for childhood health in order to correct for its endogeneity. Childhood health recalled by the respondents was positively and significantly associated with their adult health outcomes in terms of self-reported health status, cognition, and physical function in single-equation estimates that did not correct for the endogeneity of childhood health. A good childhood health status increased the probabilities of good adult health, good adult cognitive function, and good adult physical function by 16% (95% CI: 13-18%), 13% (95% CI: 10-15%), and 14% (95% CI: 12-17%), respectively. After correcting for endogeneity, the estimated effects of good childhood health were consistent but stronger. We also studied the male and female populations separately, finding that the positive effects of childhood health on adult health were larger for males. In China, childhood health significantly affects adult health. This suggests that early interventions to promote

  7. mHealth Interventions for Health System Strengthening in China: A Systematic Review.

    Science.gov (United States)

    Tian, Maoyi; Zhang, Jing; Luo, Rong; Chen, Shi; Petrovic, Djordje; Redfern, Julie; Xu, Dong Roman; Patel, Anushka

    2017-03-16

    With rapidly expanding infrastructure in China, mobile technology has been deemed to have the potential to revolutionize health care delivery. There is particular promise for mobile health (mHealth) to positively influence health system reform and confront the new challenges of chronic diseases. The aim of this study was to systematically review existing mHealth initiatives in China, characterize them, and examine the extent to which mHealth contributes toward the health system strengthening in China. Furthermore, we also aimed to identify gaps in mHealth development and evaluation. We systematically reviewed the literature from English and Chinese electronic database and trial registries, including PubMed, EMBASE, Cochrane, China National Knowledge of Infrastructure (CNKI), and World Health Organization (WHO) International Clinical Trials Registry Platform. We used the English keywords of mHealth, eHealth, telemedicine, telehealth, mobile phone, cell phone, text messaging, and China, as well as their corresponding Chinese keywords. All articles using mobile technology for health care management were included in the study. A total of 1704 articles were found using the search terms, and eventually 72 were included. Overall, few high quality interventions were identified. Most interventions were found to be insufficient in scope, and their evaluation was of inadequate rigor to generate scalable solutions and provide reliable evidence of effectiveness. Most interventions focused on text messaging for consumer education and behavior change. There were a limited number of interventions that addressed health information management, health workforce issues, use of medicines and technologies, or leadership and governance from a health system perspective. We provide four recommendations for future mHealth interventions in China that include the need for the development, evaluation and trials examining integrated mHealth interventions to guide the development of future mHealth

  8. mHealth Interventions for Health System Strengthening in China: A Systematic Review

    Science.gov (United States)

    Zhang, Jing; Luo, Rong; Chen, Shi; Petrovic, Djordje; Redfern, Julie; Xu, Dong Roman; Patel, Anushka

    2017-01-01

    Background With rapidly expanding infrastructure in China, mobile technology has been deemed to have the potential to revolutionize health care delivery. There is particular promise for mobile health (mHealth) to positively influence health system reform and confront the new challenges of chronic diseases. Objective The aim of this study was to systematically review existing mHealth initiatives in China, characterize them, and examine the extent to which mHealth contributes toward the health system strengthening in China. Furthermore, we also aimed to identify gaps in mHealth development and evaluation. Methods We systematically reviewed the literature from English and Chinese electronic database and trial registries, including PubMed, EMBASE, Cochrane, China National Knowledge of Infrastructure (CNKI), and World Health Organization (WHO) International Clinical Trials Registry Platform. We used the English keywords of mHealth, eHealth, telemedicine, telehealth, mobile phone, cell phone, text messaging, and China, as well as their corresponding Chinese keywords. All articles using mobile technology for health care management were included in the study. Results A total of 1704 articles were found using the search terms, and eventually 72 were included. Overall, few high quality interventions were identified. Most interventions were found to be insufficient in scope, and their evaluation was of inadequate rigor to generate scalable solutions and provide reliable evidence of effectiveness. Most interventions focused on text messaging for consumer education and behavior change. There were a limited number of interventions that addressed health information management, health workforce issues, use of medicines and technologies, or leadership and governance from a health system perspective. Conclusions We provide four recommendations for future mHealth interventions in China that include the need for the development, evaluation and trials examining integrated mHealth

  9. Effect of Air Pollution and Rural-Urban Difference on Mental Health of the Elderly in China.

    Science.gov (United States)

    Tian, Tao; Chen, Yuhuai; Zhu, Jing; Liu, Pengling

    2015-08-01

    China has become an aging society, and the mental health problem of the elderly is increasingly becoming prominent. This paper aimed to analyze the effect of air pollution and rural-urban difference on mental health of the elderly in China. Using the data from the China Health and Retirement Longitudinal Survey (CHARLS, 2013), after controlling the social demography variable via Tobit and Probit, a regression analysis of the effect of air pollution and rural-urban difference on mental health and psychological disorder was conducted on 6,630 old people (≧60 yr old) of China from February to April 2015. Mental health and psychological disorder of the elderly were measured by the CES-D score of respondents. Air pollution degree of counties and cities (n=123) were measured by SO2 emission. 27.8% of old people had psychological disorders. Air pollution significantly influenced the mental health of the elderly, showing a positive "U-shaped" curve (Phealth problems. Marriage, education, and social activities had positive effects on the mental health of the elderly. China's local governments should consider the influence of air pollution on the mental health of the elderly during economic development. This paper recommends paying attention to the difference in mental health between the urban and rural elderly when making public health policies. Governments could improve the mental health of the elderly by enriching social activities and increasing employment opportunities of the elderly.

  10. Air pollution and health studies in China--policy implications.

    Science.gov (United States)

    Chen, Bingheng; Kan, Haidong; Chen, Renjie; Jiang, Songhui; Hong, Chuanjie

    2011-11-01

    During the rapid economic development in China, ambient air pollutants in major cities, including PM10 (particulate matter with aerodynamic diameter air pollution levels in China are still at the higher end of the world level. Less information is available regarding changes in national levels of other pollutants such as PM2.5 and ozone. The Chinese Ministry of Environmental Protection (MOEP) set an index for "controlling/reducing total SO2 emissions" to evaluate the efficacy of air pollution control strategy in the country. Total SO2 emissions declined for the first time in 2007. Chinese epidemiologic studies evidenced adverse health effects of ambient air pollution similar to those reported from developed countries, though risk estimates on mortality/morbidity per unit increase of air pollutant are somewhat smaller than those reported in developed countries. Disease burden on health attributable to air pollution is relatively greater in China because of higher pollution levels. Improving ambient air quality has substantial and measurable public health benefits in China. It is recommended that the current Chinese air quality standards be updated/revised and the target for "controlling/reducing total SO2 emissions" be maintained and another target for "reducing total NO2 emissions" be added in view of rapid increase in motor vehicles. Continuous and persistent efforts should be taken to improve ambient air quality.

  11. Assessing the Association of Food Preferences and Self-Reported Psychological Well-Being among Middle-Aged and Older Adults in Contemporary China-Results from the China Health and Nutrition Survey

    OpenAIRE

    Yen-Han Lee; Mack Shelley; Ching-Ti Liu; Yen-Chang Chang

    2018-01-01

    China has undergone rapid social transitions within the last few decades. However, mental health issues, challenges to psychological well-being, and poor dietary choices have gradually surfaced. These health concerns are related to the rapid growth of the aging population and of the fast-paced industrialized society. Nevertheless, there is little knowledge about food preferences and psychological well-being measurements in contemporary China. Applying the 2011 China Health and Nutrition Surve...

  12. How China's new health reform influences village doctors' income structure: evidence from a qualitative study in six counties in China.

    Science.gov (United States)

    Zhang, Shengfa; Zhang, Weijun; Zhou, Huixuan; Xu, Huiwen; Qu, Zhiyong; Guo, Mengqi; Wang, Fugang; Zhong, You; Gu, Linni; Liang, Xiaoyun; Sa, Zhihong; Wang, Xiaohua; Tian, Donghua

    2015-05-05

    In 2009, health-care reform was launched to achieve universal health coverage in China. A good understanding of how China's health reforms are influencing village doctors' income structure will assist authorities to adjust related polices and ensure that village doctors employment conditions enable them to remain motivated and productive. This study aimed to investigate the village doctors' income structure and analyse how these health policies influenced it. Based on a review of the previous literature and qualitative study, village doctors' income structure was depicted and analysed. A qualitative study was conducted in six counties of six provinces in China from August 2013 to January 2014. Forty-nine village doctors participated in in-depth interviews designed to document their income structure and its influencing factors. The themes and subthemes of key factors influencing village doctors' income structure were analysed and determined by a thematic analysis approach and group discussion. Several policies launched during China's 2009 health-care reform had major impact on village doctors. The National Essential Medicines System cancelled drug mark-ups, removing their primary source of income. The government implemented a series of measures to compensate, including paying them to implement public health activities and provide services covered by social health insurance, but these have also changed the village doctors' role. Moreover, integrated management of village doctors' activities by township-level staff has reduced their independence, and different counties' economic status and health reform processes have also led to inconsistencies in village doctors' payment. These changes have dramatically reduced village doctors' income and employment satisfaction. The health-care reform policies have had lasting impacts on village doctors' income structure since the policies' implementation in 2009. The village doctors have to rely on the salaries and subsidies from

  13. Climate change and air quality - measures with co-benefits in China

    Energy Technology Data Exchange (ETDEWEB)

    Kristin Aunan; Jinghua Fang; Tao Hu; Hans Martin Seip; Haakon Vennemo [Center for International Climate and Environmental Research-Oslo (CICERO) (Norway)

    2006-08-15

    Several studies carried out in China over the past 5-10 years, including the authors own work, have found that many measures aimed primarily at reducing local air pollution decrease GHG emissions as a co-benefit. Conversely, a range of CO{sub 2} mitigation policies entail reductions in air pollution as a co-benefit. This implies that the real costs of climate policies in China may be lower than anticipated by the government. This article describes the links between climate change and air quality issues as well as the health and environmental benefits accruing from alterative measures and policies for CO{sub 2} mitigation in China where coal is expected to remain a main energy source for many years to come. The tremendous potential to cut GHG emissions while simultaneously reducing air pollution should make cooperation on climate control strategies more attractive to China and other countries in a similar position. 43 refs., 3 figs., 1 tab.

  14. Efficiency performance of China's health care delivery system.

    Science.gov (United States)

    Zhang, Luyu; Cheng, Gang; Song, Suhang; Yuan, Beibei; Zhu, Weiming; He, Li; Ma, Xiaochen; Meng, Qingyue

    2017-07-01

    Improving efficiency performance of the health care delivery system has been on the agenda for the health system reform that China initiated in 2009. This study examines the changes in efficiency performance and determinants of efficiency after the reform to provide evidence to assess the progress of the reform from the perspective of efficiency. Descriptive analysis, Data Envelopment Analysis, the Malmquist Index, and multilevel regressions are used with data from multiple sources, including the World Bank, the China Health Statistical Yearbook, and routine reports. The results indicate that over the last decade, health outcomes compared with health investment were relatively higher in China than in most other countries worldwide, and the trend was stable. The overall efficiency and total factor productivity increased after the reform, indicating that the reform was likely to have had a positive impact on the efficiency performance of the health care delivery system. However, the health care delivery structure showed low system efficiency, mainly attributed to the weakened primary health care system. Strengthening the primary health care system is central to enhancing the future performance of China's health care delivery system. Copyright © 2017 John Wiley & Sons, Ltd.

  15. Viewpoint: Prevention is missing: is China's health reform reform for health?

    Science.gov (United States)

    Yang, Le; Zhang, Xiaoli; Tan, Tengfei; Cheng, Jingmin

    2015-02-01

    Ancient China emphasized disease prevention. As a Chinese saying goes, 'it is more important to prevent the disease than to cure it'. Traditional Chinese medicine posits that diseases can be understood, thus, prevented. In today's China, the state of people's health seems worse than in the past. Thus the Chinese government undertook the creation of a new health system. Alas, we believe the results are not very satisfactory. The government seems to have overlooked rational allocation between resources for treatment and prevention. Public investment has been gradually limited to the domain of treatment. We respond to this trend, highlighting the importance of prevention and call for government and policymakers to adjust health policy and work out a solution suitable for improving the health of China's people.

  16. Economic transition and health transition: comparing China and Russia.

    Science.gov (United States)

    Liu, Y; Rao, K; Fei, J

    1998-05-01

    Drawing on experiences from China and Russia (the world's two largest transitional economies), this paper empirically examines the impact of economic reforms on health status. While China's overall health status continued to improve after the economic reform, Russia experienced a serious deterioration in its population health. The observed differences in health performance between China and Russia can be explained by the different impacts of economic reforms on three major socioeconomic determinants of health. Depending on whether or not the reform improves physical environment (as reflected in income level and nutritional status), social environment (including social stability and security system), and health care, we would observe either a positive or a negative net effect on health. Despite remarkable differences in overall health development, China and Russia share some common problems. Mental and social health problems such as suicides and alcohol poisoning have been on the rise in both countries. These problems were much more serious in Russia, where political and social instability was more pronounced, associated with Russia's relatively radical reform process. With their economies moving toward a free market system, health sectors in China and Russia are undergoing marketization, which has had serious detrimental effect on the public health services.

  17. Measuring and valuing health-related quality of life among children and adolescents in mainland China--a pilot study.

    Directory of Open Access Journals (Sweden)

    Fei Xu

    Full Text Available The Child Health Utility 9D (CHU9D, a new generic preference-based health-related quality of life (HRQoL instrument, has been validated for use in young people in both the UK and Australia. The main objectives of this study were to examine the feasibility of using a Chinese version of the CHU9D (CHU9D-CHN to assess HRQoL and to investigate the association of physical activity, homework hours and sleep duration with HRQoL in children and adolescents in Mainland China.Data were collected using a multi-stage sampling method from grades 4-12 students in May 2013 in Nanjing, China. Consenting participants (N = 815 completed a self-administered questionnaire including the CHU9D-CHN instrument and information on physical activity, homework and sleep duration, self-reported health status, and socio-demographic characteristics. Descriptive and multivariate linear regression analyses were undertaken. CHU9D-CHN utility scores were generated by employing two scoring algorithms currently available for the instrument, the first derived from UK adults utilising the standard gamble (SG valuation method and the second derived from Australian adolescents utilising the best-worst scaling (BWS method.It was found that CHU9D utility scores discriminated well in relation to self-reported health status and that better health status was significantly associated with higher utility scores regardless of which scoring algorithm was employed (both p<0.001. The adjusted mean utilities were significantly higher for physically active than inactive students (0.023 by SG, 0.029 by BWS scoring methods, p<0.05. An additional hour of doing homework and sleep duration were, separately, associated with mean utilities of -0.019 and 0.032 based on SG, and -0.021 and 0.040 according to BWS scoring algorithms (p<0.01.The CHU9D-CHN shows promise for measuring and valuing the HRQoL of children and adolescents in China. Levels of self-reported physical activity, homework and sleep time

  18. Health benefits from improved outdoor air quality and intervention in China

    International Nuclear Information System (INIS)

    Li, Shanshan; Williams, Gail; Guo, Yuming

    2016-01-01

    China is at its most critical stage of outdoor air quality management. In order to prevent further deterioration of air quality and to protect human health, the Chinese government has made a series of attempts to reduce ambient air pollution. Unlike previous literature reviews on the widespread hazards of air pollution on health, this review article firstly summarized the existing evidence of human health benefits from intermittently improved outdoor air quality and intervention in China. Contents of this paper provide concrete and direct clue that improvement in outdoor air quality generates various health benefits in China, and confirm from a new perspective that it is worthwhile for China to shift its development strategy from economic growth to environmental economic sustainability. Greater emphasis on sustainable environment design, consistently strict regulatory enforcement, and specific monitoring actions should be regarded in China to decrease the health risks and to avoid long-term environmental threats. - Highlights: • Firstly reviews the health benefits of improvement in outdoor air quality in China. • Reduction in air pollution generates various health benefits in China. • Chinese government should consider environmental economic sustainability. • Future research on health benefits of air quality improvement is proposed. - Improvement in outdoor air quality generates various health benefits in China. It is worthwhile for China to consider environmental economic sustainability.

  19. Economic Segmentation and Health Inequalities in Urban Post-Reform China.

    Science.gov (United States)

    Kwon, Soyoung

    2016-01-01

    During economic reform, Chinese economic labor markets became segmented by state sector associated with a planned redistributive economy and private sector associated with the market economy. By considering an economic sector as a concrete institutional setting in post-reform China, this paper compares the extent to which socioeconomic status, measured by education and income, is associated with self-rated health between state sector and private sector. The sample is limited to urban Chinese employees between the ages of 18 and 55 who were active in the labor force. By analyzing pooled data from the 1991-2006 Chinese Health and Nutrition Survey , I find that there is a stronger association between income and self-rated health in the private sector than in the state sector. This study suggests that sectoral differences between market and redistributive economies are an important key to understanding health inequalities in post-reform urban China.

  20. Understanding health constraints among rural-to-urban migrants in China.

    Science.gov (United States)

    Li, Yan

    2013-11-01

    The main purpose of this article is to examine the understanding and experience of health and health care among rural-to-urban migrants in China, and to explain the impact of the internal factors of migrants themselves and the external factors of their social environment. Understanding the perceptions and consciousness of health issues among migrants is crucial to prevention, intervention, and other health-related measures for the migrant population in China, but this has rarely been explored in studies. On the basis of a case study of a migrant community in Beijing, I explore the migrants' understandings of health and health care and analyze factors in the social environment, including exclusion from the social system and the possibility of health participation, exclusion from social relation networks, obstructed channels of health maintenance, and exclusion of crowd psychology, which impact heavily on their health understanding and health behavior. I argue that the internal and the external factors are linked together closely and interact as reciprocal causation. However, the migrants should not be seen as primarily responsible, because their poor understanding of health mainly results from the socioeconomic environment in which they live and work.

  1. THE ENVIRONMENTAL CHALLENGE AND HEALTH SECURITY IN CHINA

    Directory of Open Access Journals (Sweden)

    Wang Wuyi

    2010-01-01

    Full Text Available China has achieved impressive rapid development over the past 30 years. But China also faces the challenge of environmental change resulting from rapid economic growth and the attendant risks to human health. In this paper we described the environmental change and health risk in China from evident fluctuation of China’s climate, major changes in natural hydrological condition, raw materials and energy demand, changes of disease epidemic pattern related to climate change and ecosystem damage, new health risk raised by rapid urbanization and rural environmental quality degradation. The suggestion and countermeasures were discussed.

  2. Health system strengthening and hypertension management in China.

    Science.gov (United States)

    Huang, Kehui; Song, Yu Ting; He, Yong Huan; Feng, Xing Lin

    2016-01-01

    Non-communicable diseases are the leading causes of global burden of diseases, and hypertension is one of the most important risk factors. Hypertension prevalence doubled in China in the past decade and affects more than 300 million Chinese people. In the review we systematically searched peer-reviewed publications that link health system level factors with hypertension management in China and provide the current knowledge on how to improve a country's health system to manage the hypertension epidemic. A framework was developed to guide the review. The database of PubMed, CNKI were systematically searched from inception to April 13, 2016. Two authors independently screened the searched results for inclusion, conducted data extraction and appraised the quality of studies. Key findings were described according to the framework. Five hundred seventy-two publications were identified, where 11 articles were left according to the inclusion and exclusion criteria. The study periods range from 2010 to 2015. All about 11 researches linked health system factors to the outcome of hypertension management. And the outcomes were just focused on the awareness, treatment and control of hypertension but not hypertension incidence. One study is about the role of health system governance, investigating the performance of different organized community health care centers; three studies were about health financing comparing differences in insurance coverage; three studies were about health information practicing the hypertension guidelines of China or the WHO, and the rest three about mechanisms of health service delivery. No researches were identified about physical resources for health and human resources for health. Hypertension prevalence has been rising rapidly in China and the management of hypertension in China is a detection problem rather than treatment problem. Limited evidence shows the positive effect of health system factors on hypertension management and joint efforts

  3. Economic Segmentation and Health Inequalities in Urban Post-Reform China

    Directory of Open Access Journals (Sweden)

    Soyoung Kwon

    2016-08-01

    Full Text Available During economic reform, Chinese economic labor markets became segmented by state sector associated with a planned redistributive economy and private sector associated with the market economy. By considering an economic sector as a concrete institutional setting in post-reform China, this paper compares the extent to which socioeconomic status, measured by education and income, is associated with self-rated health between state sector and private sector. The sample is limited to urban Chinese employees between the ages of 18 and 55 who were active in the labor force. By analyzing pooled data from the 1991–2006 Chinese Health and Nutrition Survey, I find that there is a stronger association between income and self-rated health in the private sector than in the state sector. This study suggests that sectoral differences between market and redistributive economies are an important key to understanding health inequalities in post-reform urban China.

  4. The effect of community-based health management on the health of the elderly: a randomized controlled trial from China

    Directory of Open Access Journals (Sweden)

    Chao Jianqian

    2012-12-01

    Full Text Available Abstract Background An aging population poses significant challenges to health care in China. Health management has been implemented to reduce the costs of care, raise health service utilization, increase health knowledge and improve quality of life. Several studies have tried to verify the effectiveness of health management in achieving these goals worldwide. However, there have been insufficient randomized control trials (RCTs to draw reliable conclusions. The few small-scale studies conducted in China include mostly the general population rather than the elderly. Our study is designed to evaluate the impact of community-based health management on the health of the elderly through an RCT in Nanjing, China. Methods Two thousand four hundred participants, aged 60 or older and who gave informed consent, were randomly allocated 1:1 into management and control groups, the randomization schedule was concealed from community health service center staff until allocation. Community-based health management was applied in the former while the latter was only given usual care. After 18 months, three categories of variables (subjective grading health indices, objective health indices and health service utilization were measured based on a questionnaire, clinical monitoring and diagnostic measurements. Differences between the two groups were assessed before and after the intervention and analyzed with t-test, χ2-test, and multiple regression analysis. Results Compared with the control group, the management group demonstrated improvement on the following variables (P Conclusion Community-based health management improved both subjective grading health indices, objective health indices and decreased the number of outpatient clinic visits, demonstrating effectiveness in improving elderly health. Trial registration ChiCTR-OCH-11001716

  5. Main drivers of health expenditure growth in China: a decomposition analysis.

    Science.gov (United States)

    Zhai, Tiemin; Goss, John; Li, Jinjing

    2017-03-09

    In past two decades, health expenditure in China grew at a rate of 11.6% per year, which is much faster than the growth of the country's economy (9.9% per year). As cost containment is a key aspect of China's new health system reform agenda, this study aims to identify the main drivers of past growth so that cost containment policies are focussed in the right areas. The analysis covered the period 1993-2012. To understand the drivers of past growth during this period, Das Gupta's decomposition method was used to decompose the changes in health expenditure by disease into five main components that include population growth, population ageing, disease prevalence rate, expenditure per case of disease, and excess health price inflation. Demographic data on population size and age-composition were obtained from the Department of Economic and Social Affairs of the United Nations. Age- and disease- specific expenditure and prevalence rates by age and disease were extracted from China's National Health Accounts studies and Global Burden of Disease 2013 studies of the Institute for Health Metrics and Evaluation, respectively. Growth in health expenditure in China was mainly driven by a rapid increase in real expenditure per prevalent case, which contributed 8.4 percentage points of the 11.6% annual average growth. Excess health price inflation and population growth contributed 1.3 and 1.3% respectively. The effect of population ageing was relatively small, contributing 0.8% per year. However, reductions in disease prevalence rates reduced the growth rate by 0.3 percentage points. Future policy in optimising growth in health expenditure in China should address growth in expenditure per prevalent case. This is especially so for neoplasms, and for circulatory and respiratory disease. And a focus on effective interventions to reduce the prevalence of disease in the country will ensure that changing disease rates do not lead to a higher growth in future health expenditure

  6. Consolidating the social health insurance schemes in China: towards an equitable and efficient health system.

    Science.gov (United States)

    Meng, Qingyue; Fang, Hai; Liu, Xiaoyun; Yuan, Beibei; Xu, Jin

    2015-10-10

    Fragmentation in social health insurance schemes is an important factor for inequitable access to health care and financial protection for people covered by different health insurance schemes in China. To fulfil its commitment of universal health coverage by 2020, the Chinese Government needs to prioritise addressing this issue. After analysing the situation of fragmentation, this Review summarises efforts to consolidate health insurance schemes both in China and internationally. Rural migrants, elderly people, and those with non-communicable diseases in China will greatly benefit from consolidation of the existing health insurance schemes with extended funding pools, thereby narrowing the disparities among health insurance schemes in fund level and benefit package. Political commitments, institutional innovations, and a feasible implementation plan are the major elements needed for success in consolidation. Achievement of universal health coverage in China needs systemic strategies including consolidation of the social health insurance schemes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. The social income inequality, social integration and health status of internal migrants in China.

    Science.gov (United States)

    Lin, Yanwei; Zhang, Qi; Chen, Wen; Ling, Li

    2017-08-04

    To examine the interaction between social income inequality, social integration, and health status among internal migrants (IMs) who migrate between regions in China. We used the data from the 2014 Internal Migrant Dynamic Monitoring Survey in China, which sampled 15,999 IMs in eight cities in China. The Gini coefficient at the city level was calculated to measure social income inequality and was categorized into low (0.2 0.5). Health status was measured based upon self-reported health, subjective well-being, and perceptions of stress and mental health. Social integration was measured from four perspectives (acculturation and integration willingness, social insurance, economy, social communication). Linear mixed models were used to examine the interaction effects between health statuses, social integration, and the Gini coefficient. Factors of social integration, such as economic integration and acculturation and integration willingness, were significantly related to health. Social income inequality had a negative relationship with the health status of IMs. For example, IMs in one city, Qingdao, with a medium income inequality level (Gini = 0.329), had the best health statuses and better social integration. On the other hand, IMs in another city, Shenzhen, who had a large income inequality (Gini = 0.447) were worst in health statues and had worse social integration. Policies or programs targeting IMs should support integration willingness, promote a sense of belonging, and improve economic equality. In the meantime, social activities to facilitate employment and create social trust should also be promoted. At the societal level, structural and policy changes are necessary to promote income equity to promote IMs' general health status.

  8. Internal migration and the health of the returned population: a nationally representative study of China.

    Science.gov (United States)

    Zhang, Luwen; Liu, Shuaishuai; Zhang, Guoying; Wu, Shaolong

    2015-07-28

    China had 236 million internal migrants in 2012 and the majority of them migrated from rural to urban areas. The research based on medical and epidemical records found that the migrants had worse health than the urban residents, but the household and working place investigations reported better health status. The sick or unhealthy migrants are likely to return to their hometowns, which in turn may cause a report bias or over-estimation of the health status of rural-to-urban migrants in China. This paper explores the association of migration status and the physical and psychological health of Chinese internal migrants. Nationally representative household survey data from the China Labor-force Dynamics Survey 2012 (CLDS) were used to analyze the association between the migration status and the health status of internal migrants in China. Migration status of the respondents was measured by hukou status and migration experience and all respondents were divided into four groups: returned population, migrant population, urban residents, and rural residents. Health status of respondents was measured by self-reported physical and psychological health. Migration experience was associated with the physical health of the returned population. The physical health of the returned population was worse than the migrant population and was distinguished by age and sex. The physical health status of migrant population was significantly better than rural residents, but not significantly better than urban residents. However, the association between migration status and psychological health was not statistically significant. Besides migration status, the socioeconomic status (SES) had a positive correlation with both physical and psychological health status, while occupational hazards exerted negative influence. The results indicate a tight association between migration experience and health status. The internal unhealthy migrants were more likely to return to their hometown and the

  9. Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?

    Science.gov (United States)

    Fang, Hai; Jin, Yinzi; Zhao, Miaomiao; Zhang, Huyang; A Rizzo, John; Zhang, Donglan; Hou, Zhiyuan

    2017-10-20

    Background: In China, rapid urbanization has caused migration from rural to urban areas, and raised the prevalence of hypertension. However, public health insurance is not portable from one place to another, and migration may limit the effectiveness of this non-portable health insurance on healthcare. Our study aims to investigate whether migration limits the effectiveness of health insurance on hypertension management in China. Methods: Data were obtained from the national baseline survey of the China Health and Retirement Longitudinal Study in 2011, including 4926 hypertensive respondents with public health insurance. Outcome measures included use of primary care, hypertension awareness, medication use, blood pressure monitoring, physician advice, and blood pressure control. Multivariate logistic regressions were estimated to examine whether the effects of rural health insurance on hypertension management differed between those who migrated to urban areas and those who did not migrate and lived in rural areas. Results: Among hypertensive respondents, 60.7% were aware of their hypertensive status. Compared to rural residents, the non-portable feature of rural health insurance significantly reduced rural-to-urban migrants' probabilities of using primary care by 7.8 percentage points, hypertension awareness by 8.8 percentage points, and receiving physician advice by 18.3 percentage points. Conclusions: In China, migration to urban areas limited the effectiveness of rural health insurance on hypertension management due to its non-portable nature. It is critical to improve the portability of rural health insurance, and to extend urban health insurance and primary care coverage to rural-to-urban migrants to achieve better chronic disease management.

  10. Horizontal Inequity in Health Care Utilization among the Middle-Aged and Elderly in China.

    Science.gov (United States)

    Li, Chaofan; Dou, Lei; Wang, Haipeng; Jing, Shanshan; Yin, Aitian

    2017-07-26

    Equitable utilization of health care is a primary goal of the Chinese health system. This study aimed to examine horizontal inequity in health care utilization and identify the factors resulting in inequity among the middle-aged and elderly in China. The data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). We employed the concentration index (CI) and horizontal inequity (HI) to measure inequity in health care utilization. Non-linear regression models were used to decompose the CI into the contribution of each factor. The CIs for the probability of and total number of outpatient visits were 0.0642 and 0.0780, respectively, and those for inpatient visits were 0.1418 and 0.1471, respectively. The HIs were also significantly positive. Living standard was the most important contributor. The contribution of health insurance varied between plans. This study supported the presence of pro-rich inequity in health care utilization for both probability and frequency among the middle-aged and elderly in China. Narrowing the living standard gap and improving the health insurance benefit package for the elderly should help to resolve these inequities.

  11. The need for health impact assessment in China: Potential benefits for public health and steps forward

    Energy Technology Data Exchange (ETDEWEB)

    Wu Liming, E-mail: lmwu@scdc.sh.c [Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336 (China); Center for Environment and Population Health, Griffith University, Nathan 4111 (Australia); Rutherford, Shannon; Chu, Cordia [Center for Environment and Population Health, Griffith University, Nathan 4111 (Australia)

    2011-07-15

    Health impact assessment (HIA) is a useful tool to predict and estimate the potential health impact associated with programs, projects, and policies by comprehensively identifying relevant health determinants and their consequences. China is undergoing massive and rapid socio-economic changes leading to environment and population health challenges such as a large increase in non-communicable diseases, the emergence and re-emergence of infectious diseases, new health risks associated with environmental pollutants and escalating health inequality. These health issues are affected by multiple determinants which can be influenced by planned policies, programs, and projects. This paper discusses the needs for health impact assessment in China in order to minimize the negative health consequences from projects, programs and policies associated with rapid social and economic development. It first describes the scope of China's current impact assessment system and points out its inadequacy in meeting the requirements of population health protection and promotion. It then analyses the potential use of HIA and why China needs to develop and apply HIA as a tool to identify potential health impacts of proposed programs, projects and policies so as to influence decision-making early in the planning process. Thus, the paper recommends the development of HIA as a useful tool in China to enhance decision-making for the protection and promotion of population health. For this to happen, the paper outlines steps necessary for the establishment and successful implementation of HIA in China: beginning with the establishment of a HIA framework, followed by workforce capacity building, methodology design, and intersectoral collaboration and stakeholder engagement.

  12. The need for health impact assessment in China: Potential benefits for public health and steps forward

    International Nuclear Information System (INIS)

    Wu Liming; Rutherford, Shannon; Chu, Cordia

    2011-01-01

    Health impact assessment (HIA) is a useful tool to predict and estimate the potential health impact associated with programs, projects, and policies by comprehensively identifying relevant health determinants and their consequences. China is undergoing massive and rapid socio-economic changes leading to environment and population health challenges such as a large increase in non-communicable diseases, the emergence and re-emergence of infectious diseases, new health risks associated with environmental pollutants and escalating health inequality. These health issues are affected by multiple determinants which can be influenced by planned policies, programs, and projects. This paper discusses the needs for health impact assessment in China in order to minimize the negative health consequences from projects, programs and policies associated with rapid social and economic development. It first describes the scope of China's current impact assessment system and points out its inadequacy in meeting the requirements of population health protection and promotion. It then analyses the potential use of HIA and why China needs to develop and apply HIA as a tool to identify potential health impacts of proposed programs, projects and policies so as to influence decision-making early in the planning process. Thus, the paper recommends the development of HIA as a useful tool in China to enhance decision-making for the protection and promotion of population health. For this to happen, the paper outlines steps necessary for the establishment and successful implementation of HIA in China: beginning with the establishment of a HIA framework, followed by workforce capacity building, methodology design, and intersectoral collaboration and stakeholder engagement.

  13. Urbanization, economic development and health: evidence from China's labor-force dynamic survey.

    Science.gov (United States)

    Chen, Hongsheng; Liu, Ye; Li, Zhigang; Xue, Desheng

    2017-11-29

    The frequent outbreak of environmental threats in China has resulted in increased criticism regarding the health effects of China's urbanization. Urbanization is a double-edged sword with regard to health in China. Although great efforts have been made to investigate the mechanisms through which urbanization influences health, the effect of both economic development and urbanization on health in China is still unclear, and how urbanization-health (or development-health) relationships vary among different income groups remain poorly understood. To bridge these gaps, the present study investigates the impact of both urbanization and economic development on individuals' self-rated health and its underlying mechanisms in China. We use data from the national scale of the 2014 China Labor-force Dynamics Survey to analyze the impact of China's urbanization and economic development on health. A total of 14,791 individuals were sampled from 401 neighborhoods within 124 prefecture-level cities. Multilevel ordered logistic models were applied. Model results showed an inverted U-shaped relationship between individuals' self-rated health and urbanization rates (with a turning point of urbanization rate at 42.0%) and a positive linear relationship between their self-rated health and economic development. Model results also suggested that the urbanization-health relationship was inverted U-shaped for high- and middle-income people (with a turning point of urbanization rate at 0.0% and 49.2%, respectively), and the development-health relationship was inverted U-shaped for high- and low-income people (with turning points of GDP per capita at 93,462 yuan and 71,333 yuan, respectively) and linear for middle-income people. The impact of urbanization and economic development on health in China is complicated. Careful assessments are needed to understand the health impact of China's rapid urbanization. Social and environmental problems arising from rapid urbanization and economic growth

  14. Air Pollution Exposure and Physical Activity in China: Current Knowledge, Public Health Implications, and Future Research Needs

    Directory of Open Access Journals (Sweden)

    Jiaojiao Lü

    2015-11-01

    Full Text Available Deteriorating air quality in China has created global public health concerns in regard to health and health-related behaviors. Although emerging environmental regulations address ambient air pollution in China, the level of enforcement and long-term impact of these measures remain unknown. Exposure to air pollution has been shown to lead to multiple adverse health outcomes, including increased rates of heart disease and mortality. However, a lesser-known but increasingly significant concern is the relationship between air pollution and its effects on outdoor exercise. This is especially important in China, which has a culturally rooted lifestyle that encourages participation in outdoor physical activity. This article evaluates the intersection of air pollution and outdoor exercise and provides a discussion of issues related to its public health impact in China, where efforts to promote a healthy lifestyle may be adversely affected by the ambient air pollution that has accompanied rapid economic development and urbanization.

  15. Air Pollution Exposure and Physical Activity in China: Current Knowledge, Public Health Implications, and Future Research Needs.

    Science.gov (United States)

    Lü, Jiaojiao; Liang, Leichao; Feng, Yi; Li, Rena; Liu, Yu

    2015-11-20

    Deteriorating air quality in China has created global public health concerns in regard to health and health-related behaviors. Although emerging environmental regulations address ambient air pollution in China, the level of enforcement and long-term impact of these measures remain unknown. Exposure to air pollution has been shown to lead to multiple adverse health outcomes, including increased rates of heart disease and mortality. However, a lesser-known but increasingly significant concern is the relationship between air pollution and its effects on outdoor exercise. This is especially important in China, which has a culturally rooted lifestyle that encourages participation in outdoor physical activity. This article evaluates the intersection of air pollution and outdoor exercise and provides a discussion of issues related to its public health impact in China, where efforts to promote a healthy lifestyle may be adversely affected by the ambient air pollution that has accompanied rapid economic development and urbanization.

  16. Mobile health in China: a review of research and programs in medical care, health education, and public health.

    Science.gov (United States)

    Corpman, David W

    2013-01-01

    There are nearly 1 billion mobile phone subscribers in China. Health care providers, telecommunications companies, technology firms, and Chinese governmental organizations use existing mobile technology and social networks to improve patient-provider communication, promote health education and awareness, add efficiency to administrative practices, and enhance public health campaigns. This review of mobile health in China summarizes existing clinical research and public health text messaging campaigns while highlighting potential future areas of research and program implementation. Databases and search engines served as the primary means of gathering relevant resources. Included material largely consists of scientific articles and official reports that met predefined inclusion criteria. This review includes 10 reports of controlled studies that assessed the use of mobile technology in health care settings and 17 official reports of public health awareness campaigns that used text messaging. All source material was published between 2006 and 2011. The controlled studies suggested that mobile technology interventions significantly improved an array of health care outcomes. However, additional efforts are needed to refine mobile health research and better understand the applicability of mobile technology in China's health care settings. A vast potential exists for the expansion of mobile health in China, especially as costs decrease and increasingly sophisticated technology becomes more widespread.

  17. Measuring urban sprawl in China by night time light images

    Science.gov (United States)

    Liu, Lu; Tang, Lin

    2017-01-01

    In the process of urbanization, a phenomenon called “urban sprawl” usually occurs. This phenomenon may exaggerated the negative effects of urbanization on environment, public and social health, energy efficiency, and maintenance of farmland. Therefore, the understanding of this phenomenon is urgently required for us to achieve sustainable development. This study proposed a group of night time lights (NTL) indicators of urban sprawl, which intend to use the distribution of lightness to quantify urban sprawl. These measures are proved to be efficient in describing urban sprawl. In addition, they are consistent and easy calculating, making comparison analysis easy to be done. These indicators are used to study urban sprawl in China during the year 2000 to 2010, the results show that in the last ten years, metropolitan areas in the northern part of China have undergone a more sprawl-like urban growth compared with other parts of China.

  18. Migration, environmental hazards, and health outcomes in China.

    Science.gov (United States)

    Chen, Juan; Chen, Shuo; Landry, Pierre F

    2013-03-01

    China's rapid economic growth has had a serious impact on the environment. Environmental hazards are major sources of health risk factors. The migration of over 200 million people to heavily polluted urban areas is likely to be significantly detrimental to health. Based on data from the 2009 national household survey "Chinese Attitudes toward Inequality and Distributive Injustice" (N = 2866) and various county-level and municipal indicators, we investigate the disparities in subjective exposure to environmental hazards and associated health outcomes in China. This study focuses particularly on migration-residency status and county-level socio-economic development. We employ multiple regressions that account for the complex multi-stage survey design to assess the associations between perceived environmental hazards and individual and county-level indicators and between perceived environmental hazards and health outcomes, controlling for physical and social environments at multiple levels. We find that perceived environmental hazards are associated with county-level industrialization and economic development: respondents living in more industrialized counties report greater exposure to environmental hazards. Rural-to-urban migrants are exposed to more water pollution and a higher measure of overall environmental hazard. Perceived environmental risk factors severely affect the physical and mental health of the respondents. The negative effects of perceived overall environmental hazard on physical health are more detrimental for rural-to-urban migrants than for urban residents. The research findings call for restructuring the household registration system in order to equalize access to public services and mitigate adverse environmental health effects, particularly among the migrant population. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Women's health status and gender inequality in China.

    Science.gov (United States)

    Yu, M Y; Sarri, R

    1997-12-01

    This paper examines the health status of women in China by reviewing levels and trends of female mortality at several phases of a woman's life cycle focusing on infancy girlhood, childbearing and old age. The mortality rates of Chinese women and men are compared for the period 1950-1990 as are comparisons with women in selected countries. The cause-specific death rate, expressed as a percentage of all deaths, and the burden of disease, measured in terms of the disability-adjusted life years (DALYs), are used to reflect the changing patterns of female diseases and causes of deaths. Significant improvement in the health status of Chinese women since 1950 is widely acknowledged as a major achievement for a developing country with the largest population in the world, but the differentials in women's health by region and urban/rural areas are considerable. The Physical Quality of Life Index (PQLI) indicates that the overall level of physical well-being of Chinese women has increased in recent decades, but disparity in health between men and women still exists. The Gender-Related Development Index (GDI) further reveals that China has achieved significant progress in women's health during the past four decades, but far less has been achieved with respect to gender equality overall. The final sections of the paper focus on the discussion of some health problems faced by the female population during the process of economic reform since the 1980 s. In order to promote gender equality between women and men, concerns on women's health care needs are highlighted.

  20. Strengthening health system to improve immunization for migrants in China.

    Science.gov (United States)

    Fang, Hai; Yang, Li; Zhang, Huyang; Li, Chenyang; Wen, Liankui; Sun, Li; Hanson, Kara; Meng, Qingyue

    2017-07-01

    Immunization is the most cost-effective method to prevent and control vaccine-preventable diseases. Migrant population in China has been rising rapidly, and their immunization status is poor. China has tried various strategies to strengthen its health system, which has significantly improved immunization for migrants. This study applied a qualitative retrospective review method aiming to collect, analyze and synthesize health system strengthening experiences and practices about improving immunizations for migrants in China. A conceptual framework of Theory of Change was used to extract the searched literatures. 11 searched literatures and 4 national laws and policies related to immunizations for migrant children were carefully studied. China mainly employed 3 health system strengthening strategies to significantly improve immunization for migrant population: stop charging immunization fees or immunization insurance, manage immunization certificates well, and pay extra attentions on immunization for special children including migrant children. These health system strengthening strategies were very effective, and searched literatures show that up-to-date and age-appropriate immunization rates were significantly improved for migrant children. Economic development led to higher migrant population in China, but immunization for migrants, particularly migrant children, were poor. Fortunately various health system strengthening strategies were employed to improve immunization for migrants in China and they were rather successful. The experiences and lessons of immunization for migrant population in China might be helpful for other developing countries with a large number of migrant population.

  1. Improving equity in health care financing in China during the progression towards Universal Health Coverage.

    Science.gov (United States)

    Chen, Mingsheng; Palmer, Andrew J; Si, Lei

    2017-12-29

    China is reforming the way it finances health care as it moves towards Universal Health Coverage (UHC) after the failure of market-oriented mechanisms for health care. Improving financing equity is a major policy goal of health care system during the progression towards universal coverage. We used progressivity analysis and dominance test to evaluate the financing channels of general taxation, pubic health insurance, and out-of-pocket (OOP) payments. In 2012 a survey of 8854 individuals in 3008 households recorded the socioeconomic and demographic status, and health care payments of those households. The overall Kakwani index (KI) of China's health care financing system is 0.0444. For general tax KI was -0.0241 (95% confidence interval (CI): -0.0315 to -0.0166). The indices for public health schemes (Urban Employee Basic Medical Insurance, Urban Resident's Basic Medical Insurance, New Rural Cooperative Medical Scheme) were respectively 0.1301 (95% CI: 0.1008 to 0.1594), -0.1737 (95% CI: -0.2166 to -0.1308), and -0.5598 (95% CI: -0.5830 to -0.5365); and for OOP payments KI was 0.0896 (95%CI: 0.0345 to 0.1447). OOP payments are still the dominant part of China's health care finance system. China's health care financing system is not really equitable. Reducing the proportion of indirect taxes would considerably improve health care financing equity. The flat-rate contribution mechanism is not recommended for use in public health insurance schemes, and more attention should be given to optimizing benefit packages during China's progression towards UHC.

  2. Income-related health inequality of migrant workers in China and its decomposition: An analysis based on the 2012 China Labor-force Dynamics Survey data.

    Science.gov (United States)

    Shao, Cenyi; Meng, Xuehui; Cui, Shichen; Wang, Jingru; Li, Chengcheng

    2016-10-01

    Although migrant workers are a vulnerable group in China, they demonstrably contribute to the country's economic growth and prosperity. This study aimed to describe and assess the inequality of migrant worker health in China and its association with socioeconomic determinants. The data utilized in this study were obtained from the 2012 China Labor-force Dynamics Survey conducted in 29 Chinese provinces. This study converted the self-rated health of these migrant workers into a general cardinal ill-health score. Determinants associated with migrant worker health included but were not limited to age, marital status, income, and education, among other factors. Concentration index, concentration curve, and decomposition of the concentration index were employed to measure socioeconomic inequality in migrant workers' health. Prorich inequality was found in the health of migrant workers. The concentration index was -0.0866, as a score indicator of ill health. Decomposition of the concentration index revealed that the factors most contributing to the observed inequality were income, followed by gender, age, marital status, and smoking history. It is generally known that there is an unequal socioeconomic distribution of migrant worker health in China. In order to reduce the health inequality, the government should make a substantial effort to strengthen policy implementation in improving the income distribution for vulnerable groups. After this investigation, it is apparent that the findings we have made warrant further investigation. Copyright © 2016. Published by Elsevier Taiwan LLC.

  3. Trade-driven relocation of air pollution and health impacts in China.

    Science.gov (United States)

    Wang, Haikun; Zhang, Yanxu; Zhao, Hongyan; Lu, Xi; Zhang, Yanxia; Zhu, Weimo; Nielsen, Chris P; Li, Xin; Zhang, Qiang; Bi, Jun; McElroy, Michael B

    2017-09-29

    Recent studies show that international trade affects global distributions of air pollution and public health. Domestic interprovincial trade has similar effects within countries, but has not been comprehensively investigated previously. Here we link four models to evaluate the effects of both international exports and interprovincial trade on PM 2.5 pollution and public health across China. We show that 50-60% of China's air pollutant emissions in 2007 were associated with goods and services consumed outside of the provinces where they were produced. Of an estimated 1.10 million premature deaths caused by PM 2.5 pollution throughout China, nearly 19% (208,500 deaths) are attributable to international exports. In contrast, interprovincial trade leads to improved air quality in developed coastal provinces with a net effect of 78,500 avoided deaths nationwide. However, both international export and interprovincial trade exacerbate the health burdens of air pollution in China's less developed interior provinces. Our results reveal trade to be a critical but largely overlooked consideration in effective regional air quality planning for China.International and domestic interprovincial trade of China are entangled, but their health impacts have been treated separately in earlier studies. Here Wang. quantify the complex impacts of trade on public health across China within an integrative framework.

  4. Health benefits from improved outdoor air quality and intervention in China.

    Science.gov (United States)

    Li, Shanshan; Williams, Gail; Guo, Yuming

    2016-07-01

    China is at its most critical stage of outdoor air quality management. In order to prevent further deterioration of air quality and to protect human health, the Chinese government has made a series of attempts to reduce ambient air pollution. Unlike previous literature reviews on the widespread hazards of air pollution on health, this review article firstly summarized the existing evidence of human health benefits from intermittently improved outdoor air quality and intervention in China. Contents of this paper provide concrete and direct clue that improvement in outdoor air quality generates various health benefits in China, and confirm from a new perspective that it is worthwhile for China to shift its development strategy from economic growth to environmental economic sustainability. Greater emphasis on sustainable environment design, consistently strict regulatory enforcement, and specific monitoring actions should be regarded in China to decrease the health risks and to avoid long-term environmental threats. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Improving reproductive health in rural China through participatory planning.

    Science.gov (United States)

    Kaufman, Joan; Liu, Yunguo; Fang, Jing

    2012-01-01

    China's new health reform initiative aims to provide quality accessible health care to all, including remote rural populations, by 2020. Public health insurance coverage for the rural poor has increased, but rural women have fared worse because of lower status and lack of voice in shaping the services they need. Use of prenatal care, safe delivery and reproductive tract infections (RTIs) services is inadequate and service seeking for health problems remains lower for men. We present findings from a study of gender and health equity in rural China from 2002 to 2008 and offer recommendations from over a decade of applied research on reproductive health in rural China. Three studies, conducted in poor counties between 1994 and 2008, identified problems in access and pilot tested interventions and mechanisms to increase women's participation in health planning. They were done in conjunction with a World Bank programme and the global Gender and Health Equity Network (GHEN). Reproductive health service-seeking improved and the study interventions increased local government commitment to providing such services through new health insurance mechanisms. Findings from the studies were summarised into recommendations on gender and health for inclusion in new health reform efforts.

  6. Economic reforms and health insurance in China.

    Science.gov (United States)

    Du, Juan

    2009-08-01

    During the 1990s, Chinese state-owned enterprises (SOEs) and collective enterprises continually decreased coverage of public health insurance to their employees. This paper investigates this changing pattern of health insurance coverage in China using panel data from the China Nutrition and Health Survey (1991-2000). It is the first attempt in this literature that tries to identify precisely the effects of specific policies and reforms on health insurance coverage in the transitional period of China. The fixed effects linear model clustering at the province level is used for estimation, and results are compared to alternative models, including pooled OLS, random effects GLS model and fixed effects logit model. Strong empirical evidence is found that unemployment as a side effect of the Open Door Policy, and the deregulation of SOE and collective enterprises were the main causes for the decreasing trend. For example, urban areas that were highly affected by the Open Door Policy were associated with 17 percentage points decrease in the insurance coverage. Moreover, I found evidence that the gaps between SOE and non-SOE employees, collective and non-collective employees, urban and rural employees have considerably decreased during the ten years.

  7. China`s current anti-inflation measures in nurturing an electricity supply crisis

    Energy Technology Data Exchange (ETDEWEB)

    Binsheng Li; Johnson, C.J.

    1995-06-01

    This report examines the potential impacts of anti-inflation measures on the power sector in China. Price control measures implemented include maintaining on-grid tariff levels even though operating costs are increasing substantially. As a result, stocks have dropped to about one half their previous value. In addition, a one-fourth reduction in power project investments is scheduled. The resulting postponement of new generating capacity is projected to result in a shortfall of 7 to 10 GW per year. The economic impact of foreign investment in China`s power industry is also examined, and recommendations are made for policy reform. 10 refs., 3 figs.

  8. Household income, income inequality, and health-related quality of life measured by the EQ-5D in Shaanxi, China: a cross-sectional study.

    Science.gov (United States)

    Tan, Zhijun; Shi, Fuyan; Zhang, Haiyue; Li, Ning; Xu, Yongyong; Liang, Ying

    2018-03-14

    In advanced economies, economic factors have been found to be associated with many health outcomes, including health-related quality of life (HRQL), and people's health is affected more by income inequality than by absolute income. However, few studies have examined the association of income inequality and absolute income with HRQL in transitional economies using individual data. This paper focuses on the effects of county or district income inequality and absolute income on the HRQL measured by EQ-5D and the differences between rural and urban regions in Shaanxi province, China. Data were collected from the 2008 National Health Service Survey conducted in Shaanxi, China. The EQ-5D index based on Japanese weights was employed as a health indicator. The income inequality was calculated on the basis of self-reported income. The special requirements for complex survey data analysis were considered in the bivariate analysis and linear regression models. The mean of the EQ-5D index was 94.6. The EQ-5D index of people with low income was lower than that in the high-income group (for people in the rural region: 93.2 v 96.1, P gender, education, marital status, employment, medical insurance, and chronic disease, all the coefficients of the low-income group and high income inequality were significantly negative. After stratifying by income group, all the effects of high income inequality remained negative in both income groups. However, the coefficients of the models in the high income group were not statistically significant. Income inequality has damaging effects on HRQL in Shaanxi, China, especially for people with low income. In addition, people living in rural regions were more vulnerable to economic factors.

  9. Health care systems in Sweden and China: Legal and formal organisational aspects.

    Science.gov (United States)

    Albin, Björn; Hjelm, Katarina; Chang Zhang, Wen

    2010-06-22

    Sharing knowledge and experience internationally can provide valuable information, and comparative research can make an important contribution to knowledge about health care and cost-effective use of resources. Descriptions of the organisation of health care in different countries can be found, but no studies have specifically compared the legal and formal organisational systems in Sweden and China. To describe and compare health care in Sweden and China with regard to legislation, organisation, and finance. Literature reviews were carried out in Sweden and China to identify literature published from 1985 to 2008 using the same keywords. References in recent studies were scrutinized, national legislation and regulations and government reports were searched, and textbooks were searched manually. The health care systems in Sweden and China show dissimilarities in legislation, organisation, and finance. In Sweden there is one national law concerning health care while in China the law includes the "Hygienic Common Law" and the "Fundamental Health Law" which is under development. There is a tendency towards market-orientated solutions in both countries. Sweden has a well-developed primary health care system while the primary health care system in China is still under development and relies predominantly on hospital-based care concentrated in cities. Despite dissimilarities in health care systems, Sweden and China have similar basic assumptions, i.e. to combine managerial-organisational efficiency with the humanitarian-egalitarian goals of health care, and both strive to provide better care for all.

  10. Prevalence and Risk Factors of Low Health Literacy: A Community-Based Study in Shanghai, China

    Directory of Open Access Journals (Sweden)

    Ying Wu

    2017-06-01

    Full Text Available Background: Health literacy is an increasingly important public health concern. However, little is known about the health literacy of general public in China. The aim of this study was to evaluate the prevalence of low health literacy and demographic associations in Shanghai, China. Methods: This study was a community-based cross-sectional health survey utilizing a multi-stage random sampling design. The sample consisted of 1360 individuals aged 15–69 years with the total community-dwelling Chinese as the sample frame. Health literacy was measured by a questionnaire developed on the basis of a national health literacy manual released by the Chinese Ministry of Health. Multiple logistic regression models were used to identify whether common socio-demographic features were associated with health literacy level. Results: The prevalence of low health literacy was 84.49% (95% CI, 82.56% to 86.41%. The prevalence of low health literacy was negatively associated with the level of education, occupation, and annual household income, but was not associated with gender, age, or the presence of non-communicable chronic disease. Conclusions: Simplifying health services, enhancing health education, and promoting interventions to improve health literacy in high-risk populations should be considered as part of the strategies in the making of health policy in China.

  11. Transport demand, harmful emissions, environment and health co-benefits in China

    International Nuclear Information System (INIS)

    HE, Ling-Yun; QIU, Lu-Yi

    2016-01-01

    The Chinese residents' travel demand has been increasing dramatically. As a result, emissions from motor vehicles have been found as one main source of air pollution in China, which consequently influences the residents' health. To better understand the environmental deterioration and health losses caused by the transport sector in China, in current circumstances, one must know how the changes in residents' travel demand and alternative transport modes affect environment and health co-benefits in China. We first of all calculate the demand from nearly all the residents' travel means, including road, rail, water, and air transport. Besides, based on the results, this paper further makes projections for a business-as-usual scenario for 2050 with several alternative transport scenarios to reduce harmful emissions and improve the welfare of the residents' health in China. Our integrated framework includes the harmful emissions models, the fixed box model and the exposure-response models, to link transport demand with possible environmental and health outcomes. The findings suggest that significant environment and health co-benefits are possible if alternative transport replaces. This research, to the best of our knowledge, is the first attempt to estimate the total resident's travel demand under different scenarios and the consequent environment and health co-benefits in the transitional China. - Highlights: • The changes in travel demand affect both environment and health in China. • Integrated framework is proposed to analyze environment and health co-benefits. • Travel demand here includes all travel means: road, rail, water, and air transport. • Counter-factual scenarios are proposed to estimate environment and health impacts.

  12. Global commitments and China's endeavors to promote health and achieve sustainable development goals.

    Science.gov (United States)

    Tan, Xiaodong; Wu, Qian; Shao, Haiyan

    2018-04-12

    With its immense population and as the largest developing country in the world, China has made remarkable achievements in health promotion at a relatively low cost. However, China is still faced with challenges such as changes of disease spectrum, the coming era of an aging society, and the risk of environmental pollution. On October 25, 2016, China formally passed the blueprint of "Healthy China 2030," working towards the national goal of reaching a health standard on par with developed countries by 2030, which was also a response to realize the 2030 United Nations Sustainable Development Goals. "Healthy China 2030" is comprised of 29 chapters that cover five health areas. China is sparing no effort to transfer from being merely the most populous country, to becoming a leading nation in health education. In "Healthy China 2030," collaborated construction and resource sharing were clearly stated as the core strategy. A shift in concentration towards coordinated development of health-based economy from a previous pursuit of rapid economic growth was also underlined. There are also several major issues, such as severely aging population, the burden of chronic diseases, the insufficiency of health expenditure, and the great demand on health protection, waiting to be dealt with during the implementation process of "Healthy China 2030". "Healthy China 2030" is a momentous move to enhance public health, which is also a response to the global commitments. We also need to rethink our approach to reach the living standards and maintain a better environment.

  13. Unequal distribution of health human resource in mainland China: what are the determinants from a comprehensive perspective?

    Science.gov (United States)

    Li, Dan; Zhou, Zhongliang; Si, Yafei; Xu, Yongjian; Shen, Chi; Wang, Yiyang; Wang, Xiao

    2018-02-27

    The inequality of health human resource is a worldwide problem, and solving it also is one of the major goals of China's recent health system reform. Yet there is a huge disparity among cities in mainland China. The aim of this study is to analyze the distribution inequality of the health human resource in 322 prefecture-level cities of mainland China in 2014, and to reveal the facets and causes of the inequalities. The data for this study were acquired from the provincial and municipal Health Statistics Yearbook (2014) and Statistical Yearbook (2014), the municipal National Economic Bulletin (2014), and the official websites of municipal governments, involving 322 prefecture-level cities. Meanwhile, Concentration Index was used to measure the magnitude of the unequal distribution of health human resource. A decomposition analysis was employed to quantify the contribution of each determinant to the total inequality. The overall concentration index of doctors and nurses in mainland China in 2014 was 0.1038 (95% CI = 0.0208, 0.1865) and 0.0785 (95% CI =0.0018, 0.1561). Decomposition of the concentration index revealed that economic status was the primary contributor (58.5% and 57%) to the inequality of doctors and nurses, followed by the Southwest China (19.1% and 18.6%), urbanization level (- 13.1% and - 12.8%), and revenue (8.0% and 7.8%). Party secretaries with Master degree (7.0%, 6.8%), mayors who were 60 years old or above (6.3%, 6.1%) also were proved to be a major contributor to the inequality of health human resource. There was inequality of health human resource distribution which was pro-rich in mainland China in 2014. Economic status of the cities accounted for most of the existing inequality, followed by the Southwest China, urbanization level, revenue, party secretaries with Master degree, and mayors who were 60 years old or above in respective importance. Besides, the party secretaries and mayors also had certain influence on the allocation

  14. Progress of Nuclear Data Measurement in China during 2013

    International Nuclear Information System (INIS)

    Zhigang, Ge; Xichao, Ruan

    2014-01-01

    The China nuclear data activities consists of nuclear data measurement and related measurement methods development, data evaluation and model study, data library establishment and library management, nuclear data benchmark and validation. The main activities are being carried out at China Nuclear Data Center (CNDC), China Institute of Atomic Energy (CIAE) and China Nuclear Data Coordination Network (CNDCN). More than 10 institutions and universities are involved in CNDCN. The facilities used for the nuclear data measurements and studies include the HI-13 tandem accelerator, 600 kV-Cockcroft-Walton accelerator, 5SDH-2 2x1.7 MV tandem accelerator and the China Advanced Research Reactor (CARR) at CIAE, The 4.5-MV Van de Graaff accelerator at Peking University and 300 kV -Cockcroft-Walton accelerator at Lanzhou university. This document presents the recent Progress of Nuclear Data Measurement in China: - the fission yields of 235 U at 3 MeV neutrons measured at CIAE; - the nuclear data benchmark system improvement at CIAE. With the new nuclear data benchmark system, the integral measurements were carried out for Be, Ga, natural iron and liquid Pb-Bi alloy. - The measurements of the 57 Fe(n,α) 54 Cr and 63 Cu(n,α) 60 Co reactions at neutron energies of 5.0, 5.5, 6.0 and 6.5 MeV at Peking University. Finally, the document describes the new facilities for Nuclear Data Measurement: the Back-n white neutron source of the China Spallation Neutron Source (CSNS), the neutron facility of Shanghai Institute of Applied Physics (SINAP-NF), and the multipurpose Cooling Storage Ring system, a new accelerator project planned at the Heavy Ion Research Facility in Lanzhou (HIRFL-CRS)

  15. What are the new challenges, goals, and tasks of occupational health in China's Thirteenth Five-Year Plan (13th FYP) period?

    Science.gov (United States)

    Wang, Bing; Wu, Chao; Kang, Liangguo; Huang, Lang; Pan, Wei

    2018-03-20

    In recent years, the Chinese government has attached great importance to occupational health under the guidance of people-oriented concept. This paper introduces the current status and future development of occupational health in China's Thirteenth Five-Year Plan (13th FYP) period (2016-2020) to promote the cooperation and exchange on occupational health between China and other countries. We collected statistical data about occupational diseases and information addressing occupational diseases. We included all types of official reports, guidelines, policies, and relevant laws published by the Chinese government. China has carried out a series of strategies and measures to reduce the incidence of occupational diseases, and has made progress in occupational health protection. However, occupational health in China still faces severe conditions and challenges for occupational diseases that have not been prevented and controlled effectively. To actively promote the future development of occupational health during the 13th FYP period, China has issued a series of important policy documents (such as the Plan for a Healthy China 2030, the 13th FYP for Occupational Disease Prevention and Control, and the 13th FYP for Occupational Health Hazard Prevention and Control) in the last two years. The overall situation condition of occupational health in China is still serious. Occupational health in China's 13th FYP period faces a series of challenges, future tasks include plans to add the employer and regulatory levels of occupational health management, and occupational health education and publicity to the current technology-dominated approaches.

  16. Job Satisfaction among Health-Care Staff in Township Health Centers in Rural China: Results from a Latent Class Analysis

    OpenAIRE

    Haipeng Wang; Chengxiang Tang; Shichao Zhao; Qingyue Meng; Xiaoyun Liu

    2017-01-01

    Background: The lower job satisfaction of health-care staff will lead to more brain drain, worse work performance, and poorer health-care outcomes. The aim of this study was to identify patterns of job satisfaction among health-care staff in rural China, and to investigate the association between the latent clusters and health-care staff’s personal and professional features; Methods: We selected 12 items of five-point Likert scale questions to measure job satisfaction. A latent-class analysis...

  17. Use of a Digital Health Application for Influenza Surveillance in China.

    Science.gov (United States)

    Hswen, Yulin; Brownstein, John S; Liu, Jeremiah; Hawkins, Jared B

    2017-07-01

    To examine whether a commercial digital health application could support influenza surveillance in China. We retrieved data from the Thermia online and mobile educational tool, which allows parents to monitor their children's fever and infectious febrile illnesses including influenza. We modeled monthly aggregated influenza-like illness case counts from Thermia users over time and compared them against influenza monthly case counts obtained from the National Health and Family Planning Commission of the People's Republic of China by using time series regression analysis. We retrieved 44 999 observations from January 2014 through July 2016 from Thermia China. Thermia appeared to predict influenza outbreaks 1 month earlier than the National Health and Family Planning Commission influenza surveillance system (P = .046). Being younger, not having up-to-date immunizations, and having an underlying health condition were associated with participant-reported influenza-like illness. Digital health applications could supplement traditional influenza surveillance systems in China by providing access to consumers' symptom reporting. Growing popularity and use of commercial digital health applications in China potentially affords opportunities to support disease detection and monitoring and rapid treatment mobilization.

  18. Dealing with Health and Health Care System Challenges in China: assessing health determinants and health care reforms

    NARCIS (Netherlands)

    H. Zhang (Hao)

    2017-01-01

    markdownabstractThis dissertation investigates the challenges faced by China around 2010 in two domains – population health and the health care system. Specifically, chapters 2 and 3 are devoted to health challenges, explaining the female health disadvantage in later life and assessing the effect

  19. Factors predicting health services use among older people in China: An analysis of the China Health and Retirement Longitudinal Study 2013.

    Science.gov (United States)

    Gong, Cathy Honge; Kendig, Hal; He, Xiaojun

    2016-02-18

    Rapid population ageing in China is increasing the numbers of older people who are likely to require health services in response to higher levels of poor perceived health and chronic diseases. Understanding factors influencing health services use at late life will help to plan for increasing needs for health care, reducing inequalities in health services use and releasing severe pressures on a highly variable health care system that has constrained public resources and increasing reliance on health insurance and user payments. Drawing on the nationally representative China Health and Retirement Longitudinal Study 2013 data, we apply the Andersen healthcare utilization conceptual model to binary logistic regression multivariate analyses to examine the joint predictors of physical examinations, outpatient and inpatient care among the middle-aged and elderly in China. The multivariate analyses find that both physical examinations and inpatient care rates increase significantly by age when health deteriorates. Females are less likely to use inpatient care. Significant socio-economic variations exist in healthcare utilization. Older people with higher education, communist party membership, urban residence, non-agricultural household registration, better financial situation are more likely to have physical examinations or inpatient care. Factors influencing all three types of health care utilization are household expenditure, losing a partner, having multiple chronic diseases or perceiving poor health. With activities of daily living limitations or pain increases the probability of seeing a doctor while with functional loss increases the rates of having physical examinations, but being the ethnic minorities, no social health insurance, with depression, fair or poor memory could be a barrier to having physical examinations or seeing a doctor, which might delay the early diagnose of severe health problems among these groups. Not drinking, not smoking and regular physical

  20. The Impacts of China's Urban Employee Basic Medical Insurance on Healthcare Expenditures and Health Outcomes.

    Science.gov (United States)

    Huang, Feng; Gan, Li

    2017-02-01

    At the end of 1998, China launched a government-run mandatory insurance program, the urban employee basic medical insurance (UEBMI), to replace the previous medical insurance system. Using the UEBMI reform in China as a natural experiment, this study identifies variations in patient cost sharing that were imposed by the UEBMI reform and examines their effects on the demand for healthcare services. Using data from the 1991-2006 waves of the China Health and Nutrition Survey, we find that increased cost sharing is associated with decreased outpatient medical care utilization and expenditures but not with decreased inpatient care utilization and expenditures. Patients from low-income and middle-income households or with less severe medical conditions are more sensitive to prices. We observe little impact on patient's health, as measured by self-reported health status. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  1. Ambient air pollution, climate change, and population health in China.

    Science.gov (United States)

    Kan, Haidong; Chen, Renjie; Tong, Shilu

    2012-07-01

    As the largest developing country, China has been changing rapidly over the last three decades and its economic expansion is largely driven by the use of fossil fuels, which leads to a dramatic increase in emissions of both ambient air pollutants and greenhouse gases (GHGs). China is now facing the worst air pollution problem in the world, and is also the largest emitter of carbon dioxide. A number of epidemiological studies on air pollution and population health have been conducted in China, using time-series, case-crossover, cross-sectional, cohort, panel or intervention designs. The increased health risks observed among Chinese population are somewhat lower in magnitude, per amount of pollution, than the risks found in developed countries. However, the importance of these increased health risks is greater than that in North America or Europe, because the levels of air pollution in China are very high in general and Chinese population accounts for more than one fourth of the world's totals. Meanwhile, evidence is mounting that climate change has already affected human health directly and indirectly in China, including mortality from extreme weather events; changes in air and water quality; and changes in the ecology of infectious diseases. If China acts to reduce the combustion of fossil fuels and the resultant air pollution, it will reap not only the health benefits associated with improvement of air quality but also the reduced GHG emissions. Consideration of the health impact of air pollution and climate change can help the Chinese government move forward towards sustainable development with appropriate urgency. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Defining migration and its health impact in China.

    Science.gov (United States)

    Mou, J; Griffiths, S M; Fong, H F; Dawes, M G

    2015-10-01

    The scale and rapid expansion of urbanization resulting from socio-economic transformation in China at the beginning of the 21st century has accelerated rural-urban migration. Public health concerns from this increasing internal population mobility are now receiving attention from researchers. The health problems from internal migration pose particular demands on healthcare systems and relate to its demographic characteristics, with many younger and older people being left behind in the rural countryside. A review of literature, census, policy reports, government documents and media was undertaken to look at the classification system and health characteristics of China's internal migrants. It suggests that public health bears the consequences of political and economic decisions made elsewhere in society. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  3. Evaluation of health resource utilization efficiency in community health centers of Jiangsu Province, China.

    Science.gov (United States)

    Xu, Xinglong; Zhou, Lulin; Antwi, Henry Asante; Chen, Xi

    2018-02-20

    While the demand for health services keep escalating at the grass roots or rural areas of China, a substantial portion of healthcare resources remain stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, China's Deepen Medical Reform started in 2012 was intended to flush out possible disparities and promote a more equitable and efficient distribution of healthcare resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight. Using a hybrid of panel data analysis and an augmented data envelopment analysis (DEA), we model human resources, material, finance to determine their technical and scale efficiency to comprehensively evaluate the transverse and longitudinal allocation efficiency of community health resources in Jiangsu Province. We observed that the Deepen Medical Reform in China has led to an increase concern to ensure efficient allocation of community health resources by health policy makers in the province. This has led to greater efficiency in health resource allocation in Jiangsu in general but serious regional or municipal disparities still exist. Using the DEA model, we note that the output from the Community Health Centers does not commensurate with the substantial resources (human resources, materials, and financial) invested in them. We further observe that the case is worst in less-developed Northern parts of Jiangsu Province. The government of Jiangsu Province could improve the efficiency of health resource allocation by improving the community health service system, rationalizing the allocation of health personnel, optimizing the allocation of material resources, and enhancing the level of health of financial resource allocation.

  4. Perceived Environmental Pollution and Its Impact on Health in China, Japan, and South Korea.

    Science.gov (United States)

    Kamimura, Akiko; Armenta, Bianca; Nourian, Maziar; Assasnik, Nushean; Nourian, Kimiya; Chernenko, Alla

    2017-01-01

    Environmental pollution is a significant global issue. Both objective (scientifically measured) environmental pollution and perceived levels of pollution are important predictors of self-reported health. The purpose of this study was to compare the associations between perceived environmental pollution and health in China, Japan, and South Korea. Data were obtained from the East Asian Social Survey and the Cross-National Survey Data Sets: Health and Society in East Asia, 2010 (n=7938; China, n=3866; Japan, n=2496; South Korea, n=1576). South Koreans perceived environmental pollution to be the most severe, while Japanese participants perceived environmental pollution to be the least severe. Although the Japanese did not perceive environmental pollution to be very severe, their self-rated physical health was significantly related to perceived environmental pollution, while the analogous relationships were not significant for the Chinese or Korean participants. Better mental health was related to lower levels of perceived air pollution in China, as well as lower levels of perceived all types of pollution in Japan and lower levels of perceived noise pollution in South Korea. Physical and mental health and individual socio-demographic characteristics were associated with levels of perceived environmental pollution, but with different patterns among these three countries.

  5. Perceived Environmental Pollution and Its Impact on Health in China, Japan, and South Korea

    Directory of Open Access Journals (Sweden)

    Akiko Kamimura

    2017-05-01

    Full Text Available Objectives Environmental pollution is a significant global issue. Both objective (scientifically measured environmental pollution and perceived levels of pollution are important predictors of self-reported health. The purpose of this study was to compare the associations between perceived environmental pollution and health in China, Japan, and South Korea. Methods Data were obtained from the East Asian Social Survey and the Cross-National Survey Data Sets: Health and Society in East Asia, 2010 (n=7938; China, n=3866; Japan, n=2496; South Korea, n=1576. Results South Koreans perceived environmental pollution to be the most severe, while Japanese participants perceived environmental pollution to be the least severe. Although the Japanese did not perceive environmental pollution to be very severe, their self-rated physical health was significantly related to perceived environmental pollution, while the analogous relationships were not significant for the Chinese or Korean participants. Better mental health was related to lower levels of perceived air pollution in China, as well as lower levels of perceived all types of pollution in Japan and lower levels of perceived noise pollution in South Korea. Conclusions Physical and mental health and individual socio-demographic characteristics were associated with levels of perceived environmental pollution, but with different patterns among these three countries.

  6. Industrial water pollution, water environment treatment, and health risks in China.

    Science.gov (United States)

    Wang, Qing; Yang, Zhiming

    2016-11-01

    The negative health effects of water pollution remain a major source of morbidity and mortality in China. The Chinese government is making great efforts to strengthen water environment treatment; however, no studies have evaluated the effects of water treatment on human health by water pollution in China. This study evaluated the association between water pollution and health outcomes, and determined the extent to which environmental regulations on water pollution may lead to health benefits. Data were extracted from the 2011 and 2013 China Health and Retirement Longitudinal Study (CHARLS). Random effects model and random effects Logit model were applied to study the relationship between health and water pollution, while a Mediator model was used to estimate the effects of environmental water treatment on health outcomes by the intensity of water pollution. Unsurprisingly, water pollution was negatively associated with health outcomes, and the common pollutants in industrial wastewater had differential impacts on health outcomes. The effects were stronger for low-income respondents. Water environment treatment led to improved health outcomes among Chinese people. Reduced water pollution mediated the associations between water environment treatment and health outcomes. The results of this study offer compelling evidence to support treatment of water pollution in China. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Disadvantaged populations in maternal health in China who and why?

    Directory of Open Access Journals (Sweden)

    Beibei Yuan

    2013-04-01

    Full Text Available Background: China has made impressive progress towards the Millennium Development Goal (MDG for maternal and reproductive health, but ensuring that progress reaches all segments of the population remains a challenge for policy makers. The aim of this review is to map disadvantaged populations in terms of maternal health in China, and to explain the causes of these inequities to promote policy action. Methods: We searched PUBMED, Popline, Proquest and WanFang and included primary studies conducted in mainland China. Experts were also contacted to identify additional studies. Disadvantaged populations in terms of MDG 5 and the reasons for this disadvantage explored by authors were identified and coded based on the conceptual framework developed by the WHO Commission on the Social Determinants of Health. Results: In China, differences in maternal health service utilization and the maternal mortality ratio among different income groups, and among regions with different socio-economic development still exist, although these differences are narrowing. Groups with low levels of education and ethnic minorities utilize maternal health care less frequently and experience higher maternal mortality, although we could not determine whether these differences have changed in the last decade. Rural-to-urban migrants use maternal health care and contraception to a lower extent than permanent residents of cities, and differential maternal mortality shows a widening trend among these groups. Gender inequity also contributes to the disadvantaged position of women. Intermediary factors that explain these inequities include material circumstances such as long distances to health facilities for women living in remote areas, behavioral factors such as traditional beliefs that result in reduced care seeking among ethnic minorities, and health system determinants such as out-of-pocket payments posing financial barriers for the poor. Conclusions: Inequity in maternal

  8. Disadvantaged populations in maternal health in China who and why?

    Science.gov (United States)

    Yuan, Beibei; Qian, Xu; Thomsen, Sarah

    2013-04-03

    China has made impressive progress towards the Millennium Development Goal (MDG) for maternal and reproductive health, but ensuring that progress reaches all segments of the population remains a challenge for policy makers. The aim of this review is to map disadvantaged populations in terms of maternal health in China, and to explain the causes of these inequities to promote policy action. We searched PUBMED, Popline, Proquest and WanFang and included primary studies conducted in mainland China. Experts were also contacted to identify additional studies. Disadvantaged populations in terms of MDG 5 and the reasons for this disadvantage explored by authors were identified and coded based on the conceptual framework developed by the WHO Commission on the Social Determinants of Health. In China, differences in maternal health service utilization and the maternal mortality ratio among different income groups, and among regions with different socio-economic development still exist, although these differences are narrowing. Groups with low levels of education and ethnic minorities utilize maternal health care less frequently and experience higher maternal mortality, although we could not determine whether these differences have changed in the last decade. Rural-to-urban migrants use maternal health care and contraception to a lower extent than permanent residents of cities, and differential maternal mortality shows a widening trend among these groups. Gender inequity also contributes to the disadvantaged position of women. Intermediary factors that explain these inequities include material circumstances such as long distances to health facilities for women living in remote areas, behavioral factors such as traditional beliefs that result in reduced care seeking among ethnic minorities, and health system determinants such as out-of-pocket payments posing financial barriers for the poor. Inequity in maternal health continues to be an issue worthy of greater programmatic and

  9. Fuel for Life: Domestic Cooking Fuels and Women’s Health in Rural China

    Science.gov (United States)

    Nie, Peng; Sousa-Poza, Alfonso; Xue, Jianhong

    2016-01-01

    Background: There is evidence that household air pollution is associated with poor health in China, and that this form of air pollution may even be more of a health concern in China than the much-publicized outdoor air pollution. However, there is little empirical evidence on the relationship between household air pollution and health in China based on nationally representative and longitudinal data. This study examines the association between the type of domestic cooking fuel and the health of women aged ≥16 in rural China. Methods: Using longitudinal and biomarker data from the China Family Panel Studies (n = 12,901) and the China Health and Nutrition Survey (n = 15,539), we investigate the impact of three major domestic cooking fuels (wood/straw, coal, liquefied petroleum gas (LPG)) on health status using both cross-sectional and panel approaches. Results: Compared to women whose households cook with dirty fuels like wood/straw, women whose households cook with cleaner fuels like LPG have a significantly lower probability of chronic or acute diseases and are more likely to report better health. Cooking with domestic coal instead of wood or straw is also associated with elevated levels of having certain risks (such as systolic blood pressure) related to cardiovascular diseases. Conclusions: Our study provides evidence that using cleaner fuels like LPG is associated with better health among women in rural China, suggesting that the shift from dirty fuels to cleaner choices may be associated with improved health outcomes. PMID:27517950

  10. Health status and air pollution related socioeconomic concerns in urban China.

    Science.gov (United States)

    Jiao, Kaishan; Xu, Mengjia; Liu, Meng

    2018-02-05

    China is experiencing environmental issues and related health effects due to its industrialization and urbanization. The health effects associated with air pollution are not just a matter of epidemiology and environmental science research, but also an important social science issue. Literature about the relationship of socioeconomic factors with the environment and health factors is inadequate. The relationship between air pollution exposure and health effects in China was investigated with consideration of the socioeconomic factors. Based on nationwide survey data of China in 2014, we applied the multilevel mixed-effects model to evaluate how socioeconomic status (represented by education and income) contributed to the relationship between self-rated air pollution and self-rated health status at community level and individual level. The findings indicated that there was a non-linear relationship between the community socioeconomic status and community air pollution in urban China, with the highest level of air pollution presented in the communities with moderate socioeconomic status. In addition, health effects associated air pollution in different socioeconomic status groups were not equal. Self-rated air pollution had the greatest impact on self-rated health of the lower socioeconomic groups. With the increase of socioeconomic status, the effect of self-rated air pollution on self-rated health decreased. This study verified the different levels of exposure to air pollution and inequality in health effects among different socioeconomic groups in China. It is imperative for the government to urgently formulate public policies to enhance the ability of the lower socioeconomic groups to circumvent air pollution and reduce the health damage caused by air pollution.

  11. Pet Dogs Benefit Owners' Health: A "Natural Experiment" in China

    Science.gov (United States)

    Headey, Bruce; Na, Fu; Zheng, Richard

    2008-01-01

    This paper reports results from a "natural experiment" taking place in China on the impact of dogs on owners' health. Previous Western research has reported modest health benefits, but results have remained controversial. In China pets were banned in urban areas until 1992. Since then dog ownership has grown quite rapidly in the major…

  12. New evidence on financing equity in China's health care reform--a case study on Gansu province, China.

    Science.gov (United States)

    Chen, Mingsheng; Chen, Wen; Zhao, Yuxin

    2012-12-18

    In the transition from a planned economy to a market-oriented economy, China's state funding for health care declined and traditional coverage plans collapsed, leaving China's poor exposed to potentially ruinous health care costs. In reforming health care for the 21st century, equity in health care financing has become a major policy goal. To assess progress towards this goal, this paper examines the equity characteristics of health care financing in a province of northwestern China, comparing the equity performance between urban and rural areas at two different points in time. Analysis of whether health care financing contributions were progressive according to income were made using the Kakwani index for each of the four health care financing channels of general taxes, public and private health insurance, and out-of-pocket payments. Two rounds of surveys were conducted, the first in 2003 (13,619 individuals in 3946 households) and the second in 2008 (12,973 individuals in 3958 households). Household socio-economic, health care payment, and utilization information were recorded in household interviews. Low-income households have undertaken a larger share of the health care financing burden in recent years, reflected by negative Kakwani indices, which indicate a regressive system. We found that the indices for general taxation were -0.0024 (urban) and -0.0281 (rural) in 2002, and -0.0177 (urban) and -0.0097 (rural) in 2007. Public health insurance presented different financing distributions in urban and rural areas (urban: 0.0742 in 2002, 0.0661 in 2007; rural: -0.0615 in 2002,-0.1436 in 2007.). Out-of-pocket payments were progressive but not equitable. Public health insurance coverage has expanded but financing equity has decreased. Health care financing policies in China need ongoing reform. Given the inequity of general consumption taxes, elimination of these would improve financing equity considerably. Optimizing benefit packages in public health insurance is

  13. Income-related inequality in health insurance coverage: analysis of China Health and Nutrition Survey of 2006 and 2009

    OpenAIRE

    Liu, Jinan; Shi, Lizheng; Meng, Qingyue; Khan, M Mahmud

    2012-01-01

    Abstract Introduction China introduced the urban resident basic medical insurance (URBMI) in 2007 to cover children and urban unemployed adults, in addition to the new cooperative medical scheme (NCMS) for rural residents in 2003 and the basic health insurance scheme (BHIS) for urban employees in 1998. This study examined whether the overall income-related inequality in health insurance coverage improved during 2006 and 2009 in China. Methods The China Health and Nutrition Survey (CHNS) data ...

  14. Health status and air pollution related socioeconomic concerns in urban China

    OpenAIRE

    Jiao, Kaishan; Xu, Mengjia; Liu, Meng

    2018-01-01

    Background China is experiencing environmental issues and related health effects due to its industrialization and urbanization. The health effects associated with air pollution are not just a matter of epidemiology and environmental science research, but also an important social science issue. Literature about the relationship of socioeconomic factors with the environment and health factors is inadequate. The relationship between air pollution exposure and health effects in China was investig...

  15. Internet-based health education in China: a content analysis of websites.

    Science.gov (United States)

    Peng, Ying; Wu, Xi; Atkins, Salla; Zwarentein, Merrick; Zhu, Ming; Zhan, Xing Xin; Zhang, Fan; Ran, Peng; Yan, Wei Rong

    2014-01-27

    The Internet is increasingly being applied in health education worldwide; however there is little knowledge of its use in Chinese higher education institutions. The present study provides the first review and highlights the deficiencies and required future advances in Chinese Internet-based health education. Two authors independently conducted a duplicate Internet search in order to identify information regarding Internet-based health education in China. The findings showed that Internet-based education began in China in September 1998. Currently, only 16 of 150 (10.7%) health education institutions in China offer fee-based online undergraduate degree courses, awarding associates and/or bachelors degrees. Fifteen of the 16 institutions were located in the middle or on the eastern coast of China, where were more developed than other regions. Nursing was the most popular discipline in Internet-based health education, while some other disciplines, such as preventive medicine, were only offered at one university. Besides degree education, Chinese institutions also offered non-degree online training and free resources. The content was mainly presented in the form of PowerPoint slides or videos for self-learning. Very little online interactive mentoring was offered with any of the courses. There is considerable potential for the further development of Internet-based health education in China. These developments should include a focus on strengthening cooperation among higher education institutions in order to develop balanced online health curricula, and on enhancing distance education in low- and middle-income regions to meet extensive learning demands.

  16. Air Pollution, Disease Burden, and Health Economic Loss in China.

    Science.gov (United States)

    Niu, Yue; Chen, Renjie; Kan, Haidong

    2017-01-01

    As the largest developing country in the world, China is now facing one of the severest air pollution problems. The objective of this section is to evaluate the disease burden and corresponding economic loss attributable to ambient air pollution in China. We reviewed a series of studies by Chinese or foreign investigators focusing on the disease burden and economic loss in China. These studies showed both the general air pollution and haze episodes have resulted in substantial disease burden in terms of excess number of premature deaths, disability-adjusted life-year loss, and years of life lost. The corresponding economic loss has accounted for an appreciable proportion of China's national economy. Overall, the disease burden and health economic loss due to ambient air pollution in China is greater than in the remaining parts of the world, for one of the highest levels of air pollution and the largest size of exposed population. Consideration of both health and economic impacts of air pollution can facilitate the Chinese government to develop environmental policies to reduce the emissions of various air pollutants and protect the public health.

  17. The role of health system governance in strengthening the rural health insurance system in China.

    Science.gov (United States)

    Yuan, Beibei; Jian, Weiyan; He, Li; Wang, Bingyu; Balabanova, Dina

    2017-05-23

    Systems of governance play a key role in the operation and performance of health systems. In the past six decades, China has made great advances in strengthening its health system, most notably in establishing a health insurance system that enables residents of rural areas to achieve access to essential services. Although there have been several studies of rural health insurance schemes, these have focused on coverage and service utilization, while much less attention has been given to the role of governance in designing and implementing these schemes. Information from publications and policy documents relevant to the development of two rural health insurance policies in China was obtained, analysed, and synthesise. 92 documents on CMS (Cooperative Medical Scheme) or NCMS (New Rural Cooperative Medical Scheme) from four databases searched were included. Data extraction and synthesis of the information were guided by a framework that drew on that developed by the WHO to describe health system governance and leadership. We identified a series of governance practices that were supportive of progress, including the prioritisation by the central government of health system development and certain health policies within overall national development; strong government commitment combined with a hierarchal administrative system; clear policy goals coupled with the ability for local government to adopt policy measures that take account of local conditions; and the accumulation and use of the evidence generated from local practices. However these good practices were not seen in all governance domains. For example, poor collaboration between different government departments was shown to be a considerable challenge that undermined the operation of the insurance schemes. China's success in achieving scale up of CMS and NCMS has attracted considerable interest in many low and middle income countries (LMICs), especially with regard to the schemes' designs, coverage, and funding

  18. Improvement of Emergency Management Mechanism of Public Health Crisis in Rural China: A Review Article.

    Science.gov (United States)

    Hu, Jiaxiang; Chen, Chao; Kuai, Tingting

    2018-02-01

    With the rapid development of social economy in China, various public health emergencies frequently occur. Such emergencies cause a serious threat to human health and public safety, especially in rural China. Owing to flaws in emergency management mechanism and policy, the government is not capable to effectively deal with public health emergencies. Therefore, this study aimed to discuss the path to improve the emergency management mechanism for public health emergency in rural China. This study was conducted in 2017 to detect the emergency management mechanism of public health crisis (EMMPHC) in Rural China. Data were collected using the following keywords: Rural China, public health emergency, emergency management mechanism, organization mechanism, operation mechanism in the databases of PubMed, Scopus, Web of Science, and CNKI. EMMPHC in rural China can be enhanced from the following three aspects. First, a permanent institution for rural emergency management with public health management function is established. Second, the entire process of emergency management mechanism, including the stages of pre-disaster, disaster, and post-disaster, is improved. Finally, investment in rural public health is increased, and an adequate reserve system for emergency resources is formed. The new path of EMMPHC in rural China can effectively help the local government accomplish the dispatch capability in public health emergency, and it has important research significance for the protection of public health and social stability of residents in rural China.

  19. The development and impact of primary health care in China from 1949 to 2015: A focused review.

    Science.gov (United States)

    Li, Huazhang; Liu, Kun; Gu, Jianjun; Zhang, Yimin; Qiao, Yun; Sun, Xiaoming

    2017-07-01

    High-quality primary health care (PHC) services are associated with better health outcomes and positive health equity. Providing PHC services to all inhabitants is one of the Chinese government's health care objectives. However, an imbalance between people's increasing health needs and effective health service utilization exists in China. The objective of this review is to identify evidence for PHC development in China and to summarize the challenges as a reference for the future improvement of China's PHC system. Literature searches related to China's PHC were performed in PubMed, Web of Science, China National Knowledge Infrastructure, and Wan-fang databases. Related data were collected from the China Statistical Yearbook on Health and Family Planning 2003-2016, the China National Health Accounts Report 2015, and An Analysis Report of National Health Services Survey in China, 2013. The PHC network and the population's health have improved in China in recent years, with general practitioners as "gatekeepers" who have gradually taken the initiative to offer health services to residents. The limitation of input and shortages of resources and skilled health care providers may restrict the sustainable development of China's PHC system. Therefore, policy support from the government is necessary. Copyright © 2017 John Wiley & Sons, Ltd.

  20. Mental health inpatient treatment expenditure trends in China, 2005-2012: evidence from Shandong.

    Science.gov (United States)

    Xu, Junfang; Wang, Jian; Liu, Ruiyun; Xing, Jinshui; Su, Lei; Yu, Fenghua; Lu, Mingshan

    2014-12-01

    Mental health is increasingly becoming a huge public health issue in China. Yet for various cultural, healthcare system, and social economic reasons, people with mental health need have long been under-served in China. In order to inform the current on-going health care reform, empirical evidences on the economic burden of mental illnesses in China are urgently needed to contribute to health policy makers' understanding of the potential benefits to society from allocating more resources to preventing and treating mental illness. However, the cost of mental illnesses and particularly its trend in China remains largely unknown. To investigate the trend of health care resource utilization among inpatients with mental illnesses in China, and to analyze what are the factors influencing the inpatient costs. Our study sample included 15,721 patients, both adults and children, who were hospitalized over an eight-year period (2005-2012) in Shandong Center for Mental Health (SCMH), the only provincial psychiatric hospital in Shandong province, China. Data were extracted from the Health Information System (HIS) at SCMH, with detailed and itemized cost data on all inpatient expenses incurred during hospitalization. The identification of the patients was based on the ICD-10 diagnoses recorded in the HIS. Descriptive analysis was done to analyze the trend of hospitalization cost and length of stay during the study period. Multivariate stepwise regression analysis was conducted to assess the factors that influence hospitalization cost. Among the inpatients in our sample, the most common mental disorders were schizophrenia, schizotypal and delusional disorders. The disease which had the highest per capita hospital expense was behavioral and emotional disorders with onset usually occurring in childhood and adolescence (RMB 8,828.4; US$ 1,419.4, as compared to the average reported household annual income of US$ 2,095.3 in China). The average annual growth rate of per capita

  1. The impact of climate change on infectious disease transmission: perceptions of CDC health professionals in Shanxi Province, China.

    Directory of Open Access Journals (Sweden)

    Junni Wei

    Full Text Available There have been increasing concerns about the challenge of emerging and re-emerging infectious diseases due to climate change, especially in developing countries including China. Health professionals play a significant role in the battle to control and prevent infectious diseases. This study therefore aims to investigate the perceptions and attitudes of health professionals at the Centers for Disease Control and Prevention (CDC in different levels in China, and to consider adaptation measures to deal with the challenge of climate change. In 2013, a cross-sectional questionnaire survey was undertaken among 314 staff in CDCs in Shanxi Province, China, whose routine work involves disease control and prevention. Data were analyzed using descriptive methods and logistic regression. A majority of the CDC staff were aware of the health risks from climate change, especially its impacts on infectious disease transmission in their jurisdictions, and believed climate change might bring about both temporal and spatial change in transmission patterns. It was thought that adaptation measures should be established including: strengthening/improving currently existing disease surveillance systems and vector monitoring; building CDC capacity in terms of infrastructure and in-house health professional training; development and refinement of relevant legislation, policies and guidelines; better coordination among various government departments; the involvement of the community in infectious disease interventions; and collaborative research with other institutions. This study provides a snapshot of the understanding of CDC staff regarding climate change risks relevant to infectious diseases and adaptation in China. Results may help inform future efforts to develop adaptation measures to minimize infectious disease risks due to climate change.

  2. The impact of climate change on infectious disease transmission: perceptions of CDC health professionals in Shanxi Province, China.

    Science.gov (United States)

    Wei, Junni; Hansen, Alana; Zhang, Ying; Li, Hong; Liu, Qiyong; Sun, Yehuan; Xue, Shulian; Zhao, Shufang; Bi, Peng

    2014-01-01

    There have been increasing concerns about the challenge of emerging and re-emerging infectious diseases due to climate change, especially in developing countries including China. Health professionals play a significant role in the battle to control and prevent infectious diseases. This study therefore aims to investigate the perceptions and attitudes of health professionals at the Centers for Disease Control and Prevention (CDC) in different levels in China, and to consider adaptation measures to deal with the challenge of climate change. In 2013, a cross-sectional questionnaire survey was undertaken among 314 staff in CDCs in Shanxi Province, China, whose routine work involves disease control and prevention. Data were analyzed using descriptive methods and logistic regression. A majority of the CDC staff were aware of the health risks from climate change, especially its impacts on infectious disease transmission in their jurisdictions, and believed climate change might bring about both temporal and spatial change in transmission patterns. It was thought that adaptation measures should be established including: strengthening/improving currently existing disease surveillance systems and vector monitoring; building CDC capacity in terms of infrastructure and in-house health professional training; development and refinement of relevant legislation, policies and guidelines; better coordination among various government departments; the involvement of the community in infectious disease interventions; and collaborative research with other institutions. This study provides a snapshot of the understanding of CDC staff regarding climate change risks relevant to infectious diseases and adaptation in China. Results may help inform future efforts to develop adaptation measures to minimize infectious disease risks due to climate change.

  3. Measurement and decomposition of socioeconomic inequality in single and multimorbidity in older adults in China and Ghana: results from the WHO study on global AGEing and adult health (SAGE).

    Science.gov (United States)

    Kunna, Rasha; San Sebastian, Miguel; Stewart Williams, Jennifer

    2017-05-15

    Globally people are living longer and enduring non-communicable diseases (NCDs) many of which co-occur as multimorbidity. Demographic and socioeconomic factors are determinants of inequalities and inequities in health. There is a need for country-specific evidence of NCD inequalities in developing countries where populations are ageing rapidly amid economic and social change. The study measures and decomposes socioeconomic inequality in single and multiple NCD morbidity in adults aged 50 and over in China and Ghana. The data source is the World Health Organization Study on Global AGEing and Adult Health (SAGE) Wave 1 (2007-2010). Nationally representative cross-sectional data collected from adults in China (n = 11,814) and Ghana (n = 4,050) are analysed. Country populations are ranked by a socioeconomic index based on ownership of household assets. The study uses a decomposed concentration index (CI) of single and multiple NCD morbidity (multimorbidity) covering arthritis, diabetes, angina, stroke, asthma, depression, chronic lung disease and hypertension. The CI quantifies the extent of overall inequality on each morbidity measure. The decomposition utilises a regression-based approach to examine individual contributions of demographic and socioeconomic factors, or determinants, to the overall inequality. In China, the prevalence of single and multiple NCD morbidity was 64.7% and 53.4%, compared with 65.9% and 55.5% respectively in Ghana. Inequalities were significant and more highly concentrated among the poor in China (single morbidity CI = -0.0365: 95% CI = -0.0689,-0.0040; multimorbidity CI = -0.0801: 95% CI = -0.1233,-0.0368;). In Ghana inequalities were significant and more highly concentrated among the rich (single morbidity CI = 0.1182; 95% CI = 0.0697, 0.1668; multimorbidity CI = 0.1453: 95% CI = 0.0794, 0.2083). In China, rural residence contributed most to inequality in single morbidity (36.4%) and the wealth

  4. Does Rapid and Sustained Economic Growth Lead to Convergence in Health Resources: The Case of China From 1980 to 2010.

    Science.gov (United States)

    Liang, Di; Zhang, Donglan; Huang, Jiayan; Schweitzer, Stuart

    2016-01-01

    China's rapid and sustained economic growth offers an opportunity to ask whether the advantages of growth diffuse throughout an economy, or remain localized in areas where the growth has been the greatest. A critical policy area in China has been the health system, and health inequality has become an issue that has led the government to broaden national health insurance programs. This study investigates whether health system resources and performance have converged over the past 30 years across China's 31 provinces. To examine geographic variation of health system resources and performance at the provincial level, we measure the degree of sigma convergence and beta convergence in indicators of health system resources (structure), health services utilization (process), and outcome. All data are from officially published sources: the China Health Statistics Year Book and the China Statistics Year Book. Sigma convergence is found for resource indicators, whereas it is not observed for either process or outcome indicators, indicating that disparities only narrowed in health system resources. Beta convergence is found in most indicators, except for 2 procedure indicators, reflecting that provinces with poorer resources were catching up. Convergence found in this study probably reflects the mixed outcome of government input, and market forces. Thus, left alone, the equitable distribution of health care resources may not occur naturally during a period of economic growth. Governmental and societal efforts are needed to reduce geographic health variation and promote health equity. © The Author(s) 2016.

  5. Harnessing the privatisation of China's fragmented health-care delivery.

    Science.gov (United States)

    Yip, Winnie; Hsiao, William

    2014-08-30

    Although China's 2009 health-care reform has made impressive progress in expansion of insurance coverage, much work remains to improve its wasteful health-care delivery. Particularly, the Chinese health-care system faces substantial challenges in its transformation from a profit-driven public hospital-centred system to an integrated primary care-based delivery system that is cost effective and of better quality to respond to the changing population needs. An additional challenge is the government's latest strategy to promote private investment for hospitals. In this Review, we discuss how China's health-care system would perform if hospital privatisation combined with hospital-centred fragmented delivery were to prevail--population health outcomes would suffer; health-care expenditures would escalate, with patients bearing increasing costs; and a two-tiered system would emerge in which access and quality of care are decided by ability to pay. We then propose an alternative pathway that includes the reform of public hospitals to pursue the public interest and be more accountable, with public hospitals as the benchmarks against which private hospitals would have to compete, with performance-based purchasing, and with population-based capitation payment to catalyse coordinated care. Any decision to further expand the for-profit private hospital market should not be made without objective assessment of its effect on China's health-policy goals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. The impact of parental migration on health status and health behaviours among left behind adolescent school children in China

    Directory of Open Access Journals (Sweden)

    Congdon Nathan

    2010-02-01

    Full Text Available Abstract Background One out of ten of China's population are migrants, moving from rural to urban areas. Many leave their families behind resulting in millions of school children living in their rural home towns without one or both their parents. Little is known about the health status of these left behind children (LBC. This study compares the health status and health-related behaviours of left behind adolescent school children and their counterparts in a rural area in Southern China. Methods A cross-sectional study was conducted among middle school students in Fuyang Township, Guangdong, China (2007-2008. Information about health behaviours, parental migration and demographic characteristics was collected using a self-administered questionnaire. Overweight/obesity and stunting were defined based on measurements of height and weight. Univariate and multivariate analyses were used to estimate the differences in health outcomes between LBC and non-LBC. Results 18.1% of the schoolchildren had one or both parents working away from home. Multivariate analysis showed that male LBC were at higher risk of skipping breakfast, higher levels of physical inactivity, internet addiction, having ever smoked tobacco, suicide ideation, and being overweight. LBC girls were more likely to drink excessive amounts of sweetened beverage, to watch more TV, to have ever smoked or currently smoke tobacco, to have ever drunk alcohol and to binge drinking. They were also more likely to be unhappy, to think of planning suicide and consider leaving home. Conclusions Our findings suggest that parental migration is a risk factor for unhealthy behaviours amongst adolescent school children in rural China. Further research is required in addition to the consideration of the implications for policies and programmes to protect LBC.

  7. Mental health care reforms in Asia: the urgency of now: building a recovery-oriented, community mental health service in china.

    Science.gov (United States)

    Tse, Samson; Ran, Mao-Sheng; Huang, Yueqin; Zhu, Shimin

    2013-07-01

    For the first time in history, China has a mental health legal framework. People in China can now expect a better life and more accessible, better-quality health care services for their loved ones. Development of a community mental health service (CMHS) is at a crossroads. In this new column on mental health reforms in Asia, the authors review the current state of the CMHS in China and propose four strategic directions for future development: building on the strengths of the "686 Project," the 2004 initiative that launched China's mental health reform; improving professional skills of the mental health workforce, especially for a recovery approach; empowering families and caregivers to support individuals with severe mental illness; and using information and communications technology to promote self-help and reduce the stigma associated with psychiatric disorders.

  8. The Contribution of Population Health and Demographic Change to Economic Growth in China and India

    Science.gov (United States)

    Bloom, David E.; Canning, David; Hu, Linlin; Liu, Yuanli; Mahal, Ajay; Yip, Winnie

    2010-01-01

    We find that a cross-country model of economic growth successfully tracks the growth takeoffs in China and India. The major drivers of the predicted takeoffs are improved health, increased openness to trade, and a rising labor force-to-population ratio due to fertility decline. We also explore the effect of the reallocation of labor from low-productivity agriculture to the higher-productivity industry and service sectors. Including the money value of longevity improvements in a measure of full income reduces the gap between the magnitude of China's takeoff relative to India's due to the relative stagnation in life expectancy in China since 1980. PMID:20419074

  9. A Cross-National Study of the Gender Gap in Health Among Older Adults in India and China

    DEFF Research Database (Denmark)

    Oksuzyan, Anna; Singh, Prashant Kumar; Christensen, Kaare

    2018-01-01

    and cognitive function were used to investigate gender differences in health. Results: A consistent female disadvantage was found in India and in China for all three health measures. Compared to their male counterparts, women in the Indian and the Chinese samples had, respectively, 38% (95% confidence interval...

  10. Outcome-based health equity across different social health insurance schemes for the elderly in China.

    Science.gov (United States)

    Liu, Xiaoting; Wong, Hung; Liu, Kai

    2016-01-14

    Against the achievement of nearly universal coverage for social health insurance for the elderly in China, a problem of inequity among different insurance schemes on health outcomes is still a big challenge for the health care system. Whether various health insurance schemes have divergent effects on health outcome is still a puzzle. Empirical evidence will be investigated in this study. This study employs a nationally representative survey database, the National Survey of the Aged Population in Urban/Rural China, to compare the changes of health outcomes among the elderly before and after the reform. A one-way ANOVA is utilized to detect disparities in health care expenditures and health status among different health insurance schemes. Multiple Linear Regression is applied later to examine the further effects of different insurance plans on health outcomes while controlling for other social determinants. The one-way ANOVA result illustrates that although the gaps in insurance reimbursements between the Urban Employee Basic Medical Insurance (UEBMI) and the other schemes, the New Rural Cooperative Medical Scheme (NCMS) and Urban Residents Basic Medical Insurance (URBMI) decreased, out-of-pocket spending accounts for a larger proportion of total health care expenditures, and the disparities among different insurances enlarged. Results of the Multiple Linear Regression suggest that UEBMI participants have better self-reported health status, physical functions and psychological wellbeing than URBMI and NCMS participants, and those uninsured. URBMI participants report better self-reported health than NCMS ones and uninsured people, while having worse psychological wellbeing compared with their NCMS counterparts. This research contributes to a transformation in health insurance studies from an emphasis on the opportunity-oriented health equity measured by coverage and healthcare accessibility to concern with outcome-based equity composed of health expenditure and health

  11. Rising inequalities in income and health in China: Who is left behind?

    Science.gov (United States)

    Baeten, Steef; Van Ourti, Tom; van Doorslaer, Eddy

    2013-01-01

    In recent decades, China has experienced double-digit economic growth rates and rising inequality. This paper implements a new decomposition approach using the China Health and Nutrition Survey (1991–2006) to examine the extent to which changes in level and distribution of incomes and in income mobility are related to health disparities between rich and poor. We find that health disparities in China relate to rising income inequality and in particular to the adverse health and income experience of older (wo)men, but not to the growth rate of average incomes over the last decades. These findings suggest that replacement incomes and pensions at older ages may be one of the most important policy levers for reducing health disparities between rich and poor Chinese. PMID:24189450

  12. Assessing the Association of Food Preferences and Self-Reported Psychological Well-Being among Middle-Aged and Older Adults in Contemporary China-Results from the China Health and Nutrition Survey

    Directory of Open Access Journals (Sweden)

    Yen-Han Lee

    2018-03-01

    Full Text Available China has undergone rapid social transitions within the last few decades. However, mental health issues, challenges to psychological well-being, and poor dietary choices have gradually surfaced. These health concerns are related to the rapid growth of the aging population and of the fast-paced industrialized society. Nevertheless, there is little knowledge about food preferences and psychological well-being measurements in contemporary China. Applying the 2011 China Health and Nutrition Survey (CHNS with a cross-sectional study design (n = 7970, we conducted multinomial logistic regression models to investigate the associations of food preferences, including fast food, salty snacks, fruits, vegetables, and sweetened beverages, with psychological well-being among Chinese middle-aged and older adults (age ≥ 45. Food preferences are mostly associated with psychological well-being (p < 0.05. However, respondents’ preferences regarding fast food, salty snacks, and sweetened beverages are associated not only with poorer psychological health status, but also with positive psychological well-being. We speculate that Chinese older adults may consume Westernized fast food and salty snacks as pleasure to the palate due to the recent Westernization in modern China. We also provide practical implications of results from this preliminary study.

  13. Assessing the Association of Food Preferences and Self-Reported Psychological Well-Being among Middle-Aged and Older Adults in Contemporary China-Results from the China Health and Nutrition Survey.

    Science.gov (United States)

    Lee, Yen-Han; Shelley, Mack; Liu, Ching-Ti; Chang, Yen-Chang

    2018-03-07

    China has undergone rapid social transitions within the last few decades. However, mental health issues, challenges to psychological well-being, and poor dietary choices have gradually surfaced. These health concerns are related to the rapid growth of the aging population and of the fast-paced industrialized society. Nevertheless, there is little knowledge about food preferences and psychological well-being measurements in contemporary China. Applying the 2011 China Health and Nutrition Survey (CHNS) with a cross-sectional study design ( n = 7970), we conducted multinomial logistic regression models to investigate the associations of food preferences, including fast food, salty snacks, fruits, vegetables, and sweetened beverages, with psychological well-being among Chinese middle-aged and older adults (age ≥ 45). Food preferences are mostly associated with psychological well-being ( p fast food, salty snacks, and sweetened beverages are associated not only with poorer psychological health status, but also with positive psychological well-being. We speculate that Chinese older adults may consume Westernized fast food and salty snacks as pleasure to the palate due to the recent Westernization in modern China. We also provide practical implications of results from this preliminary study.

  14. Quality of life of young clinical doctors in public hospitals in China's developed cities as measured by the Nottingham Health Profile (NHP).

    Science.gov (United States)

    Liang, Ying; Wang, Hanwei; Tao, Xiaojun

    2015-09-24

    In contemporary Chinese society, obstacles such as frequent violence against medical workers and tense doctor-patient relationships affect the health of Chinese doctors. This study attempted to explore the quality of life (QOL) of young clinical doctors in public hospitals in China's developed cities to study the psychometric properties of QOL and related risk factors of doctors' health. This study sampled young doctors aged 15-45 in 18 public hospitals of three cities in East China (Shanghai, Nanjing, and Hangzhou, N = 762). The Nottingham Health Profile was used to measure QOL, the dependent variable of this study. Methodologies such as reliability analysis, mean comparison, and exploratory factor analysis were used to study related psychometric properties. Almost 90 % of young Chinese clinical doctors have a bachelor's degree or above. Approximately 70.4 % of the doctors have relatively low job titles. Among the sample, 76.1 % have a monthly income ranging from USD 326 to USD 1139, and 91.3 % work over eight hours daily. These respondents have poor sleeping habits and mental functions, but have relatively good physical functions. Being female, low education, low job title, low salary, and long work hours are factors associated with doctors' poor QOL. Regression analysis results emphasize the great effect of high education on the improvement of QOL. Young clinical doctors in public hospitals in Chinese developed cities have poor QOL. Reforms on the current medical health system, improving the working environment of doctors and relieve their occupational stress should be required.

  15. Service functions of private community health stations in China: A comparison analysis with government-sponsored community health stations.

    Science.gov (United States)

    Hou, Wanli; Fan, Hong; Xu, Jing; Wang, Fang; Chai, Yun; Xu, Hancheng; Li, Yongbin; Liu, Liqun; Wang, Bin; Jin, Jianqiang; Lu, Zuxun

    2012-04-01

    In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

  16. Inequality trends of health workforce in different stages of medical system reform (1985-2011) in China.

    Science.gov (United States)

    Zhou, Kaiyuan; Zhang, Xinyi; Ding, Yi; Wang, Duolao; Lu, Zhou; Yu, Min

    2015-12-08

    The aim of this study was to identify whether policies in different stages of medical system reform had been effective in decreasing inequalities and increasing the density of health workers in rural areas in China between 1985 and 2011. With data from China Health Statistics Yearbooks from 2004 to 2012, we measured the Gini coefficient and the Theil L index across the urban and rural areas from 1985 to 2011 to investigate changes in inequalities in the distributions of health workers, doctors, and nurses by states, regions, and urban-rural stratum and account for the sources of inequalities. We found that the overall inequalities in the distribution of health workers decreased to the lowest in 2000, then increased gently until 2011. Nurses were the most unequally distributed between urban-rural districts among health workers. Most of the overall inequalities in the distribution of health workers across regions were due to inequalities within the rural-urban stratum. Different policies and interventions in different stages would result in important changes in inequality in the distribution of the health workforce. It was also influenced by other system reforms, like the urbanization, education, and employment reforms in China. The results are useful for the Chinese government to decide how to narrow the gap of the health workforce and meet its citizens' health needs to the maximum extent.

  17. Association between Social Integration and Health among Internal Migrants in ZhongShan, China.

    Directory of Open Access Journals (Sweden)

    Yanwei Lin

    Full Text Available Internal migrants are the individuals who migrate between regions in one country. The number of internal migrants were estimated at 245 million in China in 2013. Results were inconsistent in the literature about the relationship between their health statuses and social integration. The main difference exists on how to measure the social integration and whether health statuses of internal migrants improve with years of residence. To complement the existing literature, this study measured social integration more comprehensively and estimated the internal migrants' health statuses with varying years of residence, and explored the associations between the migrants' social integration and health. We used the data from 2014 Internal Migrant Dynamic Monitoring Survey of Health and Family Planning in ZhongShan, China. Health status was measured from four aspects: self-reported health, subjective well-being, perception of stress, mental health. We measured social integration through four dimensions: economy, social communication, acculturation, and self-identity. The analyses used multiple linear regressions to examine the associations between self-reported health, subjective well-being, and perception of stress, mental health and social integration. The analytical sample included 1,999 households of the internal migrants and 1,997 local registered households, who were permanent residents in ZhongShan. Among the internal migrants, Adults in the labor force, who were aged 25 to 44 years old, accounted for 91.2% of the internal migrant population, while 74.6% of the registered population were in that age group. Median residential time among migrants was 2.8 (1.3-6.2 years, and 20.2% of them were migrating in the same Guangdong province. Except for mental health, other health statuses among migrants had significant differences compared with local registered population, e.g. self-reported health was better, but subjective well-being was worse. However, these

  18. Observations of Health Care in China: Four Perspectives.

    Science.gov (United States)

    Attwood, Madge, Ed.

    This collection consists of four papers dealing with the delivery of health care in the People's Republic of China. The papers resulted from a study tour of the Chinese health care system in June 1980. Included in the volume are the following papers: "A Comparison of Selected Aspects of the Health Care Systems of the Socialist Federal…

  19. Obesitas bij kinderen in China: prevalentie, determinanten en gezondheid = Childhood obesity in China: prevalence, determinants and health

    NARCIS (Netherlands)

    Li Yanping,

    2007-01-01

    Over the past two decades, China has been undergoing rapid socio-economic and nutrition transitions. Along with these transitions, childhood obesity and its related metabolic and psychological abnormalities are becoming serious public health problems in China. However, no national figures on the

  20. Visiting entertainment venues and sexual health in China.

    Science.gov (United States)

    Li, Li; Wu, Zunyou; Rotheram-Borus, Mary Jane; Guan, Jihui; Yin, Yueping; Detels, Roger; Wu, Sheng; Lee, Sung-Jae; Cao, Haijun; Lin, Chunqing; Rou, Keming; Liu, Zhendong

    2009-10-01

    Entertainment venues in China are associated with risky sexual behavior. Most previous studies related to entertainment venues in China have focused on sex workers and commercial sex, but this study addressed sexual health in a sample of the general urban population. A randomly selected sample of market vendors (n = 4,510) from an eastern city was recruited and assessed to examine relationships between entertainment venue visits and sexual risk. Both behavioral (self-reports of unprotected sex) and biomedical (STD test results) measures were used. About 18% of the sample (26.8% of men and 9% of women) reported visiting entertainment venues in the past 30 days. Those who visited entertainment venues were more likely to be male, younger, single, with higher education, and to have more discretionary income. For both men and women, visiting entertainment venues was a significant predictor for unprotected sex and STD infection. Gender differences were observed in predicting unprotected sex and STD infections. Entertainment venues could be potential sites for place-based intervention programs and outreach for the general population.

  1. Decomposing the causes of socioeconomic-related health inequality among urban and rural populations in China: a new decomposition approach.

    Science.gov (United States)

    Cai, Jiaoli; Coyte, Peter C; Zhao, Hongzhong

    2017-07-18

    In recent decades, China has experienced tremendous economic growth and also witnessed growing socioeconomic-related health inequality. The study aims to explore the potential causes of socioeconomic-related health inequality in urban and rural areas of China over the past two decades. This study used six waves of the China Health and Nutrition Survey (CHNS) from 1991 to 2006. The recentered influence function (RIF) regression decomposition method was employed to decompose socioeconomic-related health inequality in China. Health status was derived from self-rated health (SRH) scores. The analyses were conducted on urban and rural samples separately. We found that the average level of health status declined from 1989 to 2006 for both urban and rural populations. Average health scores were greater for the rural population compared with those for the urban population. We also found that there exists pro-rich health inequality in China. While income and secondary education were the main factors to reduce health inequality, older people, unhealthy lifestyles and a poor home environment increased inequality. Health insurance had the opposite effects on health inequality for urban and rural populations, resulting in lower inequality for urban populations and higher inequality for their rural counterparts. These findings suggest that an effective way to reduce socioeconomic-related health inequality is not only to increase income and improve access to health care services, but also to focus on improvements in the lifestyles and the home environment. Specifically, for rural populations, it is particularly important to improve the design of health insurance and implement a more comprehensive insurance package that can effectively target the rural poor. Moreover, it is necessary to comprehensively promote the flush toilets and tap water in rural areas. For urban populations, in addition to promoting universal secondary education, healthy lifestyles should be promoted

  2. Rising inequalities in income and health in China: who is left behind?

    Science.gov (United States)

    Baeten, Steef; Van Ourti, Tom; van Doorslaer, Eddy

    2013-12-01

    In recent decades, China has experienced double-digit economic growth rates and rising inequality. This paper implements a new decomposition approach using the China Health and Nutrition Survey (1991-2006) to examine the extent to which changes in level and distribution of incomes and in income mobility are related to health disparities between rich and poor. We find that health disparities in China relate to rising income inequality and in particular to the adverse health and income experience of older (wo)men, but not to the growth rate of average incomes over the last decades. These findings suggest that replacement incomes and pensions at older ages may be one of the most important policy levers for reducing health disparities between rich and poor Chinese. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Experiences and Lessons from Urban Health Insurance Reform in China.

    Science.gov (United States)

    Xin, Haichang

    2016-08-01

    Health care systems often face competing goals and priorities, which make reforms challenging. This study analyzed factors influencing the success of a health care system based on urban health insurance reform evolution in China, and offers recommendations for improvement. Findings based on health insurance reform strategies and mechanisms that did or did not work can effectively inform improvement of health insurance system design and practice, and overall health care system performance, including equity, efficiency, effectiveness, cost, finance, access, and coverage, both in China and other countries. This study is the first to use historical comparison to examine the success and failure of China's health care system over time before and after the economic reform in the 1980s. This study is also among the first to analyze the determinants of Chinese health system effectiveness by relating its performance to both technical reasons within the health system and underlying nontechnical characteristics outside the health system, including socioeconomics, politics, culture, values, and beliefs. In conclusion, a health insurance system is successful when it fits its social environment, economic framework, and cultural context, which translates to congruent health care policies, strategies, organization, and delivery. No health system can survive without its deeply rooted socioeconomic environment and cultural context. That is why one society should be cautious not to radically switch from a successful model to an entirely different one over time. There is no perfect health system model suitable for every population-only appropriate ones for specific nations and specific populations at the right place and right time. (Population Health Management 2016;19:291-297).

  4. An economic assessment of the health effects and crop yield losses caused by air pollution in mainland China.

    Science.gov (United States)

    Miao, Weijie; Huang, Xin; Song, Yu

    2017-06-01

    Air pollution is severe in China, and pollutants such as PM 2.5 and surface O 3 may cause major damage to human health and crops, respectively. Few studies have considered the health effects of PM 2.5 or the loss of crop yields due to surface O 3 using model-simulated air pollution data in China. We used gridded outputs from the WRF-Chem model, high resolution population data, and crop yield data to evaluate the effects on human health and crop yield in mainland China. Our results showed that outdoor PM 2.5 pollution was responsible for 1.70-1.99 million cases of all-cause mortality in 2006. The economic costs of these health effects were estimated to be 151.1-176.9 billion USD, of which 90% were attributed to mortality. The estimated crop yield losses for wheat, rice, maize, and soybean were approximately 9, 4.6, 0.44, and 0.34 million tons, respectively, resulting in economic losses of 3.4 billion USD. The total economic losses due to ambient air pollution were estimated to be 154.5-180.3 billion USD, accounting for approximately 5.7%-6.6% of the total GDP of China in 2006. Our results show that both population health and staple crop yields in China have been significantly affected by exposure to air pollution. Measures should be taken to reduce emissions, improve air quality, and mitigate the economic loss. Copyright © 2016. Published by Elsevier B.V.

  5. A review of biomass burning: Emissions and impacts on air quality, health and climate in China.

    Science.gov (United States)

    Chen, Jianmin; Li, Chunlin; Ristovski, Zoran; Milic, Andelija; Gu, Yuantong; Islam, Mohammad S; Wang, Shuxiao; Hao, Jiming; Zhang, Hefeng; He, Congrong; Guo, Hai; Fu, Hongbo; Miljevic, Branka; Morawska, Lidia; Thai, Phong; Lam, Yun Fat; Pereira, Gavin; Ding, Aijun; Huang, Xin; Dumka, Umesh C

    2017-02-01

    Biomass burning (BB) is a significant air pollution source, with global, regional and local impacts on air quality, public health and climate. Worldwide an extensive range of studies has been conducted on almost all the aspects of BB, including its specific types, on quantification of emissions and on assessing its various impacts. China is one of the countries where the significance of BB has been recognized, and a lot of research efforts devoted to investigate it, however, so far no systematic reviews were conducted to synthesize the information which has been emerging. Therefore the aim of this work was to comprehensively review most of the studies published on this topic in China, including literature concerning field measurements, laboratory studies and the impacts of BB indoors and outdoors in China. In addition, this review provides insights into the role of wildfire and anthropogenic BB on air quality and health globally. Further, we attempted to provide a basis for formulation of policies and regulations by policy makers in China. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  6. Health financing and integration of urban and rural residents' basic medical insurance systems in China.

    Science.gov (United States)

    Zhu, Kun; Zhang, Luying; Yuan, Shasha; Zhang, Xiaojuan; Zhang, Zhiruo

    2017-11-07

    China is in the process of integrating the new cooperative medical scheme (NCMS) and the urban residents' basic medical insurance system (URBMI) into the urban and rural residents' basic medical insurance system (URRBMI). However, how to integrate the financing policies of NCMS and URBMI has not been described in detail. This paper attempts to illustrate the differences between the financing mechanisms of NCMS and URBMI, to analyze financing inequity between urban and rural residents and to identify financing mechanisms for integrating urban and rural residents' medical insurance systems. Financing data for NCMS and URBMI (from 2008 to 2015) was collected from the China health statistics yearbook, the China health and family planning statistics yearbook, the National Handbook of NCMS Information, the China human resources and social security statistics yearbook, and the China social security yearbook. "Ability to pay" was introduced to measure inequity in health financing. Individual contributions to NCMS and URBMI as a function of per capita disposable income was used to analyze equity in health financing between rural and urban residents. URBMI had a financing mechanism that was similar to that used by NCMS in that public finance accounted for more than three quarters of the pooling funds. The scale of financing for NCMS was less than 5% of the per capita net income of rural residents and less than 2% of the per capita disposable income of urban residents for URBMI. Individual contributions to the NCMS and URBMI funds were less than 1% of their disposable and net incomes. Inequity in health financing between urban and rural residents in China was not improved as expected with the introduction of NCMS and URBMI. The role of the central government and local governments in financing NCMS and URBMI was oscillating in the past decade. The scale of financing for URRBMI is insufficient for the increasing demands for medical services from the insured. The pooling fund

  7. Influencing factors of mental health of medical students in China.

    Science.gov (United States)

    Yang, Fan; Meng, Heng; Chen, Hui; Xu, Xin-hao; Liu, Zhuo; Luo, Ai; Feng, Zhan-chun

    2014-06-01

    This study investigated the mental health status of medical students in China, and analyzed the influencing factors in order to provide evidence for mental health education for medical students. A stratified cluster sampling method was used to recruit medical students from Huazhong University of Science and Technology, China. The questionnaire survey on general information and Symptom Checklist 90 (SCL-90) were used for investigation and analysis. The results showed among the 1137 valid questionnaires, 278 (24.45%) participants had SCL-90 score ≥ 160. The top three mental problems of medical students were obsessive-compulsive disorder, interpersonal sensitivity and depression in terms of the factor score ≥ 2.5 and the number of participants who reflected on the diseases. The third-year medical students had the worst mental health status, and fifth-year medical students had the best mental health status. Students from rural area had more psychological problems than those from urban area; furthermore, students with high professional satisfaction, those who were the single child of the family, non-poor students, and those whose parents had high education level had better mental health status. It was concluded that the mental health of medical students is not optimistic in China. Medical students have some mental health problems of different degrees. Factors that influence the mental health of medical students include academic pressure, professional satisfaction level and family environment.

  8. Health hazards of China's lead-acid battery industry: a review of its market drivers, production processes, and health impacts.

    Science.gov (United States)

    van der Kuijp, Tsering Jan; Huang, Lei; Cherry, Christopher R

    2013-08-03

    Despite China's leaded gasoline phase out in 2000, the continued high rates of lead poisoning found in children's blood lead levels reflect the need for identifying and controlling other sources of lead pollution. From 2001 to 2007, 24% of children in China studied (N = 94,778) were lead poisoned with levels exceeding 100 μg/L. These levels stand well above the global average of 16%. These trends reveal that China still faces significant public health challenges, with millions of children currently at risk of lead poisoning. The unprecedented growth of China's lead-acid battery industry from the electric bike, automotive, and photovoltaic industries may explain these persistently high levels, as China remains the world's leading producer, refiner, and consumer of both lead and lead-acid batteries.This review assesses the role of China's rising lead-acid battery industry on lead pollution and exposure. It starts with a synthesis of biological mechanisms of lead exposure followed by an analysis of the key technologies driving the rapid growth of this industry. It then details the four main stages of lead battery production, explaining how each stage results in significant lead loss and pollution. A province-level accounting of each of these industrial operations is also included. Next, reviews of the literature describe how this industry may have contributed to mass lead poisonings throughout China. Finally, the paper closes with a discussion of new policies that address the lead-acid battery industry and identifies policy frameworks to mitigate exposure.This paper is the first to integrate the market factors, production processes, and health impacts of China's growing lead-acid battery industry to illustrate its vast public health consequences. The implications of this review are two-fold: it validates calls for a nationwide assessment of lead exposure pathways and levels in China as well as for a more comprehensive investigation into the health impacts of the lead

  9. Air pollution threatens the health of children in China

    Energy Technology Data Exchange (ETDEWEB)

    Millman, A.; Tang, D.L.; Perera, F.P. [Columbia University, New York, NY (United States)

    2008-09-15

    China's rapid economic development has come at the cost of severe environmental degradation, most notably from coal combustion. Outdoor air pollution is associated with >300 000 deaths, 20 million cases of respiratory illness, and a health cost of >500 billion renminbi (>3% of gross domestic product) annually. The young are particularly susceptible to air pollution, yet there has been only limited recognition of its effects on children's health and development. To fill this gap, we reviewed relevant published environmental studies, biomedical and molecular/epidemiologic research, and economic and policy analyses. China relies on coal for about 70% to 75% of its energy needs, consuming 1.9 billion tons of coal each year. In addition to CO{sub 2}, the major greenhouse gas, coal burning in China emits vast quantities of particulate matter, polycyclic aromatic hydrocarbons, sulfur dioxide, arsenic, and mercury. Seventy percent of Chinese households burn coal or biomass for cooking and heating, which contaminates indoor air. Adverse effects of combustion-related air pollution include reduced fetal and child growth, pulmonary disease including asthma, developmental impairment, and increased risk of cancer. A prospective molecular epidemiologic study of newborns in Chongqing has demonstrated direct benefits to children's health and development from the elimination of a coal-burning plant. Recognition of the full health and economic cost of air pollution to Chinese children and the benefits of pollution reduction should spur increased use of renewable energy, energy efficiency, and clean-fuel vehicles. This is a necessary investment for China's future.

  10. Preferred ecosystem characteristics: their food and health relevance to China's rapid urbanisation.

    Science.gov (United States)

    Gibson, Valerie; Zhu, Yong-Guan; Ge, Rubing; Wahlqvist, Mark L

    2015-01-01

    For most of its history, China has supported a growing population through food systems which have been mutually inclusive of people and their locality. This trajectory has required adequate ecosystem maintenance or humanised reformulation and a high degree of recyclable nutrient flow. The 'tipping point' in habitat sustainability has come with the size and demographic structure of China's population to one that is ageing, with modernisation of its infrastructure and increased expectations of better livelihoods, standards of living and health. In order to meet these expectations, China has embarked on rapid urbanisation for upwards of 300 million people over the next 15-20 years and to do so taking account of the environmental limitations. The process will radically change rural as well as urban China and the systems which connect them. Chief among these will be ecosystems in number and type along with the food and health systems integral to them. To minimise ecological damage and optimise the benefits to people and place, describing, monitoring and managing the process will be paramount. The present paper is a situational analysis of health as it may be ecologically favoured or disordered (Ecosystem Health Disorders) and of the food systems on which the environment and health depend. An effort is made to enumerate the current situation in China in a way that might enable the optimisation of humanised ecosystems.

  11. Socioeconomic gradients of cardiovascular risk factors in China and India: results from the China health and retirement longitudinal study and longitudinal aging study in India.

    Science.gov (United States)

    Hu, Peifeng; Wang, Serena; Lee, Jinkook

    2017-09-01

    Cardiovascular disease has become a major public health challenge in developing countries. The goal of this study is to compare socioeconomic status (SES) gradients of cardiovascular risk factors (CVRF) both within and between China and India. We used multivariable logistic regression models to examine the associations between SES and CVRF, using data from the China health and retirement longitudinal study and the longitudinal aging study in India. The results showed that, compared to illiteracy, the odds ratios of completing junior high school for high-risk waist circumference were 4.99 (95% confidence interval: 1.77-14.06) among Indian men, 3.42 (95% confidence interval: 1.66-7.05) among Indian women, but 0.74 (95% confidence interval: 0.59-0.92) among Chinese women. Similar patterns were observed between educational attainment and high-risk body mass index, and between education and hypertension, based on self-reported physician diagnosis and direct blood pressure measurements. SES is associated with CVRF in both China and India. However, this relationship showed opposite patterns across two countries, suggesting that this association is not fixed, but is subjective to underlying causal pathways, such as patterns of risky health behaviors and different social and health policies.

  12. Climate change, food, water and population health in China.

    Science.gov (United States)

    Tong, Shilu; Berry, Helen L; Ebi, Kristie; Bambrick, Hilary; Hu, Wenbiao; Green, Donna; Hanna, Elizabeth; Wang, Zhiqiang; Butler, Colin D

    2016-10-01

    Anthropogenic climate change appears to be increasing the frequency, duration and intensity of extreme weather events. Such events have already had substantial impacts on socioeconomic development and population health. Climate change's most profound impacts are likely to be on food, health systems and water. This paper explores how climate change will affect food, human health and water in China. Projections indicate that the overall effects of climate change, land conversion and reduced water availability could reduce Chinese food production substantially - although uncertainty is inevitable in such projections. Climate change will probably have substantial impacts on water resources - e.g. changes in rainfall patterns and increases in the frequencies of droughts and floods in some areas of China. Such impacts would undoubtedly threaten population health and well-being in many communities. In the short-term, population health in China is likely to be adversely affected by increases in air temperatures and pollution. In the medium to long term, however, the indirect impacts of climate change - e.g. changes in the availability of food, shelter and water, decreased mental health and well-being and changes in the distribution and seasonality of infectious diseases - are likely to grow in importance. The potentially catastrophic consequences of climate change can only be avoided if all countries work together towards a substantial reduction in the emission of so-called greenhouse gases and a substantial increase in the global population's resilience to the risks of climate variability and change.

  13. Comprehensive health protection measures and its effects at the Bayun Obo Rare-earth Iron mine in China

    International Nuclear Information System (INIS)

    Chen, Xing-an; Cheng, Yong-e

    2008-01-01

    The purpose of this paper is to present the comprehensive sanitary protection methods carried out by the authors at Bayun Obo Rare-earth Iron Mine. The methods are as follows. First, comprehensive measures to prevent dusts in the air. Second, enhancement of the individual protection measures; Third, promoting long-distance running and the establishment a workers. club; Fourth, the establishment of job rotation system; Fifth, increasing the transparency of the medical examination results, paying more attention to the health of the miners; Sixth, publicizing the value of stopping smoking. Results showed that the above-mentioned six aspects of comprehensive sanitary protection methods which we instituted brought about predominant effects. For example, the average dust concentrations in the air at 7 locations in the crushing workshop and 6 in the mining workshop decreased from 1143.67 mg.m -3 in January to June 1983 to 47.617 mg.m -3 in January to June 1991, and to 13.4 mg.m -3 in 2001. In 1983 the average thorium lung burden of 130 dust exposed miners selected by random stratification was 0.85 Bq, while the average thorium lung burden of 135 dust-exposed miners, similarly selected in 1991 was 0.25 Bq, a decrease by a factor of 3.4. It is concluded that the comprehensive health protection measures carried out by the authors for about 20 years in Bayun Obo Mine were proved very effective and should be continued and improved. It is also valuable to recommend our experience to other rare-earth mines and factories as well as thorium dusty units both in China and abroad. (author)

  14. Benefits of Multidimensional Measures of Child Well Being in China.

    Science.gov (United States)

    Gatenio Gabel, Shirley; Zhang, Yiwei

    2017-11-06

    In recent decades, measures of child well-being have evolved from single dimension to multidimensional measures. Multi-dimensional measures deepen and broaden our understanding of child well-being and inform us of areas of neglect. Child well-being in China today is measured through proxy measures of household need. This paper discusses the evolution of child well-being measures more generally, explores the benefits of positive indicators and multiple dimensions in formulating policy, and then reviews efforts to date by the Chinese government, researchers, and non-governmental and intergovernmental organizations to develop comprehensive multidimensional measures of child well-being in China. The domains and their potential interactions, as well as data sources and availability, are presented. The authors believe that child well-being in China would benefit from the development of a multidimensional index and that there is sufficient data to develop such an index.

  15. Understanding the administrative regulation on occupational health and trend in China.

    Science.gov (United States)

    Zhou, Zhijun

    2018-03-27

    With the immense economic growth and social development, China has gained worldwide attention. With the quick growth of industrialization, several international professionals are gaining interest in occupational management system and in the role of the Chinese Government in protecting the worker's health. The Law on Prevention and Control of Occupational Diseases and the Work Safety Law are the two most important laws in China, which highlight the responsibilities of the employer, employee, governmental agencies, authorized occupational health service agency, and other stakeholders. The State Council comprises two departments, namely, the State Administration on Work Safety (SAWS) and the National Health and Family Planning Commission (NHFPC), which are responsible for governing the occupational health work. A series of regulations and standards have been promulgated by the Chinese Government to encourage or instruct the employers to fulfill their responsibility; however, several issues persist related to occupational health work, including administrative, technological, and sociocultural aspects. At present, the Chinese Government wants to enhance the reform in both economic and administrative structures, and the adjustments for modifying and/or improving the occupational health regulatory system are expected. Notably, the occupational health work in China must be altered for better.

  16. A study on the equality and benefit of China's national health care system.

    Science.gov (United States)

    Zhai, Shaoguo; Wang, Pei; Dong, Quanfang; Ren, Xing; Cai, Jiaoli; Coyte, Peter C

    2017-08-29

    This study is designed to evaluate whether the benefit which the residents received from the national health care system is equal in China. The perceived equality and benefit are used to measure the personal status of health care system, health status. This study examines variations in perceived equality and benefit of the national health care system between urban and rural residents from five cities of China and assessed their determinants. One thousand one hundred ninty eight residents were selected from a random survey among five nationally representative cities. The research characterizes perceptions into four population groupings based on a binary assessment of survey scores: high equality & high benefit; low equality & low benefit; high equality & low benefit; and low equality & high benefit. The distribution of the four groups above is 30.4%, 43.0%, 4.6% and 22.0%, respectively. Meanwhile, the type of health insurance, educational background, occupation, geographic regions, changes in health status and other factors have significant impacts on perceived equality and benefit derived from the health care system. The findings demonstrate wide variations in perceptions of equality and benefit between urban and rural residents and across population characteristics, leading to a perceived lack of fairness in benefits and accessibility. Opportunities exist for policy interventions that are targeted to eliminate perceived differences and promote greater equality in access to health care.

  17. Visiting Entertainment Venues and Sexual Health in China

    OpenAIRE

    Li, Li; Wu, Zunyou; Rotheram-Borus, Mary Jane; Guan, Jihui; Yin, Yueping; Detels, Roger; Wu, Sheng; Lee, Sung-Jae; Cao, Haijun; Lin, Chunqing; Rou, Keming; Liu, Zhendong

    2008-01-01

    Entertainment venues in China are associated with risky sexual behavior. Most previous studies related to entertainment venues in China have focused on sex workers and commercial sex, but this study addressed sexual health in a sample of the general urban population. A randomly selected sample of market vendors (n = 4,510) from an eastern city was recruited and assessed to examine relationships between entertainment venue visits and sexual risk. Both behavioral (self-reports of unprotected se...

  18. Outlining a preventive oral health care system for China.

    Science.gov (United States)

    Saekel, Rüdiger

    2015-01-01

    The most recent Chinese health care reform, scheduled to run until 2020, has been underway for a number of years. Oral health care has not been explicitly mentioned in the context of this reform. However, oral health is an integral part of general health and the under-servicing of the Chinese population in the area of dental care is particularly high. The article describes how this problem could be addressed. Based on present scientific knowledge,specifically on evidence-based strategies and long-term empirical experience from Western industrialised countries, as well as findings from Chinese pilot studies, the author outlines a preventive oral health care system tailored specifically to the conditions prevailing in China. He describes the background and rationale for a clearly structured, preventive system and summarises the scientific cornerstones on which this concept is founded. The single steps of this model, that are adapted specifically to China, are presented so as to facilitate a critical discussion on the pros and cons of the approach. The author concludes that, by implementing preventive oral care, China could gradually reduce the under-servicing of great parts of the population with dental care that largely avoids dental disease and preserves teeth at a price that is affordable to both public health and patients. This approach would minimise the danger of starting a cycle of re-restorations, owing to outdated treatment methods. The proposal would both fit in well with and add to the current blueprint for Chinese health care reform.

  19. China's "market economics in command": footwear workers' health in jeopardy.

    Science.gov (United States)

    Chen, M S; Chan, A

    1999-01-01

    This study of occupational safety and health (OSH) problems in the footwear industry in China, the world's largest shoemaker, is based on four years of research in China supplemented by research in Taiwan, Australia, and the United States. With the advent of the economic reforms of the early 1980s, the Chinese state is being driven by an economic imperative under which the profit motive overrides other concerns, causing a deterioration in OSH conditions. Footwear workers are being exposed to high levels of benzene, toluene, and other toxic solvents contained in the adhesives used in the shoe-making process. Many workers have been afflicted with aplastic anemia, leukemia, and other health problems. Most of China's current permissible exposure limits to toxins are either outdated or underenforced. As a result, the Chinese state's protection of footwear workers' health is inadequate. The article aims to draw the attention of the international OSH community to the importance of setting specific exposure standards for the footwear industry worldwide.

  20. [Using the concept of universal health coverage to promote the health system reform in China].

    Science.gov (United States)

    Hu, S L

    2016-11-06

    The paper is systematically explained the definition, contents of universal health coverage (UHC). Universal health coverage calls for all people to have access to quality health services they need without facing undue financial burden. The relationship between five main attributes, i.e., quality, efficiency, equity, accountability and resilience, and their 15 action plans has been explained. The nature of UHC is belonged to the State and government. The core function is commitment with equality. The whole-of-system method is used to promoting the health system reform. In China, the universal health coverage has been reached to the preliminary achievements, which include universal coverage of social medical insurance, basic medical services, basic public health services, and the provision of essential medicines. China has completed millennium development goals (MDG) and is being stepped to the sustainable development goals (SDG).

  1. Analysis of inequality in maternal and child health outcomes and mortality from 2000 to 2013 in China.

    Science.gov (United States)

    Li, Yanting; Zhang, Yimin; Fang, Shuai; Liu, Shanshan; Liu, Xinyu; Li, Ming; Liang, Hong; Fu, Hua

    2017-04-20

    Inequality in maternal and child health seriously hinders the overall improvement of health, which is a concern in both the United Nations Sustainable Development Goals (SDGs) and Healthy China 2030. However, research on the equality of maternal and child health is scarce. This study longitudinally assessed the equality trends in China's maternal and child health outcomes from 2000 to 2013 based on place of residence and gender to improve the fairness of domestic maternal and child health. Data on China's maternal and child health monitoring reports were collected from 2000 to 2013. Horizontal and vertical monitoring were performed on the following maternal and child health outcome indicators: incidence of birth defects (IBD), maternal mortality rate (MMR), under 5 mortality rate (U5MR) and neonatal mortality rate (NMR). The newly developed HD*Calc software by the World Health Organization (WHO) was employed as a tool for the health inequality assessment. The between group variance (BGV) and the Theil index (T) were used to measure disparity between different population groups, and the Slope index was used to analyse the BGV and T trends. The disparity in the MMR, U5MR and NMR for the different places of residence (urban and rural) improved over time. The BGV (Slope BGV = -32.24) and T (Slope T = -7.87) of MMR declined the fastest. The gender differences in the U5MR (Slope BGV = -0.06, Slope T = -0.21) and the NMR (Slope BGV = -0.01, Slope T = 0.23) were relatively stable, but the IBD disparity still showed an upward trend in both the place of residence and gender strata. A decline in urban-rural differences in the cause of maternal death was found for obstetric bleeding (Slope BGV = -14.61, Slope T = -20.84). Improvements were seen in the urban-rural disparity in premature birth and being underweight (PBU) in children under 5 years of age. Although diarrhoea and pneumonia decreased in the U5MR, no obvious gender-based trend in the causes of death was observed. We

  2. Regulatory system reform of occupational health and safety in China.

    Science.gov (United States)

    Wu, Fenghong; Chi, Yan

    2015-01-01

    With the explosive economic growth and social development, China's regulatory system of occupational health and safety now faces more and more challenges. This article reviews the history of regulatory system of occupational health and safety in China, as well as the current reform of this regulatory system in the country. Comprehensive, a range of laws, regulations and standards that promulgated by Chinese government, duties and responsibilities of the regulatory departments are described. Problems of current regulatory system, the ongoing adjustments and changes for modifying and improving regulatory system are discussed. The aim of reform and the incentives to drive forward more health and safety conditions in workplaces are also outlined.

  3. Health Care Experiences and Perceived Barriers to Health Care Access: A Qualitative Study Among African Migrants in Guangzhou, Guangdong Province, China.

    Science.gov (United States)

    Lin, Lavinia; Brown, Katherine B; Yu, Fan; Yang, Jingqi; Wang, Jason; Schrock, Joshua M; Bodomo, Adams B; Yang, Ligang; Yang, Bin; Nehl, Eric J; Tucker, Joseph D; Wong, Frank Y

    2015-10-01

    Guangzhou, one of China's largest cities and a main trading port in South China, has attracted many African businessmen and traders migrating to the city for financial gains. Previous research has explored the cultural and economic roles of this newly emerging population; however, little is known about their health care experiences while in China. Semi-structured interviews and focus groups were used to assess health care experiences and perceived barriers to health care access among African migrants in Guangzhou, China. Overall, African migrants experienced various barriers to accessing health care and were dissatisfied with local health services. The principal barriers to care reported included affordability, legal issues, language barriers, and cultural differences. Facing multiple barriers, African migrants have limited access to care in Guangzhou. Local health settings are not accustomed to the African migrant population, suggesting that providing linguistically and culturally appropriate services may improve access to care for the migrants.

  4. Zebrafish Health Conditions in the China Zebrafish Resource Center and 20 Major Chinese Zebrafish Laboratories.

    Science.gov (United States)

    Liu, Liyue; Pan, Luyuan; Li, Kuoyu; Zhang, Yun; Zhu, Zuoyan; Sun, Yonghua

    2016-07-01

    In China, the use of zebrafish as an experimental animal in the past 15 years has widely expanded. The China Zebrafish Resource Center (CZRC), which was established in 2012, is becoming one of the major resource centers in the global zebrafish community. Large-scale use and regular exchange of zebrafish resources have put forward higher requirements on zebrafish health issues in China. This article reports the current aquatic infrastructure design, animal husbandry, and health-monitoring programs in the CZRC. Meanwhile, through a survey of 20 Chinese zebrafish laboratories, we also describe the current health status of major zebrafish facilities in China. We conclude that it is of great importance to establish a widely accepted health standard and health-monitoring strategy in the Chinese zebrafish research community.

  5. Organization and Finance of China's Health Sector: Historical Antecedents for Macroeconomic Structural Adjustment.

    Science.gov (United States)

    Li, Hui; Hilsenrath, Peter

    2016-01-01

    China has exploded onto the world economy over the past few decades and is undergoing rapid transformation toward relatively more services. The health sector is an important part of this transition. This article provides a historical account of the development of health care in China since 1949. It also focuses on health insurance and macroeconomic structural adjustment to less saving and more consumption. In particular, the question of how health insurance impacts precautionary savings is considered. Multivariate analysis using data from 1990 to 2012 is employed. The household savings rate is the dependent variable in 3 models segmented for rural and urban populations. Independent variables include out-of-pocket health expenditures, health insurance payouts, housing expenditure, education expenditure, and consumption as a share of gross domestic product (GDP). Out-of-pocket health expenditures were positively correlated with household savings rates. But health insurance remains weak, and increased payouts by health insurers have not been associated with lower levels of household savings so far. Housing was positively correlated, whereas education had a negative association with savings rates. This latter finding was unexpected. Perhaps education is perceived as investment and a substitute for savings. China's shift toward a more service-oriented economy includes growing dependence on the health sector. Better health insurance is an important part of this evolution. The organization and finance of health care is integrally linked with macroeconomic policy in an environment constrained by prevailing institutional convention. Problems of agency relationships, professional hegemony, and special interest politics feature prominently, as they do elsewhere. China also has a dual approach to medicine relying heavily on providers of traditional Chinese medicine. Both of these segments will take part in China's evolution, adding another layer of complexity to policy. © The

  6. Child health security in China: a survey of child health insurance coverage in diverse areas of the country.

    Science.gov (United States)

    Xiong, Juyang; Hipgrave, David; Myklebust, Karoline; Guo, Sufang; Scherpbier, Robert W; Tong, Xuetao; Yao, Lan; Moran, Andrew E

    2013-11-01

    China embarked on an ambitious health system reform in 2009, and pledged to achieve universal health insurance coverage by 2020. However, there are gaps in access to healthcare for some children in China. We assessed health insurance status and associated variables among children under five in twelve communities in 2010: two urban community health centers and two rural township health centers in each of three municipalities located in China's distinctly different East, Central and Western regions. Information on demographic and socio-economic variables and children's insurance status was gathered from parents or caregivers of all children enrolled in local health programs, and others recruited from the local communities. Only 62% of 1131 children assessed were insured. This figure did not vary across geographic regions, but urban children were less likely to be insured than rural children. In multivariate analysis, infants were 2.44 times more likely to be uninsured than older children and children having at least one migrant parent were 1.90 times more likely to be uninsured than those living with non-migrant parents. Low maternal education was also associated with being uninsured. Gaps in China's child health insurance coverage might be bridged if newborns are automatically covered from birth, and if insurance is extended to all urban migrant children, regardless of the family's residential registration status and size. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. mHealth For Aging China: Opportunities and Challenges.

    Science.gov (United States)

    Sun, Jing; Guo, Yutao; Wang, Xiaoning; Zeng, Qiang

    2016-01-01

    The aging population with chronic and age-related diseases has become a global issue and exerted heavy burdens on the healthcare system and society. Neurological diseases are the leading chronic diseases in the geriatric population, and stroke is the leading cause of death in China. However, the uneven distribution of caregivers and critical healthcare workforce shortages are major obstacles to improving disease outcome. With the advancement of wearable health devices, cloud computing, mobile technologies and Internet of Things, mobile health (mHealth) is rapidly developing and shows a promising future in the management of chronic diseases. Its advantages include its ability to improve the quality of care, reduce the costs of care, and improve treatment outcomes by transferring in-hospital treatment to patient-centered medical treatment at home. mHealth could also enhance the international cooperation of medical providers in different time zones and the sharing of high-quality medical service resources between developed and developing countries. In this review, we focus on trends in mHealth and its clinical applications for the prevention and treatment of diseases, especially aging-related neurological diseases, and on the opportunities and challenges of mHealth in China. Operating models of mHealth in disease management are proposed; these models may benefit those who work within the mHealth system in developing countries and developed countries.

  8. Childhood Health Status and Adulthood Cardiovascular Disease Morbidity in Rural China: Are They Related?

    Science.gov (United States)

    Wang, Qing; Shen, Jay J

    2016-06-06

    Cardiovascular diseases (CVDs) are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS), a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on adulthood health later on, health policy and programs to improve the health status and well-being of Chinese populations over the entire life cycle, especially in persons' early life, are expected to be effective and successful.

  9. Childhood Health Status and Adulthood Cardiovascular Disease Morbidity in Rural China: Are They Related?

    Directory of Open Access Journals (Sweden)

    Qing Wang

    2016-06-01

    Full Text Available Cardiovascular diseases (CVDs are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS, a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on adulthood health later on, health policy and programs to improve the health status and well-being of Chinese populations over the entire life cycle, especially in persons’ early life, are expected to be effective and successful.

  10. Carbon balance of China constrained by CONTRAIL aircraft CO2 measurements

    Science.gov (United States)

    Jiang, F.; Wang, H. M.; Chen, J. M.; Machida, T.; Zhou, L. X.; Ju, W. M.; Matsueda, H.; Sawa, Y.

    2014-09-01

    Terrestrial carbon dioxide (CO2) flux estimates in China using atmospheric inversion method are beset with considerable uncertainties because very few atmospheric CO2 concentration measurements are available. In order to improve these estimates, nested atmospheric CO2 inversion during 2002-2008 is performed in this study using passenger aircraft-based CO2 measurements over Eurasia from the Comprehensive Observation Network for Trace gases by Airliner (CONTRAIL) project. The inversion system includes 43 regions with a focus on China, and is based on the Bayesian synthesis approach and the TM5 transport model. The terrestrial ecosystem carbon flux modeled by the Boreal Ecosystems Productivity Simulator (BEPS) model and the ocean exchange simulated by the OPA-PISCES-T model are considered as the prior fluxes. The impacts of CONTRAIL CO2 data on inverted China terrestrial carbon fluxes are quantified, the improvement of the inverted fluxes after adding CONTRAIL CO2 data are rationed against climate factors and evaluated by comparing the simulated atmospheric CO2 concentrations with three independent surface CO2 measurements in China. Results show that with the addition of CONTRAIL CO2 data, the inverted carbon sink in China increases while those in South and Southeast Asia decrease. Meanwhile, the posterior uncertainties over these regions are all reduced (2-12%). CONTRAIL CO2 data also have a large effect on the inter-annual variation of carbon sinks in China, leading to a better correlation between the carbon sink and the annual mean climate factors. Evaluations against the CO2 measurements at three sites in China also show that the CONTRAIL CO2 measurements may have improved the inversion results.

  11. The effect of herd formation among healthcare investors on health sector growth in China.

    Science.gov (United States)

    Lulin, Zhou; Antwi, Henry Asante; Wang, Wenxin; Yiranbon, Ethel; Marfo, Emmanuel Opoku; Acheampong, Patrick

    2016-07-19

    China has become the world's second largest healthcare market based on a recent report by the World Health Organization. Eventhough China achieved universal health insurance coverage in 2011, representing the largest expansion of insurance coverage in human history achieved; health inequality remains endemic in China. Lessons from the effect of market crisis on health equity in Europe and other places has reignited interest in exploring the potential healthcare market aberrations that can trigger distributive injustice in healthcare resource allocation among China's provinces. Recently, many healthcare investors in China have become more concerned about capital preservation, and are responding by abandoning long term investments strategies in healthcare. This investment withdrawal en mass is perceived to be influenced by herding tendencies and can trigger or consolidate endemic health inequality. Our study simultaneously employs four testing models (two state spaced models and two return dispersion models) to establish the existence of procyclical (herding) behavior among the stocks and its health equity implications. These are applied to a large set of data to compare and contrast results of herd formation among investors in fourteen healthcare sectors in China. The study reveals that apart from the cross sectional standard deviation (CSSD) model, the remaining two models and our augmented state space model yields significant evidence of herding in all subsectors of the healthcare market. We also find that the herding effect is more prominent during down movements of the market. Herding behavior may lead to contemporaneous loss of investor confidence and capital withdrawal and thereby deprive the healthcare sector of the much needed capital for expansion. Thus there may be obvious delay in efforts to bridge the gap in access to healthcare facilities, medical support services, medical supplies, pharmaceuticals, biotechnology, diagnostic substances, medical

  12. Measuring patient safety culture in maternal and child health institutions in China: a qualitative study.

    Science.gov (United States)

    Wang, Yuanyuan; Liu, Weiwei; Shi, Huifeng; Liu, Chaojie; Wang, Yan

    2017-07-12

    Patient safety culture (PSC) plays a critical role in ensuring safe and quality care. Extensive PSC studies have been undertaken in hospitals. However, little is known about PSC in maternal and child health (MCH) institutions in China, which provide both population-based preventive services as well as individual care for patients. This study aimed to develop a theoretical framework for conceptualising PSC in MCH institutions in China. The study was undertaken in six MCH institutions (three in Hebei and three in Beijing). Participants (n=118) were recruited through stratified purposive sampling: 20 managers/administrators, 59 care providers and 39 patients. In-depth interviews were conducted with the participants. The interview data were coded using both inductive (based on the existing PSC theory developed by the Agency for Healthcare Research and Quality) and deductive (open coding arising from data) approaches. A PSC framework was formulated through axial coding that connected initial codes and selective coding that extracted a small number of themes. The interviewees considered patient safety in relation to six aspects: safety and security in public spaces, safety of medical services, privacy and information security, financial security, psychological safety and gap in services. A 12-dimensional PSC framework was developed, containing 69 items. While the existing PSC theory was confirmed by this study, some new themes emerged from the data. Patients expressed particular concerns about psychological safety and financial security. Defensive medical practices emerged as a PSC dimension that is associated with not only medical safety but also financial security and psychological safety. Patient engagement was also valued by the interviewees, especially the patients, as part of PSC. Although there are some common features in PSC across different healthcare delivery systems, PSC can also be context specific. In MCH settings in China, the meaning of 'patient safety

  13. Development of village doctors in China: financial compensation and health system support.

    Science.gov (United States)

    Hu, Dan; Zhu, Weiming; Fu, Yaqun; Zhang, Minmin; Zhao, Yang; Hanson, Kara; Martinez-Alvarez, Melisa; Liu, Xiaoyun

    2017-07-01

    Since 1968, China has trained about 1.5 million barefoot doctors in a few years' time to provide basic health services to 0.8 billion rural population. China's Ministry of Health stopped using the term of barefoot doctor in 1985, and changed policy to develop village doctors. Since then, village doctors have kept on playing an irreplaceable role in China's rural health, even though the number of village doctors has fluctuated over the years and they face serious challenges. United Nations declared Sustainable Development Goals in 2015 to achieve universal health coverage by 2030. Under this context, development of Community Health workers (CHWs) has become an emerging policy priority in many resource-poor developing countries. China's experiences and lessons learnt in developing and maintaining village doctors may be useful for these developing countries. This paper aims to synthesis lessons learnt from the Chinese CHW experiences. It summarizes China's experiences in exploring and using strategic partnership between the community and the formal health system to develop CHWs in the two stages, the barefoot doctor stage (1968 -1985) and the village doctor stage (1985-now). Chinese and English literature were searched from PubMed, CNKI and Wanfang. The information extracted from the selected articles were synthesized according to the four partnership strategies for communities and health system to support CHW development, namely 1) joint ownership and design of CHW programmes; 2) collaborative supervision and constructive feedback; 3) a balanced package of incentives, both financial and non-financial; and 4) a practical monitoring system incorporating data from the health system and community. The study found that the townships and villages provided an institutional basis for barefoot doctor policy, while the formal health system, including urban hospitals, county health schools, township health centers, and mobile medical teams provided training to the barefoot

  14. Leisure and health in cross-cultural settings: Evidences from China ...

    African Journals Online (AJOL)

    In Okinawa, SES has no impact on health. The findings in Japan study suggest a major revision of SGTLE and FSCT that health is not related to SES. All three studies contribute to our understanding of the relationship between leisure lifestyle and health cross-culturally. Keywords: Leisure lifestyle, health, China, Korea, ...

  15. mHealth Series: mHealth project in Zhao County, rural China – Description of objectives, field site and methods

    Directory of Open Access Journals (Sweden)

    Michelle Helena van Velthoven

    2013-12-01

    Full Text Available We set up a collaboration between researchers in China and the UK that aimed to explore the use of mHealth in China. This is the first paper in a series of papers on a large mHealth project part of this collaboration. This paper included the aims and objectives of the mHealth project, our field site, and the detailed methods of two studies.

  16. Perception, attitude and behavior in relation to climate change: A survey among CDC health professionals in Shanxi province, China

    International Nuclear Information System (INIS)

    Wei, Junni; Hansen, Alana; Zhang, Ying; Li, Hong; Liu, Qiyong; Sun, Yehuan; Bi, Peng

    2014-01-01

    Background: A better understanding of public perceptions, attitude and behavior in relation to climate change will provide an important foundation for government's policy-making, service provider's guideline development and the engagement of local communities. The purpose of this study was to assess the perception towards climate change, behavior change, mitigation and adaptation measures issued by the central government among the health professionals in the Centres for Disease Control and Prevention (CDC) in China. Methods: In 2013, a cross-sectional questionnaire survey was undertaken among 314 CDC health professionals in various levels of CDC in Shanxi Province, China. Descriptive analyses were performed. Results: More than two thirds of the respondents believed that climate change has happened at both global and local levels, and climate change would lead to adverse impacts to human beings. Most respondents (74.8%) indicated the emission of greenhouse gases was the cause of climate change, however there was a lack of knowledge about greenhouse gases and their sources. Media was the main source from which respondents obtained the information about climate change. A majority of respondents showed that they were willing to change behavior, but their actions were limited. In terms of mitigation and adaptation measures issued by the Chinese Government, respondents' perception showed inconsistency between strategies and relevant actions. Moreover, although the majority of respondents believed some strategies and measures were extremely important to address climate change, they were still concerned about economic development, energy security, and local environmental protection. Conclusion: There are gaps between perceptions and actions towards climate change among these health professionals. Further efforts need to be made to raise the awareness of climate change among health professionals, and to promote relevant actions to address climate change in

  17. Perception, attitude and behavior in relation to climate change: A survey among CDC health professionals in Shanxi province, China

    Energy Technology Data Exchange (ETDEWEB)

    Wei, Junni, E-mail: junxinni@163.com [Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, Shanxi (China); Hansen, Alana, E-mail: alana.hansen@adelaide.edu.au [Discipline of Public Health, School of Population Health, The University of Adelaide, Adelaide 5005 (Australia); Zhang, Ying, E-mail: ying.zhang@sydney.edu.au [Sydney School of Public Health, The University of Sydney, NSW 2006 (Australia); Li, Hong [Shanxi Center for Disease Control and Prevention, Taiyuan 030001 Shanxi (China); Liu, Qiyong, E-mail: liuqiyong@icdc.cn [State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206 (China); Shandong University Climate Change and Health Center, Jinan 250012, Shandong (China); Sun, Yehuan, E-mail: yhsun@sina.com [Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui (China); Bi, Peng, E-mail: peng.bi@adelaide.edu.au [Discipline of Public Health, School of Population Health, The University of Adelaide, Adelaide 5005 (Australia)

    2014-10-15

    Background: A better understanding of public perceptions, attitude and behavior in relation to climate change will provide an important foundation for government's policy-making, service provider's guideline development and the engagement of local communities. The purpose of this study was to assess the perception towards climate change, behavior change, mitigation and adaptation measures issued by the central government among the health professionals in the Centres for Disease Control and Prevention (CDC) in China. Methods: In 2013, a cross-sectional questionnaire survey was undertaken among 314 CDC health professionals in various levels of CDC in Shanxi Province, China. Descriptive analyses were performed. Results: More than two thirds of the respondents believed that climate change has happened at both global and local levels, and climate change would lead to adverse impacts to human beings. Most respondents (74.8%) indicated the emission of greenhouse gases was the cause of climate change, however there was a lack of knowledge about greenhouse gases and their sources. Media was the main source from which respondents obtained the information about climate change. A majority of respondents showed that they were willing to change behavior, but their actions were limited. In terms of mitigation and adaptation measures issued by the Chinese Government, respondents' perception showed inconsistency between strategies and relevant actions. Moreover, although the majority of respondents believed some strategies and measures were extremely important to address climate change, they were still concerned about economic development, energy security, and local environmental protection. Conclusion: There are gaps between perceptions and actions towards climate change among these health professionals. Further efforts need to be made to raise the awareness of climate change among health professionals, and to promote relevant actions to address climate change in

  18. Mental health of Automobile Transportation Troop personnel stationed in the Western Sichuan Plateau of China

    Science.gov (United States)

    Tan, Yan; Li, Yunming; Wu, Juan; Chen, Fuqin; Lu, Hao; Lu, Shijun; Yang, Xianjun; Ma, Xiao

    2018-01-01

    Abstract This study investigated the mental health of military transport personnel in the Western Sichuan Plateau of China, and factors that correlate with their mental health. The Symptom Checklist 90 (SCL-90) was used to investigate the mental health status of the subjects. Their scores were compared with the national and military norm in China. Demographic factors were analyzed for associations with SCL-90 scores. Psychological problems were detected in 28.90% of total 1076 male officers and soldiers surveyed. The SCL-90 scale somatization score of these servicemen was higher than the national and military norms in China, while other scores were comparable. The reported physical health symptoms and being an only child were strongly associated with the SCL-90 scores. The mental health of military transport personnel in the China Western Sichuan Plateau should receive more attention. PMID:29561449

  19. Experience-based VAS values for EQ-5D-3L health states in a national general population health survey in China.

    Science.gov (United States)

    Sun, Sun; Chen, Jiaying; Kind, Paul; Xu, Ling; Zhang, Yaoguang; Burström, Kristina

    2015-03-01

    To investigate the feasibility of deriving experience-based visual analogue scale (VAS) values for EQ-5D-3L health states using national general population health survey data in China. The EQ-5D-3L was included in the National Health Services Survey (n = 120,709, aged 15-103 years) to measure health-related quality of life. The respondents reported their current health status on a VAS and completed the EQ-5D-3L questionnaire, enabling modelling of the association between the experience-based VAS values and self-reported problems on EQ-5D dimensions and severity levels. VAS values were generally negatively associated with problems reported on the EQ-5D dimensions, and the anxiety/depression dimension had the greatest impact on VAS values. A previously obtained value for dead allowed the values for all 243 EQ-5D-3L health states to be transformed to the 0-1 scale (0 = dead, 1 = full health). This study presents the feasibility of deriving an experience-based VAS values for EQ-5D-3L health states in China. The analysis of these VAS data raises more fundamental issues concerning the universal nature of the classification system and the extent to which Chinese respondents utilise the same concepts of health as defined by this classification system.

  20. The development of biodiversity conservation measures in China's hydro projects: A review.

    Science.gov (United States)

    Bai, Ruiqiao; Liu, Xuehua; Liu, Xiaofei; Liu, Lanmei; Wang, Jianping; Liao, Sihui; Zhu, Annah; Li, Zhouyuan

    2017-11-01

    The hydropower capacity of China ranks first in the world and accounts for approximately 20% of the total energy production in the country. While hydropower has substantially contributed to meeting China's renewable energy targets and providing clean energy to rural areas, the development of hydropower in China has been met with significant controversy. Ecologically, hydro projects alter the landscape, with potential impacts to the country's aquatic biodiversity. Over the past four decades in China, various mainstream opinions and misunderstandings have been presented concerning how to alleviate the negative impacts of hydro projects on aquatic ecosystems. This article reviews research concerning potential mitigation measures to enhance aquatic biodiversity conservation in hydro projects in China. Based on the academic attention such research has attracted, three technical measures for aquatic biodiversity conservation are considered: (1) fish passages, (2) restocking efforts and (3) river and lake renovations. This article provides a historical comparison of these three practices in China to demonstrate the advantages and disadvantages of each method. The article also reviews the relevant legislation, regulations and technical guidelines concerning China's hydro projects dating back to 1979. The dynamics in research, publications, and patents concerning these three mitigation measures are summarized to demonstrate their technological developments in the context of legislative and policy advances. Data were gathered through the China Knowledge Resource Integrated Database and the State Intellectual Property Office of the People's Republic of China. Based on the analysis provided, the article recommends an expansion of China's environmental certification system for hydro projects, more robust regional legislation to bolster the national framework, the cooperation between upstream and downstream conservation mechanisms, and better monitoring to determine the efficacy

  1. Urbanization and health in China, thinking at the national, local and individual levels.

    Science.gov (United States)

    Li, Xinhu; Song, Jinchao; Lin, Tao; Dixon, Jane; Zhang, Guoqin; Ye, Hong

    2016-03-08

    China has the biggest population in the world, and has been experiencing the largest migration in history, and its rapid urbanization has profound and lasting impacts on local and national public health. Under these conditions, a systems understanding on the correlation among urbanization, environmental change and public health and to devise solutions at national, local and individual levels are in urgent need. In this paper, we provide a comprehensive review of recent studies which have examined the relationship between urbanization, urban environmental changes and human health in China. Based on the review, coupled with a systems understanding, we summarize the challenges and opportunities for promoting the health and wellbeing of the whole nation at national, local, and individual levels. Urbanization and urban expansion result in urban environmental changes, as well as residents' lifestyle change, which can lead independently and synergistically to human health problems. China has undergone an epidemiological transition, shifting from infectious to chronic diseases in a much shorter time frame than many other countries. Environmental risk factors, particularly air and water pollution, are a major contributing source of morbidity and mortality in China. Furthermore, aging population, food support system, and disparity of public service between the migrant worker and local residents are important contributions to China's urban health. At the national level, the central government could improve current environmental policies, food safety laws, and make adjustments to the health care system and to demographic policy. At the local level, local government could incorporate healthy life considerations in urban planning procedures, make improvements to the local food supply, and enforce environmental monitoring and management. At the individual level, urban residents can be exposed to education regarding health behaviour choices while being encouraged to take

  2. Nanoparticle pollution and associated increasing potential risks on environment and human health: a case study of China.

    Science.gov (United States)

    Gao, Yang; Yang, Tiantian; Jin, Jin

    2015-12-01

    The aims of this study are (1) to discuss the mechanism of nanoparticle lifecycle and estimate the impacts of its associated pollution on environment and human health; and (2) to provide recommendation to policy makers on how to leverage nanopollution and human health along with the rapid development of economics in China. Manufactured nanoparticles (MNPs) could either directly or indirectly impair human health and the environment. Exposures to MNP include many ways, such as via inhalation, ingestion, direct contact, or the use of consumer products over the lifecycle of the product. In China, the number of people exposed to MNP has been increasing year by year. To better provide medical care to people exposed to MNP, the Chinese government has established many disease control and prevention centers over China. However, the existing facilities and resources for controlling MNP are still not enough considering the number of people impacted by MNP and the number of ordinary workers in the MNP related industry applying for their occupational identification through the Center for Disease Control and Prevention. China should assess the apparent risk environment and human health being exposed to MNP and develop action plans to reduce the possibility of direct contacts between human beings and the emerging nanomaterials. In addition, we suggest more comprehensive studies on the MNP behavior and the development of quantitative approaches to measure MNP transport, and persistence should be carried out.

  3. Air Quality and Health Benefits of China's Recent Stringent Environmental Policy

    Science.gov (United States)

    Zheng, Y.; Xue, T.; Zhang, Q.; Geng, G.; He, K.

    2016-12-01

    Aggressive emission control measures were taken by China's central and local governments after the promulgation of the "Air Pollution Prevention and Control Action Plan" in 2013. We evaluated the air quality and health benefits of this ever most stringent air pollution control policy during 2013-2015 by utilizing a two-stage data fusion model and newly-developed cause-specific integrated exposure-response functions (IER) developed for the Global Burden of Disease (GBD). The two-stage data fusion model predicts spatiotemporal continuous PM2.5 (particulate matter with aerodynamic diameter less than 2.5 µm) concentrations by integrating satellite-derived aerosol optical depth (AOD) measurements, PM2.5 concentrations from measurement and air quality model, and other ancillary information. During the years of analysis, PM2.5 concentration dropped significantly on national average and over heavily polluted regions as identified by Mann-Kendall analysis. The national PM2.5-attributable mortality decreased by 72.8 (95% CI: 59.4, 85.2) thousand (6%) from 1.23 (95% CI: 1.06, 1.39) million in 2013 to 1.15 (95% CI: 0.98, 1.31) million in 2015 due to considerable reduction (i.e. 18%) of population-weighted PM2.5 from 61.4 to 50.5 µg/m3. Meteorological variations between 2013 and 2015 were estimated to raise the PM2.5 levels by 0.24 µg/m3 and national mortality by 2.1 (95% CI: 1.6, 2.6) thousand through sensitivity tests, which implies the dominant role of anthropogenic impacts on PM2.5 abatement and attributable mortality reduction. Our study affirms the effectiveness of China's recent air quality policy, however, due to the possible supralinear shape of C-R functions, health benefits induced by air quality improvement in these years are limited. We therefore appeal for continuous implementation of current policies and further stringent measures from both air quality improvement and public health protection perspectives.

  4. Measuring functional, interactive and critical health literacy of Chinese secondary school students: reliable, valid and feasible?

    Science.gov (United States)

    Guo, Shuaijun; Davis, Elise; Yu, Xiaoming; Naccarella, Lucio; Armstrong, Rebecca; Abel, Thomas; Browne, Geoffrey; Shi, Yanqin

    2018-04-01

    Health literacy is an increasingly important topic in the global context. In mainland China, health literacy measures mainly focus on health knowledge and practices or on the functional domain for adolescents. However, little is known about interactive and critical domains. This study aimed to adopt a skills-based and three-domain (functional, interactive and critical) instrument to measure health literacy in Chinese adolescents and to examine the status and determinants of each domain. Using a systematic review, the eight-item Health Literacy Assessment Tool (HLAT-8) was selected and translated from English to Chinese (c-HLAT-8). Following the translation process, a cross-sectional study was conducted in four secondary schools in Beijing, China. A total of 650 students in Years 7-9 were recruited to complete a self-administered questionnaire that assessed socio-demographics, self-efficacy, social support, school environment, community environment and health literacy. Results showed that the c-HLAT-8 had satisfactory reliability (Cronbach's α = 0.79; intra-class correlation coefficient = 0.72) and strong validity (translation validity index (TVI) ≥0.95; χ 2 / df = 3.388, p students had an average score of 26.37 (±5.89) for the c-HLAT-8. When the determinants of each domain of health literacy were examined, social support was the strongest predictor of interactive and critical health literacy. On the contrary, self-efficacy and school environment played more dominant roles in predicting functional health literacy. The c-HLAT-8 was demonstrated to be a reliable, valid and feasible instrument for measuring functional, interactive and critical health literacy among Chinese students. The current findings indicate that increasing self-efficacy, social support and creating supportive environments are important for promoting health literacy in secondary school settings in China.

  5. Health Improvements Have Been More Rapid and Widespread in China than in India: A Comparative Analysis of Health and Socioeconomic Trends from 1960 to 2011

    Directory of Open Access Journals (Sweden)

    Gopal K. Singh, PhD

    2012-11-01

    Full Text Available ObjectivesWe examined differences between China and India in key health and socioeconomic indicators, including life expectancy, infant and child mortality, non-communicable disease mortality from cancer, cardiovascular diseases (CVD, and diabetes, Human Development Index, Gender Inequality Index, material living conditions, and health expenditure.MethodsData on health and social indicators came from various World Health Organization and United Nations databases on global health and development statistics, including the GLOBOCAN cancer database. Mortality trends were modeled by log-linear regression, and differences in rates and relative risks were tested for statistical significance.ResultsAlthough both countries have made marked improvements, India lags behind China on several key health indicators. Differential rates of mortality decline during 1960-2009 have led to a widening health gap between China and India. In 2009 the infant mortality rate in India was 50 deaths per 1,000 live births, 3 times greater than the rate for China. Sixty-six out of 1,000 Indian children died before reaching their 5th birthday, compared with 19 children in China. China’s life expectancy is 9 years longer than India’s. Life expectancy at birth in India increased from 42 years in 1960 to 65 years in 2009, while life expectancy in China increased from 47 years in 1960 to 74 years in 2009. Major health concerns for China include high rates of stomach, liver, and lung cancer, CVD, and smoking prevalence. Globally, India ranked 90th and China 102nd in life satisfaction.Conclusions and Public Health Implications:India’s less favorable health profile compared to China is largely attributable to its higher rates of mortality from communicable diseases and maternal and perinatal conditions. Further health gains can be achieved by reducing social inequality, greater investments in human development and health services, and by prevention and control of chronic

  6. Study on Measurement of Advanced Manufacturing: Case by China

    Directory of Open Access Journals (Sweden)

    She Jinghuai

    2017-01-01

    Full Text Available This article has built a system of China's Advanced Manufacturing measurement indicators. By applying the datum from 2004 to 2013, we estimate the level of development and current status of China’s Advanced Manufacturing (AM, and evaluate the measurement results by establishing Hierarchical Linear Model (HLM. We confirmed that China's Advanced Manufacturing is in the rapid development trend. And due to the difference of initial conditions in Advanced Manufacturing development there is a greater imbalance. In contrast, a region with poor initial condition of has a relatively fast development speed.

  7. China building energy consumption: Situation, challenges and corresponding measures

    International Nuclear Information System (INIS)

    Cai, W.G.; Wu, Y.; Zhong, Y.; Ren, H.

    2009-01-01

    As one of the biggest parts of total national energy consumption (TNEC), building energy consumption (BEC) catches public eyes and has been regarded as a crucial problem of the current society. For the past 20 years, BEC in china has been increasing at a high speed. To curb the rapid growing of BEC, china has enforced and implemented a series of policies. These include enforcing BEC constraints on new building projects, promoting more environment friendly building designs, establishing a more sophisticated legislation for building energy conservation, and increasing the total budget in the area of BEC control. This article analyzed china BEC situation and the challenges. As the main point, the measures required by China government to improve building energy efficiency were introduced as well.

  8. Mobility of primary health care workers in China

    Directory of Open Access Journals (Sweden)

    Jing Limei

    2009-03-01

    Full Text Available Abstract Background Rural township health centres and urban community health centres play a crucial role in the delivery of primary health care in China. Over the past two-and-a-half decades, these health institutions have not been as well developed as high-level hospitals. The limited availability and low qualifications of human resources in health are among the main challenges facing lower-level health facilities. This paper aims to analyse the mobility of health workers in township and community health centres. Methods Data used in this paper come from a nationwide survey of health facilities in 2006. Ten provinces in different locations and of varying levels of economic development were selected. From these provinces, 119 rural township health centres and 89 urban community health centres were selected to participate in a questionnaire survey. Thirty key informants were selected from these health facilities to be interviewed. Results In 2005, 8.1% and 8.9% of health workers left township and community health centres, respectively. The health workers in rural township health centres had three to 13 years of work experience and typically had received a formal medical education. The majority of the mobile health workers moved to higher-level health facilities; very few moved to other rural township health centres. The rates of workers leaving township and community health centres increased between 2000 and 2005, with the main reasons for leaving being low salaries, limited opportunities for professional development and poor living conditions. Conclusion In China, primary health workers in township health centres and community health centres move to higher-level facilities due to low salaries, limited opportunities for promotion and poor living conditions. The government already has policies in place to counteract this migration, but it must step up enforcement if rural township health centres and urban community centres are to retain health

  9. Income-related health inequality of migrant workers in China and its decomposition: An analysis based on the 2012 China Labor-force Dynamics Survey data

    OpenAIRE

    Shao, Cenyi; Meng, Xuehui; Cui, Shichen; Wang, Jingru; Li, Chengcheng

    2016-01-01

    Background: Although migrant workers are a vulnerable group in China, they demonstrably contribute to the country's economic growth and prosperity. This study aimed to describe and assess the inequality of migrant worker health in China and its association with socioeconomic determinants. Methods: The data utilized in this study were obtained from the 2012 China Labor-force Dynamics Survey conducted in 29 Chinese provinces. This study converted the self-rated health of these migrant worker...

  10. China's role as a global health donor in Africa: what can we learn from studying under reported resource flows?

    Science.gov (United States)

    Grépin, Karen A; Fan, Victoria Y; Shen, Gordon C; Chen, Lucy

    2014-12-30

    There is a growing recognition of China's role as a global health donor, in particular in Africa, but there have been few systematic studies of the level, destination, trends, or composition of these development finance flows or a comparison of China's engagement as a donor with that of more traditional global health donors. Using newly released data from AidData on China's development finance activities in Africa, developed to track under reported resource flows, we identified 255 health, population, water, and sanitation (HPWS) projects from 2000-2012, which we descriptively analyze by activity sector, recipient country, project type, and planned activity. We compare China's activities to projects from traditional donors using data from the OECD's Development Assistance Committee (DAC) Creditor Reporting System. Since 2000, China increased the number of HPWS projects it supported in Africa and health has increased as a development priority for China. China's contributions are large, ranking it among the top 10 bilateral global health donors to Africa. Over 50% of the HPWS projects target infrastructure, 40% target human resource development, and the provision of equipment and drugs is also common. Malaria is an important disease priority but HIV is not. We find little evidence that China targets health aid preferentially to natural resource rich countries. China is an important global health donor to Africa but contrasts with traditional DAC donors through China's focus on health system inputs and on malaria. Although better data are needed, particularly through more transparent aid data reporting across ministries and agencies, China's approach to South-South cooperation represents an important and distinct source of financial assistance for health in Africa.

  11. Does Health Insurance Coverage Lead to Better Health and Educational Outcomes? Evidence from Rural China. NBER Working Paper No. 16417

    Science.gov (United States)

    Chen, Yuyu; Jin, Ginger Zhe

    2010-01-01

    Many governments advocate nationwide health insurance coverage but the effects of such a program are less known in developing countries. We use part of the 2006 China Agricultural Census (CAC) to examine whether the recent health insurance coverage in rural China has affected children mortality, pregnancy mortality, and the school enrollment of…

  12. The magnitude of and health system responses to the mental health treatment gap in adults in India and China.

    Science.gov (United States)

    Patel, Vikram; Xiao, Shuiyuan; Chen, Hanhui; Hanna, Fahmy; Jotheeswaran, A T; Luo, Dan; Parikh, Rachana; Sharma, Eesha; Usmani, Shamaila; Yu, Yu; Druss, Benjamin G; Saxena, Shekhar

    2016-12-17

    This Series paper describes the first systematic effort to review the unmet mental health needs of adults in China and India. The evidence shows that contact coverage for the most common mental and substance use disorders is very low. Effective coverage is even lower, even for severe disorders such as psychotic disorders and epilepsy. There are vast variations across the regions of both countries, with the highest treatment gaps in rural regions because of inequities in the distribution of mental health resources, and variable implementation of mental health policies across states and provinces. Human and financial resources for mental health are grossly inadequate with less than 1% of the national health-care budget allocated to mental health in either country. Although China and India have both shown renewed commitment through national programmes for community-oriented mental health care, progress in achieving coverage is far more substantial in China. Improvement of coverage will need to address both supply-side barriers and demand-side barriers related to stigma and varying explanatory models of mental disorders. Sharing tasks with community-based workers in a collaborative stepped-care framework is an approach that is ripe to be scaled up, in particular through integration within national priority health programmes. India and China need to invest in increasing demand for services through active engagement with the community, to strengthen service user leadership and ensure that the content and delivery of mental health programmes are culturally and contextually appropriate. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Health disparities among the western, central and eastern rural regions of China after a decade of health promotion and disease prevention programming.

    Science.gov (United States)

    Zhang, Xi-Fan; Tian, Xiang-Yang; Cheng, Yu-Lan; Feng, Zhan-Chun; Wang, Liang; Southerland, Jodi

    2015-08-01

    Health disparities between the western, central and eastern regions of rural China, and the impact of national health improvement policies and programming were assessed. A total of 400 counties were randomly sampled. ANOVA and Logistic regression modeling were employed to estimate differences in health outcomes and determinants. Significant differences were found between the western, central and eastern rural regions in community infrastructure and health outcomes. From 2000 to 2010, health indicators in rural China were improved significantly, and the infant mortality rate (IMR), maternal mortality rate (MMR) and under 5 mortality rate (U5MR) had fallen by 62.79%, 71.74% and 61.92%, respectively. Central rural China had the greatest decrease in IMR (65.05%); whereas, western rural China had the greatest reduction in MMR (72.99%) but smallest reduction in U5MR (57.36%). Despite these improvements, Logistic regression analysis showed regional differences in key health outcome indicators (odds ratios): IMR (central: 2.13; western: 5.31), U5MR (central: 2.25; western: 5.69), MMR (central: 1.94; western: 3.31), and prevalence of infectious diseases (central: 1.62; western: 3.58). The community infrastructure and health outcomes of the western and central rural regions of China have been improved markedly during the first decade of the 21st century. However, health disparities still exist across the three regions. National efforts to increase per capita income, community empowerment and mobilization, community infrastructure, capacity of rural health facilities, and health literacy would be effective policy options to attain health equity.

  14. Equity in health financing of Guangxi after China's universal health coverage: evidence based on health expenditure comparison in rural Guangxi Zhuang autonomous region from 2009 to 2013.

    Science.gov (United States)

    Qin, Xianjing; Luo, Hongye; Feng, Jun; Li, Yanning; Wei, Bo; Feng, Qiming

    2017-09-29

    Healthcare financing should be equitable. Fairness in financial contribution and protection against financial risk is based on the notion that every household should pay a fair share. Health policy makers have long been concerned with protecting people from the possibility that ill health will lead to catastrophic financial payments and subsequent impoverishment. A number of studies on health care financing equity have been conducted in some provinces of China, but in Guangxi, we found such observation is not enough. What is the situation in Guagnxi? A research on rural areas of Guangxi can add knowledge in this field and help improve the equity and efficiency of health financing, particularly in low-income citizens in rural countries, is a major concern in China's medical sector reform. Socio-economic characteristics and healthcare payment data were obtained from two rounds of household surveys conducted in 2009 (4634 respondents) and 2013 (3951 respondents). The contributions of funding sources were determined and a progressivity analysis of government healthcare subsidies was performed. Household consumption expenditure and total healthcare payments were calculated and incidence and intensity of catastrophic health payments were measured. Summary indices (concentration index, Kakwani index and Gini coefficient) were obtained for the sources of healthcare financing: indirect taxes, out of pocket payments, and social insurance contributions. The overall health-care financing system was regressive. In 2013, the Kakwani index was 0.0013, the vertical effect of all the three funding sources was 0.0001, and some values exceeded 100%, indicating that vertical inequity had a large influence on causing total health financing inequity. The headcount of catastrophic health payment declined sharply between 2009 and 2013, using total expenditure (from 7.3% to 1.2%) or non-food expenditure (from 26.1% to 7.5%) as the indicator of household capacity to pay. Our study

  15. Child Health and Nutrition: Getting better and facing new challenges in China

    Directory of Open Access Journals (Sweden)

    Shougang Wei

    2011-03-01

    Full Text Available BackgroundChild healthcare practices in China over the last 60 yearshave extensively improved children’s health and growth, yetnew challenges lie ahead. This review aims to summarisethe successful experiences and the newly identifiedproblems in child healthcare in China.MethodInformation, available to the public, was obtained fromChinese databases and Chinese Government websites,chiefly the Chinese National Knowledge Infrastructuredatabase, the Chinese Biomedical Literature database, theMinistry of Health website and the National WorkingCommittee on Children and Women website.ResultsDuring its poverty-stricken 1950s–1970s, China protectedchildren’s health mainly through prevention and control ofcommon infectious diseases and severe malnutrition withina comprehensive healthcare system. After the subsequent30 years of rapid socio-economic development, China hasachieved great success in reducing childhood mortality ratesand promoting child growth, meeting the MillenniumDevelopment Goal 4 targets and the WHO child growthstandards. Meanwhile, new challenges for children’shealthcare emerged, including: large disparities in thehealth, growth and nutritional status of children, and in theaccessibility and quality of child healthcare, between urbanand rural areas and across different regions of China; thenutritional and healthcare concerns of the fast-expandingpopulation of migrant children and rural left-behindchildren; the burgeoning epidemic of childhood obesity inurban and economically developed areas; micronutrientdeficiencies such as calcium, iron, zinc and vitamin A; andincreasing prevalence of mental and behavioural disorders.ConclusionUnder poor economic conditions, healthcare plays a keyrole in protecting children against diseases. With thedevelopment of social economy, new challenges present tohealthcare services, specifically, to comprehensivelypromote and optimise childrens’ health and nutrition.

  16. Social Stigma, Social Capital Reconstruction and Rural Migrants in Urban China: A Population Health Perspective.

    Science.gov (United States)

    Chen, Xinguang; Stanton, Bonita; Kaljee, Linda M; Fang, Xiaoyi; Xiong, Qing; Lin, Danhua; Zhang, Liying; Li, Xiaoming

    2011-01-01

    In this study, we examine migrant stigma and its effect on social capital reconstruction among rural migrants who possess legal rural residence but live and work in urban China. After a review of the concepts of stigma and social capital, we report data collected through in-depth interviews with 40 rural migrant workers and 38 urban residents recruited from Beijing, China. Findings from this study indicate that social stigma against rural migrants is common in urban China and is reinforced through media, social institutions and their representatives, and day-to-day interactions. As an important part of discrimination, stigma against migrant workers creates inequality, undermines trust, and reduces opportunities for interpersonal interactions between migrants and urban residents. Through these social processes, social stigma interferes with the reconstruction of social capital (including bonding, bridging and linking social capital) for individual rural migrants as well as for their communities. The interaction between stigma and social capital reconstruction may present as a mechanism by which migration leads to negative health consequences. Results from this study underscore the need for taking measures against migrant stigma and alternatively work toward social capital reconstruction for health promotion and disease prevention among this population.

  17. Resilience associated with mental health problems among methadone maintenance treatment patients in Guangzhou, China.

    Science.gov (United States)

    Jiao, Mingxu; Gu, Jing; Xu, Huifang; Hao, Chun; Lau, Joseph T F; Mo, Phoenix; Liu, Di; Zhao, Yuteng; Zhang, Xiao; Babbitt, Andrew; Hao, Yuantao

    2017-05-01

    A considerable proportion of methadone maintenance treatment (MMT) clients have experienced mental health problems (e.g., depression and anxiety), and poor mental health status is associated with HIV-related risk behaviors and treatment drop-out. Resilience is known to be a protective factor for mental health problems but is not studied among MMT clients in China. This study aimed to explore the relationship between resilience and mental health problems (depression, anxiety and stress) among clients of community-based MMT clinics in China. A total of 208 MMT clients completed the face-to-face interview conducted at 4 of 11 MMT clinics in Guangzhou. The Chinese short version of Depression Anxiety Stress Scale (DASS-21) was used to assess the presence of depressive, anxiety and stress symptoms, and the Connor-Davidson Resilience Scale (CD-RISC) was used to measure resilience. Logistic regression models were fit in data analyses. Of all participants, 12.8%, 19.5% and 8.3% had depression, anxiety and stress, respectively. The mean resilience score was 57.6 (SD = 15.9). In the univariate analyses, resilience was negatively associated with two studied mental health problems (depression and anxiety, OR u  = 0.96 and 0.96, p mental health problems of MMT users should consider resilience as an important part in the designing of such interventions.

  18. Contamination features and health risk of soil heavy metals in China

    International Nuclear Information System (INIS)

    Chen, Haiyang; Teng, Yanguo; Lu, Sijin; Wang, Yeyao; Wang, Jinsheng

    2015-01-01

    China faces a big challenge of environmental deterioration amid its rapid economic development. To comprehensively identify the contamination characteristics of heavy metals in Chinese soils on a national scale, data set of the first national soil pollution survey was employed to evaluate the pollution levels using several pollution indicators (pollution index, geoaccumulation index and enrichment factor) and to quantify their exposure risks posed to human health with the risk assessment model recommended by the US Environmental Protection Agency. The results showed that, due to the drastically increased industrial operations and fast urban expansion, Chinese soils were contaminated by heavy metals in varying degrees. As a whole, the exposure risk levels of soil metals in China were tolerable or close to acceptable. Comparatively speaking, children and adult females were the relatively vulnerable populations for the non-carcinogenic and carcinogenic risks, respectively. Cadmium and mercury have been identified as the priority control metals due to their higher concentrations in soils or higher health risks posed to the public, as well as, arsenic, lead, chromium and nickel. Spatial distribution pattern analysis implied that the soil metal pollutions in southern provinces of China were relatively higher than that in other provinces, which would be related to the higher geochemical background in southwest regions and the increasing human activities in southeast areas. Meanwhile, it should be noticed that Beijing, the capital of China, also has been labeled as the priority control province for its higher mercury concentration. These results will provide basic information for the improvement of soil environment management and heavy metal pollution prevention and control in China. - Highlights: • Soil contamination with heavy metals in China was systematically studied. • Spatial distribution patterns of heavy metals in Chinese soils were identified. • Monte

  19. Contamination features and health risk of soil heavy metals in China

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Haiyang [Engineering Research Center of Groundwater Pollution Control and Remediation, Ministry of Education, Beijing 100875 (China); College of Water Sciences, Beijing Normal University, Beijing 100875 (China); Teng, Yanguo, E-mail: Teng1974@163.com [Engineering Research Center of Groundwater Pollution Control and Remediation, Ministry of Education, Beijing 100875 (China); College of Water Sciences, Beijing Normal University, Beijing 100875 (China); Lu, Sijin; Wang, Yeyao [China National Environmental Monitoring Center, Beijing 100012 (China); Wang, Jinsheng [Engineering Research Center of Groundwater Pollution Control and Remediation, Ministry of Education, Beijing 100875 (China); College of Water Sciences, Beijing Normal University, Beijing 100875 (China)

    2015-04-15

    China faces a big challenge of environmental deterioration amid its rapid economic development. To comprehensively identify the contamination characteristics of heavy metals in Chinese soils on a national scale, data set of the first national soil pollution survey was employed to evaluate the pollution levels using several pollution indicators (pollution index, geoaccumulation index and enrichment factor) and to quantify their exposure risks posed to human health with the risk assessment model recommended by the US Environmental Protection Agency. The results showed that, due to the drastically increased industrial operations and fast urban expansion, Chinese soils were contaminated by heavy metals in varying degrees. As a whole, the exposure risk levels of soil metals in China were tolerable or close to acceptable. Comparatively speaking, children and adult females were the relatively vulnerable populations for the non-carcinogenic and carcinogenic risks, respectively. Cadmium and mercury have been identified as the priority control metals due to their higher concentrations in soils or higher health risks posed to the public, as well as, arsenic, lead, chromium and nickel. Spatial distribution pattern analysis implied that the soil metal pollutions in southern provinces of China were relatively higher than that in other provinces, which would be related to the higher geochemical background in southwest regions and the increasing human activities in southeast areas. Meanwhile, it should be noticed that Beijing, the capital of China, also has been labeled as the priority control province for its higher mercury concentration. These results will provide basic information for the improvement of soil environment management and heavy metal pollution prevention and control in China. - Highlights: • Soil contamination with heavy metals in China was systematically studied. • Spatial distribution patterns of heavy metals in Chinese soils were identified. • Monte

  20. The impact of the government health funding on prescribing behaviors in community health institutions in China.

    Science.gov (United States)

    Sun, Gang; Lu, Zuxun; Gan, Yong; Dong, Xiaoxin; Li, Yongbin; Wang, Yunxia; Li, Liqing

    2017-11-01

    Government health funding (GHF) is a cosmopolitan problem. It is especially conspicuous in China, where drug sales become a main source of medical institutions' incomes due to limited GHF. This is well known as China's "drug maintain medical institutions (DMMIs)" system which results directly in very high use of antibiotics, injections, and corticosteroids. However, few statistical data existed in China on the association between the GHF and the prevalence of inappropriate drug prescribing, despite widespread acknowledgment of its existence.A multistage sampling strategy was employed to select 442,100 prescriptions written between 2007 and 2011 by urban community health (CH) institutions and check the GHF in 36 key cities (districts) across China. This study examined the association between the GHF and the prevalence of inappropriate drug prescribing, which differs somewhat from previous studies.The data suggested that from 2007 to 2011, with the increase of GHF, prescribing behaviors (PB) gradually improved on the whole although doctors still prescribed a few more drugs than the recommendations from World Health Organization (WHO). This study found that there is significant negative association between GHF and main indicators of PB (correlation coefficients more than 0.5).The findings implied that government should further perfect the compensation mechanism to medical institutions for gradually weakening the compensation function of drug sales in medical institutions.

  1. Rural Health in the People's Republic of China; Report of a Visit by the Rural Health Systems Delegation, June 1978.

    Science.gov (United States)

    Public Health Service (DHHS), Rockville, MD.

    A 28-day visit to the People's Republic of China during June and July 1978 by the Rural Health Systems Delegation from the United States, sponsored by the Committee on Scholarly Communication with the People's Republic of China, resulted in an exchange of information about rural health policy and planning. Specific areas of emphasis included:…

  2. Involuntary detention and treatment of the mentally ill: China's 2012 Mental Health Law.

    Science.gov (United States)

    Ding, Chunyan

    2014-01-01

    The long-awaited Mental Health Law of China was passed on 26 October 2012 and took effect on 1 May 2013. Being the first national legislation on mental health, it establishes a basic legal framework to regulate mental health practice and recognizes the fundamental rights of persons with mental disorders. This article focuses on the system of involuntary detention and treatment of the mentally ill under the new law, which is expected to prevent the so-called "Being misidentified as mentally disordered" cases in China. A systematic examination of the new system demonstrates that the Mental Health Law of China implicitly holds two problematic assumptions and does not provide adequate protection of the fundamental rights of the involuntary patients. Administrative enactments and further national legislative efforts are needed to remedy these flaws in the new law. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. A discussion of occupational health and safety management for the catering industry in China.

    Science.gov (United States)

    Qiang, Chen; Chow, Wan Ki

    2007-01-01

    The catering industry is developing rapidly in China. Statistics in 2002 indicated that there were over 3.5 million dining places in China, hiring over 18 million people. However, the accident rate was high. Occupational health and safety (OHS) has to be watched more carefully. It is proposed to develop an OHS management system for the catering industry and to integrate it with an ongoing management system by referring to OHSAS 18001:1999. The first step is risk identification and evaluating the major factors concerned by referring to the codes in China, the list of occupational diseases, operation rules, requirements of the law, and records of past incidents. The technological aspect has to be considered in working out the safety strategies. This includes technical measures in accident prevention at the workplace. The kitchen is the main area to be focused on. Methods for hazard identification and risk assessment of dangerous factors in kitchens are proposed in this paper.

  4. Evaluation of socio-economic inequalities in the use of maternal health services in rural western China.

    Science.gov (United States)

    Li, C; Zeng, L; Dibley, M J; Wang, D; Pei, L; Yan, H

    2015-09-01

    To describe the use of maternal health services according to the standards of the Chinese Ministry of Health, and assess socio-economic inequalities in usage in rural Shaanxi province, western China. Cross-sectional survey. Principal components analysis was used to measure the economic status of households. A concentration index (CI) approach was used as a measure of socio-economic inequalities in the use of maternal health services, and a decomposable CI was used to identify the factors that contributed to the socio-economic inequalities in usage. In total, 4760 women who had given birth in the preceding three years were selected at random to be interviewed in the five counties. Household wealth index was calculated by constructing a linear index from asset ownership indicators using principal components analysis to derive weights. The CI approach is a standard measure in the analysis of inequalities in health. If the CI for the use of maternal health services is positive, it is pro-rich; if it is negative, it is pro-poor. The decomposition method was used to estimate the contributions of individual factors to CI. The overall CI for five or more prenatal visits was 0.075. The household wealth index was found to make the greatest contribution to socio-economic inequalities for five or more prenatal visits (35.5%), followed by maternal education (28.8%), receipt of a health handbook during pregnancy (12.1%), age group (11.0%), distance from health facility (10.5%), family members (1.5%) and district of residence (0.6%). Socio-economic inequalities in the use of prenatal health services were pro-rich in rural western China. Socio-economic inequalities in hospital delivery and postnatal health check-ups were not evident. Improving household economic status, providing prenatal health services for women with low income and low educational level, providing health handbooks and improving traffic conditions should be promoted as methods to eliminate socio

  5. Health in China and India: a cross-country comparison in a context of rapid globalisation.

    Science.gov (United States)

    Dummer, Trevor J B; Cook, Ian G

    2008-08-01

    China and India are similarly huge nations currently experiencing rapid economic growth, urbanisation and widening inequalities between rich and poor. They are dissimilar in terms of their political regimes, policies for population growth and ethnic composition and heterogeneity. This review compares health and health care in China and India within the framework of the epidemiological transition model and against the backdrop of globalisation. We identify similarities and differences in health situation. In general, for both countries, infectious diseases of the past sit alongside emerging infectious diseases and chronic illnesses associated with ageing societies, although the burden of infectious diseases is much higher in India. Whilst globalisation contributes to widening inequalities in health and health care in both countries--particularly with respect to increasing disparities between urban and rural areas and between rich and poor--there is evidence that local circumstances are important, especially with respect to the structure and financing of health care and the implementation of health policy. For example, India has huge problems providing even rudimentary health care to its large population of urban slum dwellers whilst China is struggling to re-establish universal rural health insurance. In terms of funding access to health care, the Chinese state has traditionally supported most costs, whereas private insurance has always played a major role in India, although recent changes in China have seen the burgeoning of private health care payments. China has, arguably, had more success than India in improving population health, although recent reforms have severely impacted upon the ability of the Chinese health care system to operate effectively. Both countries are experiencing a decline in the amount of government funding for health care and this is a major issue that must be addressed.

  6. Cultural values and health service quality in China.

    Science.gov (United States)

    Polsa, Pia; Fuxiang, Wei; Sääksjärvi, Maria; Shuyuan, Pei

    2013-01-01

    Several service quality studies show how cultural features may influence the way service quality is perceived. However, few studies specifically describe culture's influence on health service quality. Also, there are few studies that take into account patients' health service quality perceptions. This article seeks to present a first step to fill these gaps by examining patients' cultural values and their health service quality assessments. The study draws on published work and applies its ideas to Chinese healthcare settings. Data consist of hospital service perceptions in the People's Republic of China (PRC), a society that is socially, economically and culturally undergoing major changes. In total, 96 patients were surveyed. Data relationships were tested using partial least square (PLS) analysis. Findings show that Chinese patients' cultural values and their health service assessments are related and that the cultural values themselves seem to be changing. Additionally, further analyses provided interesting results pointing to which cultural values influenced service quality perceptions. The strongest service quality predictor was power distance. The sample is relatively small and collected from only one major hospital in China. Therefore, future research should extend the sample size and scope. Follow-up research could also include cross-cultural investigations of perceived health service quality to substantiate cultural influences on health service quality perceptions. In line with similar research in other contexts, the study confirms that power distance has a significant relationship with service quality perceptions. The study contributes to existing health service literature by offering patients' views on health service quality and by describing relationships between health service perceptions and cultural values--the study's main contribution.

  7. Progress and challenges of disaster health management in China: a scoping review.

    Science.gov (United States)

    Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

    2014-01-01

    Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level).

  8. Income-related inequality in health insurance coverage: analysis of China Health and Nutrition Survey of 2006 and 2009.

    Science.gov (United States)

    Liu, Jinan; Shi, Lizheng; Meng, Qingyue; Khan, M Mahmud

    2012-08-14

    China introduced the urban resident basic medical insurance (URBMI) in 2007 to cover children and urban unemployed adults, in addition to the new cooperative medical scheme (NCMS) for rural residents in 2003 and the basic health insurance scheme (BHIS) for urban employees in 1998. This study examined whether the overall income-related inequality in health insurance coverage improved during 2006 and 2009 in China. The China Health and Nutrition Survey (CHNS) data of 2006 and 2009 were used to create the concentration curve and the concentration index. GEE logistic regression was used to model the health insurance coverage as dependent variable and household income per capita as independent variable, controlling for individuals' age, gender, marital status, educational attainment, employment status, year 2009 (Y2009), household size, retirement status, and geographic variations. The change in the income-related inequality in 2009 was estimated using the interaction term of income*Y2009. In 2006, 49.7% (4,712/9,476) respondents had health insurance: 13.4% with BHIS and 28.4% with NCMS. In 2009, 90.8% (8,964/9,863) had health insurance: 10.1% with URBMI, 18.3% with BHIS, and 57.6% with NCMS. The BHIS, URBMI, and NCMS programs had different patterns of population coverage over 10 income deciles. The concentration index was 0.15 in 2006 and 0.04 in 2009. The dominance test showed that the concentration curves were significantly different between 2006 and 2009 (p China through rapid expansion of CHNS in rural areas and initiation of URBMI in urban areas.

  9. Geographic variation in health insurance benefit in Qianjiang District, China

    OpenAIRE

    Ye, Ting; Wu, Yue; Zhang, Liang

    2017-01-01

    Background: Health insurance coverage is of great importance; yet, it is unclear whether there is some geographic variation in health insurance benefit for urban and rural patients covered by a same basic health insurance, especially in China.Objective: To identify the potential geographic variation in health insurance benefit and its possible socioeconomic and geographical factors at the town level.Methods: All the beneficiaries underthe health insurance who had the in-hospital experience in...

  10. Necessity and feasibility of improving mental health services in China: A systematic qualitative review.

    Science.gov (United States)

    Zhao, Xudong; Liu, Liang; Hu, Chengping; Chen, Fazhan; Sun, Xirong

    2017-07-01

    It has been nearly 40 years since the reform and opening up of Mainland China. The mental health services system has developed rapidly as a part of the profound socioeconomic changes that ensued. However, its development has not been as substantial as other areas of medical care. For the current qualitative systematic review, we searched databases, including China Biology Medicine disc, Weipu, China National Knowledge Infrastructure, Wanfang digital periodical full text data, China's important newspaper full text database, China Statistical Yearbook database, etc. The content of primary research, literature, and policy papers about the evolution and development of Chinese mental health services was systemically reviewed and analysed by using thematic analysis. Two main themes relative to the necessity and feasibility of reforming the current mental health services system emerged. We discuss 5 corresponding subthemes under the umbrella of the necessity of improving the current treatment, rehabilitation, prevention, and service systems and 7 requirements for the feasibility of reforming the current system. We conclude that as the development of the Chinese economy and the spirit of humanistic care continue, the improvement and reformation of the mental health services system are both necessary and feasible. Copyright © 2017 John Wiley & Sons, Ltd.

  11. Income-related inequality in health insurance coverage: analysis of China Health and Nutrition Survey of 2006 and 2009

    Directory of Open Access Journals (Sweden)

    Liu Jinan

    2012-08-01

    Full Text Available Abstract Introduction China introduced the urban resident basic medical insurance (URBMI in 2007 to cover children and urban unemployed adults, in addition to the new cooperative medical scheme (NCMS for rural residents in 2003 and the basic health insurance scheme (BHIS for urban employees in 1998. This study examined whether the overall income-related inequality in health insurance coverage improved during 2006 and 2009 in China. Methods The China Health and Nutrition Survey (CHNS data of 2006 and 2009 were used to create the concentration curve and the concentration index. GEE logistic regression was used to model the health insurance coverage as dependent variable and household income per capita as independent variable, controlling for individuals' age, gender, marital status, educational attainment, employment status, year 2009 (Y2009, household size, retirement status, and geographic variations. The change in the income-related inequality in 2009 was estimated using the interaction term of income*Y2009. Results In 2006, 49.7% (4,712/9,476 respondents had health insurance: 13.4% with BHIS and 28.4% with NCMS. In 2009, 90.8% (8,964/9,863 had health insurance: 10.1% with URBMI, 18.3% with BHIS, and 57.6% with NCMS. The BHIS, URBMI, and NCMS programs had different patterns of population coverage over 10 income deciles. The concentration index was 0.15 in 2006 and 0.04 in 2009. The dominance test showed that the concentration curves were significantly different between 2006 and 2009 (p  Discussions Comparing 2009 to 2006, the income inequality in health insurance coverage was largely corrected in China through rapid expansion of CHNS in rural areas and initiation of URBMI in urban areas.

  12. Competing Forces of Socioeconomic Development and Environmental Degradation on Health and Happiness for Different Income Groups in China.

    Science.gov (United States)

    Gu, Lijuan; Rosenberg, Mark W; Zeng, Juxin

    2017-10-01

    China's rapid socioeconomic growth in recent years and the simultaneous increase in many forms of pollution are generating contradictory pictures of residents' well-being. This paper applies multilevel analysis to the 2013 China General Social Survey data on social development and health to understand this twofold phenomenon. Multilevel models are developed to investigate the impact of socioeconomic development and environmental degradation on self-reported health (SRH) and self-reported happiness (SRHP), differentiating among lower, middle, and higher income groups. The results of the logit multilevel analysis demonstrate that income, jobs, and education increased the likelihood of rating SRH and SRHP positively for the lower and middle groups but had little or no effect on the higher income group. Having basic health insurance had an insignificant effect on health but increased the likelihood of happiness among the lower income group. Provincial-level pollutants were associated with a higher likelihood of good health for all income groups, and community-level industrial pollutants increased the likelihood of good health for the lower and middle income groups. Measures of community-level pollution were robust predictors of the likelihood of unhappiness among the lower and middle income groups. Environmental hazards had a mediating effect on the relationship between socioeconomic development and health, and socioeconomic development strengthened the association between environmental hazards and happiness. These outcomes indicate that the complex interconnections among socioeconomic development and environmental degradation have differential effects on well-being among different income groups in China.

  13. Health inequalities during 20 years of rapid economic development in China (1980-2000): a mortality analysis.

    Science.gov (United States)

    Zheng, XiaoYing; Song, XinMing; Chen, Gong; You, YunZhong; Ren, Qiang; Liu, JuFen; Zhang, Lei; Tan, LingFang; Wei, JiHong; Chen, QiuYuan

    2011-08-01

    To examine the influence of China's economic reforms on population health and regional mortality rates. Longitudinal study measuring the mortality trends and their regional variations. Using data from the three most recent national censuses, we used the model life table to adjust the mortality levels within the population for each census, and to calculate life expectancy. We then examined the variation in patterns of mortality and population health by economic status, region and gender from 1980-2000. Life expectancy varied with economic status, province, and gender. Results showed that, although life expectancy in China had increased overall since the early 1980s, regional differences became more pronounced. Life expectancy for populations who live in the eastern coastal provinces are greater than those in the western regions. Differences in life expectancy are primarily related to differences in regional economic development, which in turn exacerbate regional health inequalities. Therefore, it is necessary to improve economic development in less developed regions and to improve health policies and the public health system that address the needs of everyone. Copyright © 2011 The Editorial Board of Biomedical and Environmental Sciences. Published by Elsevier B.V. All rights reserved.

  14. Investigation of health care waste management in Binzhou District, China

    International Nuclear Information System (INIS)

    Ruoyan, Gai; Xu Lingzhong; Li Huijuan; Zhou Chengchao; He Jiangjiang; Yoshihisa, Shirayama; Tang Wei; Chushi, Kuroiwa

    2010-01-01

    In China, national regulations and standards for health care waste management were implemented in 2003. To investigate the current status of health care waste management at different levels of health care facilities (HCF) after the implementation of these regulations, one tertiary hospital, one secondary hospital, and four primary health care centers from Binzhou District were visited and 145 medical staff members and 24 cleaning personnel were interviewed. Generated medical waste totaled 1.22, 0.77, and 1.17 kg/bed/day in tertiary, secondary, and primary HCF, respectively. The amount of medical waste generated in primary health care centers was much higher than that in secondary hospitals, which may be attributed to general waste being mixed with medical waste. This study found that the level of the HCF, responsibility for medical waste management in departments and wards, educational background and training experience can be factors that determine medical staff members' knowledge of health care waste management policy. Regular training programs and sufficient provision of protective measures are urgently needed to improve occupational safety for cleaning personnel. Financing and administrative monitoring by local authorities is needed to improve handling practices and the implementation of off-site centralized disposal in primary health care centers.

  15. Transport and public health in China: the road to a healthy future

    Science.gov (United States)

    Jiang, Baoguo; Liang, Song; Peng, Zhong-Ren; Cong, Haozhe; Levy, Morgan; Cheng, Qu; Wang, Tianbing; Remais, Justin

    2017-01-01

    Transportation-related risk factors are a major source of morbidity and mortality in China, where expansion of road networks and surges in personal vehicle ownership are having profound effects on public health. Road traffic injuries and fatalities have increased alongside motorized transport in China, and accident injury risk is aggravated by inadequate emergency response systems and trauma care. National air quality standards and emission control technologies are having a positive effect, yet persistent air pollution is increasingly attributable to a growing and outdated vehicle fleet, and famously congested roads. Urban design favors motorized transport, and physical activity and its associated health benefits are hindered by poor urban infrastructure. Transport emissions of greenhouse gases contribute substantially to regional and global climate change, which compound public health risks from multiple factors. Despite these complex challenges, technological advances and innovations in planning and policy stand to make China a leader in sustainable, healthy transportation. PMID:29047445

  16. The effect of comprehensive sexual education program on sexual health knowledge and sexual attitude among college students in Southwest China.

    Science.gov (United States)

    Chi, Xinli; Hawk, Skyler T; Winter, Sam; Meeus, Wim

    2015-03-01

    The purpose of this study was to evaluate whether a comprehensive sexual education program for college students in Southwest China (a) improved sexual health knowledge in reproduction, contraception, condom use, sexually transmitted diseases, and HIV; (b) increased accepting attitudes toward lesbian, gay, bisexual, and transsexual individuals; and (c) altered participants' attitudes toward premarital sex and monogamy. The program used diverse teaching methods, providing 6 sessions over a period of 9 weeks about sexual health knowledge and sexual attitudes to college students (age 18-26 years) in Southwest China. Sexual health knowledge and sexual attitudes of 80 comprehensive sexual education class students (education group) and 92 general mental health education class students (control group) were measured at baseline, the end of course (posttest), and 3 weeks after the end of course (follow-up). There were significant effects of the program on (a) sexual health knowledge, including reproductive health, contraception, condom use, and HIV/AIDS and (b) positive attitudes toward sexual minorities, although these changes may require further reinforcement. In contrast, the program did not alter students' attitudes about premarital sex or monogamy. The results are discussed in terms of recommendations of sex education in China and future directions for research. © 2013 APJPH.

  17. Potential Impacts of Future Climate Change on Regional Air Quality and Public Health over China

    Science.gov (United States)

    Hong, C.; Zhang, Q.; Zhang, Y.; He, K.

    2017-12-01

    Future climate change would affect public health through changing air quality. Climate extremes and poor weather conditions are likely to occur at a higher frequency in China under a changing climate, but the air pollution-related health impacts due to future climate change remain unclear. Here the potential impacts of future climate change on regional air quality and public health over China is projected using a coupling of climate, air quality and epidemiological models. We present the first assessment of China's future air quality in a changing climate under the Representative Concentration Pathway 4.5 (RCP4.5) scenario using the dynamical downscaling technique. In RCP4.5 scenario, we estimate that climate change from 2006-2010 to 2046-2050 is likely to adversely affect air quality covering more than 86% of population and 55% of land area in China, causing an average increase of 3% in O3 and PM2.5 concentrations, which are found to be associated with the warmer climate and the more stable atmosphere. Our estimate of air pollution-related mortality due to climate change in 2050 is 26,000 people per year in China. Of which, the PM2.5-related mortality is 18,700 people per year, and the O3-related mortality is 7,300 people per year. The climate-induced air pollution and health impacts vary spatially. The climate impacts are even more pronounced on the urban areas where is densely populated and polluted. 90% of the health loss is concentrated in 20% of land areas in China. We use a simple statistical analysis method to quantify the contributions of climate extremes and find more intense climate extremes play an important role in climate-induced air pollution-related health impacts. Our results indicate that global climate change will likely alter the level of pollutant management required to meet future air quality targets as well as the efforts to protect public health in China.

  18. Groundwater arsenic contamination throughout China.

    Science.gov (United States)

    Rodríguez-Lado, Luis; Sun, Guifan; Berg, Michael; Zhang, Qiang; Xue, Hanbin; Zheng, Quanmei; Johnson, C Annette

    2013-08-23

    Arsenic-contaminated groundwater used for drinking in China is a health threat that was first recognized in the 1960s. However, because of the sheer size of the country, millions of groundwater wells remain to be tested in order to determine the magnitude of the problem. We developed a statistical risk model that classifies safe and unsafe areas with respect to geogenic arsenic contamination in China, using the threshold of 10 micrograms per liter, the World Health Organization guideline and current Chinese standard for drinking water. We estimate that 19.6 million people are at risk of being affected by the consumption of arsenic-contaminated groundwater. Although the results must be confirmed with additional field measurements, our risk model identifies numerous arsenic-affected areas and highlights the potential magnitude of this health threat in China.

  19. A Comparison of the Health Systems in China and India

    Science.gov (United States)

    2008-01-01

    to convey health messages is controversial (Sharma, 2005). Folk media (i.e., puppets, drama , storytelling, and music) and visual media (i.e...Novel Therapy for China: HMOs,” Los Angeles Times, June 25, 2006, C1. Lewis, M., “Informal Payments and the Financing of Health Care in Developing and

  20. Protocol for a nationwide survey of primary health care in China: the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) MPP (Million Persons Project) Primary Health Care Survey.

    Science.gov (United States)

    Su, Meng; Zhang, Qiuli; Lu, Jiapeng; Li, Xi; Tian, Na; Wang, Yun; Yip, Winnie; Cheng, Kar Keung; Mensah, George A; Horwitz, Ralph I; Mossialos, Elias; Krumholz, Harlan M; Jiang, Lixin

    2017-08-28

    China has pioneered advances in primary health care (PHC) and public health for a large and diverse population. To date, the current state of PHC in China has not been subjected to systematic assessments. Understanding variations in primary care services could generate opportunities for improving the structure and function of PHC. This paper describes a nationwide PHC study (PEACE MPP Primary Health Care Survey) conducted across 31 provinces in China. The study leverages an ongoing research project, the China Patient-centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project (MPP). It employs an observational design with document acquisition and abstraction and in-person interviews. The study will collect data and original documents on the structure and financing of PHC institutions and the adequacy of the essential medicines programme; the education, training and retention of the PHC workforce; the quality of care; and patient satisfaction with care. The study will provide a comprehensive assessment of current PHC services and help determine gaps in access and quality of care. All study instruments and documents will be deposited in the Document Bank as an open-access source for other researchers. The central ethics committee at the China National Centre for Cardiovascular Disease (NCCD) approved the study. Written informed consent has been obtained from all patients. Findings will be disseminated in future peer reviewed papers, and will inform strategies aimed at improving the PHC in China. NCT02953926. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Mobile LiDAR Measurement for Aerosol Investigation in South-Central Hebei, China

    Science.gov (United States)

    qin, kai; Wu, Lixin; Zheng, Yunhui; Wong Man, Sing; Wang, Runfeng; Hu, Mingyu; Lang, Hongmei; Wang, Luyao; Bai, Yang; Rao, Lanlan

    2016-04-01

    With the rapid industrialization and urbanization in China during the last decades, the increasing anthropogenic pollutant emissions have significantly caused serious air pollution problems which are adversely influencing public health. Hebei is one of the most air polluted provinces in China. In January 2013, an extremely severe and persistent haze episode with record-breaking PM2.5 outbreak affecting hundreds of millions of people occurred over eastern and northern China. During that haze episode, 7 of the top 10 most polluted cities in China were located in the Hebei Province according to the report of China's Ministry of Environmental Protection. To investigate and the spatial difference and to characterize the vertical distribution of aerosol in different regions of south-central Hebei, mobile measurements were carried out using a mini micro pulse LiDAR system (model: MiniMPL) in March 2014. The mobile LiDAR kit consisting of a MiniMPL, a vibration reduction mount, a power inverter, a Windows surface tablet and a GPS receiver were mounted in a car watching though the sunroof opening. For comparison, a fixed measurement using a traditional micro pulse LiDAR system (model: MPL-4B) was conducted simultaneously in Shijiazhuang, the capital of Hebei Province. The equipped car was driven from downtown Shijiazhuang by way of suburban and rural area to downtown Cangzhou, Handan, and Baoding respectively at almost stable speed around 100Km per hour along different routes which counted in total more than 1000Km. The results can be summarized as: 1) the spatial distribution of total aerosol optical depth along the measurement routes in south-central Hebei was controlled by local terrain and population in general, with high values in downtown and suburban in the plain areas, and low values in rural areas along Taihang mountain to the west and Yan mountain to the north; 2) obviously high AODs were obtained at roads crossing points, inside densely populated area and nearby

  2. Malaria training for community health workers in the setting of elimination: a qualitative study from China.

    Science.gov (United States)

    Lu, Guangyu; Liu, Yaobao; Wang, Jinsong; Li, Xiangming; Liu, Xing; Beiersmann, Claudia; Feng, Yu; Cao, Jun; Müller, Olaf

    2018-02-23

    Continuous training of health workers is a key intervention to maintain their good performance and keep their vigilance during malaria elimination programmes. However, countries progressing toward malaria elimination have a largely decreased malaria disease burden, less frequent exposure of health workers to malaria patients, and new challenges in the epidemiology of the remaining malaria cases. Moreover, competing health priorities and usually a decline in resources and in political commitment also pose challenges to the elimination programme. As a consequence, the acceptability, sustainability, and impact of malaria training and education programmes face challenges. However, little is known of the perceptions and expectations of malaria training and education programmes of health workers being engaged in countries with malaria elimination programmes. This qualitative study provides information on perceptions and expectations of health workers of malaria training programmes from China, which aims to malaria elimination by the year 2020. This study was embedded into a larger study on the challenges and lessons learned during the malaria surveillance strategy in China, involving 42 interviews with malaria experts, health staff, laboratory practitioners, and village doctors at the provincial, city, county, township, and village levels from Gansu province (northwestern China) and Jiangsu province (southeastern China). In the context of an increasing number of imported malaria cases in China, the majority of respondents emphasized the necessity and importance of such programmes and complained about a decreasing frequency of training courses. Moreover, they called for innovative strategies to improve the implementation and sustainability of the malaria training programmes until the elimination goal has been achieved. Perceptions and expectations of health workers from different health centres were quite different. Health workers from higher-level facilities were more

  3. Perspective for Future Research Direction About Health Impact of Ambient Air Pollution in China.

    Science.gov (United States)

    Dong, Guang-Hui

    2017-01-01

    Air pollution has become one of the major risks to human health because of the progressive increase in the use of vehicles powered by fossil fuels. Although lots of works on the health impact of ambient air pollution have been done in China, the following recommendations for future research were identified in this chapter: (1) the synergistic effect of indoor air pollution with climate change; (2) develop new technologies to improve accurate assessment of air pollution exposure; (3) well-designed cohort study of sensitive populations including children, older people, and people with chronic health problems; (4) multi-omics technologies in the underlying mechanisms study; and (5) benefits evaluation of improvement of air quality. In conclusion, China is becoming a suitable study site, providing an ideal opportunity to evaluate the effects of environmental pollution, including air pollution, on human health, which might serve as an example for developing countries where health impacts of air pollution are as serious as in China.

  4. Explaining public satisfaction with health-care systems: findings from a nationwide survey in China.

    Science.gov (United States)

    Munro, Neil; Duckett, Jane

    2016-06-01

    To identify factors associated with health-care system satisfaction in China. Recent research suggests that socio-demographic characteristics, self-reported health, income and insurance, ideological beliefs, health-care utilization, media use and perceptions of services may affect health-care system satisfaction, but the relative importance of these factors is poorly understood. New data from China offer the opportunity to test theories about the sources of health-care system satisfaction. Stratified nationwide survey sample analysed using multilevel logistic regression. 3680 Chinese adults residing in family dwellings between 1 November 2012 and 17 January 2013. Satisfaction with the way the health-care system in China is run. We find only weak associations between satisfaction and socio-demographic characteristics, self-reported health and income. We do, however, find that satisfaction is strongly associated with having insurance and belief in personal responsibility for meeting health-care costs. We also find it is negatively associated with utilization, social media use, perceptions of access as unequal and perceptions of service providers as unethical. To improve satisfaction, Chinese policymakers - and their counterparts in countries with similar health-care system characteristics - should improve insurance coverage and the quality of health services, and tackle unethical medical practices. © 2015 The Authors. Health Expectations published by John Wiley & Sons Ltd.

  5. Universal health insurance coverage for 1.3 billion people: What accounts for China's success?

    Science.gov (United States)

    Yu, Hao

    2015-09-01

    China successfully achieved universal health insurance coverage in 2011, representing the largest expansion of insurance coverage in human history. While the achievement is widely recognized, it is still largely unexplored why China was able to attain it within a short period. This study aims to fill the gap. Through a systematic political and socio-economic analysis, it identifies seven major drivers for China's success, including (1) the SARS outbreak as a wake-up call, (2) strong public support for government intervention in health care, (3) renewed political commitment from top leaders, (4) heavy government subsidies, (5) fiscal capacity backed by China's economic power, (6) financial and political responsibilities delegated to local governments and (7) programmatic implementation strategy. Three of the factors seem to be unique to China (i.e., the SARS outbreak, the delegation, and the programmatic strategy.) while the other factors are commonly found in other countries' insurance expansion experiences. This study also discusses challenges and recommendations for China's health financing, such as reducing financial risk as an immediate task, equalizing benefit across insurance programs as a long-term goal, improving quality by tying provider payment to performance, and controlling costs through coordinated reform initiatives. Finally, it draws lessons for other developing countries. Copyright © 2015 The Author. Published by Elsevier Ireland Ltd.. All rights reserved.

  6. The Digital Divide and Health Disparities in China: Evidence From a National Survey and Policy Implications.

    Science.gov (United States)

    Hong, Y Alicia; Zhou, Zi; Fang, Ya; Shi, Leiyu

    2017-09-11

    The digital divide persists despite broad accessibility of mobile tools. The relationship between the digital divide and health disparities reflects social status in terms of access to resources and health outcomes; however, data on this relationship are limited from developing countries such as China. The aim of this study was to examine the current rates of access to mobile tools (Internet use and mobile phone ownership) among older Chinese individuals (aged ≥45 years), the predictors of access at individual and community levels, and the relationship between access to mobile tools and health outcomes. We drew cross-sectional data from a national representative survey, the China Health and Retirement Longitudinal Study (CHARLS), which focused on the older population (aged ≥45 years). We used two-level mixed logistic regression models, controlling for unobserved heterogeneity at the community and individual levels for data analysis. In addition to individual-level socioeconomic status (SES), we included community-level resources such as neighborhood amenities, health care facilities, and community organizations. Health outcomes were measured by self-reported health and absence of disability based on validated scales. Among the 18,215 participants, 6.51% had used the Internet in the past month, and 83% owned a mobile phone. In the multivariate models, Internet use was strongly associated with SES, rural or urban residence, neighborhood amenities, community resources, and geographic region. Mobile phone ownership was strongly associated with SES and rural/urban residence but not so much with neighborhood amenities and community resources. Internet use was a significant predictor of self-reported health status, and mobile phone ownership was significantly associated with having disability even after controlling for potential confounders at the individual and community levels. This study is one of the first to examine digital divide and its relationship with health

  7. Predictors of women's attitudes toward world health organization framework convention on tobacco control policies in urban China.

    Science.gov (United States)

    Abdullah, Abu Saleh; Yang, Tingzhong; Beard, Jennifer

    2010-05-01

    In 2005 China ratified the WHO Framework Convention on Tobacco Control (FCTC) and committed to implement tobacco control legislation and policies. Wide variation in smoking prevalence between men and women in China and the high exposure of women to secondhand smoke suggest that each component of the FCTC should be analyzed from a gender perspective. This study describes women's attitudes toward and predictors of support for four key FCTC measures in China. Cross-sectional data were collected from 1,408 women in two urban cities on demographics, smoking behavior, and attitudes toward key tobacco control measures. Seventy percent of the study women (n = 1,408) were exposed to secondhand smoke at home, work, or other public places. Support for the four FCTC measures of interest was as follows: 92.5% supported banning smoking in public places, 79.2% supported increasing the cigarette tax, 92% supported stronger health warnings on cigarette packages, and 87.1% favored banning tobacco advertising. The predictors for supporting each of these measures included socioeconomic, attitudinal, and behavioral factors. Urban Chinese women appear to support implementation of key WHO FCTC measures. Predictors of women's attitudes toward the key FCTC measures varied. The formulation process resulting from the tobacco control policy should consider these women-specific predictors in order to facilitate successful implementation of FCTC.

  8. Health-related life satisfaction and its influencing factors: A cross-sectional study in China.

    Science.gov (United States)

    Wang, Shou-Qi; Ying, Jie; Zhang, Mei-Ling; Shi, Ying; Li, Yuan; Xing, Zhuang-Jie; Li, Huan-Huan; Sun, Jiao

    2018-01-24

    With the rapid development of science and technology, the pace of life has accelerated. Health and life satisfaction issues of persons are gaining more attention. China, Japan, Malaysia, and Taiwan conducted international cooperative research on health of four regional populations. This research was a part of the study in mainland China, which aimed to explore health-related life satisfaction and its influencing factors on large samples in mainland China. A random group of 1404 persons from universities, factories, companies, and elderly centers in Changchun completed a structured questionnaire. This study centered on life satisfaction indicators, which included the current whole life, income, family relationships, peer relationships, relationships with the neighbors, living environment, personal health, family health, spare time, and housework share. Other collected data included the Body Mass Index, blood pressure, self-rated health, Breslow's seven health practices, medical treatment within the past 6 months, physical examinations, General Health Questionnaire (GHQ)-12 Scale, social activities, networking relationships with persons around the community, social support, and sociodemographic variables. Associations between life satisfaction, demographics, and health-related variables were analyzed through a multiway ANOVA. The living environment and income of Chinese persons were related to their low life satisfaction. The multiway ANOVA showed that the independent relationship of self-rated health, regular physical examinations, GHQ-12 Scale, trust in the community, communication with the neighbors, education, and age related with life satisfaction accounting for 20.3% of the variance. Education and age showed interactive effects on life satisfaction. This study identified seven factors that influenced the life satisfaction of persons in mainland China. Life satisfaction can be enhanced through interventions to improve self-rated health, regular physical

  9. Health system strengthening and hypertension awareness, treatment and control: data from the China Health and Retirement Longitudinal Study.

    Science.gov (United States)

    Feng, Xing Lin; Pang, Mingfan; Beard, John

    2014-01-01

    To monitor hypertension prevalence, awareness, treatment and control in China two to three years after major reform of the health system. Data from a national survey conducted in 2011-2012 among Chinese people aged 45 years or older - which included detailed anthropometric measurements - were used to estimate the prevalence of hypertension and the percentages of hypertensive individuals who were unaware of, receiving no treatment for, and/or not controlling their hypertension well. Modified Poisson regressions were used to estimate relative risks (RRs). At the time of the survey, nearly 40% of Chinese people aged 45 years or older had a hypertensive disorder. Of the individuals with hypertension, more than 40% were unaware of their condition, about 50% were receiving no medication for it and about 80% were not controlling it well. Compared with the other hypertensive individuals, those who were members of insurance schemes that covered the costs of outpatient care were more likely to be aware of their hypertension (adjusted RR, aRR: 0.737; 95% confidence interval, CI: 0.619-0.878) to be receiving treatment for it (aRR: 0.795; 95% CI: 0.680-0.929) and to be controlling it effectively (aRR: 0.903; 95% CI: 0.817-0.996). In China many cases of hypertension are going undetected and untreated, even though the health system appears to deliver effective care to individuals who are aware of their hypertension. A reduction in the costs of outpatient care to patients would probably improve the management of hypertension in China.

  10. Impacts of Air Pollution on Health in Eastern China: Implications for future air pollution and energy policies

    Science.gov (United States)

    Wang, X.; Mauzerall, D.

    2004-12-01

    Our objective is to establish the link between energy consumption and technologies, air pollution and resulting impacts on public health in eastern China. We quantify the impacts that air pollution in the Shandong region of eastern China has on public health in 2000 and quantify the benefits in improved air quality and health that could be obtained by 2020, relative to business-as-usual, through the implementation of new energy technology. We first develop a highly-resolved emission inventory for the year 2000 for the Shandong region of China including emissions from large point, area, mobile and biogenic sources. We use the Sparse Matrix Operator Kernel Emissions Modeling System (SMOKE) to process emissions from this inventory for use in the Community Multi-scale Air Quality modeling system (CMAQ) which we drive with the NCAR/PSU MM5 meso-scale meteorology model. We evaluate the inventory by comparing CMAQ results with available measurements of PM10 and SO2 from air pollution indices (APIs) reported in various Chinese municipalities during 2002-2004. We use epidemiological dose-response functions to quantify health impacts and values of a statistical life (VSL) and years-of-life-lost (YLL) to establish a range for the monetary value of these impacts. To examine health impacts and their monetary value, we focus explicitly on Zaozhuang, a coal-intensive city in the Shandong region of eastern China, and quantify the mortalities and morbidities resulting from air pollutants emitted from this city in 2000, and in 2020 using business-as-usual, best-available control technology, and advanced coal gasification technology scenarios. In all scenarios most health damages arise from exposure to particulate matter. We find that total health damages due to year 2000 anthropogenic emissions from Zaozhuang accounted for 4-10% of its GDP. If all health damages resulting from coal use were internalized in the market price of coal, the year 2000 price would have doubled. With no new

  11. New evidence on financing equity in China's health care reform - A case study on Gansu province, China

    Directory of Open Access Journals (Sweden)

    Chen Mingsheng

    2012-12-01

    Full Text Available Abstract Background In the transition from a planned economy to a market-oriented economy, China’s state funding for health care declined and traditional coverage plans collapsed, leaving China’s poor exposed to potentially ruinous health care costs. In reforming health care for the 21st century, equity in health care financing has become a major policy goal. To assess progress towards this goal, this paper examines the equity characteristics of health care financing in a province of northwestern China, comparing the equity performance between urban and rural areas at two different points in time. Methods Analysis of whether health care financing contributions were progressive according to income were made using the Kakwani index for each of the four health care financing channels of general taxes, public and private health insurance, and out-of-pocket payments. Two rounds of surveys were conducted, the first in 2003 (13,619 individuals in 3946 households and the second in 2008 (12,973 individuals in 3958 households. Household socio-economic, health care payment, and utilization information were recorded in household interviews. Results Low-income households have undertaken a larger share of the health care financing burden in recent years, reflected by negative Kakwani indices, which indicate a regressive system. We found that the indices for general taxation were −0.0024 (urban and −0.0281 (rural in 2002, and −0.0177 (urban and −0.0097 (rural in 2007. Public health insurance presented different financing distributions in urban and rural areas (urban: 0.0742 in 2002, 0.0661 in 2007; rural: –0.0615 in 2002,���0.1436 in 2007.. Out-of-pocket payments were progressive but not equitable. Public health insurance coverage has expanded but financing equity has decreased. Conclusions Health care financing policies in China need ongoing reform. Given the inequity of general consumption taxes, elimination of these would improve

  12. New evidence on financing equity in China's health care reform - A case study on Gansu province, China

    Science.gov (United States)

    2012-01-01

    Background In the transition from a planned economy to a market-oriented economy, China’s state funding for health care declined and traditional coverage plans collapsed, leaving China’s poor exposed to potentially ruinous health care costs. In reforming health care for the 21st century, equity in health care financing has become a major policy goal. To assess progress towards this goal, this paper examines the equity characteristics of health care financing in a province of northwestern China, comparing the equity performance between urban and rural areas at two different points in time. Methods Analysis of whether health care financing contributions were progressive according to income were made using the Kakwani index for each of the four health care financing channels of general taxes, public and private health insurance, and out-of-pocket payments. Two rounds of surveys were conducted, the first in 2003 (13,619 individuals in 3946 households) and the second in 2008 (12,973 individuals in 3958 households). Household socio-economic, health care payment, and utilization information were recorded in household interviews. Results Low-income households have undertaken a larger share of the health care financing burden in recent years, reflected by negative Kakwani indices, which indicate a regressive system. We found that the indices for general taxation were −0.0024 (urban) and −0.0281 (rural) in 2002, and −0.0177 (urban) and −0.0097 (rural) in 2007. Public health insurance presented different financing distributions in urban and rural areas (urban: 0.0742 in 2002, 0.0661 in 2007; rural: –0.0615 in 2002,–0.1436 in 2007.). Out-of-pocket payments were progressive but not equitable. Public health insurance coverage has expanded but financing equity has decreased. Conclusions Health care financing policies in China need ongoing reform. Given the inequity of general consumption taxes, elimination of these would improve financing equity considerably

  13. E-waste environmental contamination and harm to public health in China.

    Science.gov (United States)

    Xu, Xijin; Zeng, Xiang; Boezen, H Marike; Huo, Xia

    2015-06-01

    The adverse effects of electronic waste (e-waste) on the human body have stirred up concern in recent years. China is one of the countries that confront serious pollution and human exposure of e-waste, and the majority of the population is exposed to potentially hazardous substances that are derived from informal e-waste recycling processes. This study reviews recent reports on human exposure to e-waste in China, with particular focus on exposure routes (e.g., inhalation and ingestion) and several toxicities of human (e.g., endocrine system, respiratory system, reproductive system, developmental toxicity, neurotoxicity, and genetic toxicity). Pieces of evidence that associate e-waste exposure with human health effects in China are assessed. The role of toxic heavy metals (e.g., lead, cadmium, chromium, mercury, and nickel) and organic pollutants (e.g., polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyl (PCBs), polycyclic aromatic hydrocarbons (PAHs), polybrominated biphenyls (PBBs), polyhalogenated aromatic hydrocarbons (PHAHs), bisphenol A (BPA)) on human health is also briefly discussed.

  14. Quantifying regional consumption-based health impacts attributable to ambient air pollution in China.

    Science.gov (United States)

    Zhang, Yanxia; Qu, Shen; Zhao, Jing; Zhu, Ge; Zhang, Yanxu; Lu, Xi; Sabel, Clive E; Wang, Haikun

    2018-03-01

    Serious air pollution has caused about one million premature deaths per year in China recently. Besides cross-border atmospheric transport of air pollution, trade also relocates pollution and related health impacts across China as a result of the spatial separation between consumption and production. This study proposes an approach for calculating the health impacts of emissions due to a region's consumption based on a multidisciplinary methodology coupling economic, atmospheric, and epidemiological models. These analyses were performed for China's Beijing and Hebei provinces. It was found that these provinces' consumption-based premature deaths attributable to ambient PM 2.5 were respectively 22,500 and 49,700, which were 23% higher and 37% lower than the numbers solely within their boundaries in 2007. The difference between the effects of trade and trade-related emissions on premature deaths attributable to air pollution in a region has also been clarified. The results illustrate the large and broad impact of domestic trade on regional air quality and the need for comprehensive consideration of supply chains in designing policy to mitigate the negative health impacts of air pollution across China. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Prevalence, diagnosis, and management of diabetes mellitus among older Chinese: results from the China Health and Retirement Longitudinal Study.

    Science.gov (United States)

    Zhao, Yaohui; Crimmins, Eileen M; Hu, Peifeng; Shen, Yang; Smith, James P; Strauss, John; Wang, Yafeng; Zhang, Yuan

    2016-04-01

    To estimate prevalence of diabetes mellitus (DM), success in diagnosing, and methods of diabetes management in China. China Health and Retirement Longitudinal Study, a representative survey of the Chinese population at least 45 years old, is used to estimate diabetes and prediabetes prevalence, diagnosis, and treatment and their associations with residence, socioe-conomic, and demographic factors. Almost 60 % of middle-aged and elderly Chinese have prediabetes or diabetes in 2011-2012. DM prevalence increases with age, but the oldest group is least likely to be diagnosed. Prevalence is higher with higher body mass index, fasting cholesterol, and larger waist circumference. Higher prevalence is found in urban areas among residents with urban registration status (the Chinese administrative registration system or hukou), especially in coastal regions. Better rates of diagnosis, management, and education regarding diabetes are strongly associated with urban hukou, living in coastal areas, and in families with higher per capita expenditures, the appropriate economic resources measure in China. Diagnosis and management of diabetes is highly differential within China but recent efforts to improve health systems are succeeding in reducing undiagnosed disease. Current high prevalence of prediabetes suggests a more intensive effort is required in the future.

  16. Effectiveness of participatory training on improving occupational health in small and medium enterprises in China.

    Science.gov (United States)

    Fu, Chuandong; Zhu, Meifeng; Yu, Tak Sun Ignatius; He, Yonghua

    2013-01-01

    Participatory training on occupational health is widely used in the world. Evaluations of local experiences are necessary to its successful performance. The project evaluated the effectiveness of participatory training on occupational health improvement in small and medium enterprises of China, and explored local practice experiences. Participatory training was provided to 525 welding workers from 25 small and medium enterprises in ship building and machinery manufacturing industries. This training consisted of interactive learning, worksite assessment and group discussion on laws/regulations, safety of machine operation, prevention of slips and trips, fire/explosion prevention, ergonomics, and recognition and prevention of other workplace hazards. Workers completed knowledge, attitude, and practice and worksite assessment questionnaires before and 3 months after intervention. Knowledge, attitude, and practice scores were significantly increased through the training. An inventory of workplace safety modifications was proposed by participants and many were fixed by workers and employers. Health management and personal protective equipment provision/use were most often improved, but improvements in engineering control and health-related accommodations remained unsatisfactory. Workers could recognize and fix workplace hazards after the participatory training. More efficient measures in China are to be explored to improve implementing solutions, especially on preventive engineering and human ergonomics.

  17. [A study on health information literacy among urban and suburban residents in six provinces in China].

    Science.gov (United States)

    Nie, Xueqiong; Li, Yinghua; Li, Li; Huang, Xianggang

    2014-07-01

    To understand the status and its influencing factors of health information literacy among urban and suburban residents in China, and to explore the method for improving the health information literacy. From March to May in 2013, residents aged 18-60 years in six provinces in China were investigated with Questionnaire of Health Literacy of Diabetes Mellitus of the Public in China about self-reported health information literacy. The results of the survey were standardized by the 6th national census data. Logistic regression analysis was used to explore influencing factors of health information literacy. A total of 4 416 residents were surveyed, and 4 282 (97.0%) valid questionnaires were collected. After weight adjustments, 30.1% of the residents aged 18-60 years had adequate health information literacy in China, and the 95%CI of the rate was 28.5% - 31.6%. Totally, 70.8% of the residents ever actively searched for health information, 43.7% of the residents could easily retrieve the health information, 49.1% of the residents could easily understand the health information, 41.8% of the residents could confidently differentiate the quality of the health information and 51.1% of the residents ever searched health information on the internet. The results of multi-logistic regression showed that the rural residents, the males, those with lower levels of education, those with poor health had a lower health information literacy. The most trusted health information source was from doctors, and the trust rate reached 97.0%, followed by family members, friends or colleagues. The residents trusted the interpersonal communication more than the mass media and the new media. The level of health information literacy of the residents was generally low in China. To improve the health information literacy, high-quality health information services should be delivered to the residents, and the health education on the internet provided by the medical professionals should also be explored.

  18. [Research on China railway health campaign in 1930s].

    Science.gov (United States)

    Huang, Huaping

    2015-01-01

    The motivation factors of China's railway health campaign in 1930s included avocation by the government, mass media mobilization, railway authorities' hygiene awareness and the systematization of the construction of organization. During the health campaign, the railway authorities adopted various approaches for its formation, including the rally speeches, distribution of materials, cleaning and vaccination etc. Unfortunately, the actual effect of railway health campaign was not satisfactory, yet, it enhanced theoretically railway employees' health knowledge and contributed to the promotion of modernization of hygienic knowledge. Meanwhile, there still existed many problems in the railway health campaign, for example, lack of funds, formalism and uneven development among the railway bureaus.

  19. The economic burden of mental disorders in China, 2005-2013: implications for health policy.

    Science.gov (United States)

    Xu, Junfang; Wang, Jian; Wimo, Anders; Qiu, Chengxuan

    2016-05-11

    Mental disorders represent a major contributor to disease burden worldwide. We sought to quantify the national economic burden of mental disorders in China. We used a prevalence-based, bottom-up approach to estimate the economic costs of mental disorders in 2005-2013 in China. Prevalence data were derived from a national survey. Cost data were derived from the electronic health records of two psychiatric hospitals that consisted of 25,289 outpatients (10%) and inpatients (90%) who were diagnosed with a mental disorder. Cost items included direct medical costs, direct non-medical costs, and indirect costs. The total annual costs of mental disorders in China increased from $1,094.8 in 2005 to $3,665.4 in 2013 for individual patients, and from $21.0 billion to $88.8 billion for the whole society. The total costs of mental disorders in 2013 accounted for more than 15% of the total health expenditure in China, and 1.1% of China's gross domestic product. If the needs of the professional care for all patients with mental illnesses were fully met, the potential economic costs would have been almost five times higher than the actual estimated costs. Mental disorders imposed a huge economic burden on individuals and the society in China. A nation-wide strategic action plan for preventing mental disorders and promoting mental health and well-being is in urgent need to reduce the individual and societal costs of mental illnesses.

  20. Mobile technology for health care in rural China

    Directory of Open Access Journals (Sweden)

    Zhao Ni

    2014-09-01

    Full Text Available With the proliferation of mobile technologies in China, the Chinese mobile medical applications market is growing rapidly. This may be particularly useful for Chinese rural populations who have limited access to quality medical care where mobile technologies can reach across geographic and socioeconomic boundaries and potentially increase access to care and improve health outcomes.

  1. Historical occupational trichloroethylene air concentrations based on inspection measurements from Shanghai, China.

    Science.gov (United States)

    Friesen, Melissa C; Locke, Sarah J; Chen, Yu-Cheng; Coble, Joseph B; Stewart, Patricia A; Ji, Bu-Tian; Bassig, Bryan; Lu, Wei; Xue, Shouzheng; Chow, Wong-Ho; Lan, Qing; Purdue, Mark P; Rothman, Nathaniel; Vermeulen, Roel

    2015-01-01

    Trichloroethylene (TCE) is a carcinogen that has been linked to kidney cancer and possibly other cancer sites including non-Hodgkin lymphoma. Its use in China has increased since the early 1990s with China's growing metal, electronic, and telecommunications industries. We examined historical occupational TCE air concentration patterns in a database of TCE inspection measurements collected in Shanghai, China to identify temporal trends and broad contrasts among occupations and industries. Using a database of 932 short-term, area TCE air inspection measurements collected in Shanghai worksites from 1968 through 2000 (median year 1986), we developed mixed-effects models to evaluate job-, industry-, and time-specific TCE air concentrations. Models of TCE air concentrations from Shanghai work sites predicted that exposures decreased 5-10% per year between 1968 and 2000. Measurements collected near launderers and dry cleaners had the highest predicted geometric means (GM for 1986 = 150-190 mg m(-3)). The majority (53%) of the measurements were collected in metal treatment jobs. In a model restricted to measurements in metal treatment jobs, predicted GMs for 1986 varied 35-fold across industries, from 11 mg m(-3) in 'other metal products/repair' industries to 390 mg m(-3) in 'ships/aircrafts' industries. TCE workplace air concentrations appeared to have dropped over time in Shanghai, China between 1968 and 2000. Understanding differences in TCE concentrations across time, occupations, and industries may assist future epidemiologic studies in China. Published by Oxford University Press on behalf of the British Occupational Hygiene Society 2014.

  2. Discrimination, perceived social inequity, and mental health among rural-to-urban migrants in China.

    Science.gov (United States)

    Lin, Danhua; Li, Xiaoming; Wang, Bo; Hong, Yan; Fang, Xiaoyi; Qin, Xiong; Stanton, Bonita

    2011-04-01

    Status-based discrimination and inequity have been associated with the process of migration, especially with economics-driven internal migration. However, their association with mental health among economy-driven internal migrants in developing countries is rarely assessed. This study examines discriminatory experiences and perceived social inequity in relation to mental health status among rural-to-urban migrants in China. Cross-sectional data were collected from 1,006 rural-to-urban migrants in 2004-2005 in Beijing, China. Participants reported their perceptions and experiences of being discriminated in daily life in urban destination and perceived social inequity. Mental health was measured using the symptom checklist-90 (SCL-90). Multivariate analyses using general linear model were performed to test the effect of discriminatory experience and perceived social inequity on mental health. Experience of discrimination was positively associated with male gender, being married at least once, poorer health status, shorter duration of migration, and middle range of personal income. Likewise, perceived social inequity was associated with poorer health status, higher education attainment, and lower personal income. Multivariate analyses indicate that both experience of discrimination and perceived social inequity were strongly associated with mental health problems of rural-to-urban migrants. Experience of discrimination in daily life and perceived social inequity have a significant influence on mental health among rural-to-urban migrants. The findings underscore the needs to reduce public or societal discrimination against rural-to-urban migrants, to eliminate structural barriers (i.e., dual household registrations) for migrants to fully benefit from the urban economic development, and to create a positive atmosphere to improve migrant's psychological well-being.

  3. Health impact assessment in environmental impact assessment in China: Status, practice and problems

    International Nuclear Information System (INIS)

    Chang, I-Shin; Yilihamu, Qimanguli; Wu, Jing; Wu, Huilei; Nan, Bo

    2017-01-01

    In China, the environmental impact assessment (EIA) system has gradually developed into an integrated evaluation system, owing to continuous improvement on institutional framework, system infrastructure, technical methods and professionals training, since EIA was first introduced in 1979. Though health impact assessment (HIA) is a part of the EIA system, the development of HIA is so slow as to remain at the early developing stage. This research aims to understand the extent and main issues concerning “health considerations” under the context of EIA, in China. Through case study on 42 environmental impact statements, the results demonstrate that HIA was not implemented in most of the cases, and health issues were not even mentioned in more than half of these cases. Where HIA was implemented, various problems were revealed through this study, including lacks of systematic approaching tools, insufficient supporting data on health effects, ineffective public participation, limited health considerations on biophysics, and so forth. Nevertheless, these problems can be attributed to lacks of legal supports, systematic evaluation methods, knowledge on evaluation technologies, and professional training institutions for HIA in China. In order to improve HIA methodologies, technologies, and management, to perfect HIA evaluation system, and to enhance public participation system within HIA, some recommendations from institutional, technical, administrative, and managerial aspects were then proposed in this study. - Highlights: •The status and deficiencies of HIA in EIA in China were identified and evaluated. •There were great industrial differences for the implementation of HIA in EIA. •Public participation was not well executed within HIA in EIA.

  4. Measuring and Benchmarking Technical Efficiency of Public Hospitals in Tianjin, China

    Science.gov (United States)

    Li, Hao; Dong, Siping

    2015-01-01

    China has long been stuck in applying traditional data envelopment analysis (DEA) models to measure technical efficiency of public hospitals without bias correction of efficiency scores. In this article, we have introduced the Bootstrap-DEA approach from the international literature to analyze the technical efficiency of public hospitals in Tianjin (China) and tried to improve the application of this method for benchmarking and inter-organizational learning. It is found that the bias corrected efficiency scores of Bootstrap-DEA differ significantly from those of the traditional Banker, Charnes, and Cooper (BCC) model, which means that Chinese researchers need to update their DEA models for more scientific calculation of hospital efficiency scores. Our research has helped shorten the gap between China and the international world in relative efficiency measurement and improvement of hospitals. It is suggested that Bootstrap-DEA be widely applied into afterward research to measure relative efficiency and productivity of Chinese hospitals so as to better serve for efficiency improvement and related decision making. PMID:26396090

  5. mHealth Series: mHealth project in Zhao County, rural China – Description of objectives, field site and methods

    Science.gov (United States)

    van Velthoven, Michelle Helena; Li, Ye; Wang, Wei; Du, Xiaozhen; Wu, Qiong; Chen, Li; Majeed, Azeem; Rudan, Igor; Zhang, Yanfeng; Car, Josip

    2013-01-01

    Background We set up a collaboration between researchers in China and the UK that aimed to explore the use of mHealth in China. This is the first paper in a series of papers on a large mHealth project part of this collaboration. This paper included the aims and objectives of the mHealth project, our field site, and the detailed methods of two studies. Field site The field site for this mHealth project was Zhao County, which lies 280 km south of Beijing in Hebei Province, China. Methods We described the methodology of two studies: (i) a mixed methods study exploring factors influencing sample size calculations for mHealth–based health surveys and (ii) a cross–over study determining validity of an mHealth text messaging data collection tool. The first study used mixed methods, both quantitative and qualitative, including: (i) two surveys with caregivers of young children, (ii) interviews with caregivers, village doctors and participants of the cross–over study, and (iii) researchers’ views. We combined data from caregivers, village doctors and researchers to provide an in–depth understanding of factors influencing sample size calculations for mHealth–based health surveys. The second study, a cross–over study, used a randomised cross–over study design to compare the traditional face–to–face survey method to the new text messaging survey method. We assessed data equivalence (intrarater agreement), the amount of information in responses, reasons for giving different responses, the response rate, characteristics of non–responders, and the error rate. Conclusions This paper described the objectives, field site and methods of a large mHealth project part of a collaboration between researchers in China and the UK. The mixed methods study evaluating factors that influence sample size calculations could help future studies with estimating reliable sample sizes. The cross–over study comparing face–to–face and text message survey data collection

  6. The Impact of Tobacco Consumption on Rural Household Expenditure and Self-rated Health Among Rural Household Members in China.

    Science.gov (United States)

    Li, Changle; Supakankunti, Siripen

    2018-03-26

    To estimate how tobacco consumption affects household expenditure on other goods and services in rural China and to assess the tobacco consumption affects self-rated health among rural household members in China. A Seemingly Unrelated Regression was used to assess the impact of tobacco consumption on rural household expenditure. To detect tobacco consumption causing heterogeneity in self-rated health among adults in rural China, this study employed a random effects generalized ordered probit model. 2010-2014 China Family Panel Studies was used for the analysis. The data set included 3,611 households and 10,610 adults in each wave. Tobacco consumption households assign significantly lower budget shares to food, health care, dress, and education in rural China. Moreover, self-rated health factor has a significantly positive coefficient with respect to non-smokers and ex-smokers, that is, when the individuals is a non-smoker or ex-smoker, he/ she will be more likely to report his/her health status as positive. The first analysis showed that tobacco consumption crowds out expenditures on food, dress, health care, and education for rural households in China, and the second analysis indicated that non-smokers and ex-smokers are more likely to report their health status as better compared with last year. The results of the present study revealed that Chinese policymakers might consider controlling tobacco consumption since tobacco control can improve not only rural household welfare but also rural household members' health status. Therefore, the tobacco tax policy and brief clinical interventions by the doctor should be implemented in rural China.

  7. China in transition: the new health insurance scheme for the urban employed.

    Science.gov (United States)

    Hindle, D

    2000-01-01

    China has been very successful in achieving good health at a low cost, mostly through national programs for health promotion and illness prevention. However, increased prosperity in recent years has led to higher expectations for therapeutic care, and the change to a socialist market economy has created new risks and opportunities for both financing and care provision. After several years of experimentation, China committed itself in 1996 to a major reform program which includes implementation of a new method of financing of care for the urban employed population. It comprises a mix of government-operated compulsory basic insurance, individual health savings accounts, and optional private health insurance. This paper outlines the new Scheme, and notes some tactical and strategic issues. I conclude that the Chinese government is correctly choosing to balance new and old ideas, but that there are many challenges to be faced including integration of the new Scheme with the rest of the health care system.

  8. Reducing health risks from indoor exposures in rapidly developing urban China.

    Science.gov (United States)

    Zhang, Yinping; Mo, Jinhan; Weschler, Charles J

    2013-07-01

    Over the past two decades there has been a large migration of China's population from rural to urban regions. At the same time, residences in cities have changed in character from single-story or low-rise buildings to high-rise structures constructed and furnished with many synthetic materials. As a consequence, indoor exposures (to pollutants with outdoor and indoor sources) have changed significantly. We briefly discuss the inferred impact that urbanization and modernization have had on indoor exposures and public health in China. We argue that growing adverse health costs associated with these changes are not inevitable, and we present steps that could be taken to reduce indoor exposures to harmful pollutants. As documented by China's Ministry of Health, there have been significant increases in morbidity and mortality among urban residents over the past 20 years. Evidence suggests that the population's exposure to air pollutants has contributed to increases in lung cancer, cardiovascular disease, pulmonary disease, and birth defects. Whether a pollutant has an outdoor or an indoor source, most exposure to the pollutant occurs indoors. Going forward, indoor exposures can be reduced by limiting the ingress of outdoor pollutants (while providing adequate ventilation with clean air), minimizing indoor sources of pollutants, updating government policies related to indoor pollution, and addressing indoor air quality during a building's initial design. Taking the suggested steps could lead to significant reductions in morbidity and mortality, greatly reducing the societal costs associated with pollutant derived ill health.

  9. China-Africa Health Development Initiatives: Benefits and Implications for Shaping Innovative and Evidence-informed National Health Policies and Programs in Sub-saharan African Countries.

    Science.gov (United States)

    Tambo, Ernest; Ugwu, Chidiebere E; Guan, Yayi; Wei, Ding; Xiao-Ning; Xiao-Nong, Zhou

    2016-01-01

    This review paper examines the growing implications of China's engagement in shaping innovative national initiatives against infectious diseases and poverty control and elimination in African countries. It seeks to understand the factors and enhancers that can promote mutual and innovative health development initiatives, and those that are necessary in generating reliable and quality data for evidence-based contextual policy, priorities and programs. We examined the China-Africa health cooperation in supporting global health agenda on infectious diseases such as malaria, schistosomiasis, Ebola, TB, HIV/AIDS, neglected tropical diseases (NTDs) prevention, control and elimination spanning a period of 10 years. We reviewed referenced publications, global support data, and extensive sources related to and other emerging epidemics and infectious diseases of poverty, programs and interventions, health systems development issues, challenges, opportunities and investments. Published literature in PubMed, Scopus, Google Scholar, Books and web-based peer-reviewed journal articles, government annual reports were assessed from the first Forum on China-Africa Cooperation (FOCAC) in November 2006 to December 2015 Third Ministerial conferences. Our findings highlight current shared public health challenges and emphasize the need to nurture, develop and establish effective, functional and sustainable health systems capacity to detect and respond to all public health threats and epidemic burdens, evidence-based programs and quality care outcomes. China's significant health diplomacy emphasizes the importance of health financing in establishing health development commitment and investment in improving the gains and opportunities, importantly efficiency and value health priorities and planning. Strengthening China-Africa health development agenda towards collective commitment and investment in quality care delivery, effective programs coverage and efficiency, preparedness and

  10. The impact of husbands' gender equity awareness on wives' reproductive health in rural areas of China.

    Science.gov (United States)

    Ying, Cui; Li, Yang; Hui, Han

    2011-02-01

    The aim of this study was to investigate the effect of husbands' gender equity awareness on wives' reproductive health in rural areas of China. A qualitative study of 1919 wives aged from 18 to 69 years and their husbands was conducted in rural China. Data were collected through 3838 structured interviews. We quantified "belief in gender equity" based on responses to 7 specific statements and graded the responses according to a system scoring the strength of the overall belief (a total score 19 or higher, strong; 15-18, moderate; and 14 or less, weak). Data were recorded by bi-input with EpiData 3.1 after being carefully checked. χ(2) tests and logistic regression were performed in this study. Only 20.0% of the husbands demonstrated strong convictions about gender equity. Husbands' gender equity awareness is related to wives' receiving any prenatal care, the number of prenatal visits to a healthcare provider, having a hospital delivery of a newborn, and having gynecological examination one time per year. Raising husbands' gender awareness on wives' reproductive health and reducing female illiteracy were very necessary. The whole community should participate actively in the progress of reproductive health promotion. China's Health System requires an integration of its various sectors, including family planning, maternal and child care in resource sharing, and service delivery. Obstetricians & gynecologists. After completing this CME activity, physicians should be better able to evaluate the impact of husbands' gender equity awareness on wives' reproductive health in rural areas of China; assess how raising husbands' gender awareness on wives' reproductive health and reducing female illiteracy will improve wives' reproductive health; and analyze how China's Health System can integrate its various sectors, including family planning, maternal, and childcare in resource sharing, and service delivery, to improve wives' reproductive health.

  11. Social trust, interpersonal trust and self-rated health in China: a multi-level study.

    Science.gov (United States)

    Feng, Zhixin; Vlachantoni, Athina; Liu, Xiaoting; Jones, Kelvyn

    2016-11-08

    Trust is important for health at both the individual and societal level. Previous research using Western concepts of trust has shown that a high level of trust in society can positively affect individuals' health; however, it has been found that the concepts and culture of trust in China are different from those in Western countries and research on the relationship between trust and health in China is scarce. The analyses use data from the national scale China General Social Survey (CGSS) on adults aged above 18 in 2005 and 2010. Two concepts of trust ("out-group" and "in-group" trust) are used to examine the relationship between trust and self-rated health in China. Multilevel logistical models are applied, examining the trust at the individual and societal level on individuals' self-rated health. In terms of interpersonal trust, both "out-group" and "in-group" trust are positively associated with good health in 2005 and 2010. At the societal level, the relationships between the two concepts of trust and health are different. In 2005, higher "out-group" social trust (derived from trust in strangers) is positively associated with better health; however, higher "in-group" social trust (derived from trust in most people) is negatively associated with good health in 2010. The cross-level interactions show that lower educated individuals (no education or only primary level), rural residents and those on lower incomes are the most affected groups in societies with higher "out-group" social trust; whereas people with lower levels of educational attainment, a lower income, and those who think that most people can be trusted are the most affected groups in societies with higher "in-group" social trust. High levels of interpersonal trust are of benefit to health. Higher "out-group" social trust is positively associated with better health; while higher "in-group" social trust is negatively associated with good health. Individuals with different levels of educational

  12. Mental Health of the Prison Medical Workers (PMWs) and Influencing Factors in Jiangxi, China.

    Science.gov (United States)

    Liu, Xiaojun; Jiang, Dongdong; Hou, Zhaoxun; He, Meikun; Lu, Yuanan; Mao, Zongfu

    2017-11-26

    Prison medical workers (PMWs) are critically important, but they are also vulnerable to psychological problems. Currently, there is no study on examining PMWs' mental health conditions and possible influencing factors in China. Hence, we conducted this cross-sectional survey, aiming to understand the mental health status of the PMWs and related impact factors in Jiangxi province of China. We employed the Chinese version of the Symptom Checklist-90-R (SCL-90-R) to assess the mental disorders and psychological health conditions of PMWs in Jiangxi. The t tests were used to compare the differences for the average score of SCL-90-R between the Chinese general population and targeted PMWs of this study. Multivariable logistic regression analyses were conducted to identify the main factors associated with overall detection rate of PMWs' psychological health conditions. The scores of four dimensions (somatization, obsessive-compulsive symptoms, anxiety, and paranoid ideation) were significantly higher than the Chinese national norm, and the total positive rate was 49.09% among the PMWs. Gender, marital status, age, and length of employment are identified to be the most significant predictors to affect PMWs' mental health. Positive correlations between each of the nine dimensions of the SCL-90-R have been verified. This study demonstrated for the first time that PMWs are facing mental health risk and suffering serious psychological problems with psychopathology symptoms, which has become a growing concern in China. Our current findings suggest a need for more in-depth studies on this subject going forward to validate our conclusions and also to identify more impact factors, since such studies and knowledge of PMWs' mental health and influencing factors are very limited in China.

  13. The measurement of China's consumer market development based on CPI data

    Science.gov (United States)

    Xiao, Jiang; Wang, Minggang; Tian, Lixin; Zhen, Zaili

    2018-01-01

    Consumer Price Index (CPI) is a comprehensive index which contains a large amount of market information. In order to effectively measure the running status of China's consumer market and analyze the dynamic evolution characteristics of regional economic consumption in China, the eigenvalues and eigenvectors of random matrix are proposed to quantitatively describe the evolution relationship of provincial and regional CPI in China. Based on the provincial data of China's CPI, system risk entropy, synchronicity ratio, stability and market induction are introduced to characterize the market evolution characteristics, and analyze the regional differences and synchronicity of the consumer price index of China and evaluate the development of China's consumer market. The results show that the average system risk entropy of China's consumer market for the period 2000-2015 is 0.1646, fluctuating in the range of 0.0512-0.3288, indicating a higher system risk of China's consumer market. The system risk of China's consumer market is still higher than the average in nearly 15 years. Fluctuating in the range of 0.3871-0.9355, the market synchronicity ratio has a mean of 0.7225, which reveals a higher market consistency level, a rising trend in fluctuation but an increasing tendency in the degree of unbalanced regional development. Evolution results of market induction demonstrate that the evolution of China's consumer market has experienced four stages. The market induction has possessed a sustained growth trend since August 2010. Scenario analysis indicates that the key to effectively improve China's consumer market system is to solve the lagging issue of China's western region market on the basis of controlling and resolving of the existing risk.

  14. What limits the utilization of health services among china labor force? analysis of inequalities in demographic, socio-economic and health status.

    Science.gov (United States)

    Lu, Liming; Zeng, Jingchun; Zeng, Zhi

    2017-02-02

    Inequalities in demographic, socio-economic and health status for China labor force place them at greater health risks, and marginalized them in the utilization of healthcare services. This paper identifies the inequalities which limit the utilization of health services among China labor force, and provides a reference point for health policy. Data were collected from 23,505 participants aged 15 to 65, from the 2014 China Labor Force Dynamic Survey (a nationwide cross-sectional survey covering 29 provinces with a multi-stage cluster, and stratified, probability sampling strategy) conducted by Sun Yat-sen University. Logistic regression models were used to study the effects of demographic (age, gender, marital status, type of hukou and migration status), socio-economic (education, social class and insurance) and health status (self-perceived general health and several chronic illnesses) variables on the utilization of health services (two-week visiting and hospitalization during the past 12 months). Goodness of fit was assessed using Hosmer-Lemeshow test. Discrimination ability was assessed based on the area under the receiver operating curve (AUC). Migrants with more than 1 (OR 2.80, 95% CI 1.01 ~ 7.82) or none chronic illnesses (OR 1.26, 95% CI 1.01 ~ 7.82) are more likely to be two week visiting to the clinic than non-migrants; migrants with none chronic illnesses (OR 0.61, 95% CI 0.45 ~ 0.82) are less likely to be in hospitalization during the past 12 months than non-migrants. Female, elder, hukou of non-agriculture, higher education level, higher social class, purchasing more insurance and poorer self-perceived health were predictors for more utilization of health service. More insurance benefited more two-week visiting (OR 1.12, 95% CI 1.06 ~ 1.17) and hospitalization during the past 12 months (OR 1.12, 95% CI 1.07 ~ 1.18) for individuals with none chronic illness but not ≥1 chronic illnesses. All models achieved good calibration

  15. Building institutions for an effective health system: lessons from China's experience with rural health reform.

    Science.gov (United States)

    Bloom, Gerald

    2011-04-01

    This paper is concerned with the management of health system changes aimed at substantially increasing the access to safe and effective health services. It argues that an effective health sector relies on trust-based relationships between users, providers and funders of health services, and that one of the major challenges governments face is to construct institutional arrangements within which these relationships can be embedded. It presents the case of China, which is implementing an ambitious health reform, drawing on a series of visits to rural counties by the author over a 10-year period. It illustrates how the development of reform strategies has been a response both to the challenges arising from the transition to a market economy and the result of actions by different actors, which have led to the gradual creation of increasingly complex institutions. The overall direction of change has been strongly influenced by the efforts made by the political leadership to manage a transition to a modern economy which provides at least some basic benefits to all. The paper concludes that the key lessons for other countries from China's experience with health system reform are less about the detailed design of specific interventions than about its approach to the management of institution-building in a context of complexity and rapid change. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. How the public uses social media wechat to obtain health information in china: a survey study

    OpenAIRE

    Zhang, Xingting; Wen, Dong; Liang, Jun; Lei, Jianbo

    2017-01-01

    Background On average, 570 million users, 93% in China?s first-tier cities, log on to WeChat every day. WeChat has become the most widely and frequently used social media in China, and has been profoundly integrated into the daily life of many Chinese people. A variety of health-related information may be found on WeChat. The objective of this study is to understand how the general public views the impact of the rapidly emerging social media on health information acquisition. Methods A self-a...

  17. Electric vehicles in China: emissions and health impacts.

    Science.gov (United States)

    Ji, Shuguang; Cherry, Christopher R; J Bechle, Matthew; Wu, Ye; Marshall, Julian D

    2012-02-21

    E-bikes in China are the single largest adoption of alternative fuel vehicles in history, with more than 100 million e-bikes purchased in the past decade and vehicle ownership about 2× larger for e-bikes as for conventional cars; e-car sales, too, are rapidly growing. We compare emissions (CO(2), PM(2.5), NO(X), HC) and environmental health impacts (primary PM(2.5)) from the use of conventional vehicles (CVs) and electric vehicles (EVs) in 34 major cities in China. CO(2) emissions (g km(-1)) vary and are an order of magnitude greater for e-cars (135-274) and CVs (150-180) than for e-bikes (14-27). PM(2.5) emission factors generally are lower for CVs (gasoline or diesel) than comparable EVs. However, intake fraction is often greater for CVs than for EVs because combustion emissions are generally closer to population centers for CVs (tailpipe emissions) than for EVs (power plant emissions). For most cities, the net result is that primary PM(2.5) environmental health impacts per passenger-km are greater for e-cars than for gasoline cars (3.6× on average), lower than for diesel cars (2.5× on average), and equal to diesel buses. In contrast, e-bikes yield lower environmental health impacts per passenger-km than the three CVs investigated: gasoline cars (2×), diesel cars (10×), and diesel buses (5×). Our findings highlight the importance of considering exposures, and especially the proximity of emissions to people, when evaluating environmental health impacts for EVs.

  18. Health promotion interventions and policies addressing excessive alcohol use: a systematic review of national and global evidence as a guide to health-care reform in China.

    Science.gov (United States)

    Li, Qing; Babor, Thomas F; Zeigler, Donald; Xuan, Ziming; Morisky, Donald; Hovell, Melbourne F; Nelson, Toben F; Shen, Weixing; Li, Bing

    2015-01-01

    Steady increases in alcohol consumption and related problems are likely to accompany China's rapid epidemiological transition and profit-based marketing activities. We reviewed research on health promotion interventions and policies to address excessive drinking and to guide health-care reform. We searched Chinese- and English-language databases and included 21 studies in China published between 1980 and 2013 that covered each policy area from the World Health Organization (WHO) Global Strategy to Reduce the Harmful Use of Alcohol. We evaluated and compared preventive interventions to the global alcohol literature for cross-national applicability. In contrast with hundreds of studies in the global literature, 11 of 12 studies from mainland China were published in Chinese; six of 10 in English were on taxation from Taiwan or Hong Kong. Most studies demonstrated effectiveness in reducing excessive drinking, and some reported the reduction of health problems. Seven were randomized controlled trials. Studies targeted schools, drink-driving, work-places, the health sector and taxation. China is the world's largest alcohol market, yet there has been little growth in alcohol policy research related to health promotion interventions over the past decade. Guided by a public health approach, the WHO Global Strategy and health reform experience in Russia, Australia, Mexico and the United States, China could improve its public health response through better coordination and implementation of surveillance and evidence-based research, and through programmatic and legal responses such as public health law research, screening and early intervention within health systems and the implementation of effective alcohol control strategies. © 2014 Society for the Study of Addiction.

  19. International trends in health science librarianship Part 10: The Greater China area.

    Science.gov (United States)

    Xie, Zhiyun; Chan, Julia L Y; Lam, Louisa Mei Chun; Chiu, Tzu-Heng

    2014-06-01

    This is the 10th in a series of articles exploring international trends in health science librarianship. This issue describes developments in health science librarianship in the first decade of the 21st century in China, Hong Kong and Taiwan. The next issue will report on Japan and South Korea. JM. © 2014 The authors. Health Information and Libraries Journal © 2014 Health Libraries Group.

  20. Associations between breakfast eating habits and health-promoting lifestyle, suboptimal health status in Southern China: a population based, cross sectional study.

    Science.gov (United States)

    Chen, Jieyu; Cheng, Jingru; Liu, Yanyan; Tang, Yang; Sun, Xiaomin; Wang, Tian; Xiao, Ya; Li, Fei; Xiang, Lei; Jiang, Pingping; Wu, Shengwei; Wu, Liuguo; Luo, Ren; Zhao, Xiaoshan

    2014-12-11

    Suboptimal health status (SHS) is the intermediate health state between health and disease, refers to medically undiagnosed or functional somatic syndromes, and has been a major global public health challenge. However, both the etiology and mechanisms associated with SHS are still unclear. Breakfast eating behavior is a dietary pattern marker and previous studies have presented evidence of associations between failure to consume breakfast and increased diseases. Accordingly, in view of the significance of breakfast eating behaviors with respect to health status, the associations between breakfast eating habits and healthy lifestyle, SHS require further elucidation. A cross-sectional survey was conducted within a clustered sample of 24,159 individuals aged 12-80 years in 2012-13 within the population of Southern China. Breakfast eating habits were categorically defined by consumption frequency ('scarcely, sometimes or always'). Health-promoting lifestyle was assessed via the health-promoting lifestyle profile (HPLP-II). SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Of the 24,159 participants, the prevalence rates for the 'health' , 'SHS' , and 'disease' were 18.8%, 46.0%, and 35.2%, respectively. Overall, 19.6% of participants reported 'scarce' breakfast eating habits, with frequent breakfast eaters scoring higher on both HPLP-II and SHMS V1.0. After demographic adjustment, regression analyses revealed a significant association between breakfast eating habits and healthy lifestyle (p eating habits are significantly associated with a healthy lifestyle, and appear to be a useful predictor of a healthy lifestyle. Irregular breakfast eating habits are related to an increased risk of SHS; increased breakfast eating frequency may contribute to lowering the prevalence of SHS in Southern China.

  1. Errors and Correction of Precipitation Measurements in China

    Institute of Scientific and Technical Information of China (English)

    REN Zhihua; LI Mingqin

    2007-01-01

    In order to discover the range of various errors in Chinese precipitation measurements and seek a correction method, 30 precipitation evaluation stations were set up countrywide before 1993. All the stations are reference stations in China. To seek a correction method for wind-induced error, a precipitation correction instrument called the "horizontal precipitation gauge" was devised beforehand. Field intercomparison observations regarding 29,000 precipitation events have been conducted using one pit gauge, two elevated operational gauges and one horizontal gauge at the above 30 stations. The range of precipitation measurement errors in China is obtained by analysis of intercomparison measurement results. The distribution of random errors and systematic errors in precipitation measurements are studied in this paper.A correction method, especially for wind-induced errors, is developed. The results prove that a correlation of power function exists between the precipitation amount caught by the horizontal gauge and the absolute difference of observations implemented by the operational gauge and pit gauge. The correlation coefficient is 0.99. For operational observations, precipitation correction can be carried out only by parallel observation with a horizontal precipitation gauge. The precipitation accuracy after correction approaches that of the pit gauge. The correction method developed is simple and feasible.

  2. Meeting the oral health needs of 12-year-olds in China: human resources for oral health.

    Science.gov (United States)

    Sun, Xiangyu; Bernabé, Eduardo; Liu, Xuenan; Zheng, Shuguo; Gallagher, Jennifer E

    2017-06-20

    An appropriate level of human resources for oral health [HROH] is required to meet the oral health needs of population, and enable maximum improvement in health outcomes. The aim of this study was to estimate the required HROH to meet the oral health needs of the World Health Organization [WHO] reference group of 12-year-olds in China and consider the implications for education, practice, policy and HROH nationally. We estimated the need of HROH to meet the needs of 12-year-olds based on secondary analysis of the epidemiological and questionnaire data from the 3rd Chinese National Oral Health Survey, including caries experience and periodontal factors (calculus), dentally-related behaviour (frequency of toothbrushing and sugar intake), and social factors (parental education). Children's risk for dental caries was classified in four levels from low (level 1) to high (level 4). We built maximum and minimum intervention models of dental care for each risk level, informed by contemporary evidence-based practice. The needs-led HROH model we used in the present study incorporated need for treatment and risk-based prevention using timings verified by experts in China. These findings were used to estimate HROH for the survey sample, extrapolated to 12-year-olds nationally and the total population, taking account of urban and rural coverage, based on different levels of clinical commitment (60-90%). We found that between 40,139 and 51,906 dental professionals were required to deliver care for 12-year-olds nationally based on 80% clinical commitment. We demonstrated that the majority of need for HROH was in the rural population (72.5%). Over 93% of HROH time was dedicated to prevention within the model. Extrapolating the results to the total population, the estimate for HROH nationally was 3.16-4.09 million to achieve national coverage; however, current HROH are only able to serve an estimated 5% of the population with minimum intervention based on a HROH spending 90% of

  3. Work-Recreation Balance, Health-Promoting Lifestyles and Suboptimal Health Status in Southern China: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Shengwei Wu

    2016-03-01

    Full Text Available Suboptimal health status (SHS—an intermediate state between health and illness—refers to functional somatic symptoms that are medically undiagnosed. Although SHS has become a great challenge for global public health, very little about its etiology and mechanisms are known. Work-recreation balance is a part of work−life balance, and is related to stress which greatly influences health status. We therefore carried out a cross-sectional investigation between 2012 and 2013 within a clustered sample of 24,475 individuals aged 15−60 years from a population in southern China. In so doing, we hoped to illuminate the associations between work-recreation balance conditions, healthy lifestyles, and SHS. Work-recreation balance conditions were categorically defined by frequency (“rarely, sometimes, or always”. Health-Promoting Lifestyle Profile (HPLP-II was used to evaluate the level of healthy lifestyles, and the medical examination report and Sub-Health Measurement Scale V1.0 (SHMS V1.0 were both used to evaluate health status. The ratio of SHS (46.3% is higher than health status (18.4% or disease status (35.3%. Overall, 4.9% of respondents reported the lowest level of work-recreation balance, and they scored lower on both the HPLP-II and SHMS V1.0 compared with those who frequently maintained a work-recreation balance. Significant association was found between work-recreation balance behaviors and healthy lifestyles (p < 0.001 after demographic adjustment. In comparison with those reporting a frequent work-recreation balance, individuals whose work-recreation balance was categorically “rare” were 1.69 times as likely to develop SHS (odds ratio (OR: 1.69, 95% confidence interval (CI: 1.49–1.92, and those with infrequent work-recreation balance (“sometimes” were 1.71 times more likely to develop SHS (OR: 1.71, 95% CI: 1.62–1.81. These findings suggest that work-recreation balance conditions are significantly associated with, and

  4. Work-Recreation Balance, Health-Promoting Lifestyles and Suboptimal Health Status in Southern China: A Cross-Sectional Study

    Science.gov (United States)

    Wu, Shengwei; Xuan, Zhengzheng; Li, Fei; Xiao, Wei; Fu, Xiuqiong; Jiang, Pingping; Chen, Jieyu; Xiang, Lei; Liu, Yanyan; Nie, Xiaoli; Luo, Ren; Sun, Xiaomin; Kwan, Hiuyee; Zhao, Xiaoshan

    2016-01-01

    Suboptimal health status (SHS)—an intermediate state between health and illness—refers to functional somatic symptoms that are medically undiagnosed. Although SHS has become a great challenge for global public health, very little about its etiology and mechanisms are known. Work-recreation balance is a part of work−life balance, and is related to stress which greatly influences health status. We therefore carried out a cross-sectional investigation between 2012 and 2013 within a clustered sample of 24,475 individuals aged 15−60 years from a population in southern China. In so doing, we hoped to illuminate the associations between work-recreation balance conditions, healthy lifestyles, and SHS. Work-recreation balance conditions were categorically defined by frequency (“rarely, sometimes, or always”). Health-Promoting Lifestyle Profile (HPLP-II) was used to evaluate the level of healthy lifestyles, and the medical examination report and Sub-Health Measurement Scale V1.0 (SHMS V1.0) were both used to evaluate health status. The ratio of SHS (46.3%) is higher than health status (18.4%) or disease status (35.3%). Overall, 4.9% of respondents reported the lowest level of work-recreation balance, and they scored lower on both the HPLP-II and SHMS V1.0 compared with those who frequently maintained a work-recreation balance. Significant association was found between work-recreation balance behaviors and healthy lifestyles (p work-recreation balance, individuals whose work-recreation balance was categorically “rare” were 1.69 times as likely to develop SHS (odds ratio (OR): 1.69, 95% confidence interval (CI): 1.49–1.92), and those with infrequent work-recreation balance (“sometimes”) were 1.71 times more likely to develop SHS (OR: 1.71, 95% CI: 1.62–1.81). These findings suggest that work-recreation balance conditions are significantly associated with, and seem to be accurate behavioral indicia of a healthy lifestyle. Poor work-recreation balance is

  5. Work-Recreation Balance, Health-Promoting Lifestyles and Suboptimal Health Status in Southern China: A Cross-Sectional Study.

    Science.gov (United States)

    Wu, Shengwei; Xuan, Zhengzheng; Li, Fei; Xiao, Wei; Fu, Xiuqiong; Jiang, Pingping; Chen, Jieyu; Xiang, Lei; Liu, Yanyan; Nie, Xiaoli; Luo, Ren; Sun, Xiaomin; Kwan, Hiuyee; Zhao, Xiaoshan

    2016-03-19

    Suboptimal health status (SHS)-an intermediate state between health and illness--refers to functional somatic symptoms that are medically undiagnosed. Although- SHS has become a great challenge for global public health, very little about its etiology and mechanisms are known. Work-recreation balance is a part of work-life balance, and is related to stress which greatly influences health status. We therefore carried out a cross-sectional investigation between 2012 and 2013 within a clustered sample of 24,475 individuals aged 15-60 years from a population in southern China. In so doing, we hoped to illuminate the associations between work-recreation balance conditions, healthy lifestyles, and SHS. Work-recreation balance conditions were categorically defined by frequency ("rarely, sometimes, or always"). Health-Promoting Lifestyle Profile (HPLP-II) was used to evaluate the level of healthy lifestyles, and the medical examination report and Sub-Health Measurement Scale V1.0 (SHMS V1.0) were both used to evaluate health status. The ratio of SHS (46.3%) is higher than health status (18.4%) or disease status (35.3%). Overall, 4.9% of respondents reported the lowest level of work-recreation balance, and they scored lower on both the HPLP-II and SHMS V1.0 compared with those who frequently maintained a work-recreation balance. Significant association was found between work-recreation balance behaviors and healthy lifestyles (p work-recreation balance, individuals whose work-recreation balance was categorically "rare" were 1.69 times as likely to develop SHS (odds ratio (OR): 1.69, 95% confidence interval (CI): 1.49-1.92), and those with infrequent work-recreation balance ("sometimes") were 1.71 times more likely to develop SHS (OR: 1.71, 95% CI: 1.62-1.81). These findings suggest that work-recreation balance conditions are significantly associated with, and seem to be accurate behavioral indicia of a healthy lifestyle. Poor work-recreation balance is associated with

  6. Changes in chronic disease management among community health centers (CHCs) in China: Has health reform improved CHC ability?

    Science.gov (United States)

    Wang, Zhaoxin; Shi, Jianwei; Wu, Zhigui; Xie, Huiling; Yu, Yifan; Li, Ping; Liu, Rui; Jing, Limei

    2017-07-01

    Since the 1980s, China has been criticized for its mode of chronic disease management (CDM) that passively provides treatment in secondary and tertiary hospitals but lacks active prevention in community health centers (CHCs). Since there are few systematic evaluations of the CHCs' methods for CDM, this study aimed to analyze their abilities. On the macroperspective, we searched the literature in China's largest and most authoritative databases and the official websites of health departments. Literature was used to analyze the government's efforts in improving CHCs' abilities to perform CDM. At the microlevel, we examined the CHCs' longitudinal data after the New Health Reform in 2009, including financial investment, facilities, professional capacities, and the conducted CDM activities. A policy analysis showed that there was an increasing tendency towards government efforts in developing CDM, and the peak appeared in 2009. By evaluating the reform at CHCs, we found that there was an obvious increase in fiscal and public health subsidies, large-scale equipment, general practitioners, and public health physicians. The benefited vulnerable population in this area also rose significantly. However, rural centers were inferior in their CDM abilities compared with urban ones, and the referral system is still not effective in China. This study showed that CHCs are increasingly valued in managing chronic diseases, especially after the New Health Reform in 2009. However, we still need to improve collaborative management for chronic diseases in the community and strengthen the abilities of CHCs, especially in rural areas. Copyright © 2017 John Wiley & Sons, Ltd.

  7. Urban-rural disparities in child nutrition-related health outcomes in China: The role of hukou policy.

    Science.gov (United States)

    Liu, Hong; Rizzo, John A; Fang, Hai

    2015-11-23

    Hukou is the household registration system in China that determines eligibility for various welfare benefits, such as health care, education, housing, and employment. The hukou system may lead to nutritional and health disparities in China. We aim at examining the role of the hukou system in affecting urban-rural disparities in child nutrition, and disentangling the institutional effect of hukou from the effect of urban/rural residence on child nutrition-related health outcomes. This study uses data from the China Health and Nutrition Survey 1993-2009 with a sample of 9616 children under the age of 18. We compute height-for-age z-score and weight-for-age z-score for children. We use both descriptive statistics and multiple regression techniques to study the levels and significance of the association between child nutrition-related health outcomes and hukou type. Children with urban hukou have 0.25 (P system exacerbates urban-rural disparities in child nutrition-related health outcomes independent of the well-known disparity stemming from urban-rural residence. Fortunately, however, child health disparities due to hukou have been declining since 2000.

  8. Health insurance coverage and impact: a survey in three cities in China.

    Science.gov (United States)

    Fang, Kuangnan; Shia, BenChang; Ma, Shuangge

    2012-01-01

    China has one of the world's largest health insurance systems, composed of government-run basic health insurance and commercial health insurance. The basic health insurance has undergone system-wide reform in recent years. Meanwhile, there is also significant development in the commercial health insurance sector. A phone call survey was conducted in three major cities in China in July and August, 2011. The goal was to provide an updated description of the effect of health insurance on the population covered. Of special interest were insurance coverage, gross and out-of-pocket medical cost and coping strategies. Records on 5,097 households were collected. Analysis showed that smaller households, higher income, lower expense, presence of at least one inpatient treatment and living in rural areas were significantly associated with a lower overall coverage rate. In the separate analysis of basic and commercial health insurance, similar factors were found to have significant associations. Higher income, presence of chronic disease, presence of inpatient treatment, higher coverage rates and living in urban areas were significantly associated with higher gross medical cost. A similar set of factors were significantly associated with higher out-of-pocket cost. Households with lower income, inpatient treatment, higher commercial insurance coverage, and living in rural areas were significantly more likely to pursue coping strategies other than salary. The surveyed cities and surrounding rural areas had socioeconomic status far above China's average. However, there was still a need to further improve coverage. Even for households with coverage, there was considerable out-of-pocket medical cost, particularly for households with inpatient treatments and/or chronic diseases. A small percentage of households were unable to self-finance out-of-pocket medical cost. Such observations suggest possible targets for further improving the health insurance system.

  9. Gender differences in the use of health care in China: cross-sectional analysis.

    Science.gov (United States)

    Song, Yan; Bian, Ying

    2014-01-30

    Differences between women and men in education, employment, political and economic empowerment have been well-documented in China due to the long traditional culture that male is superior to female. This study is to explore whether the similar gender differences exist in the use of health care by analyzing hospital admission, duration of hospitalization and medical expense of both genders in a Chinese hospital. This cross-sectional study evaluated the gender differences in clinical and epidemiologic characteristics of patients who were admitted for any reason to hospital in Zhuhai Special Economic Zone, Southern China, from January 1, 2003, through December 31, 2009. Chi-square test was used to calculate differences between proportions and the t test was used to test differences between means. A total of 156,887 patients were recruited in the analysis, with a male/female ratio of 1.1:1.0. The average age and the duration of hospitalization were significantly greater among men (p women were not significant (p > 0.05). Among all the self-paid patients, men were also superior in all investigating variables compared with women. Gender differences in the use of health care do occur in China. Despite of demographic factors, the differences between female and male can be in part explained by social power relations. China should increase attention to gender and equity in health.

  10. The Smart Health Initiative in China: The Case of Wuhan, Hubei Province.

    Science.gov (United States)

    Fan, Meiyu; Sun, Jian; Zhou, Bin; Chen, Min

    2016-03-01

    To introduce smart health in Wuhan, and provide some references for other cities. As the largest mega-city in central China, Wuhan is investing large amounts of resources to push forward the development of Smart Wuhan and Health Wuhan, and it has unique features. It is one of the centerpieces of China's New Healthcare Reform, and great hope is put on it to help solve the conflict between limited healthcare resources and the large population of patients. How to plan and design smart health is important. The construction of Wuhan Smart Health includes some aspects as follows, like requirement analysis, the establishment of objectives and blueprint, the architecture design of regional health information platform, evaluation and implementation, problems and solutions, and so on. Wuhan Smart Health has obtained some achievements in health network, information systems, resident's health records, information standard, and the first phase of municipal health information platform. The focus of this article is the whole construction process of smart health in Wuhan. Although there are some difficulties during this period, some smart health services and management have been reflected. Compared with other cities or countries, Wuhan Smart Health has its own advantages and disadvantages. This study aims to provide a reference for other cities. Because smart health of Wuhan is characteristic in construction mode. Though still in the initial stage, it has great potentials in the future.

  11. A population-based study on health-related quality of life among urban community residents in Shenyang, Northeast of China.

    Science.gov (United States)

    Song, Tian; Ding, Yan-wei; Sun, Yan; He, Yi-Ni; Qi, Dian-Jun; Wu, Ying; Wu, Bin; Lang, Lang; Yu, Kai; Zhao, Xin; Zhu, Liang-liang; Wang, Shuang; Yu, Xiao-Song

    2015-09-19

    Due to the rising standard of living environment and advances in public health and medical care in China, it has been a tendency in recent years that health-related quality of life (HRQoL) has been increasingly acknowledged in community health management. However, large-scale population-based study on evaluating HQRoL in northeast of China was not conducted. This article aims to investigate the HRQoL in community residents in Northeast China and explore the associated factors. Stratified multiple-stage sampling method was used in the cross-sectional survey to investigate HRQoL of community residents in northeast of China. Univariate analysis and multiple linear regressions were used to analyze the factors associated to HRQoL of the community residents. The results were confirmed that HRQoL in general population was well performed for the first time in northeast of China in a large scale population. Community residents had better mental health than physical health. The factors influencing HRQoL included gender, age, educational level, marital status, ethnic group, chronic disease status, having breakfast frequency weekly and sleep quality. However, drinking and smoking habits did not affect residents' HRQoL. In this study, the result of the large-scale survey was satisfactory in northeast of China, providing HRQoL status of community residents. Policies on specific health management in community public health would emphasize on lifestyle behaviors especially eating habits in order to improving HRQoL.

  12. Mental Health of the Prison Medical Workers (PMWs and Influencing Factors in Jiangxi, China

    Directory of Open Access Journals (Sweden)

    Xiaojun Liu

    2017-11-01

    Full Text Available Prison medical workers (PMWs are critically important, but they are also vulnerable to psychological problems. Currently, there is no study on examining PMWs’ mental health conditions and possible influencing factors in China. Hence, we conducted this cross-sectional survey, aiming to understand the mental health status of the PMWs and related impact factors in Jiangxi province of China. We employed the Chinese version of the Symptom Checklist-90-R (SCL-90-R to assess the mental disorders and psychological health conditions of PMWs in Jiangxi. The t tests were used to compare the differences for the average score of SCL-90-R between the Chinese general population and targeted PMWs of this study. Multivariable logistic regression analyses were conducted to identify the main factors associated with overall detection rate of PMWs’ psychological health conditions. The scores of four dimensions (somatization, obsessive-compulsive symptoms, anxiety, and paranoid ideation were significantly higher than the Chinese national norm, and the total positive rate was 49.09% among the PMWs. Gender, marital status, age, and length of employment are identified to be the most significant predictors to affect PMWs’ mental health. Positive correlations between each of the nine dimensions of the SCL-90-R have been verified. This study demonstrated for the first time that PMWs are facing mental health risk and suffering serious psychological problems with psychopathology symptoms, which has become a growing concern in China. Our current findings suggest a need for more in-depth studies on this subject going forward to validate our conclusions and also to identify more impact factors, since such studies and knowledge of PMWs’ mental health and influencing factors are very limited in China.

  13. Social capital, neighbourhood characteristics and utilisation of local public health services among domestic migrants in China: a cross-sectional study

    Science.gov (United States)

    Hou, Zhiyuan; Lin, Senlin; Zhang, Donglan

    2017-01-01

    Objectives We examined the association between structural social capital and public health services use, and explored the modifiable effect of neighbourhood factors on this association among domestic migrants in China. Methods Data were from a 2014 nationally representative cross-sectional sample of domestic migrants aged 15–59 years in China. Survey-weighted logistic regression models were applied to assess the association between structural social capital, measured by participation in social organisations and social activities, and use of public health services. Interaction terms between neighbourhood urban status, neighbourhood composition and social capital were further assessed in the models. Results Migrants who participated in social organisations were more likely to establish health records (OR 1.467, 95% CI 1.201 to 1.793) and receive health education information (OR 1.729, 95% CI 1.484 to 2.016) than those who did not. Participation in social activities was positively associated with establishing health records only in urban communities (OR 1.853, 95% CI 1.060 to 3.239), and it was positively linked to receiving health education information among those living with a higher percentage of local neighbours (OR 1.451, 95% CI 1.044 to 2.017). Conclusions Structural social capital was related to an increased utilisation of local public health services among migrants. The findings of this study provided new evidence for the differential influences of social capital by neighbourhood characteristics in China, which suggested the importance to enhance social capital in rural/suburban communities and communities where the majority of the residents were migrants. PMID:28821507

  14. Progress and challenges in maternal health in western China: a Countdown to 2015 national case study

    Directory of Open Access Journals (Sweden)

    Yanqiu Gao, PhD

    2017-05-01

    Full Text Available Summary: Background: China is one of the few Countdown countries to have achieved Millennium Development Goal 5 (75% reduction in maternal mortality ratio between 1990 and 2015. We aimed to examine the health systems and contextual factors that might have contributed to the substantial decline in maternal mortality between 1997 and 2014. We chose to focus on western China because poverty, ethnic diversity, and geographical access represent particular challenges to ensuring universal access to maternal care in the region. Methods: In this systematic assessment, we used data from national census reports, National Statistical Yearbooks, the National Maternal and Child Health Routine Reporting System, the China National Health Accounts report, and National Health Statistical Yearbooks to describe changes in policies, health financing, health workforce, health infrastructure, coverage of maternal care, and maternal mortality by region between 1997 and 2014. We used a multivariate linear regression model to examine which contextual and health systems factors contributed to the regional variation in maternal mortality ratio in the same period. Using data from a cross-sectional survey in 2011, we also examined equity in access to maternity care in 42 poor counties in western China. Findings: Maternal mortality declined by 8·9% per year between 1997 and 2014 (geometric mean ratio for each year 0·91, 95% CI 0·91–0·92. After adjusting for GDP per capita, length of highways, female illiteracy, the number of licensed doctors per 1000 population, and the proportion of ethnic minorities, the maternal mortality ratio was 118% higher in the western region (2·18, 1·44–3·28 and 41% higher in the central region (1·41, 0·99–2·01 than in the eastern region. In the rural western region, the proportion of births in health facilities rose from 41·9% in 1997 to 98·4% in 2014. Underpinning such progress was the Government's strong commitment to long

  15. [A general review on women's health education of modern China].

    Science.gov (United States)

    Wang, Shaoyang

    2015-07-01

    In the modern social background of strengthening the nation and its people, woman's health got the attention of Chinese and became one important part in the modernization progress of state and nation, they started the work of women's health education, publicized women's health knowledge and nursery methods through many ways and carried out midwifery education.In the name of "health", woman's body gradually be socialized and internationalized. Meanwhile, Chinese women also gradually got rid of their own discipline of the state and society, began to seek their own liberation, became one important part of China's modernization.

  16. Demographics, phenotypic health characteristics and genetic analysis of centenarians in China

    DEFF Research Database (Denmark)

    Zeng, Yi; Feng, Qiushi; Gu, Danan

    2017-01-01

    -old aged 65-79. Based on the CLHLS data and other relevant studies, we summarize demographic and socioeconomic characteristics as well as self-reported and objectively-tested health indicators of centenarians in China, with an emphasis on gender differences and rural/urban disparities. We then compare five......After a brief introduction to the background, significance and unique features of the centenarian population in China, we describe the Chinese Longitudinal Healthy Longevity Study (CLHLS), which is the world's largest study of centenarians, nonagenarians, octogenarians, and compatible young...

  17. 75 FR 60159 - WTO Dispute Settlement Proceeding Regarding China-Certain Measures Affecting Electronic Payment...

    Science.gov (United States)

    2010-09-29

    ... measures: Measures for the Administration of Bank Card Business by the People's Bank of China (Yinfa [1999] 17), issued on 27 January 1999; Circular of the People's Bank of China on Promulgation of Opinions on...; Circular on Uniform Use of CUP Logo and its Holographic Label for Anti-counterfeiting by the People's Bank...

  18. 76 FR 12401 - WTO Dispute Settlement Proceeding Regarding China-Certain Measures Affecting Electronic Payment...

    Science.gov (United States)

    2011-03-07

    ... measures: Measures for the Administration of Bank Card Business by the People's Bank of China (Yinfa [1999] 17), issued on 27 January 1999; Circular of the People's Bank of China on Promulgation of Opinions on...; Circular on Uniform Use of CUP Logo and its Holographic Label for Anti-counterfeiting by the People's Bank...

  19. Air quality and students' health in Shanghai (China): an educational and scientific project

    Science.gov (United States)

    Bigot-Cormier, Florence; Nicolaï, Marie-Pierre; Martinez, Claire-Marie; Bethmont, Valérie; Guinot, Benjamin

    2014-05-01

    The quality of our environment and especially air quality is a hot topic in any urban environment. Hourly air quality data tend to be easily available to the populations either in the news or on mobile phones. Studies underlining the relationship between environment and health exist in developed countries, but the results cannot be used in such different environmental and sociological contexts as the ones we have in China. In collaboration with the CNRS, students from the Lycée Français de Shanghai (LFS- 5th and 2nd grade) undertake a study in order to obtain an empiric relationship between the atmospheric pollutants they are exposed to in and out the classrooms, and their own health. This study is a part of a scientific and educational project including Beijing, and possibly other foreign schools in Asia later on. The atmospheric pollution in China is essentially caused by particles from different sizes mainly coming from coal combustion. First, in order to quantify the pollution at Shanghai, the students are recording information regarding fine particles as PM2.5 and PM1.0, NO2, SO2, and O3 using active and passive sensors indoors and outdoors, within the school campus. CO2, temperature and relative humidity are used to qualify the confinement rate indoors. In parallel, approximately 100 students (chosen regarding their age, health records, residence time in China…) and some teachers are going to complete a monthly survey regarding their health. Moreover, they will perform some specific measurements to obtain their breathing performances by spirometry, and an indication of the inflammation of their lower airways by exhaled NO measurements. The protocol of these experimentations and the first results will be presented in the poster. At the end of the project, these results will allow us to get a better knowledge about the air pollution we are exposed to, within the school campus, which will help us to adopt an optimized risk management protocol when pollution

  20. Oral health status of rural-urban migrant children in South China.

    Science.gov (United States)

    Gao, Xiao-Li; McGrath, Colman; Lin, Huan-Cai

    2011-01-01

    In China, there is a massive rural-urban migration and the children of migrants are often unregistered residents (a 'floating population'). This pilot study aimed to profile the oral health of migrant children in South China's principal city of migration and identify its socio-demographic/behavioural determinants. An epidemiological survey was conducted in an area of Guangzhou among 5-year-old migrant children (n = 138) who received oral examinations according to the World Health Organization criteria. Parents' oral health knowledge/attitude, child practices, and impact of children's oral health on their quality-of-life (QoL) were assessed. The caries rate and mean (SD) dmft were 86% and 5.17 (4.16), respectively, higher than those national statistics for both rural and urban areas (P Oral hygiene was satisfactory (DI-S Oral health impacts on QoL were considerable; 60% reported one or more impacts. 58% variance in 'dmft' was explained by 'non-local-born', 'low-educated parents', 'bedtime feeding', 'parental unawareness of fluoride's effect and importance of teeth', and 'poor oral hygiene' (all P oral health-related QoL (both P Oral health is poor among rural-urban migrant children and requires effective interventions in targeted sub-groups. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.

  1. [Pollution characteristics and health risk assessment of atmospheric VOCs in the downtown area of Guangzhou, China].

    Science.gov (United States)

    Li, Lei; Li, Hong; Wang, Xue-Zhong; Zhang, Xin-Min; Wen, Chong

    2013-12-01

    The measurements of 31 kinds of VOCs in the ambient air of a site were carried out in the downtown of Guangzhou by online method from November 5, 2009 to November 9, 2009. The ambient level and composition characteristics, temporal variation characteristics, sources identification, and chemical reactivity of VOCs were studied, and the health risk of VOCs in the ambient air in the study area was assessed by using the international recognized health risk assessment method. Results showed that the mean and the range of the mass concentrations of 31 VOCs were 114.51 microg x m(-3) and 29.42-546.06 microg x m(-3), respectively. The mass concentrations of 31 VOCs, and those of alkanes, alkenes, and aromatics all showed a changing trend of higher in the morning and in the evening, and lower at noontime. Vehicular exhaust, gasoline and liquefied petroleum gas evaporates were the main sources of VOCs with the volatilization of paints and solvents being important emission sources. Toluene, trans-2-butene, m/p-xylene, i-butane, and 1,3,5-trimethylbenzene were the key reactive species among the 31 VOCs. Vehicular exhaust and gasoline evaporation were the main sources of VOCs leading to the formation of ozone. Health risk assessment showed that n-hexane, 1,3-butadiene, benzene, toluene, ethylbenzene, m/p-xylene and o-xylene had no appreciable risk of adverse non-cancer health effect on the exposed population, but 1, 3-butadiene and benzene had potential cancer risk. By comparing the corresponding data about health risk assessment of benzene compounds in some cities in China, it is concluded that benzene can impose relatively high cancer risk to the exposed populations in the ambient air of some cities in China. Therefore, strict countermeasures should be taken to further control the pollution of benzene in the ambient air of cities, and it is imperative to start the related studies and develop the atmospheric environmental health criteria and national ambient air quality

  2. A comparative study of vocational education and occupational safety and health training in China and the UK.

    Science.gov (United States)

    Nie, Baisheng; Huang, Xin; Xue, Fei; Chen, Jiang; Liu, Xiaobing; Meng, Yangyang; Huang, Jinxin

    2018-06-01

    In order to enhance Chinese workers' occupational safety awareness, it is essential to learn from developed countries' experiences. This article investigates thoroughly occupational safety and health (OSH) in China and the UK; moreover, the article performs a comparison of Chinese and British OSH training-related laws, regulations and education system. The following conclusions are drawn: China's work safety continues to improve, but there is still a large gap compared with the UK. In China a relatively complete vocational education and training (VET) system has been established. However, there exist some defects in OSH. In the UK, the employer will not only pay attention to employees' physiological health, but also to their mental health. The UK's VET is characterized by classification and grading management, which helps integrate OSH into the whole education system. China can learn from the UK in the development of policies, VET and OSH training.

  3. Traditional oral health beliefs and practices of Bulang people in Yunnan, China.

    Science.gov (United States)

    Zhang, Shinan; Lo, Edward C M; Chu, Chun-Hung

    2018-02-01

    The aim of the present study was to explore traditional oral health beliefs among the Bulang ethnic minority group in China. Eighteen village leaders, chiefs, elders, and seniors in Yunnan, China were assigned to three focus groups for discussion of traditional oral health beliefs. The discussions were led by a facilitator. Transcripts were made, and data were extracted. The focus group discussions on traditional oral health beliefs addressed three themes: (a) the perception of oral health; (b) the impact of healthy teeth (oral health), in that healthy teeth essentially have an impact on physical health, emotions, and social status; and (c) toothache management, which was regarded as tooth decay (dental caries). Blackening teeth was a pain relief method. Blackened teeth were reported to be part of ethnic identity, and considered esthetically pleasing. It also indicated the marital status of women. Some Bulang people believed that healthy dentition has no spacing, pain, or functioning problems. Well-aligned dentition was associated with higher social status. Toothaches were considered to be caused by tooth worms. Consulting a monk was another way to manage a toothache. Tooth blackening was considered traditional, and effective for caries prevention. © 2017 John Wiley & Sons Australia, Ltd.

  4. Barriers and facilitators to diabetes self-management: perspectives of older community dwellers and health professionals in China.

    Science.gov (United States)

    Shen, Huixia; Edwards, Helen; Courtney, Mary; McDowell, Jan; Wei, Juan

    2013-12-01

    Little is known about self-management among people with Type 2 diabetes living in mainland China. Understanding the experiences of this target population is needed to provide socioculturally relevant education to effectively promote self-management. The aim of this study was to explore perceived barriers and facilitators to diabetes self-management for both older community dwellers and health professionals in China. Four focus groups, two for older people with diabetes and two for health professionals, were conducted. All participants were purposively sampled from two communities in Shanghai, China. Six barriers were identified: overdependence on but dislike of western medicine, family role expectations, cuisine culture, lack of trustworthy information sources, deficits in communication between clients and health professionals, and restriction of reimbursement regulations. Facilitators included family and peer support, good relationships with health professionals, simple and practical instruction and a favourable community environment. The findings provide valuable information for diabetes self-management intervention development in China, and have implications for programmes tailored to populations in similar sociocultural circumstances. © 2013 Wiley Publishing Asia Pty Ltd.

  5. Does health insurance reduce out-of-pocket expenditure? Heterogeneity among China's middle-aged and elderly.

    Science.gov (United States)

    Zhang, Anwen; Nikoloski, Zlatko; Mossialos, Elias

    2017-10-01

    China's recent healthcare reforms aim to provide fair and affordable health services for its huge population. In this paper, we investigate the association between China's health insurance and out-of-pocket (OOP) healthcare expenditure. We further explore the heterogeneity in this association. Using data of 32,387 middle-aged and elderly individuals drawn from the 2011 and 2013 waves of China Health and Retirement Longitudinal Study (CHARLS), we report five findings. First, having health insurance increases the likelihood of utilizing healthcare and reduces inpatient OOP expenditure. Second, healthcare benefits are distributed unevenly: while low- and medium-income individuals are the main beneficiaries with reduced OOP expenditure, those faced with very high medical bills are still at risk, owing to limited and shallow coverage in certain aspects. Third, rural migrants hardly benefit from having health insurance, suggesting that institutional barriers are still in place. Fourth, health insurance does not increase patient visits to primary care facilities; hospitals are still the main provider of healthcare. Nonetheless, there is some evidence that patients shift from higher-tier to lower-tier hospitals. Last, OOP spending on pharmaceuticals is reduced for inpatient care but not for outpatient care, suggesting that people rely on inpatient care to obtain reimbursable drugs, putting further pressure on the already overcrowded hospitals. Our findings suggest that China's health insurance system has been effective in boosting healthcare utilization and lowering OOP hospitalization expenditure, but there still remain challenges due to the less generous rural scheme, shallow outpatient care coverage, lack of insurance portability, and an underdeveloped primary healthcare system. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Positive future orientation as a mediator between traumatic events and mental health among children affected by HIV/AIDS in rural China.

    Science.gov (United States)

    Zhang, Jintao; Zhao, Guoxiang; Li, Xiaoming; Hong, Yan; Fang, Xiaoyi; Barnett, Douglas; Lin, Xiuyun; Zhao, Junfeng; Zhang, Liying

    2009-12-01

    The current study was designed to explore the effect of future orientation in mediating the relationship between traumatic events and mental health in children affected by HIV/AIDS in rural China. Cross-sectional data were collected from 1221 children affected by HIV/AIDS (755 AIDS orphans and 466 vulnerable children). Future orientation among children was measured using three indicators (future expectation, hopefulness toward the future, and perceived control over the future). Measures of mental health consisted of depression, loneliness, and self-esteem. Children's experience of any traumatic events was measured using a modified version of the Life Incidence of Traumatic Events-Student Form. Mediation analysis was conducted using structural equation modeling (SEM) methods. Among the children surveyed, most of the traumatic indicators were negatively associated with future expectation, hopefulness, perceived control, and self-esteem, and positively associated with depression and loneliness. The SEM of mediation analysis demonstrated an adequate fit. Future orientation fully mediated the relationship between traumatic events and mental health and accounted for 67.9% of the total effect of traumatic events on mental health. Results of this study support the positive effect of future expectation in mediating the relationship between traumatic events and mental health among children affected by HIV/AIDS in China. Future mental health promotion and intervention efforts targeting children affected by HIV/AIDS should include components that can mitigate the negative impact of traumatic events on their lives. These components may aim to develop children's positive future expectations, increase their hopefulness toward the future, and improve their perceived control over the future.

  7. Job satisfaction of urban community health workers after the 2009 healthcare reform in China: a systematic review.

    Science.gov (United States)

    Zhang, Mingji; Yang, Rongrong; Wang, Wei; Gillespie, James; Clarke, Susan; Yan, Fei

    2016-02-01

    In 2009 China introduced a new round of healthcare reform to strengthen primary care networks through the development of Community Health Services (CHS). This study aimed to measure the degree of overall job satisfaction and also satisfaction dimensions and then find common causes of dissatisfaction among Community Health Workers (CHWs) in urban China by conducting a systematic review of relevant studies on CHWs' job satisfaction. Web of Science, PubMed, Google scholar, Wanfangdata and CNKI were searched. Publications about job satisfaction of CHWs were screened and assessed. Finally 18 Chinese articles and 4 English articles were included. Quantitative and qualitative data were extracted for nine themes concerning job satisfaction. Narrative synthesis was employed to analyze the data. CHWs were generally neither satisfied nor dissatisfied with their work after 2009. Financial rewards and opportunities for professional development were the most important determinants of job dissatisfaction. Workers were generally satisfied with interpersonal relationships in the workplace. The expanded public health services package and human-resources related regulations, e.g. the professional rank promotion system, government-controlled staffing policy (i.e. staff-quota system) and government-controlled budgetary planning (i.e. the Separation of Revenue and Expenditure), were policies that had an effect on job satisfaction. Financial rewards and professional development were the two main predictors of job satisfaction. To improve CHS in China, policy-makers (especially the central government) need to consider the impact of current policies on job satisfaction in order to reduce job dissatisfaction. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  8. Insured without moral hazard in the health care reform of China.

    Science.gov (United States)

    Wong, Chack-Kie; Cheung, Chau-Kiu; Tang, Kwong-Leung

    2012-01-01

    Public insurance possibly increases the use of health care because of the insured person's interest in maximizing benefits without incurring out-of-pocket costs. A newly reformed public insurance scheme in China that builds on personal responsibility is thus likely to provide insurance without causing moral hazard. This possibility is the focus of this study, which surveyed 303 employees in a large city in China. The results show that the coverage and use of the public insurance scheme did not show a significant positive effect on the average employee's frequency of physician consultation. In contrast, the employee who endorsed public responsibility for health care visited physicians more frequently in response to some insurance factors. On balance, public insurance did not tempt the average employee to consult physicians frequently, presumably due to personal responsibility requirements in the insurance scheme.

  9. Validity of COPD diagnoses reported through nationwide health insurance systems in the People’s Republic of China

    Directory of Open Access Journals (Sweden)

    Kurmi OP

    2016-03-01

    Full Text Available Om P Kurmi,1 Julien Vaucher,1 Dan Xiao,2 Michael V Holmes,1 Yu Guo,3 Kourtney J Davis,4 Chen Wang,5 Haiyan Qin,6 Iain Turnbull,1 Peng Peng,7 Zheng Bian,3 Robert Clarke,1 Liming Li,8 Yiping Chen,1 Zhengming Chen1 On behalf of the China Kadoorie Biobank collaborative group 1Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU, Nuffield Department of Population Health, University of Oxford, Oxford, UK; 2Tobacco Medicine and Tobacco Cessation Center, China–Japan Friendship Hospital, Beijing, People’s Republic of China; 3National Coordinating Centre for China Kadoorie Biobank Study, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 4Worldwide Epidemiology, GlaxoSmithKline R&D, Collegeville, PA, USA; 5National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 6Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China; 7Radiology Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China; 8Department of Epidemiology, School of Public Health, Peking University Health Science Center, Beijing, People’s Republic of China Background: COPD is the fourth leading cause of death worldwide, with particularly high rates in the People’s Republic of China, even among never smokers. Large population-based cohort studies should allow for reliable assessment of the determinants of diseases, which is dependent on the quality of disease diagnoses. We assessed the validity of COPD diagnoses collected through electronic health records in the People’s Republic of China. Methods: The CKB study recruited 0.5 million adults aged 30–79 years from ten diverse regions in the People’s Republic of China during the period 2004–2008. During 7 years of follow-up, 11,800 COPD cases were identified by linkage with mortality registries and the national

  10. Meeting the oral health needs of 12-year-olds in China: human resources for oral health

    Directory of Open Access Journals (Sweden)

    Xiangyu Sun

    2017-06-01

    Full Text Available Abstract Background An appropriate level of human resources for oral health [HROH] is required to meet the oral health needs of population, and enable maximum improvement in health outcomes. The aim of this study was to estimate the required HROH to meet the oral health needs of the World Health Organization [WHO] reference group of 12-year-olds in China and consider the implications for education, practice, policy and HROH nationally. Methods We estimated the need of HROH to meet the needs of 12-year-olds based on secondary analysis of the epidemiological and questionnaire data from the 3rd Chinese National Oral Health Survey, including caries experience and periodontal factors (calculus, dentally-related behaviour (frequency of toothbrushing and sugar intake, and social factors (parental education. Children’s risk for dental caries was classified in four levels from low (level 1 to high (level 4. We built maximum and minimum intervention models of dental care for each risk level, informed by contemporary evidence-based practice. The needs-led HROH model we used in the present study incorporated need for treatment and risk-based prevention using timings verified by experts in China. These findings were used to estimate HROH for the survey sample, extrapolated to 12-year-olds nationally and the total population, taking account of urban and rural coverage, based on different levels of clinical commitment (60-90%. Results We found that between 40,139 and 51,906 dental professionals were required to deliver care for 12-year-olds nationally based on 80% clinical commitment. We demonstrated that the majority of need for HROH was in the rural population (72.5%. Over 93% of HROH time was dedicated to prevention within the model. Extrapolating the results to the total population, the estimate for HROH nationally was 3.16–4.09 million to achieve national coverage; however, current HROH are only able to serve an estimated 5% of the population with

  11. Integrated assessment of the health and economic benefits of long-term renewable energy development in China

    Science.gov (United States)

    Dai, H.; Xie, Y.; Zhang, Y.

    2017-12-01

    Context/Purpose: Power generation from renewable energy (RE) could substitute huge amount of fossil energy in the power sector and have substantial co-benefits of air quality and human health improvement. In 2016, China National Renewable Energy Center (CNREC) released China Renewable Energy Outlook, CREO2016 and CREO2017, towards 2030 and 2050, respectively, in which two scenarios are proposed, namely, a conservative "Stated Policy" scenario and a more ambitious "High RE" scenario. This study, together with CNREC, aims to quantify the health and economic benefits of developing renewable energy at the provincial level in China up to 2030 and 2050. Methods: For this purpose, we developed an integrated approach that combines a power dispatch model at CNREC, an air pollutant emission projection model using energy consumption data from the Long-range Energy Alternatives Planning System (LEAP) model, an air quality model (GEOS-Chem at Harvard), an own-developed health model, and a macro economic model (Computable General Equilibrium model). Results: All together, we attempt to quantify how developing RE could reduce the concentration of PM2.5 and ozone in 30 provinces of China, how the human health could be improved in terms of mortality, morbidity and work hour loss, and what is the economic value of the health improvement in terms of increased GDP and the value of statistical life lost. The results show that developing RE as stated in the CREO2016 could prevent chronic mortality of 286 thousand people in China in 2030 alone, the value of saved statistical life is worthy 1200 billion Yuan, equivalent to 1.2% of GDP. In addition, averagely, due to reduced mortality and improved morbidity each person could work additionally by 1.16 hours per year, this could contribute to an increase of GDP by 0.1% in 2030. The assessment up to 2050 is still underway. Interpretation: The results imply that when the external benefit of renewable energy is taken into account, RE could be

  12. A brief, standardized tool for measuring HIV-related stigma among health facility staff: results of field testing in China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis.

    Science.gov (United States)

    Nyblade, Laura; Jain, Aparna; Benkirane, Manal; Li, Li; Lohiniva, Anna-Leena; McLean, Roger; Turan, Janet M; Varas-Díaz, Nelson; Cintrón-Bou, Francheska; Guan, Jihui; Kwena, Zachary; Thomas, Wendell

    2013-11-13

    Within healthcare settings, HIV-related stigma is a recognized barrier to access of HIV prevention and treatment services and yet, few efforts have been made to scale-up stigma reduction programs in service delivery. This is in part due to the lack of a brief, simple, standardized tool for measuring stigma among all levels of health facility staff that works across diverse HIV prevalence, language and healthcare settings. In response, an international consortium led by the Health Policy Project, has developed and field tested a stigma measurement tool for use with health facility staff. Experts participated in a content-development workshop to review an item pool of existing measures, identify gaps and prioritize questions. The resulting questionnaire was field tested in six diverse sites (China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis). Respondents included clinical and non-clinical staff. Questionnaires were self- or interviewer-administered. Analysis of item performance across sites examined both psychometric properties and contextual issues. The key outcome of the process was a substantially reduced questionnaire. Eighteen core questions measure three programmatically actionable drivers of stigma within health facilities (worry about HIV transmission, attitudes towards people living with HIV (PLHIV), and health facility environment, including policies), and enacted stigma. The questionnaire also includes one short scale for attitudes towards PLHIV (5-item scale, α=0.78). Stigma-reduction programmes in healthcare facilities are urgently needed to improve the quality of care provided, uphold the human right to healthcare, increase access to health services, and maximize investments in HIV prevention and treatment. This brief, standardized tool will facilitate inclusion of stigma measurement in research studies and in routine facility data collection, allowing for the monitoring of stigma within healthcare facilities and evaluation of

  13. Quantitative Evaluation of Ecosystem Health in a Karst Area of South China

    Directory of Open Access Journals (Sweden)

    Shengzi Chen

    2016-10-01

    Full Text Available The purpose of this study is to propose a GIS-based mechanism for diagnosing karst rocky desertification (KRD ecosystem health. Using the Huajiang Demonstration Area in Guizhou Province as a case study, this research offers a multi-factor indicator system for diagnosing KRD ecosystem health. A set of geologic, environmental, and socio-economic health indicators were developed based on remote sensing images from field-investigation, hydrological, and meteorological monitoring data. With the use of grid GIS technology, this study gives an indicator for diagnosing the spatial expression of desertification at a 5 m × 5 m grid scale. Using spatial overlaying technology based on grid data, the temporal and spatial dynamics of ecosystem health in the Huajiang Demonstration Area were tracked over a 10 year time span. The results of the analysis indicate that ecosystem health in the Huajiang Demonstration Area varies regionally, and has overall improved over time. The proportion of healthy area increased from 3.7% in 2000 to 8.2% in 2010. However, unhealthy and middle-health areas still accounted for 78.7% of the total area by 2010. The most obvious improvement of ecosystem health was in an area where comprehensive control measures for curbing KRD were implemented. These results suggest that comprehensive control of KRD can effectively mitigate ecosystem deterioration and improve ecosystem health in karst regions of South China.

  14. The comparison of health status between male and female medical radiation workers in China

    International Nuclear Information System (INIS)

    Wang, Hui; Liu, Guochao; Tian, Youjia; Zhang, Fengmei; Feng, Zhihui; Chen, Qianshu; Qu, Jianying; Lim, David

    2017-01-01

    To assess the health statue of chronically exposed Chinese medical radiation workers. A cross-sectional study of 530 medical radiation workers in a city of China was conducted to document the health status and the monitored annually absorbed doses. Long-term and low-dose radiation exposure can affect a number of health indicators in the individuals, which covered the cardiovascular system, hematologic system, ophthalmology, liver and kidney s functions, chromosome aberration and micronucleus. The differences in the health status between male and female individuals were associated with job types and exposed years of service. The monitored doses of individuals were lower than the limit value of the national standard. The health status in chronically exposed individuals demonstrated some gender difference associated with length of exposure and work type. This study provides some evidence to understand the health status of medical radiation workers in China and have the potentially to inform screening and clinical diagnosis. (authors)

  15. Causal effects of informal care and health on falls and other accidents among the elderly population in China.

    Science.gov (United States)

    Wu, Hong; Lu, Naiji; Wang, Chenguang; Tu, Xinming

    2018-03-01

    This article analyzes the causal effects of informal care, mental health, and physical health on falls and other accidents (e.g., traffic accidents) among elderly people. We also examine if there are heterogeneous impacts on elderly of different gender, urban status, and past accident history. To purge potential reversal causal effects, e.g., past accidents induce more future informal care, we use two-stage least squares to identify the impacts. We use longitudinal data from a representative national China Health and Retirement Longitudinal Study of people aged 45 and older in China. A total of 3935 respondents with two-wave data are included in our study. Each respondent is interviewed to measure health status and report their accident history. Mental health is assessed using CES-D questions. Our findings indicate that while informal care decreased the occurrence of accidents, poor health conditions increase the occurrence of accidents. We also find heterogeneous impacts on the occurrence of accidents, varying by gender, urban status, and past accident history. Our findings suggest the following three policy implications. First, policy makers who aim to decrease accidents should take informal care of elders into account. Second, ease of birth policy and postponed retirement policy are urgently needed to meet the demands of informal care. Third, medical policies should attach great importance not only to physical health but also mental health of elderly parents especially for older people with accident history.

  16. Health-seeking behavior and hospital choice in China's New Cooperative Medical System.

    Science.gov (United States)

    Brown, Philip H; Theoharides, Caroline

    2009-07-01

    Since the dissolution of the Rural Cooperative Medical System at the end of the commune period, illness has emerged as a leading cause of poverty in rural China. To address the poor state of health care, the Chinese government unveiled the New Cooperative Medical System in 2002. Because local governments have been given significant control over program design, fundamental characteristics of the program vary from one county to the next. These differences may influence the decision to seek health care as well as the choice of hospital conditional on that initial decision. In this paper, we use a nested logit model to analyze household survey data from 25 counties to analyze the determinants of such health-seeking behavior. We find that age, the share of household expenditures allocated to food consumption (a measure of relative income), and the presence of other sick people in the household negatively affect the decision to seek health care while disability has a positive influence. Further, conditional on seeking treatment, the reimbursement scheme in place in each county and the average daily expenditure associated with hospitalization strongly influence hospital choice.

  17. The impact of rural mutual health care on health status: evaluation of a social experiment in rural China.

    Science.gov (United States)

    Wang, Hong; Yip, Winnie; Zhang, Licheng; Hsiao, William C

    2009-07-01

    Despite widespread efforts to expand health insurance in developing countries, there is scant evidence as to whether doing so actually improves people's health. This paper aims to fill this gap by evaluating the impact of Rural Mutual Health Care (RMHC), a community-based health insurance scheme, on enrollees' health outcomes. RMHC is a social experiment that was conducted in one of China's western provinces from 2003 to 2006. The RMHC experiment adopted a pre-post treatment-control study design. This study used panel data collected in 2002, 1 year prior to the intervention, and followed up in 2005, 2 years after the intervention, both in the intervention and control sites. We measured health status using both a 5-point Categorical Rating Scale and the EQ-5D instruments. The estimation method used here is difference-in-difference combined propensity score matching. The results show that RMHC has a positive effect on the health status of participants. Among the five dimensions of EQ-5D, RMHC significantly reduces pain/discomfort and anxiety/depression for the general population, and has a positive impact on mobility and usual activity for those over 55-years old. Our study provides useful policy information on the development of health insurance in developing countries, and also identifies areas where further research is needed.

  18. Demographics, phenotypic health characteristics and genetic analysis of centenarians in China.

    Science.gov (United States)

    Zeng, Yi; Feng, Qiushi; Gu, Danan; Vaupel, James W

    2017-07-01

    After a brief introduction to the background, significance and unique features of the centenarian population in China, we describe the Chinese Longitudinal Healthy Longevity Study (CLHLS), which is the world's largest study of centenarians, nonagenarians, octogenarians, and compatible young-old aged 65-79. Based on the CLHLS data and other relevant studies, we summarize demographic and socioeconomic characteristics as well as self-reported and objectively-tested health indicators of centenarians in China, with an emphasis on gender differences and rural/urban disparities. We then compare five-year-age-specific trajectories of physical and cognitive functions, self-reported health, and life satisfactions from ages 65-69 to 100+, concluding that good psychological resilience and optimism are keys to the exceptional longevity enjoyed by centenarians. We discuss recent findings of novel loci and pathways that are significantly associated with longevity based on the genome-wide association study (GWAS) of the CLHLS centenarian sample, which is 2.7 times as large as prior GWAS of longevity. We also highlight colleagues' and our own studies on longevity candidate genes and gene-environment interaction analyses. Finally, we discuss limitations inherent in our studies of centenarians in China and further research perspectives. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. How does social capital matter to the health status of older adults? Evidence from the China Health and Retirement Longitudinal Survey.

    Science.gov (United States)

    Liu, Gordon G; Xue, Xindong; Yu, Chenxi; Wang, Yafeng

    2016-09-01

    This paper uses longitudinal data from China to examine the causal relationship between structural social capital and health among Chinese older adults. We employ various econometric strategies to control for the potential endogeneity of social capital and account for the possible contextual confounding effects by including community-level social capital. We use three indicators to measure individuals' general, physical, and mental health. Results indicate that social capital has a significant and positive effect on general and physical health. Based on our primary IV findings, a one standard-deviation increase in social capital leads to a 4.9 standard-deviation decrease in the probability of having bad health and a 2.2 standard-deviation decrease in physical activity limitations. Our results are robust to a series of sensitivity checks. Further analysis suggests heterogeneous effects by age but not by gender or area of residence. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Traditional, complementary, and alternative medicine approaches to mental health care and psychological wellbeing in India and China.

    Science.gov (United States)

    Thirthalli, Jagadisha; Zhou, Liang; Kumar, Kishore; Gao, Jie; Vaid, Henna; Liu, Huiming; Hankey, Alex; Wang, Guojun; Gangadhar, Bangalore N; Nie, Jing-Bao; Nichter, Mark

    2016-07-01

    India and China face the same challenge of having too few trained psychiatric personnel to manage effectively the substantial burden of mental illness within their population. At the same time, both countries have many practitioners of traditional, complementary, and alternative medicine who are a potential resource for delivery of mental health care. In our paper, part of The Lancet and Lancet Psychiatry's Series about the China-India Mental Health Alliance, we describe and compare types of traditional, complementary, and alternative medicine in India and China. Further, we provide a systematic overview of evidence assessing the effectiveness of these alternative approaches for mental illness and discuss challenges in research. We suggest how practitioners of traditional, complementary, and alternative medicine and mental health professionals might forge collaborative relationships to provide more accessible, affordable, and acceptable mental health care in India and China. A substantial proportion of individuals with mental illness use traditional, complementary, and alternative medicine, either exclusively or with biomedicine, for reasons ranging from faith and cultural congruence to accessibility, cost, and belief that these approaches are safe. Systematic reviews of the effectiveness of traditional, complementary, and alternative medicine find several approaches to be promising for treatment of mental illness, but most clinical trials included in these systematic reviews have methodological limitations. Contemporary methods to establish efficacy and safety-typically through randomised controlled trials-need to be complemented by other means. The community of practice built on collaborative relationships between practitioners of traditional, complementary, and alternative medicine and providers of mental health care holds promise in bridging the treatment gap in mental health care in India and China. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. United States import safety, environmental health, and food safety regulation in China.

    Science.gov (United States)

    Nyambok, Edward O; Kastner, Justin J

    2012-01-01

    China boasts a rapidly growing economy and is a leading food exporter. Since China has dominated world export markets in food, electronics, and toys, many safety concerns about Chinese exports have emerged. For example, many countries have had problems with Chinese food products and food-processing ingredients. Factors behind food safety and environmental health problems in China include poor industrial waste management, the use of counterfeit agricultural inputs, inadequate training of farmers on good farm management practices, and weak food safety laws and poor enforcement. In the face of rising import safety problems, the U.S. is now requiring certification of products and foreign importers, pursuing providing incentives to importers who uphold good safety practices, and considering publicizing the names of certified importers.

  2. Disability and ageing in China and India - decomposing the effects of gender and residence. Results from the WHO study on global AGEing and adult health (SAGE).

    Science.gov (United States)

    Stewart Williams, Jennifer; Norström, Fredrik; Ng, Nawi

    2017-08-31

    China and India are the world's two most populous countries. Although their populations are growing in number and life expectancies are extending they have different trajectories of economic growth, epidemiological transition and social change. Cross-country comparisons can allow national and global insights and provide evidence for policy and decision-making. The aim of this study is to measure and compare disability in men and women, and in urban and rural dwellers in China and India, and assess the extent to which social and other factors contribute to the inequalities. National samples of adults aged 50 to 79 years in China (n = 11,694) and India (n = 6187) from the World Health Organization (WHO) longitudinal Study on global AGEing and adult health (SAGE) Wave 1 were analysed. Stratified multiple linear regressions were undertaken to assess disability differences by sex and residence, controlling for other biological and socioeconomic determinants of disability. Oaxaca-Blinder decomposition partitioned the two-group inequalities into explained and unexplained components. In both countries women and rural residents reported more disability. In India, the gender inequality is attributed to the distribution of the determinants (employment, education and chronic conditions) but in China about half the inequality is attributed to the same. In India, more than half of the urban rural inequality is attributed to the distribution of the determinants (education, household wealth) compared with under 20% in China. Education and employment were important drivers of these measured inequalities. Overall inequalities in disability among older adults in China and India were shaped by gender and residence, suggesting the need for policies that target women and rural residents. There is a need for further research, using both qualitative and quantitative methods, to question and challenge entrenched practices and institutions and grasp the implications of global economic

  3. Health impact assessment in China: Emergence, progress and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Huang Zheng, E-mail: huangzhg@mails.tjmu.edu.cn

    2012-01-15

    The values, concepts and approaches of health impact assessment (HIA) were outlined in the Gothenburg consensus paper and some industrialized countries have implemented HIA for many years. HIA has played an important role in environmental protection in China, however, the emergence, progress and challenges of HIA in China have not been well described. In this paper, the evolution of HIA in China was analyzed and the challenges of HIA were presented based on the author's experiences. HIA contributed to decision-making for large capital construction projects, such as the Three Gorges Dam project, in its emergence stage. Increasing attention has been given to HIA in recent years due to supportive policies underpinning development of the draft HIA guidelines in 2008. However enormous challenges lie ahead in ensuring the institutionalization of HIA into project, program and policy decision-making process due to limited scope, immature tools and insufficient professionals in HIA practice. HIA should broaden its horizons by encompassing physical, chemical, biological and socio-economic aspects and constant attempts should be made to integrate HIA into the decision-making process, not only for projects and programs but also for policies as well.

  4. Two-Step Optimization for Spatial Accessibility Improvement: A Case Study of Health Care Planning in Rural China

    Directory of Open Access Journals (Sweden)

    Jing Luo

    2017-01-01

    Full Text Available A recent advancement in location-allocation modeling formulates a two-step approach to a new problem of minimizing disparity of spatial accessibility. Our field work in a health care planning project in a rural county in China indicated that residents valued distance or travel time from the nearest hospital foremost and then considered quality of care including less waiting time as a secondary desirability. Based on the case study, this paper further clarifies the sequential decision-making approach, termed “two-step optimization for spatial accessibility improvement (2SO4SAI.” The first step is to find the best locations to site new facilities by emphasizing accessibility as proximity to the nearest facilities with several alternative objectives under consideration. The second step adjusts the capacities of facilities for minimal inequality in accessibility, where the measure of accessibility accounts for the match ratio of supply and demand and complex spatial interaction between them. The case study illustrates how the two-step optimization method improves both aspects of spatial accessibility for health care access in rural China.

  5. Measuring economic activity in China with mobile big data

    Directory of Open Access Journals (Sweden)

    Lei Dong

    2017-11-01

    Full Text Available Abstract Emerging trends in the use of smartphones, online mapping applications, and social media, in addition to the geo-located data they generate, provide opportunities to trace users’ socio-economic activities in an unprecedentedly granular and direct fashion and have triggered a revolution in empirical research. These vast mobile data offer new perspectives and approaches to measure economic dynamics, and they are broadening the social science and economics fields. In this paper, we explore the potential for using mobile data to measure economic activity in China from a bottom-up view. First, we build indices for gauging employment and consumer trends based on billions of geo-positioning data. Second, we advance the estimation of offline store foot traffic via location search data derived from Baidu Maps, which is then applied to predict Apple’s revenues in China and to accurately detect box-office fraud. Third, we construct consumption indicators to track trends in various service sector industries and verify them with several existing indicators. To the best of our knowledge, this is the first study to measure the world’s second-largest economy by mining such unprecedentedly large-scale and fine-granular spatial-temporal data. In this way, our research provides new approaches and insights into measuring economic activity.

  6. Outpatient prescription practices in rural township health centers in Sichuan Province, China

    Directory of Open Access Journals (Sweden)

    Jiang Qian

    2012-09-01

    Full Text Available Abstract Background Sichuan Province is an agricultural and economically developing province in western China. To understand practices of prescribing medications for outpatients in rural township health centers is important for the development of the rural medical and health services in this province and western China. Methods This is an observational study based on data from the 4th National Health Services Survey of China. A total of 3,059 prescriptions from 30 township health centers in Sichuan Province were collected and analyzed. Seven indicators were employed in the analyses to characterize the prescription practices. They are disease distribution, average cost per encounter, number of medications per encounter, percentage of encounters with antibiotics, percentage of encounters with glucocorticoids, percentage of encounters with combined glucocorticoids and antibiotics, and percentage of encounters with injections. Results The average medication cost per encounter was 16.30 Yuan ($2.59. About 60% of the prescriptions contained Chinese patent medicine (CPM, and almost all prescriptions (98.07% contained western medicine. 85.18% of the prescriptions contained antibiotics, of which, 24.98% contained two or more types of antibiotics; the percentage of prescriptions with glucocorticoids was 19.99%; the percentage of prescriptions with both glucocorticoids and antibiotics was 16.67%; 51.40% of the prescriptions included injections, of which, 39.90% included two or more injections. Conclusions The findings from this study demonstrated irrational medication uses of antibiotics, glucocorticoids and injections prescribed for outpatients in the rural township health centers in Sichuan Province. The reasons for irrational medication uses are not only solely due to the pursuit of maximizing benefits in the township health centers, but also more likely attributable to the lack of medical knowledge of rational medication uses among rural doctors and the

  7. Dietary Pattern Is Associated with Obesity in Older People in China: Data from China Health and Nutrition Survey (CHNS

    Directory of Open Access Journals (Sweden)

    Xiaoyue Xu

    2015-09-01

    Full Text Available Background: No studies have been conducted to explore the associations between dietary patterns and obesity among older Chinese people, by considering gender and urbanization level differences. Methods: We analyzed data from the 2009 China Health and Nutrition Survey (2745 individuals, aged ≥ 60 years. Dietary data were obtained using 24 hour-recall over three consecutive days. Height, Body Weight, and Waist Circumference were measured. Exploratory factor analysis was used to identify dietary patterns. Multinomial and Poisson regression models were used to examine the association between dietary patterns and Body Mass Index (BMI status/central obesity. Results: The prevalence of general and central obesity was 9.5% and 53.4%. Traditional dietary pattern (high intake of rice, pork and vegetables was inversely associated with general/central obesity; modern dietary pattern (high intake of fruit, fast food, and processed meat was positively associated with general/central obesity. The highest quartile of traditional dietary pattern had a lower risk of general/central obesity compared with the lowest quartile, while an inverse picture was found for the modern dietary pattern. These associations were consistent by gender and urbanization levels. Conclusions: Dietary patterns are associated with general/central obesity in older Chinese. This study reinforces the importance of a healthy diet in promoting healthy ageing in China.

  8. Dietary Pattern Is Associated with Obesity in Older People in China: Data from China Health and Nutrition Survey (CHNS).

    Science.gov (United States)

    Xu, Xiaoyue; Hall, John; Byles, Julie; Shi, Zumin

    2015-09-23

    No studies have been conducted to explore the associations between dietary patterns and obesity among older Chinese people, by considering gender and urbanization level differences. We analyzed data from the 2009 China Health and Nutrition Survey (2745 individuals, aged ≥ 60 years). Dietary data were obtained using 24 hour-recall over three consecutive days. Height, Body Weight, and Waist Circumference were measured. Exploratory factor analysis was used to identify dietary patterns. Multinomial and Poisson regression models were used to examine the association between dietary patterns and Body Mass Index (BMI) status/central obesity. The prevalence of general and central obesity was 9.5% and 53.4%. Traditional dietary pattern (high intake of rice, pork and vegetables) was inversely associated with general/central obesity; modern dietary pattern (high intake of fruit, fast food, and processed meat) was positively associated with general/central obesity. The highest quartile of traditional dietary pattern had a lower risk of general/central obesity compared with the lowest quartile, while an inverse picture was found for the modern dietary pattern. These associations were consistent by gender and urbanization levels. Dietary patterns are associated with general/central obesity in older Chinese. This study reinforces the importance of a healthy diet in promoting healthy ageing in China.

  9. Social supports and mental health: a cross-sectional study on the correlation of self-consistency and congruence in China.

    Science.gov (United States)

    Gu, YanMei; Hu, Jie; Hu, YaPing; Wang, JianRong

    2016-06-28

    Psychosocial job characteristics require nursing staff with high self-consistency and good mental health. However, the attention and effort of such study remained very limited in China. A self-administered questionnaire was distributed to the bedside nurses in an affiliated hospital of Hebei Medical University, China. Of 218 registered bedside nurses eligible to participate in the survey anonymously, the data producing sample of 172 subjects resulted in a 79 % of effective response rate.. The Social Support Rating Scale was used to measure social support, and the Self-Consistency and Congruence Scale were used to measure mental health. Compared with the normal referenced group of college students, higher self-flexibility scores, lower self-conflict and self-stethoscope scores from the sample group were obtained with statistical significance in self-conflict scores. The close correlations were observed between participants' social support and Self-Consistency and Congruence Scale score. The difference of Social Support Rating Scale score was significant in demographic features including years of work, marital status, only child family, and levels of cooperation with other health worker. Bedside nurses in this study show a better inner harmony, and their Self-Consistency and Congruence closely correlates with the levels of social support. Thus, it is substantial to improve inner perception of support and external factors, such as the workplace support, and offer beneficial social environment to improve the bedside nurse's sub-health symptoms and decrease the high turnover rate.

  10. Work stress, work motivation and their effects on job satisfaction in community health workers: a cross-sectional survey in China

    Science.gov (United States)

    Li, Li; Hu, Hongyan; Zhou, Hao; He, Changzhi; Fan, Lihua; Liu, Xinyan; Zhang, Zhong; Li, Heng; Sun, Tao

    2014-01-01

    Objective It is well documented that both work stress and work motivation are key determinants of job satisfaction. The aim of this study was to examine levels of work stress and motivation and their contribution to job satisfaction among community health workers in Heilongjiang Province, China. Design Cross-sectional survey. Setting Heilongjiang Province, China. Participants The participants were 930 community health workers from six cities in Heilongjiang Province. Primary and secondary outcome measures Multistage sampling procedures were used to measure socioeconomic and demographic status, work stress, work motivation and job satisfaction. Logistic regression analysis was performed to assess key determinants of job satisfaction. Results There were significant differences in some subscales of work stress and work motivation by some of the socioeconomic characteristics. Levels of overall stress perception and scores on all five work stress subscales were higher in dissatisfied workers relative to satisfied workers. However, levels of overall motivation perception and scores on the career development, responsibility and recognition motivation subscales were higher in satisfied respondents relative to dissatisfied respondents. The main determinants of job satisfaction were occupation; age; title; income; the career development, and wages and benefits subscales of work stress; and the recognition, responsibility and financial subscales of work motivation. Conclusions The findings indicated considerable room for improvement in job satisfaction among community health workers in Heilongjiang Province in China. Healthcare managers and policymakers should take both work stress and motivation into consideration, as two subscales of work stress and one subscale of work motivation negatively influenced job satisfaction and two subscales of work motivation positively influenced job satisfaction. PMID:24902730

  11. Aging, and separation from children: The health implications of adult migration for elderly parents in rural China

    Directory of Open Access Journals (Sweden)

    Qian Song

    2017-12-01

    Full Text Available Background: Massive rural-to-urban migration in China has profoundly altered the family life of rural older adults, as adult children remain the primary caretakers of their elderly parents. And yet little is known about the health and well-being of the parents of adult migrants in rural China whose main source of support has been displaced. Objective: This study takes a comprehensive view and compares the trajectories of self-rated health among the rural elderly and examines how these health trajectories are associated with adult children's migration. Methods: We analyze older adults aged 55 years and over in rural China, using four waves of data from the China Health and Nutrition Survey (1997, 2000, 2004, 2006 and multilevel growth curve models. Results: The results show that parents of migrants persistently scored worse self-rated health across ages than their counterparts whose children had not migrated. Long-term migration of adults takes a heavier toll on the health of their elderly parents than short-term migration. However, these associations with children's migration are driven by the migration of sons. The migration of daughters and of children of both genders may have disparate effects on the health trajectories of elderly men and women. Conclusions: The findings suggest that the interplay of gendered family dynamics and migration processes affects the health outcomes of older adults. Contribution: The findings contribute to current debates on the health and well-being of family members left behind by migrants and call for further study of the relationship between migration and family processes in the well-being of migrant families.

  12. Urban-rural differences in the association between access to healthcare and health outcomes among older adults in China.

    Science.gov (United States)

    Zhang, Xufan; Dupre, Matthew E; Qiu, Li; Zhou, Wei; Zhao, Yuan; Gu, Danan

    2017-07-19

    Studies have shown that inadequate access to healthcare is associated with lower levels of health and well-being in older adults. Studies have also shown significant urban-rural differences in access to healthcare in developing countries such as China. However, there is limited evidence of whether the association between access to healthcare and health outcomes differs by urban-rural residence at older ages in China. Four waves of data (2005, 2008/2009, 2011/2012, and 2014) from the largest national longitudinal survey of adults aged 65 and older in mainland China (n = 26,604) were used for analysis. The association between inadequate access to healthcare (y/n) and multiple health outcomes were examined-including instrumental activities of daily living (IADL) disability, ADL disability, cognitive impairment, and all-cause mortality. A series of multivariate models were used to obtain robust estimates and to account for various covariates associated with access to healthcare and/or health outcomes. All models were stratified by urban-rural residence. Inadequate access to healthcare was significantly higher among older adults in rural areas than in urban areas (9.1% vs. 5.4%; p China. The associations between access to healthcare and health outcomes were generally stronger among older adults in rural areas than in urban areas. Our findings underscore the importance of providing adequate access to healthcare for older adults-particularly for those living in rural areas in developing countries such as China.

  13. Heavy metal concentrations in wild fishes captured from the South China Sea and associated health risks.

    Science.gov (United States)

    Gu, Yang-Guang; Lin, Qin; Wang, Xue-Hui; Du, Fei-Yan; Yu, Zi-Ling; Huang, Hong-Hui

    2015-07-15

    Heavy metal concentrations were measured in 29 marine wild fish species from the South China Sea. Concentrations (wet weight) were 0.51-115.81 ng/g (Cd), 0.54-27.31 ng/g (Pb), 0.02-1.26 μg/g (Cr), 8.32-57.48 ng/g (Ni), 0.12-1.13 μg/g (Cu), 2.34-6.88 μg/g (Zn), 2.51-22.99 μg/g (Fe), and 0.04-0.81 μg/g (Mn), respectively. Iron concentrations in all and Mn in some fish species were higher than the acceptable daily upper limit, suggesting human consumption of these wild fish species may pose a health risk. Human health risk assessment, however, indicated no significant adverse health effects with consumption. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Social capital, neighbourhood characteristics and utilisation of local public health services among domestic migrants in China: a cross-sectional study.

    Science.gov (United States)

    Hou, Zhiyuan; Lin, Senlin; Zhang, Donglan

    2017-08-18

    We examined the association between structural social capital and public health services use, and explored the modifiable effect of neighbourhood factors on this association among domestic migrants in China. Data were from a 2014 nationally representative cross-sectional sample of domestic migrants aged 15-59 years in China. Survey-weighted logistic regression models were applied to assess the association between structural social capital, measured by participation in social organisations and social activities, and use of public health services. Interaction terms between neighbourhood urban status, neighbourhood composition and social capital were further assessed in the models. Migrants who participated in social organisations were more likely to establish health records (OR 1.467, 95% CI 1.201 to 1.793) and receive health education information (OR 1.729, 95% CI 1.484 to 2.016) than those who did not. Participation in social activities was positively associated with establishing health records only in urban communities (OR 1.853, 95% CI 1.060 to 3.239), and it was positively linked to receiving health education information among those living with a higher percentage of local neighbours (OR 1.451, 95% CI 1.044 to 2.017). Structural social capital was related to an increased utilisation of local public health services among migrants. The findings of this study provided new evidence for the differential influences of social capital by neighbourhood characteristics in China, which suggested the importance to enhance social capital in rural/suburban communities and communities where the majority of the residents were migrants. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Validity of LupusQoL-China for the assessment of health related quality of life in Chinese patients with systemic lupus erythematosus.

    Directory of Open Access Journals (Sweden)

    Su-li Wang

    Full Text Available OBJECTIVES: To adapt and assess the validity and reliability of LupusQoL for use in Chinese patients with systemic lupus erythematosus (SLE. METHODS: Debriefing interviews of subjects with SLE guided the language modifications of the tool. The process of adaptation proceeded according to the guideline and pre-testing results of LupusQoL-China. 220 SLE patients completed LupusQoL-China and a generic preference-based measurement of health EuroQoL scale (EQ-5D, and 20 patients repeated them after 2 weeks. Internal consistency (ICR and test-retest (TRT reliability, convergent and discriminant validity were examined. Factor analysis and Rasch analysis were performed. RESULTS: The mean (SD age of the 208 subjects with SLE was 33.93 (± 9.19 years. ICR and TRT of the eight domains ranged from 0.811 to 0.965 and 0.836 to 0.974, respectively. The LupusQoL-China domains demonstrated substantial evidence of construct validity when compared with equivalent domains on the EQ-5D (physical health and usual activities r = -0.63, pain and pain/discomfort r = -0.778, emotional health and anxiety/depression r = -0.761, planning and usual activities r = -0.560. Most LupusQoL-China domains could discriminate patients with varied disease activities and end-organ damage (according to SELENA-SLEDAI and SLICC-DI. The principal component analysis revealed six factors, and confirmatory factor analysis result of which is similar to eight factors model. CONCLUSIONS: These results provide evidence that the LupusQoL-China is valid as a disease-specific HRQoL assessment tool for Chinese patients with SLE.

  16. Job Satisfaction among Health-Care Staff in Township Health Centers in Rural China: Results from a Latent Class Analysis.

    Science.gov (United States)

    Wang, Haipeng; Tang, Chengxiang; Zhao, Shichao; Meng, Qingyue; Liu, Xiaoyun

    2017-09-22

    Background : The lower job satisfaction of health-care staff will lead to more brain drain, worse work performance, and poorer health-care outcomes. The aim of this study was to identify patterns of job satisfaction among health-care staff in rural China, and to investigate the association between the latent clusters and health-care staff's personal and professional features; Methods : We selected 12 items of five-point Likert scale questions to measure job satisfaction. A latent-class analysis was performed to identify subgroups based on the items of job satisfaction; Results : Four latent classes of job satisfaction were identified: 8.9% had high job satisfaction, belonging to "satisfied class"; 38.2% had low job satisfaction, named as "unsatisfied class"; 30.5% were categorized into "unsatisfied class with the exception of interpersonal relationships"; 22.4% were identified as "pseudo-satisfied class", only satisfied with management-oriented items. Low job satisfaction was associated with specialty, training opportunity, and income inequality. Conclusions : The minority of health-care staff belong to the "satisfied class". Three among four subgroups are not satisfied with income, benefit, training, and career development. Targeting policy interventions should be implemented to improve the items of job satisfaction based on the patterns and health-care staff's features.

  17. Human Resources for Health in Rural China : an Assessment of the ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Recent official documents pertaining to healthcare delivery system reform in China have focused mainly on infrastructure, equipment, management, insurance and drug policies. There has been little if any attention paid to human resources for health. Given the time and resources required to train qualified primary care ...

  18. Internalized homophobia, mental health, sexual behaviors, and outness of gay/bisexual men from Southwest China.

    Science.gov (United States)

    Xu, Wenjian; Zheng, Lijun; Xu, Yin; Zheng, Yong

    2017-02-17

    Social attitudes toward male homosexuality in China so far are still not optimistic. Sexual minorities in China have reported high levels of internalized homophobia. This Internet-based study examined the associations among internalized homophobia, mental health, sexual behaviors, and outness among 435 gay/bisexual men in Southwest China from 2014 to 2015. Latent profile analysis, confirmatory factor analysis, univariate logistic regression, and separate multivariate logistic regression analyses were conducted. This descriptive study found the Internalized Homophobia Scale to be suitable for use in China. The sample demonstrated a high prevalence of internalized homophobia. Latent profile analysis suggested a 2-class solution as optimal, and a high level of internalized homophobia was significantly associated with greater psychological distress (Wald = 6.49, AOR = 1.66), transactional sex during the previous 6 months (Wald = 5.23, AOR = 2.77), more sexual compulsions (Wald = 14.05, AOR = 2.12), and the concealment of sexual identity from others (Wald = 30.70, AOR = 0.30) and parents (Wald = 6.72, AOR = 0.49). These findings contribute to our understanding of internalized homophobia in China, and highlight the need to decrease gay-related psychological stress/distress and improve public health services.

  19. Benefit distribution of social health insurance: evidence from china's urban resident basic medical insurance.

    Science.gov (United States)

    Pan, Jay; Tian, Sen; Zhou, Qin; Han, Wei

    2016-09-01

    Equity is one of the essential objectives of the social health insurance. This article evaluates the benefit distribution of the China's Urban Residents' Basic Medical Insurance (URBMI), covering 300 million urban populations. Using the URBMI Household Survey data fielded between 2007 and 2011, we estimate the benefit distribution by the two-part model, and find that the URBMI beneficiaries from lower income groups benefited less than that of higher income groups. In other words, government subsidy that was supposed to promote the universal coverage of health care flew more to the rich. Our study provides new evidence on China's health insurance system reform, and it bears meaningful policy implication for other developing countries facing similar challenges on the way to universal coverage of health insurance. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  20. On residents’ satisfaction with community health services after health care system reform in Shanghai, China, 2011

    Directory of Open Access Journals (Sweden)

    Li Zhijian

    2012-06-01

    Full Text Available Abstract Background Health care system reform is a major issue in many countries and therefore how to evaluate the effects of changes is incredibly important. This study measured residents’ satisfaction with community health care service in Shanghai, China, and aimed to evaluate the effect of recent health care system reform. Methods Face-to-face interviews were performed with a stratified random sample of 2212 residents of the Shanghai residents using structured questionnaires. In addition, 972 valid responses were retrieved from internet contact. Controlling for sex, age, income and education, the study used logistic regression modeling to analyze factors associated with satisfaction and to explain the factors that affect the residents’ satisfaction. Results Comparing current attitudes with those held at the initial implementation of the reform in this investigation, four dimensions of health care were analyzed: 1 the health insurance system; 2 essential drugs; 3 basic clinical services; and 4 public health services. Satisfaction across all dimensions improved since the reform was initiated, but differences of satisfaction level were found among most dimensions and groups. Residents currently expressed greater satisfaction with clinical service (average score=3.79, with 5 being most satisfied and the public health/preventive services (average score=3.62; but less satisfied with the provision of essential drugs (average score=3.20 and health insurance schemes (average score=3.23. The disadvantaged groups (the elderly, the retired, those with only an elementary education, those with lower incomes had overall poorer satisfaction levels on these four aspects of health care (P Conclusion The respondents showed more satisfaction with the clinical services (average score=3.79 and public health services/interventions (average score=3.79; and less satisfaction with the health insurance system (average score=3.23 and the essential drug system

  1. Continuing nursing education policy in China and its impact on health equity.

    Science.gov (United States)

    Xiao, Lily Dongxia

    2010-09-01

    The aim of this study was to evaluate the mandatory continuing nursing education (MCNE) policy in China and to examine whether or not the policy addresses health equity. MCNE was instituted in 1996 in China to support healthcare reform was to include producing greater equity in health-care. However, the literature increasingly reports inequity in participation in MCNE, which is likely to have had a detrimental effect on the pre-existing discrepancies of education in the nursing workforce, and thereby failing to really address health equity. Despite a growing appeal for change, there is lack of critical reflection on the issues of MCNE policy. Critical ethnography underpinned by Habermas' Communicative Action Theory and Giddens' Structuration Theory were used to guide this study. Findings are presented in four themes: (i) inaccessibility of learning programs for nurses; (ii) undervaluation of workplace-based learning; (iii) inequality of the allocation of resources; and (iv) demands for additional support in MCNE from non-tertiary hospitals. The findings strongly suggest the need for an MCNE policy review based on rational consensus with stakeholders while reflecting the principles of health equity.

  2. Availability, cost, and prescription patterns of antihypertensive medications in primary health care in China: a nationwide cross-sectional survey.

    Science.gov (United States)

    Su, Meng; Zhang, Qiuli; Bai, Xueke; Wu, Chaoqun; Li, Yetong; Mossialos, Elias; Mensah, George A; Masoudi, Frederick A; Lu, Jiapeng; Li, Xi; Salas-Vega, Sebastian; Zhang, Anwen; Lu, Yuan; Nasir, Khurram; Krumholz, Harlan M; Jiang, Lixin

    2017-12-09

    Around 200 million adults in China have hypertension, but few are treated or achieve adequate control of their blood pressure. Available and affordable medications are important for successfully controlling hypertension, but little is known about current patterns of access to, and use of, antihypertensive medications in Chinese primary health care. We used data from a nationwide cross-sectional survey (the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project primary health care survey), which was undertaken between November, 2016 and May, 2017, to assess the availability, cost, and prescription patterns of 62 antihypertensive medications at primary health-care sites across 31 Chinese provinces. We surveyed 203 community health centres, 401 community health stations, 284 township health centres, and 2474 village clinics to assess variation in availability, cost, and prescription by economic region and type of site. We also assessed the use of high-value medications, defined as guideline-recommended and low-cost. We also examined the association of medication cost with availability and prescription patterns. Our study sample included 3362 primary health-care sites and around 1 million people (613 638 people at 2758 rural sites and 478 393 people at 604 urban sites). Of the 3362 sites, 8·1% (95% CI 7·2-9·1) stocked no antihypertensive medications and 33·8% (32·2-35·4) stocked all four classes that were routinely used. Village clinics and sites in the western region of China had the lowest availability. Only 32·7% (32·2-33·3) of all sites stocked high-value medications, and few high-value medications were prescribed (11·2% [10·9-11·6] of all prescription records). High-cost medications were more likely to be prescribed than low-cost alternatives. China has marked deficiencies in the availability, cost, and prescription of antihypertensive medications. High-value medications are not preferentially used. Future efforts to

  3. Economic evaluation of health benefits of mercury emission controls for China and the neighboring countries in East Asia

    International Nuclear Information System (INIS)

    Zhang, Wei; Zhen, Gengchong; Chen, Long; Wang, Huanhuan; Li, Ying; Ye, Xuejie; Tong, Yindong; Zhu, Yan; Wang, Xuejun

    2017-01-01

    Globally, coal-fired power plant (CFPP) is a major source of mercury. China is developing its first National Implementation Plan on Mercury Control, which priorities the control of emissions from CFPPs. While social benefits play an important role in designing environmental policies in China, the benefits associated with mercury control are not yet understood, mainly due to the scientific challenges to trace mercury's emissions-to-impacts path. This study evaluates the benefits of mercury reductions in China's CFPPs for China and its three neighboring countries in East Asia. Four policy scenarios are analyzed following the policies-to-impacts path, which links a global atmospheric model to health benefit analysis models to estimate the economic gains from avoided mercury-related adverse health outcomes under each scenario, and take into account key uncertainties in the path. Under the most stringent scenario, the benefits of mercury reduction by 2030 are projected to be $432 billion (95% CI: $166–941 billion), with the benefits for China and the neighboring countries accounting for 96% and 4% of the total benefits, respectively. Policy scenario analysis indicates that coal washing generates the greatest benefits in the near term, whereas upgrading air pollution control devices maximizes health benefits in the long term. - Highlights: • Benefits of mercury controls for China and neighboring countries are analyzed. • Policy analysis shows that coal washing generates the largest benefits in near term. • Upgrading air pollution control devices maximizes health benefits in long term. • For mercury controls, local policies contribute most to local benefits.

  4. Training community mental health staff in Guangzhou, China: evaluation of the effect of a new training model.

    Science.gov (United States)

    Li, Jie; Li, Juan; Thornicroft, Graham; Yang, Hui; Chen, Wen; Huang, Yuanguang

    2015-10-26

    Increasing numbers of people with mental disorders receive services at primary care in China. The aims of this study are to evaluate impact of a new training course and supervision for community mental health staff to enhance their levels of mental health knowledge and to reduce their stigmatization toward people with mental illness. A total of 77 community mental health staff from eight regions in Guangzhou in China were recruited for the study.4 regions were randomly allocated to the new training model group, and 4 to the old training model group. Levels of mental health knowledge were measured by purpose-made assessment schedule and by the Mental Health Knowledge Schedule (MAKS). Stigma was evaluated by the Mental Illness: Clinicians' Attitudes Scale (MICA) and the Reported and Intended Behavior Scale (RIBS). Evaluation questionnaires were given at the beginning of course, at the end, and at 6 month and at 12 month follow-up. After the training period, the 6-month, and the 12-month, knowledge scores of the intervention group were higher than the control group. At 6-month and 12-month follow-up, means scores of MAKS of the intervention group increased more than the control group (both p training, at 6-months, and at 12-months, mean scores of RIBS of the intervention group increased more than the control (p training course and supervision, the new course improved community mental health staff knowledge of mental disorders, improving their attitudes toward people with mental disorder, and increasing their willingness to have contact with people with mental disorder.

  5. Health care-seeking behaviours and health expenditures in adults aged 45 years and older in China, 2011-2013.

    Science.gov (United States)

    Li, Jiasen; Feng, Xing Lin

    2017-05-01

    To provide an assessment of China's progress to universal health coverage (UHC) from the perspective of people-centred care. We obtained data on 28 103 participants from the China Health and Retirement Longitudinal Study (CHALRS) during 2011-2013. We used logistic regressions and generalised linear models to analyse care-seeking behaviours and medical expenditures. We found that 95.5% of the subjects were covered by social health insurance in 2013, and nearly 60% subjects in need of medical care were self-medicated. Health insurance was a strong predictor for the access to outpatient care. Use of pure and mixed self-medication increased by 15% and 32% respectively, while use of pure outpatient care fell by 10% between 2011 and 2013, after adjusting for predisposing, service needs and enabling factors. Such trends were particularly evident for the Urban Resident Basic Medical Insurance and the New Cooperative Medical Scheme, which covered more than 80%. The monthly out-of-pocket medical expenditures and the probability of encountering catastrophic health expenditures for outpatient care were four times larger than that for self-medication. Between 2011 and 2013, outpatient care medical costs rose by nearly 50%, whereas there was no such obvious trend for self-medication. People with insurance schemes offering lower cost sharing incurred consistently higher out-of-pocket outpatient payments. The monitoring of global progress to UHC should incorporate self-medication. In China, it seems that the current reform and the huge government investment have not resulted in access to affordable quality care. To achieve UHC, not only universal insurance, but system-level efforts are needed. © 2017 John Wiley & Sons Ltd.

  6. On residents' satisfaction with community health services after health care system reform in Shanghai, China, 2011.

    Science.gov (United States)

    Li, Zhijian; Hou, Jiale; Lu, Lin; Tang, Shenglan; Ma, Jin

    2012-01-01

    Health care system reform is a major issue in many countries and therefore how to evaluate the effects of changes is incredibly important. This study measured residents' satisfaction with community health care service in Shanghai, China, and aimed to evaluate the effect of recent health care system reform. Face-to-face interviews were performed with a stratified random sample of 2212 residents of the Shanghai residents using structured questionnaires. In addition, 972 valid responses were retrieved from internet contact. Controlling for sex, age, income and education, the study used logistic regression modeling to analyze factors associated with satisfaction and to explain the factors that affect the residents' satisfaction. Comparing current attitudes with those held at the initial implementation of the reform in this investigation, four dimensions of health care were analyzed: 1) the health insurance system; 2) essential drugs; 3) basic clinical services; and 4) public health services. Satisfaction across all dimensions improved since the reform was initiated, but differences of satisfaction level were found among most dimensions and groups. Residents currently expressed greater satisfaction with clinical service (average score=3.79, with 5 being most satisfied) and the public health/preventive services (average score=3.62); but less satisfied with the provision of essential drugs (average score=3.20) and health insurance schemes (average score=3.23). The disadvantaged groups (the elderly, the retired, those with only an elementary education, those with lower incomes) had overall poorer satisfaction levels on these four aspects of health care (Phealth services/interventions (average score=3.79); and less satisfaction with the health insurance system (average score=3.23) and the essential drug system (average score=3.20). Disadvantaged groups showed lower satisfaction levels overall relative to non-disadvantaged groups.

  7. Universal Health Coverage through Community Nursing Services: China vs. Hong Kong.

    Science.gov (United States)

    Chan, Wai Yee; Fung, Ita M; Chan, Eric

    2017-01-30

    this article looks at how the development of community nursing services in China and Hong Kong can enhance universal health coverage. literature and data review have been utilized in this study. nursing services have evolved much since the beginning of the nursing profession. The development of community nursing services has expanded the scope of nursing services to those in need of, not just hospital-level nursing care, but more holistic care to improve health and quality of life. despite the one-country-two-systems governance and the difference in population and geography, Hong Kong and China both face the aging population and its complications. Community nursing services help to pave the road to Universal Health Coverage. este artigo analisa a forma como o desenvolvimento de serviços de enfermagem comunitários na China e Hong Kong pode melhorar a cobertura universal de saúde. literatura e revisão de dados foram utilizados neste estudo. serviços de enfermagem têm evoluído muito desde o início da profissão de enfermagem. O desenvolvimento dos serviços de enfermagem da comunidade ampliou o escopo dos serviços de enfermagem, para aqueles que precisam não apenas de cuidados de enfermagem de nível de hospital, mas cuidados mais holísticos para melhorar a saúde e qualidade de vida. apesar de ser "um-país-dois-sistemas" de governo, e as diferenças de população e geografia, Hong Kong e China enfrentam o envelhecimento da população e suas complicações. Os serviços de enfermagem da comunidade ajudam a pavimentar o caminho para a cobertura de saúde universal. este artículo analiza cómo el desarrollo de los servicios de enfermería comunitaria en China y Hong Kong pueden expandir la cobertura universal de salud. revisión de datos y literatura han sido utilizados en este estudio. los servicios de enfermería han evolucionado mucho desde el comienzo de la profesión. El desarrollo de los servicios de enfermería comunitaria han ampliado el alcance

  8. Regional disparities in child mortality within China 1996-2004: epidemiological profile and health care coverage.

    Science.gov (United States)

    Feng, Xing Lin; Guo, Sufang; Yang, Qing; Xu, Ling; Zhu, Jun; Guo, Yan

    2011-07-01

    China was one of the 68 "countdown" countries prioritized to attain Millennium Development Goals (MDG 4). The aim of this study was to analyze data on child survival and health care coverage of proven cost-effective interventions in China, with a focus on national disparities. National maternal and child mortality surveillance data were used to estimate child mortality. Coverage for proven interventions was analyzed based on data from the National Health Services Survey, National Nutrition and Health Survey, and National Immunization Survey. Consultations and qualitative field observations by experts were used to complement the Survey data. Analysis of the data revealed a significant reduction in the overall under-5 (U5) child mortality rate in China from 1996 to 2007, but also great regional disparities, with the risk of child mortality in rural areas II-IV being two- to sixfold higher than that in urban areas. Rural areas II-IV also accounted for approximately 80% of the mortality burden. More than 60% of child mortality occurred during the neonatal period, with 70% of this occurring during the first week of life. The leading causes of neonatal mortality were asphyxia at birth and premature birth; during the post-neonatal period, these were diarrhea and pneumonia, especially in less developed rural areas. Utilization of health care services in terms of both quantity and quality was positively correlated with the region's development level. A large proportion of children were affected by inadequate feeding, and the lack of safe water and essential sanitary facilities are vital indirect factors contributing to the increase in child mortality. The simulation analysis revealed that increasing access to and the quality of the most effective interventions combined with relatively low costs in the context of a comprehensive approach has the potential to reduce U5 deaths by 34%. China is on track to meet MDG 4; however, great disparities in health care do exist within

  9. External costs of PM2.5 pollution in Beijing, China: Uncertainty analysis of multiple health impacts and costs

    DEFF Research Database (Denmark)

    Hao, Yin; Pizzol, Massimo; Xu, Linyu

    2017-01-01

    Some cities in China are facing serious air pollution problems including high concentrations of particles, SO2 and NOx. Exposure to PM2.5, one of the primary air pollutants in many cities in China, is highly correlated with various adverse health impacts and ultimately represents a cost for society....... The aim of this study is to assess health impacts and external costs related to PM2.5 pollution in Beijing, China with different baseline concentrations and valuation methods. The idea is to provide a reasonable estimate of the total health impacts and external cost due to PM2.5 pollution, as well...... as a quantification of the relevant uncertainty. PM2.5 concentrations were retrieved for the entire 2012 period in 16 districts of Beijing. The various PM2.5 related health impacts were identified and classified to avoid double counting. Exposure-response coefficients were then obtained from literature. Both...

  10. The less healthy urban population: income-related health inequality in China

    Science.gov (United States)

    2012-01-01

    Background Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. Methods This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH) and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS) 2006 are used. Results The study finds that the poor are less likely to report their health status as “excellent or good” and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. Conclusion The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality. PMID:22989200

  11. The less healthy urban population: income-related health inequality in China.

    Science.gov (United States)

    Yang, Wei; Kanavos, Panos

    2012-09-18

    Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH) and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS) 2006 are used. The study finds that the poor are less likely to report their health status as "excellent or good" and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality.

  12. The less healthy urban population: income-related health inequality in China

    Directory of Open Access Journals (Sweden)

    Yang Wei

    2012-09-01

    Full Text Available Abstract Background Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. Methods This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS 2006 are used. Results The study finds that the poor are less likely to report their health status as “excellent or good” and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. Conclusion The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality.

  13. Heavy metal pollution in reservoirs in the hilly area of southern China: Distribution, source apportionment and health risk assessment.

    Science.gov (United States)

    Wang, Xiaolong; Zhang, Lu; Zhao, Zhonghua; Cai, Yongjiu

    2018-09-01

    Reservoirs play more and more important role in providing potable water in many developing countries, including the China. In the present study, pollution characteristics, source and health risk of dissolved heavy metals in 19 representative reservoirs in the hilly area of southern China were investigated. The results presented great spatial heterogeneity in heavy metal concentrations among the studied reservoirs due to the disturbances by different anthropogenic activities. Several reservoirs had significantly higher concentrations of heavy metals compared with others, FengTan (FT) reservoir (0.34μg/L in dry season), Cr in reservoirs of HuangShi (HS) and ZheLin (ZL) with values of 4.16μg/L and 3.45μg/L in dry season respectively, and Al in reservoirs of JiaoKou (JK), GuTian (GT) and DouShui (DS) with values of 1011μg/L, 1036μg/L and 1001μg/L in wet season, respectively. Furthermore, there was a great difference in the seasonal variation of heavy metals, especially for Al and Pb in wet season characterized with relatively high values of 643μg/L and 0.67μg/L, respectively. Accordingly, Al was identified with a great health risk to living beings in view of its mean value in wet season, which greatly exceeded the criteria for drinking water of China, WHO and US EPA. Furthermore, As might be the greatest concern of health risk in this region considering its high carcinogenic risk to the local residents around the reservoirs of OuYangHai (OYH), DS, ZhiXi (ZX) and HS. Multivariate statistical analysis suggested that there was great heterogeneity in the sources of these heavy metals in the hilly area of southern China. Therefore, specific measures, such as controls on point source pollution control and tailings, should be taken for maintaining drinking water safety and aquatic ecosystem health. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Current status and progress of pancreatic cancer in China.

    Science.gov (United States)

    Lin, Quan-Jun; Yang, Feng; Jin, Chen; Fu, De-Liang

    2015-07-14

    Cancer is currently one of the most important public health problems in the world. Pancreatic cancer is a fatal disease with poor prognosis. As in most other countries, the health burden of pancreatic cancer in China is increasing, with annual mortality rates almost equal to incidence rates. The increasing trend of pancreatic cancer incidence is more significant in the rural areas than in the urban areas. Annual diagnoses and deaths of pancreatic cancer in China are now beyond the number of cases in the United States. GLOBOCAN 2012 estimates that cases in China account for 19.45% (65727/337872) of all newly diagnosed pancreatic cancer and 19.27% (63662/330391) of all deaths from pancreatic cancer worldwide. The population's growing socioeconomic status contributes to the rapid increase of China's proportional contribution to global rates. Here, we present an overview of control programs for pancreatic cancer in China focusing on prevention, early diagnosis and treatment. In addition, we describe key epidemiological, demographic, and socioeconomic differences between China and developed countries. Facts including no nationwide screening program for pancreatic cancer, delay in early detection resulting in a late stage at presentation, lack of awareness of pancreatic cancer in the Chinese population, and low investment compared with other cancer types by government have led to backwardness in China's pancreatic cancer diagnosis and treatment. Finally, we suggest measures to improve health outcomes of pancreatic cancer patients in China.

  15. Mental health status and work environment among workers in small- and medium-sized enterprises in Guangdong, China-a cross-sectional survey.

    Science.gov (United States)

    Zeng, Zhi; Guo, Yan; Lu, Liming; Han, Lu; Chen, Wen; Ling, Li

    2014-11-12

    Small- and medium-sized enterprises (SMEs) generate nearly 80% of the jobs in China, but the dangerous work environment often found in these enterprises poses a major concern for public health. Psychosocial pressure and mental health problems among the workers are also common in SMEs. However, mental health of workers in SMEs is largely neglected in occupational health research and practice in China. The purpose of this study is to assess mental health of the workers and to explore the associations between physical and psychosocial work environment and workers' mental health in SMEs in South China. Data were collected in 2012 through a cross-sectional survey among 1200 workers working in small- and medium-sized enterprises (SMEs) in Guangdong, China. Mental health was measured by psychological well-being in the current study. Job Demand-Control-Support (JDCS) model was used as a theoretical framework to examine the psychosocial factors associated with workers' psychological well-being. Data were analyzed using SPSS 20.0 and analysis was performed using bivariate analyses and multivariate logistic regression. About three in ten workers (35.3%) in the sample had poor psychological well-being. Those who were men, younger in age, or migrant workers had worse psychological outcome in bivariate analyses. After controlling for individual variables (gender, age, marital status, and household registration), we found that longer weekly work hours (OR = 1.30, 95% CI: 1.13 ~ 1.50), more exposure to hazardous work environment (OR = 1.26, 95% CI: 1.10 ~ 1.44), higher job demands (OR = 1.29, 95% CI: 1.12 ~ 1.49), and lower job autonomy (OR = 0.70, 95% CI: 0.60 ~ 0.81) were significant associated with worse psychological well-being. The results were consistent with predictions of the JDCS model. The results indicate that the JDCS model is a useful framework in predicting psychological well-being among Chinese workers in SMEs. Future mental health promotion should focus on young

  16. The implication of health insurance for child development and maternal nutrition: evidence from China.

    Science.gov (United States)

    Peng, Xiaobo; Conley, Dalton

    2016-06-01

    We use the implementation of the new rural cooperative medical scheme (NCMS) in China to investigate the effect of health insurance on maternal nutrition and child health. Given the uneven roll-out of the NCMS across rural counties, we are able to deploy its implementation as a natural experiment in order to obviate problems of adverse selection that typically plague research on the effects of health insurance. We find that, among children, the NCMS has the greatest positive effect on infants between birth and 5 years of age. Also, with respect to female nutritional status, our models show that the NCMS has the greatest effect on women of childbearing age (aged between 16 and 35), indicating that women who benefit from the NCMS benefits may, in turn, give birth to healthier babies. Thus, taken together, our findings indicate that the NCMS plays an important role in health dynamics in rural China.

  17. Socio-Economic Differentials in Impoverishment Effects of Out-of-Pocket Health Expenditure in China and India: Evidence from WHO SAGE.

    Science.gov (United States)

    Kumar, Kaushalendra; Singh, Ashish; Kumar, Santosh; Ram, Faujdar; Singh, Abhishek; Ram, Usha; Negin, Joel; Kowal, Paul R

    2015-01-01

    The provision of affordable health care is generally considered a fundamental goal of a welfare state. In addition to its role in maintaining and improving the health status of individuals and households, it impacts the economic prosperity of a society through its positive effects on labor productivity. Given this context, this paper assesses socioeconomic-differentials in the impact of out-of-pocket-health-expenditure (OOPHE) on impoverishment in China and India, two of the fastest growing economies of the world. The paper uses data from the World Health Organisation's Study on Global Ageing and Adult Health (WHO SAGE), and Bivariate as well as Multivariate analyses for investigating the socioeconomic-differentials in the impact of out-of-pocket-health-expenditure (OOPHE) on impoverishment in China and India. Annually, about 7% and 8% of the population in China and India, respectively, fall in poverty due to OOPHE. Also, the percentage shortfall in income for the population from poverty line due to OOPHE is 2% in China and 1.3% in India. Further, findings from the multivariate analysis indicate that lower wealth status and inpatient as well as outpatient care increase the odds of falling below poverty line significantly (with the extent much higher in the case of in-patient care) due to OOPHE in both China and India. In addition, having at least an under-5 child in the household, living in rural areas and having a household head with no formal education increases the odds of falling below poverty line significantly (compared to a head with college level education) due to OOPHE in China; whereas having at least an under-5 child, not having health insurance and residing in rural areas increases the odds of becoming poor significantly due to OOPHE in India.

  18. Socio-Economic Differentials in Impoverishment Effects of Out-of-Pocket Health Expenditure in China and India: Evidence from WHO SAGE

    Science.gov (United States)

    Kumar, Kaushalendra; Singh, Ashish; Kumar, Santosh; Ram, Faujdar; Singh, Abhishek; Ram, Usha; Negin, Joel; Kowal, Paul R.

    2015-01-01

    Background and Objectives The provision of affordable health care is generally considered a fundamental goal of a welfare state. In addition to its role in maintaining and improving the health status of individuals and households, it impacts the economic prosperity of a society through its positive effects on labor productivity. Given this context, this paper assesses socioeconomic-differentials in the impact of out-of-pocket-health-expenditure (OOPHE) on impoverishment in China and India, two of the fastest growing economies of the world. Data and Methods The paper uses data from the World Health Organisation’s Study on Global Ageing and Adult Health (WHO SAGE), and Bivariate as well as Multivariate analyses for investigating the socioeconomic-differentials in the impact of out-of-pocket-health-expenditure (OOPHE) on impoverishment in China and India. Results and Conclusions Annually, about 7% and 8% of the population in China and India, respectively, fall in poverty due to OOPHE. Also, the percentage shortfall in income for the population from poverty line due to OOPHE is 2% in China and 1.3% in India. Further, findings from the multivariate analysis indicate that lower wealth status and inpatient as well as outpatient care increase the odds of falling below poverty line significantly (with the extent much higher in the case of in-patient care) due to OOPHE in both China and India. In addition, having at least an under-5 child in the household, living in rural areas and having a household head with no formal education increases the odds of falling below poverty line significantly (compared to a head with college level education) due to OOPHE in China; whereas having at least an under-5 child, not having health insurance and residing in rural areas increases the odds of becoming poor significantly due to OOPHE in India. PMID:26270049

  19. Bisphenol A (BPA) in China: a review of sources, environmental levels, and potential human health impacts.

    Science.gov (United States)

    Huang, Y Q; Wong, C K C; Zheng, J S; Bouwman, H; Barra, R; Wahlström, B; Neretin, L; Wong, M H

    2012-07-01

    Bisphenol A (BPA), identified as an endocrine disruptor, is an industrially important chemical that is used as a raw material in the manufacture of many products such as engineering plastics (e.g., epoxy resins/polycarbonate plastics), food cans (i.e., lacquer coatings), and dental composites/sealants. The demand and production capacity of BPA in China have grown rapidly. This trend will lead to much more BPA contamination in the environmental media and in the general population in China. This paper reviews the current literature concerning the pollution status of BPA in China (the mainland, Hong Kong, and Taiwan) and its potential impact on human health. Due to potential human health risks from long-term exposure to BPA, body burden of the contaminant should be monitored. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Regulatory system reform of occupational health and safety in China

    Science.gov (United States)

    WU, Fenghong; CHI, Yan

    2015-01-01

    With the explosive economic growth and social development, China’s regulatory system of occupational health and safety now faces more and more challenges. This article reviews the history of regulatory system of occupational health and safety in China, as well as the current reform of this regulatory system in the country. Comprehensive, a range of laws, regulations and standards that promulgated by Chinese government, duties and responsibilities of the regulatory departments are described. Problems of current regulatory system, the ongoing adjustments and changes for modifying and improving regulatory system are discussed. The aim of reform and the incentives to drive forward more health and safety conditions in workplaces are also outlined. PMID:25843565

  1. [Association of job burnout with subjective well-being and health status among employees from 29 provinces in China].

    Science.gov (United States)

    Xu, C J; Xiao, Y; Pan, N; Ye, J; Lin, Q X; Jin, Y

    2017-10-20

    Objective: To investigate the influence of job burnout on subjective well-being and health status among employees in China. Methods: The data from the 2014 China Labor-force Dynamic Survey were used to analyze the association of job burnout with subjective well-being and health status among 7289 employees aged 18-64 years from 29 provinces in China.Some items from the Maslach Burnout Inventory-General Survey were used to investigate job burnout; subjective well-being assessment included life happiness and degree of satisfaction with living condition; the questions for self-evaluation of health status were used to analyze health status. Results: Of all employees,30.5% had low subjective well-being and 4.7% had poor health status based on self-evaluation. The logistic regression analysis showed that emotional exhaustion(two items), reduced sense of personal accomplishment,and cynicism were risk factors for low subjective well-being( OR =1.07,1.11,1.10,and 1.06, P factor for poor health status ( OR =1.10 and 1.07, P influence on health status( P >0.05). Conclusion: Emotional exhaustion is a major influencing factor for health status,and reducing job burnout may be an effective method for improving subjective well-being and health status.

  2. Extending access to essential services against constraints: the three-tier health service delivery system in rural China (1949-1980).

    Science.gov (United States)

    Feng, Xing Lin; Martinez-Alvarez, Melisa; Zhong, Jun; Xu, Jin; Yuan, Beibei; Meng, Qingyue; Balabanova, Dina

    2017-05-23

    China has made remarkable progress in scaling up essential services during the last six decades, making health care increasingly available in rural areas. This was partly achieved through the building of a three-tier health system in the 1950s, established as a linked network with health service facilities at county, township and village level, to extend services to the whole population. We developed a Theory of Change to chart the policy context, contents and mechanisms that may have facilitated the establishment of the three-tier health service delivery system in rural China. We systematically synthesized the best available evidence on how China achieved universal access to essential services in resource-scarce rural settings, with a particular emphasis on the experiences learned before the 1980s, when the country suffered a particularly acute lack of resources. The search identified only three peered-reviewed articles that fit our criteria for scientific rigor. We therefore drew extensively on government policy documents, and triangulated them with other publications and key informant interviews. We found that China's three-tier health service delivery system was established in response to acute health challenges, including high fertility and mortality rates. Health system resources were extremely low in view of the needs and insufficient to extend access to even basic care. With strong political commitment to rural health and a "health-for-all" policy vision underlying implementation, a three-tier health service delivery model connecting villages, townships and counties was quickly established. We identified several factors that contributed to the success of the three-tier system in China: a realistic health human resource development strategy, use of mass campaigns as a vehicle to increase demand, an innovative financing mechanisms, public-private partnership models in the early stages of scale up, and an integrated approach to service delivery. An

  3. Health of the Elderly Migration Population in China: Benefit from Individual and Local Socioeconomic Status?

    Science.gov (United States)

    Wang, Qing

    2017-04-01

    The study aims to estimate the relationship between the individual/local socioeconomic status and the health of internal elderly migrants in China. A multilevel logistic model was used to estimate this association. The estimations were undertaken for 11,111 migrants aged over 60 years, using nationally representative data: the 2015 Migrant Dynamics Monitoring Survey (MDMS), which was carried out in China. Odds ratios with 95% confidence intervals were reported. Both the household income per capita and the area-level average wage were positively associated with migrants' self-reported health; however, public service supply was not significantly related to their health. In addition, given the household income, migrants living in communities with a higher average wage were more likely to report poor health. Migrants' health benefited from individual socioeconomic status, but not from the local socioeconomic status, which the migrants cannot enjoy. This study highlights the importance of multilevel and non-discriminatory policies between migrants and local residents.

  4. Violence, stigma and mental health among female sex workers in China: A structural equation modeling.

    Science.gov (United States)

    Zhang, Liying; Li, Xiaoming; Wang, Bo; Shen, Zhiyong; Zhou, Yuejiao; Xu, Jinping; Tang, Zhenzhu; Stanton, Bonita

    2017-07-01

    Intimate partner violence is prevalent among female sex workers (FSWs) in China, and it is significantly associated with mental health problems among FSWs. However, limited studies have explored the mechanisms/process by which violence affects mental health. The purpose of this study was to explore the relationships among partner violence, internalized stigma, and mental health problems among FSWs. Data were collected using a self-administered cross-sectional survey administered to 1,022 FSWs in the Guangxi Zhuang Autonomous Region (Guangxi), China during 2008-2009. We used structural equation modeling to test the hypothesized relationships. Results indicated that violence perpetrated by either stable sexual partners or clients was directly and positively associated with mental health problems. Violence also had an indirect relation to mental health problems through stigma. Results highlight the need for interventions on counseling and care for FSWs who have experienced violence and for interventions to increase FSWs' coping skills and empowerment strategies.

  5. Equity and the utilization of health services: report of an eight-province survey in China.

    Science.gov (United States)

    Henderson, G; Akin, J; Zhiming, L; Jin, S; Ma, H; Ge, K

    1994-09-01

    This paper investigates equity with respect to one component of welfare in China--the provision and use of health services. Based upon a large-scale survey of almost 16,000 individuals in eight provinces in China, we examine a sub-sample of working-age adults who have identified themselves as injured or ill during the four weeks prior to being interviewed. We found that, beyond the level of severity of the reported condition, very few individual-level factors are related to the use of services when ill or injured. Only gender (female) and employment in state-run enterprises are associated with higher patterns of use. These results suggest that China has achieved a very wide distribution of clinics and other services at the local level, and that they are widely used by those who identify need for them. It is rare to be over half an hour away by bike from some form of care and the majority of care appears to be reasonably inexpensive. This broad availability of services contrasts with recent reports from China stressing declining accessibility, and paints a picture of relatively equal access to health care.

  6. Perception, attitude and behavior in relation to climate change: a survey among CDC health professionals in Shanxi province, China.

    Science.gov (United States)

    Wei, Junni; Hansen, Alana; Zhang, Ying; Li, Hong; Liu, Qiyong; Sun, Yehuan; Bi, Peng

    2014-10-01

    A better understanding of public perceptions, attitude and behavior in relation to climate change will provide an important foundation for government׳s policy-making, service provider׳s guideline development and the engagement of local communities. The purpose of this study was to assess the perception towards climate change, behavior change, mitigation and adaptation measures issued by the central government among the health professionals in the Centres for Disease Control and Prevention (CDC) in China. In 2013, a cross-sectional questionnaire survey was undertaken among 314 CDC health professionals in various levels of CDC in Shanxi Province, China. Descriptive analyses were performed. More than two thirds of the respondents believed that climate change has happened at both global and local levels, and climate change would lead to adverse impacts to human beings. Most respondents (74.8%) indicated the emission of greenhouse gases was the cause of climate change, however there was a lack of knowledge about greenhouse gases and their sources. Media was the main source from which respondents obtained the information about climate change. A majority of respondents showed that they were willing to change behavior, but their actions were limited. In terms of mitigation and adaptation measures issued by the Chinese Government, respondents׳ perception showed inconsistency between strategies and relevant actions. Moreover, although the majority of respondents believed some strategies and measures were extremely important to address climate change, they were still concerned about economic development, energy security, and local environmental protection. There are gaps between perceptions and actions towards climate change among these health professionals. Further efforts need to be made to raise the awareness of climate change among health professionals, and to promote relevant actions to address climate change in the context of the proposed policies with local

  7. How to apply SHA 2011 at a subnational level in China's practical situation: take children health expenditure as an example.

    Science.gov (United States)

    Li, Mingyang; Zheng, Ang; Duan, Wenjuan; Mu, Xin; Liu, Chunli; Yang, Yang; Wang, Xin

    2018-06-01

    System of Health Accounts 2011 (SHA 2011) is a new health care accounts system, revised from SHA 1.0 by the Organisation for Economic Co-operation and Development (OECD), the World Health Organization (WHO) and Eurostat. It keeps the former tri-axial relationship and develops three analytical interfaces, in order to fix the existing shortcomings and make it more convenient for analysis and comparison across countries. SHA 2011 was introduced in China in 2014, and little about its application in China has been reported. This study takes children as an example to study how to apply SHA 2011 at the subnational level in the practical situation of China's health system. Multistage random sampling method was applied and 3 532 517 samples from 252 institutions were included in the study. Official yearbooks and account reports helped the estimation of provincial data. The formula to calculate Current Health Expenditure (CHE) was introduced step-by-step. STATA 10.0 was used for statistics. Under the frame of SHA 2011, the CHE for children in Liaoning was calculated as US$ 0.74 billion in 2014; 98.56% of the expenditure was spent in hospital and the allocation to primary health care institutions was insufficient. Infection, maternal and prenatal diseases cost the most in terms of Global Burden of Disease (GBD), and respiratory system diseases took the leading place in terms of International Classification of Disease Tenth Revision (ICD-10). In addition, medical income contributed most to the health financing. The method to apply SHA 2011 at the subnational level is feasible in China. It makes health accounts more adaptable to rapidly developing health systems and makes the financing data more readily available for analytical use. SHA 2011 is a better health expenditure accounts system to reveal the actual burden on residents and deserves further promotion in China as well as around the world.

  8. Pharmaceuticals in tap water: human health risk assessment and proposed monitoring framework in China.

    Science.gov (United States)

    Leung, Ho Wing; Jin, Ling; Wei, Si; Tsui, Mirabelle Mei Po; Zhou, Bingsheng; Jiao, Liping; Cheung, Pak Chuen; Chun, Yiu Kan; Murphy, Margaret Burkhardt; Lam, Paul Kwan Sing

    2013-07-01

    Pharmaceuticals are known to contaminate tap water worldwide, but the relevant human health risks have not been assessed in China. We monitored 32 pharmaceuticals in Chinese tap water and evaluated the life-long human health risks of exposure in order to provide information for future prioritization and risk management. We analyzed samples (n = 113) from 13 cities and compared detected concentrations with existing or newly-derived safety levels for assessing risk quotients (RQs) at different life stages, excluding the prenatal stage. We detected 17 pharmaceuticals in 89% of samples, with most detectable concentrations (92%) at risk levels, but 4 (i.e., dimetridazole, thiamphenicol, sulfamethazine, and clarithromycin) were found to have at least one life-stage RQ ≥ 0.01, especially for the infant and child life stages, and should be considered of high priority for management. We propose an indicator-based monitoring framework for providing information for source identification, water treatment effectiveness, and water safety management in China. Chinese tap water is an additional route of human exposure to pharmaceuticals, particularly for dimetridazole, although the risk to human health is low based on current toxicity data. Pharmaceutical detection and application of the proposed monitoring framework can be used for water source protection and risk management in China and elsewhere.

  9. E-learning for grass-roots emergency public health personnel: Preliminary lessons from a national program in China.

    Science.gov (United States)

    Xu, Wangquan; Jiang, Qicheng; Qin, Xia; Fang, Guixia; Hu, Zhi

    2016-07-19

    In China, grass-roots emergency public health personnel have relatively limited emergency response capabilities and they are constantly required to update their professional knowledge and skills due to recurring and new public health emergencies. However, professional training, a principal solution to this problem, is inadequate because of limitations in manpower and financial resources at grass-roots public health agencies. In order to provide a cost-effective and easily expandable way for grass-roots personnel to acquire knowledge and skills, the National Health Planning Commission of China developed an emergency response information platform and provided trial access to this platform in Anhui and Heilongjiang provinces in China. E-learning was one of the modules of the platform and this paper has focused on an e-learning pilot program. Results indicated that e-learning had satisfactorily improved the knowledge and ability of grass-roots emergency public health personnel, and the program provided an opportunity to gain experience in e-course design and implementing e-learning. Issues such as the lack of personalized e-courses and the difficulty of evaluating the effectiveness of e-learning are topics for further study.

  10. Long-term spatiotemporal trends and health risk assessment of oyster arsenic levels in coastal waters of northern South China Sea.

    Science.gov (United States)

    Wang, Xuefeng; Wang, Lifei; Jia, Xiaoping; Jackson, Donald A

    2017-09-01

    Long-term spatiotemporal trends and health risk assessment of oyster arsenic levels in the coastal waters of northern South China Sea were investigated in order to help improve the quality and safety control and sustainable aquaculture for mollusks in China. Cultured oysters (Crassostrea rivularis) collected from the waters of 23 bays, harbors, and estuaries along the coast of northern South China Sea from 1989 to 2012 were examined for spatial patterns and long-term temporal trends of oyster arsenic levels. Single-factor index and health risk assessment were used to quantify arsenic exposure to human health through oyster consumption. Overall, arsenic was detected in 97.4% of the oyster samples, and oyster arsenic levels were non-detectable-2.51 mg/kg with an average of 0.63 ± 0.54 mg/kg. Oyster arsenic levels in the coastal waters of northern South China Sea showed an overall decline from 1989 to 2012, remained relatively low since 2005, and slightly increased after 2007. Oyster arsenic levels in Guangdong coastal waters were much higher with more variation than in Guangxi and Hainan coastal waters, and the long-term trends of oyster arsenic levels in Guangdong coastal waters dominated the overall trends of oyster arsenic levels in the coastal waters of northern South China Sea. Within Guangdong Province, oyster arsenic levels were highest in east Guangdong coastal waters, followed by the Pearl River estuary and west Guangdong coastal waters. Single-factor index ranged between 0.27 and 0.97, and average health risk coefficient was 3.85 × 10 -5 , both suggesting that oyster arsenic levels in northern South China Sea are within the safe range for human consumption. However, long-term attention should be given to seafood market monitoring in China and the risk of arsenic exposure to human health through oyster consumption.

  11. DEVELOPMENT AND IMPLEMENTATION OF A PRACTICAL PUBLIC HEALTH TRAINING SYSTEM IN CHINA.

    Science.gov (United States)

    Liu, Changjiang; Zhang, Junyue; Chen, Guoyuan; Yang, Kedi

    2015-03-01

    Public health education is becoming an increasing priority among educators of medicine. In China, little attention has been paid to public health education reform. A new public health training system was introduced in China in 2007. We conducted this study during 2006-2012 to evaluate the graduate core competencies under the new system. Data were collected from 231 graduates and 49 public health agencies. The 144 graduates who enrolled in 2006 and were trained under the old system constituted the control group; the 87 graduates who enrolled in 2007 and were trained under the new system constituted the experimental group. Surveys of graduate core competencies found analyzing and solving problems in the laboratory, conducting on-site practice and learning new technologies were the top three abilities most expected by public health agencies. After 5-year practical ability training, the graduates in the experimental group had better performance; on-site practical ability and laboratory practical ability increased significantly by 24.5% and 20.0%, respectively. Three other important competencies also improved: designing epidemiologic surveys, collecting information from the literature and doing statistical analyses. However, preventing and controlling common diseases and dealing with emergencies remained weak. These results show the new training system should be continued, but revisions are needed to improve this training system, especially in the areas of preventing and controlling common diseases and dealing with emergencies.

  12. Social Capital and Health Outcomes among Older Adults in China: The Urban-Rural Dimension

    Science.gov (United States)

    Norstrand, Julie A.; Xu, Qingwen

    2012-01-01

    Purpose: This study examines different types of individual-level social capital (bonding, bridging, and linking) and their relationships with physical and emotional health among older Chinese living in urban and rural settings. Design and Methods: Using the 2005 China General Social Survey, physical and emotional health were regressed on social…

  13. Social capital and health in China: exploring the mediating role of lifestyle.

    Science.gov (United States)

    Xue, Xindong; Cheng, Mingmei

    2017-11-06

    Although social capital as a key determinant of health has been well established in various studies, little is known about how lifestyle factors mediate this relationship. Understanding the cross-relationships between social capital, health, and lifestyle factors is important if health promotion policies are to be effective. The purpose of this study is to explore whether different dimensions of social capital and lifestyle factors are related, and whether lifestyle factors mediate the association between social capital and self-rated health (SRH) and psychological well-being (PWB) in China. This study used nationally representative data from the 2014 China Family Panel Studies (n = 28,916). The data reported on three dimensions of individual-level social capital: social trust, social relationship and Chinese Communist Party (CCP) membership. Health was assessed using SRH and PWB. Five lifestyle indicators were recorded: healthy diet, physical activity, smoking, sleeping, and non-overweight status. Logistic regression was used to examine the associations between social capital and lifestyle factors, and whether there was a mediating role of lifestyle. Odds ratios relating health status to social capital were reported before and after adjustment for lifestyle factors. Mediation analysis was then used to calculate the total, direct and indirect effects of social capital on SRH and PWB. The results show that social trust was significantly associated with all five lifestyle factors. Social relationship was significantly associated with four of the five: healthy diet, physical activity, sleeping and non-overweight. CCP membership was only significantly associated with two lifestyle factors: physical activity and non-overweight. Social trust and social relationship were significantly related to both SRH and PWB. CCP membership was only significantly related to SRH. Mediation analysis found modest evidence that lifestyle factors influenced the relationship between all

  14. Social capital and health in China: exploring the mediating role of lifestyle

    Directory of Open Access Journals (Sweden)

    Xindong Xue

    2017-11-01

    Full Text Available Abstract Background Although social capital as a key determinant of health has been well established in various studies, little is known about how lifestyle factors mediate this relationship. Understanding the cross-relationships between social capital, health, and lifestyle factors is important if health promotion policies are to be effective. The purpose of this study is to explore whether different dimensions of social capital and lifestyle factors are related, and whether lifestyle factors mediate the association between social capital and self-rated health (SRH and psychological well-being (PWB in China. Methods This study used nationally representative data from the 2014 China Family Panel Studies (n = 28,916. The data reported on three dimensions of individual-level social capital: social trust, social relationship and Chinese Communist Party (CCP membership. Health was assessed using SRH and PWB. Five lifestyle indicators were recorded: healthy diet, physical activity, smoking, sleeping, and non-overweight status. Logistic regression was used to examine the associations between social capital and lifestyle factors, and whether there was a mediating role of lifestyle. Odds ratios relating health status to social capital were reported before and after adjustment for lifestyle factors. Mediation analysis was then used to calculate the total, direct and indirect effects of social capital on SRH and PWB. Results The results show that social trust was significantly associated with all five lifestyle factors. Social relationship was significantly associated with four of the five: healthy diet, physical activity, sleeping and non-overweight. CCP membership was only significantly associated with two lifestyle factors: physical activity and non-overweight. Social trust and social relationship were significantly related to both SRH and PWB. CCP membership was only significantly related to SRH. Mediation analysis found modest evidence that

  15. Measuring the sustainability of tin in China.

    Science.gov (United States)

    Yang, Congren; Tan, Quanyin; Zeng, Xianlai; Zhang, Yuping; Wang, Zhishi; Li, Jinhui

    2018-09-01

    Tin is a component of many items used in daily activities, including solder in consumer electronics, tin can containing food and beverages, polyvinyl chloride stabilizers in construction products, catalysts in industrial processes, etc. China is the largest producer and consumer of refined tin, and more than 60% of this refined tin is applied in the electronics sector as solder. China is the leader in global economic growth; simultaneously, China is also a major producer and consumer of electrical and electronic equipment (EEE). Thus, future tin supply and demand in China are forecasted, based on the gross domestic product per capita and the average consumption of refined tin in past five years. Current tin reserves and identified resources in China can meet the future two decades of mine production, but import of tin will also be critical for China's future tin consumption. However, there will be a lot of uncertainty for import of tin from other countries. At the same time, virgin mining of geological ores is a process of high energy consumption and destruction of the natural environment. Hence recycling tin from Sn-bearing secondary resources like tailings and waste electrical and electronic equipment (WEEE) can not only address the shortage of tin mineral resources, but also save energy and protect the ecological environment. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Assessing the Effects of the New Cooperative Medical Scheme on Alleviating the Health Payment-Induced Poverty in Shaanxi Province, China

    Science.gov (United States)

    Gao, Jianmin; Zhou, Zhongliang; Yan, Jue; Lai, Sha; Xu, Yongjian; Chen, Gang

    2016-01-01

    Background Disease has become one of the key causes of falling into poverty in rural China. The poor households are even more likely to suffer. The New Cooperative Medical Scheme (NCMS) has been implemented to provide rural residents financial protection against health risks. This study aims to assess the effect of the NCMS on alleviating health payment-induced poverty in the Shaanxi Province of China. Methods The data was drawn from the 5th National Health Service Survey of Shaanxi Province, conducted in 2013. In total, 41,037 individuals covered by NCMS were selected. Poverty headcount ratio (HCR), poverty gap and mean positive poverty gap were used for measuring the incidence, depth and intensity of poverty, respectively. The differences on poverty measures pre- and post- insurance reimbursement indicate the effectiveness of alleviating health payment-induced poverty under NCMS. Results For the general insured, 5.81% of households fell below the national poverty line owing to the health payment; this HCR dropped to 4.84% after insurance reimbursement. The poverty HCRs for the insured that had hospitalization in the past year dropped from 7.50% to 2.09% after reimbursement. With the NCMS compensation, the poverty gap declined from 42.90 Yuan to 34.49 Yuan (19.60% decreased) for the general insured and from 57.48 Yuan to 10.01 Yuan (82.59% decreased) for the hospital admission insured. The mean positive poverty gap declined 3.56% and 37.40% for two samples, respectively. Conclusion The NCMS could alleviate the health payment-induced poverty. The effectiveness of alleviating health payment-induced poverty is greater for hospital admission insured than for general insured, mainly because NCMS compensates for serious diseases. Our study suggests that a more comprehensive insurance benefit package design could further improve the effectiveness of poverty alleviation. PMID:27380417

  17. Analysis and Maintenance of Mental Health of Female Teachers in Colleges of China

    Science.gov (United States)

    Zhang, Yin-ling; Cao, Bao-hua; Miao, Dan-min

    2006-01-01

    Mental health has received increasing attention over the past few years as a common problem with serious consequences for the health and well-being of the people. But there is little attention paid to the problem for the special group of population, female teachers in China's colleges. Most of them are in a dilemma of how to perform and harmonize…

  18. Landfills in Jiangsu province, China, and potential threats for public health: Leachate appraisal and spatial analysis using geographic information system and remote sensing

    International Nuclear Information System (INIS)

    Yang Kun; Zhou Xiaonong; Yan Weian; Hang Derong; Steinmann, Peter

    2008-01-01

    Waste disposal is of growing environmental and public health concern in China where landfilling is the predominant method of disposal. The assessment of potential health hazards posed by existing landfills requires sound information, and processing of a significant amount of spatial data. Geographical information system (GIS) and remote sensing (RS) are valuable tools for assessing health impacts due to landfills. The aims of this study were: (i) to analyze the leachate and gas emissions from landfills used for domestic waste disposal in a metropolitan area of Jiangsu province, China, (ii) to investigate remotely-sensed environmental features in close proximity to landfills, and (iii) to evaluate the compliance of their location and leachate quality with the relevant national regulations. We randomly selected five landfills in the metropolitan areas of Wuxi and Suzhou city, Jiangsu province, established a GIS database and examined whether data were in compliance with national environmental and public health regulations. The leachates of the sampled landfills contained heavy metals (Pb, As, Cr 6+ and Hg) and organic compounds in concentrations considered harmful to human health. Measured methane concentrations on landfill surfaces were low. Spatial analysis of the location of landfills with regard to distance from major water bodies, sensible infrastructure and environmental conditions according to current national legislation resulted in the rejection of four of the five sites as inappropriate for landfills. Our results call for rigorous evaluation of the spatial location of landfills in China that must take into consideration environmental and public health criteria

  19. Job Satisfaction among Health-Care Staff in Township Health Centers in Rural China: Results from a Latent Class Analysis

    Directory of Open Access Journals (Sweden)

    Haipeng Wang

    2017-09-01

    Full Text Available Background: The lower job satisfaction of health-care staff will lead to more brain drain, worse work performance, and poorer health-care outcomes. The aim of this study was to identify patterns of job satisfaction among health-care staff in rural China, and to investigate the association between the latent clusters and health-care staff’s personal and professional features; Methods: We selected 12 items of five-point Likert scale questions to measure job satisfaction. A latent-class analysis was performed to identify subgroups based on the items of job satisfaction; Results: Four latent classes of job satisfaction were identified: 8.9% had high job satisfaction, belonging to “satisfied class”; 38.2% had low job satisfaction, named as “unsatisfied class”; 30.5% were categorized into “unsatisfied class with the exception of interpersonal relationships”; 22.4% were identified as “pseudo-satisfied class”, only satisfied with management-oriented items. Low job satisfaction was associated with specialty, training opportunity, and income inequality. Conclusions: The minority of health-care staff belong to the “satisfied class”. Three among four subgroups are not satisfied with income, benefit, training, and career development. Targeting policy interventions should be implemented to improve the items of job satisfaction based on the patterns and health-care staff’s features.

  20. A cross-sectional study of health-related behaviors in rural eastern China.

    Science.gov (United States)

    Sun, Ye-Huan; Yu, Tak-Sun Ignatius; Tong, Shi-Lu; Zhang, Yan; Shi, Xiao-Ming; Li, Wei

    2002-12-01

    This study examined the status of health-related behaviors among rural residents and the factors influencing the practice of such behaviors. One thousand and ninety subjects aged 15 years or over in a rural community, Anhui Province, China were surveyed. A questionnaire was used to collect information on the health knowledge, attitude and behavior of the subjects. Information on health behavior included smoking, drinking, dietary habits, regular exercises, sleeping pattern and oral health behavior. The prevalence of smoking and drinking in the male subjects was 46.5% and 46.9%, respectively. There was a positive significant association between smoking and drinking. Only 8.3% of all subjects ate three regular meals a day regularly. Among subjects who ate two meals a day, 89.7% did not have breakfast. Only 1.7% of subjects took part in regular exercise. About 85% of subjects slept 6 to 8 h per day. Only 38.4% of the respondents had the habit of hand washing before eating and after using the lavatory. 79.3% of the subjects brushed their teeth every day, and among them, only 10.6 percent brushed their teeth twice a day. Further analyses showed that 64.8% of subjects had 3-5 items of positive health behaviors out of 8 items and only 16.9% had six or more items. Logistical regression analyses suggested that better health behavior was affected by sex, age, years of education, income and health knowledge. The status of health behaviors among rural residents was generally poor. It is thus urgent to reinforce health education in rural communities in China.

  1. Impacts of soil and water pollution on food safety and health risks in China.

    Science.gov (United States)

    Lu, Yonglong; Song, Shuai; Wang, Ruoshi; Liu, Zhaoyang; Meng, Jing; Sweetman, Andrew J; Jenkins, Alan; Ferrier, Robert C; Li, Hong; Luo, Wei; Wang, Tieyu

    2015-04-01

    Environmental pollution and food safety are two of the most important issues of our time. Soil and water pollution, in particular, have historically impacted on food safety which represents an important threat to human health. Nowhere has that situation been more complex and challenging than in China, where a combination of pollution and an increasing food safety risk have affected a large part of the population. Water scarcity, pesticide over-application, and chemical pollutants are considered to be the most important factors impacting on food safety in China. Inadequate quantity and quality of surface water resources in China have led to the long-term use of waste-water irrigation to fulfill the water requirements for agricultural production. In some regions this has caused serious agricultural land and food pollution, especially for heavy metals. It is important, therefore, that issues threatening food safety such as combined pesticide residues and heavy metal pollution are addressed to reduce risks to human health. The increasing negative effects on food safety from water and soil pollution have put more people at risk of carcinogenic diseases, potentially contributing to 'cancer villages' which appear to correlate strongly with the main food producing areas. Currently in China, food safety policies are not integrated with soil and water pollution management policies. Here, a comprehensive map of both soil and water pollution threats to food safety in China is presented and integrated policies addressing soil and water pollution for achieving food safety are suggested to provide a holistic approach. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Zero Health Worker Infection: Experiences From the China Ebola Treatment Unit During the Ebola Epidemic in Liberia.

    Science.gov (United States)

    Liu, Lei; Yin, Huahua; Liu, Ding

    2017-04-01

    In November 2014, a total of 164 health care workers were dispatched by the Chinese government as the first medical assistance team to Liberia. The tasks of this team were to establish a China Ebola treatment unit (ETU), to commence the initial admission and treatment of suspected and confirmed Ebola patients, and to provide public health and infection control training for relevant local personnel. Overall, during the 2-month stay of this first medical assistance team in Liberia, 112 Ebola-suspected patients presented to the ETU, 65 patients were admitted, including 5 confirmed cases, and 3 confirmed cases were cured. Furthermore, 1520 local people were trained, including health care workers, military health care workers, staff members employed by the ETU, and community residents. Most importantly, as the first Chinese medical assistance team deployed to Liberia fighting the Ebola virus on the frontline, not a single member of this team or the hired local staff were infected by Ebola virus. This highly successful outcome was due to the meticulous infection control initiatives developed by the team, thereby making a significant contribution to China's ETU "zero infection" of health workers in Liberia. The major infection control initiatives conducted in the China ETU that contributed to achieving "zero infection" of all health workers in the ETU are introduced in this report. (Disaster Med Public Health Preparedness. 2017;11:262-266).

  3. Prospects for regulated competition in the health care system: what can China learn from Russia's experience?

    Science.gov (United States)

    Xu, Weiwei; Sheiman, Igor; van de Ven, Wynand P M M; Zhang, Wei

    2011-05-01

    As China explores new directions to reform its health care system, regulated competition among both insurers and providers of care might be one potential model. The Russian Federation in 1993 implemented legislation intended to stimulate such regulated competition in the health care sector. The subsequent progress and lessons learned over these 17 years can shed light on and inform the future evolution of the Chinese system. In this paper, we list the necessary pre-conditions for reaping the benefits of regulated competition in the health care sector. We indicate to what extent these conditions are being fulfilled in the post-reform Russian and current Chinese health care systems. We draw lessons from the Russian experience for the Chinese health care system, which shares a similar economic and political background with the pre-reform Russian health care system in terms of the starting point of the reform, and analyse the prospects for regulated competition in China.

  4. Impact of ambient fine particulate matter air pollution on health behaviors: a longitudinal study of university students in Beijing, China.

    Science.gov (United States)

    An, R; Yu, H

    2018-03-19

    Poor air quality has become a national public health concern in China. This study examines the impact of ambient fine particulate matter (PM 2.5 ) air pollution on health behaviors among college students in Beijing, China. Prospective cohort study. Health surveys were repeatedly administered among 12,000 newly admitted students at Tsinghua University during 2012-2015 over their freshman year. Linear individual fixed-effect regressions were performed to estimate the impacts of ambient PM 2.5 concentration on health behaviors among survey participants, adjusting for various time-variant individual characteristics and environmental measures. Ambient PM 2.5 concentration was found to be negatively associated with time spent on walking, vigorous physical activity and sedentary behavior in the last week, but positively associated with time spent on nighttime/daytime sleep among survey participants. An increase in the ambient PM 2.5 concentration by one standard deviation (36.5 μg/m³) was associated with a reduction in weekly total minutes of walking by 7.3 (95% confidence interval [CI] = 5.3-9.4), a reduction in weekly total minutes of vigorous physical activity by 10.1 (95% CI = 8.5-11.7), a reduction in daily average hours of sedentary behavior by 0.06 (95% CI = 0.02-0.10) but an increase in daily average hours of nighttime/daytime sleep by 1.07 (95% CI = 1.04-1.11). Ambient PM 2.5 air pollution was inversely associated with physical activity level but positively associated with sleep duration among college students. Future studies are warranted to replicate study findings in other Chinese cities and universities, and policy interventions are urgently called to reduce air pollution level in China's urban areas. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  5. The Structure and Effectiveness of Health Systems: Exploring the Impact of System Integration in Rural China.

    Science.gov (United States)

    Wang, Xin; Birch, Stephen; Ma, Huifen; Zhu, Weiming; Meng, Qingyue

    2016-08-12

    Facing the challenges of aging populations, increasing chronic diseases prevalence and health system fragmentation, there have been several pilots of integrated health systems in China. But little is known about their structure, mechanism and effectiveness. The aim of this paper is to analyze health system integration and develop recommendations for achieving integration. Huangzhong and Hualong counties in Qinghai province were studied as study sites, with only Huangzhong having implemented health system integration. Questionnaires, interviews, and health insurance records were sources of data. Social network analysis was employed to analyze integration, through structure measurement and effectiveness evaluation. Health system integration in Huangzhong is higher than in Hualong, so is system effectiveness. The patient referral network in Hualong has more "leapfrog" referrals. The information sharing networks in both counties are larger than the other types of networks. The average distance in the joint training network of Huangzhong is less than in Hualong. Meanwhile, there are deficiencies common to both systems. Both county health systems have strengths and limitations regarding system integration. The use of medical consortia in Huangzhong has contributed to system effectiveness. Future research might consider alternative more context specific models of health system integration.

  6. Climate Penalty on Air Quality and Human Health in China and India

    Science.gov (United States)

    Li, M.; Zhang, S.; Garcia-Menendez, F.; Monier, E.; Selin, N. E.

    2017-12-01

    Climate change, favoring more heat waves and episodes of stagnant air, may deteriorate air quality by increasing ozone and fine particulate matter (PM2.5) concentrations and high pollution episodes. This effect, termed as "climate penalty", has been quantified and explained by many earlier studies in the U.S. and Europe, but research efforts in Asian countries are limited. We evaluate the impact of climate change on air quality and human health in China and India using a modeling framework that links the Massachusetts Institute of Technology Integrated Global System Model to the Community Atmosphere Model (MIT IGSM-CAM). Future climate fields are projected under three climate scenarios including a no-policy reference scenario and two climate stabilization scenarios with 2100 total radiative forcing targets of 9.7, 4.5 and 3.7 W m-2, respectively. Each climate scenario is run for five representations of climate variability to account for the role of natural variability. Thirty-year chemical transport simulations are conducted in 1981-2010 and 2086-2115 under the three climate scenarios with fixed anthropogenic emissions at year 2000 levels. We find that 2000—2100 climate change under the no-policy reference scenario would increase ozone concentrations in eastern China and northern India by up to 5 ppb through enhancing biogenic emissions and ozone production efficiency. Ozone extreme episodes also become more frequent in these regions, while climate policies can offset most of the increase in ozone episodes. Climate change between 2000 and 2100 would slightly increase anthropogenic PM2.5 concentrations in northern China and Sichuan province, but significantly reduce anthropogenic PM2.5 concentrations in southern China and northern India, primarily due to different chemical responses of sulfate-nitrate-ammonium aerosols to climate change in these regions. Our study also suggests that the mitigation costs of climate policies can be partially offset by health

  7. Oral health knowledge, attitudes and behaviour of adults in China

    DEFF Research Database (Denmark)

    Zhu, L.; Petersen, P.E.; Wang, H.-Y.

    2005-01-01

    OBJECTIVES: To describe oral health behaviour, illness behaviour, oral health knowledge and attitudes among 35-44 and 65-74-year-old Chinese; to analyse the oral health behaviour profile of the two age groups in relation to province and urbanisation, and to assess the relative effect of socio......-behavioural risk factors on dental caries experience. METHODS: A total number of 4,398 35-44-year-olds and 4,399 65-74-year-olds were selected by multistage stratified cluster random sampling which involved 11 provinces in China. Data were collected by self-administered structured questionnaires and clinical...... fifth of the rural participants had economic support for their dental treatment from a third party, either totally or partially. Significant variations in oral health practices were found according to urbanisation and province. At age 35-44 years 43% of participants had daily consumption of sweets...

  8. Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China.

    Directory of Open Access Journals (Sweden)

    Xinyu Zhang

    Full Text Available This study aims to evaluate the dialectical relationship between equity and efficiency of health resource allocation and health service utilization in China.We analyzed the inequity of health resource allocation and health service utilization based on concentration index (CI and Gini coefficient. Data envelopment analysis (DEA was used to evaluate the inefficiency of resource allocation and service utilization. Factor Analysis (FA was used to determine input/output indicators.The CI of Health Institutions, Beds in Health Institutions, Health Professionals and Outpatient Visits were -0.116, -0.012, 0.038, and 0.111, respectively. Gini coefficient for the 31 provinces varied between 0.05 and 0.43; out of these 23 (742% were observed to be technically efficient constituting the "best practice frontier". The other 8 (25.8% provinces were technically inefficient.Health professionals and outpatient services are focused on higher income levels, while the Health Institutions and Beds in Health Institutions were concentrated on lower income levels. In China, a few provinces attained a basic balance in both equity and efficiency in terms of current health resource and service utilization, thus serving as a reference standard for other provinces.

  9. Male and Female Adult Population Health Status in China: A Cross-Sectional National Survey

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    Lu Mingshan

    2008-08-01

    Full Text Available Abstract Background With rapid economic growth and globalization, lifestyle in China has been changing dramatically. This study aimed to describe the male and female adult Chinese population health status. Methods The Chinese Third National Health Services Survey was conducted in 2003 to collect information about health status and quality of life from randomly selected residents. Of the 193,689 respondents to the survey (response rate 77.8%, 139,831 (69,748 male and 70,083 female respondents who were 18 years of age or older were analyzed. Results Among the respondents, fewer males than females rated their overall wellbeing as being poor or very poor (4.8% versus 6.2%, reported illness in the last 2 weeks (14.1% versus 17.4%, presence of physician diagnosed chronic disease (15.0% versus 17.7% and at least one functional problem in seven items of the quality of life (26.9% versus 32.8%. More males than females were currently smoking (52.4% versus 3.4% and drank alcohol more than three times per week (16.5% versus 1.1%. Physically inactive rate was similar between males and females (85.8% versus 87.0%. Fewer rural respondents reported chronic disease than urban respondents (13.0% versus 19.9% for males and 15.5% versus 22.8% for females. In all seven items of the quality of life measured, rural respondents reported less problems than urban respondents (26.2% versus 28.7% for males and 32.0% versus 34.7% for females. Conclusion Males had better health status than females in terms of self-perceived wellbeing, presence of illness, chronic disease, and quality of life. However, smoking and frequent alcohol drinking was more prevalent among males than that among females. In contrast with the social-economic gradient in health commonly found in the literature, the wealthier urban population in China was not found to be healthier than the rural population in terms of physician diagnosed chronic disease.

  10. Overview of the health care system in Hong Kong and its referential significance to mainland China.

    Science.gov (United States)

    Kong, Xiangyi; Yang, Yi; Gao, Jun; Guan, Jian; Liu, Yang; Wang, Renzhi; Xing, Bing; Li, Yongning; Ma, Wenbin

    2015-10-01

    Hong Kong's health system was established within the framework of a perfect market-oriented economic matrix, where there are wide-ranging social security and medical service systems. There are many differences in the economic foundations, social systems, and ideologies between Hong Kong and mainland China, therefore, it would probably be entirely impossible to copy Hong Kong's health care system mode. However, under the framework of one country, two systems, the referential significance of relevant concepts of Hong Kong's medical service system to mainland China cannot be ignored, and merits further study. Copyright © 2015. Published by Elsevier Taiwan.

  11. Operational and environmental performance in China's thermal power industry: Taking an effectiveness measure as complement to an efficiency measure.

    Science.gov (United States)

    Wang, Ke; Zhang, Jieming; Wei, Yi-Ming

    2017-05-01

    The trend toward a more fiercely competitive and strictly environmentally regulated electricity market in several countries, including China has led to efforts by both industry and government to develop advanced performance evaluation models that adapt to new evaluation requirements. Traditional operational and environmental efficiency measures do not fully consider the influence of market competition and environmental regulations and, thus, are not sufficient for the thermal power industry to evaluate its operational performance with respect to specific marketing goals (operational effectiveness) and its environmental performance with respect to specific emissions reduction targets (environmental effectiveness). As a complement to an operational efficiency measure, an operational effectiveness measure not only reflects the capacity of an electricity production system to increase its electricity generation through the improvement of operational efficiency, but it also reflects the system's capability to adjust its electricity generation activities to match electricity demand. In addition, as a complement to an environmental efficiency measure, an environmental effectiveness measure not only reflects the capacity of an electricity production system to decrease its pollutant emissions through the improvement of environmental efficiency, but it also reflects the system's capability to adjust its emissions abatement activities to fulfill environmental regulations. Furthermore, an environmental effectiveness measure helps the government regulator to verify the rationality of its emissions reduction targets assigned to the thermal power industry. Several newly developed effectiveness measurements based on data envelopment analysis (DEA) were utilized in this study to evaluate the operational and environmental performance of the thermal power industry in China during 2006-2013. Both efficiency and effectiveness were evaluated from the three perspectives of operational

  12. Arsenic contamination and potential health risk implications at an abandoned tungsten mine, southern China

    International Nuclear Information System (INIS)

    Liu Chuanping; Luo Chunling; Gao Yun; Li Fangbai; Lin Lanwen; Wu Changan; Li Xiangdong

    2010-01-01

    In an extensive environmental study, field samples, including soil, water, rice, vegetable, fish, human hair and urine, were collected at an abandoned tungsten mine in Shantou City, southern China. Results showed that arsenic (As) concentration in agricultural soils ranged from 3.5 to 935 mg kg -1 with the mean value of 129 mg kg -1 . In addition, As concentration reached up to 325 μg L -1 in the groundwater, and the maximum As concentration in local food were 1.09, 2.38 and 0.60 mg kg -1 for brown rice, vegetable and fish samples, respectively, suggesting the local water resource and food have been severely contaminated with As. Health impact monitoring data revealed that As concentrations in hair and urine samples were up to 2.92 mg kg -1 and 164 μg L -1 , respectively, indicating a potential health risk among the local residents. Effective measurements should be implemented to protect the local community from the As contamination in the environment. - It is the first report on arsenic contamination and potential health risk implications at abandoned Lianhuashan tungsten mine.

  13. Concentration and potential health risk of heavy metals in market vegetables in Chongqing, China.

    Science.gov (United States)

    Yang, Qing-Wei; Xu, Yuan; Liu, Shou-Jiang; He, Jin-Feng; Long, Fang-Yan

    2011-09-01

    Concentration and daily intake (DI) of heavy metals (Pb, Zn, Mn, Cu, Cd and Cr) in market vegetables in Chongqing of China are investigated and their potential health risk for local consumers is simultaneously evaluated by calculating the target hazard quotient (THQ). The results showed that the measured Pb and Cd concentrations exceeded the safety limits given by FAO/WHO and Chinese regulations, indicating serious contamination of market vegetables by these metals. As respective DI values for Pb, Mn and Cd were also above the international guideline bases, health risk to the consumers is obvious. The individual THQ for Pb and Cd in pakchoi and Cd in mustard, and the combined THQ for all metals in each vegetable species excluding cos lettuce were above the threshold 1.0, implying the obviously adverse effect on health. Therefore, attention should be paid particularly to the potential hazardous exposure to vegetable heavy metals, especially for Pb and Cd, over a lifetime for people in Chongqing. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Globalisation, Language Planning and Language Rights: The Recent Script Policy Measures Adopted by Japan and the People's Republic of China

    Science.gov (United States)

    Premaratne, Dilhara D.

    2015-01-01

    In 2009, two significant script policy measures were adopted by Japan and the People's Republic of China (China hereafter), both as a response to national language needs triggered by globalisation. However, the measures chosen by the two countries were very different, Japan choosing to increase and China choosing to standardise the Chinese…

  15. The gender health gap in China: A decomposition analysis.

    Science.gov (United States)

    Zhang, Hao; Bago d'Uva, Teresa; van Doorslaer, Eddy

    2015-07-01

    Around the world, and in spite of their higher life expectancy, women tend to report worse health than men until old age. Explanations for this gender gap in self-perceived health may be different in China than in other countries due to the traditional phenomenon of son preference. We examine several possible reasons for the gap using the Chinese SAGE data. We first rule out differential reporting by gender as a possible explanation, exploiting information on anchoring vignettes in eight domains of health functioning. Decomposing the gap in general self-assessed health, we find that about 31% can be explained by socio-demographic factors, most of all by discrimination against women in education in the 20th century. A more complete specification including chronic conditions and health functioning fully explains the remainder of the gap (about 69%). Adding chronic conditions and health functioning also explains at least two thirds of the education contribution, suggesting how education may affect health. In particular, women's higher rates of arthritis, angina and eye diseases make the largest contributions to the gender health gap, by limiting mobility, increasing pain and discomfort, and causing sleep problems and a feeling of low energy. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Health-Related Quality of Life and Associated Factors of Frontline Railway Workers: A Cross-Sectional Survey in the Ankang Area, Shaanxi Province, China

    Directory of Open Access Journals (Sweden)

    Xiaona Zhang

    2016-11-01

    Full Text Available After validation of the widely used health-related quality of life (HRQOL generic measure, the Short Form 36 version 2 (SF-36v2, we investigated the HRQOL and associated factors of frontline railway workers in China. Ground workers, conductors, and train drivers were selected from Ankang Precinct by using a stratified cluster sampling technique. A total of 784 frontline railway workers participated in the survey. The reliability and validity of SF-36v2 was satisfactory. The physical component summary (PCS scores of three subgroups attained the average range for the USA general population, whereas the mental component summary (MCS scores were well below the range. Most domains scored below the norm, except for the physical functioning (PF domain. Among three subgroups, train drivers reported significantly lower scores on MCS and six health domains (excluding PF and bodily pain (BP. After controlled confounders, conductors had significantly higher PCS and MCS scores than ground workers. There is heterogeneity on risk factors among three subgroups, but having long or irregular working schedules was negatively associated with HRQOL in all subgroups. SF-36v2 is a reliable and valid HRQOL measurement in railway workers in China. The frontline railway workers’ physical health was comparative to American norms, whilst mental health was relatively worse. Long or irregular working schedules were the most important factors.

  17. Health Disparities by Type of Disability: Health Examination Results of Adults (18-64 Years) with Disabilities in Shanghai, China.

    Science.gov (United States)

    Kang, Qi; Chen, Gang; Lu, Jun; Yu, Huijiong

    2016-01-01

    There have been few studies on the disparities within the population with disabilities, especially in China. The aim of this study was to evaluate the differences in some health conditions among people with different types of disabilities in Shanghai. This study was conducted using data from the Shanghai Disabled Persons' Rehabilitation Comprehensive Information Platform. The records of 31,082 persons with disabilities who had undergone professional health examination were analyzed, and the prevalence and number of five diseases and five risk factors were examined. Logistic regression was used to explore disparities from two perspectives: 1) basic differences, unadjusted for other factors, and 2) differences after adjusting for key demographic covariates. A p-value disability had a high rate of refractive error (60.0%), and averaged 1.75 diseases of interest, which was the highest value among all disability types. The mean number of risk factors we measured was greatest (1.96) in the population with mental disability. There were significant differences (p types of disabilities remained after controlling for key demographic indicators. Further research is needed to explore the relationships between health conditions and disability types.

  18. Public Perception of Extreme Cold Weather-Related Health Risk in a Cold Area of Northeast China.

    Science.gov (United States)

    Ban, Jie; Lan, Li; Yang, Chao; Wang, Jian; Chen, Chen; Huang, Ganlin; Li, Tiantian

    2017-08-01

    A need exists for public health strategies regarding extreme weather disasters, which in recent years have become more frequent. This study aimed to understand the public's perception of extreme cold and its related health risks, which may provide detailed information for public health preparedness during an extreme cold weather event. To evaluate public perceptions of cold-related health risk and to identify vulnerable groups, we collected responses from 891 participants in a face-to-face survey in Harbin, China. Public perception was measured by calculating the score for each perception question. Locals perceived that extreme cold weather and related health risks were serious, but thought they could not avoid these risks. The significant difference in perceived acceptance level between age groups suggested that the elderly are a "high health risk, low risk perception" group, meaning that they are relatively more vulnerable owing to their high susceptibility and low awareness of the health risks associated with extreme cold weather. The elderly should be a priority in risk communication and health protective interventions. This study demonstrated that introducing risk perception into the public health field can identify vulnerable groups with greater needs, which may improve the decision-making of public health intervention strategies. (Disaster Med Public Health Preparedness. 2017;11:417-421).

  19. Universal health coverage in emerging economies: findings on health care utilization by older adults in China, Ghana, India, Mexico, the Russian Federation, and South Africa.

    Science.gov (United States)

    Peltzer, Karl; Williams, Jennifer Stewart; Kowal, Paul; Negin, Joel; Snodgrass, James Josh; Yawson, Alfred; Minicuci, Nadia; Thiele, Liz; Phaswana-Mafuya, Nancy; Biritwum, Richard Berko; Naidoo, Nirmala; Chatterji, Somnath

    2014-01-01

    The achievement of universal health coverage (UHC) in emerging economies is a high priority within the global community. This timely study uses standardized national population data collected from adults aged 50 and older in China, Ghana, India, Mexico, the Russian Federation, and South Africa. The objective is to describe health care utilization and measure association between inpatient and outpatient service use and patient characteristics in these six low- and middle-income countries. Secondary analysis of data from the World Health Organization's Study on global AGEing and adult health Wave 1 was undertaken. Country samples are compared by socio-demographic characteristics, type of health care, and reasons for use. Logistic regressions describe association between socio-demographic and health factors and inpatient and outpatient service use. In the pooled multi-country sample of over 26,000 adults aged 50-plus, who reported getting health care the last time it was needed, almost 80% of men and women received inpatient or outpatient care, or both. Roughly 30% of men and women in the Russian Federation used inpatient services in the previous 3 years and 90% of men and women in India used outpatient services in the past year. In China, public hospitals were the most frequently used service type for 52% of men and 51% of women. Multivariable regression showed that, compared with men, women were less likely to use inpatient services and more likely to use outpatient services. Respondents with two or more chronic conditions were almost three times as likely to use inpatient services and twice as likely to use outpatient services compared with respondents with no reported chronic conditions. This study provides a basis for further investigation of country-specific responses to UHC.

  20. Perspectives of IBD China: Is Crohn's and Colitis Foundation Model a Solution to Health Care Issues for the Country?

    Science.gov (United States)

    Chen, Yan

    2018-04-21

    The success of the Crohn's and Colitis Foundation of America (CCFA), now Crohn's and Colitis Foundation (CCF) has established a role model for developing countries with an increasing incidence of inflammatory bowel disease (IBD), including China. While there are shared etiopathogenetic pathways and clinical features in IBD between Eastern and Western countries, patients with IBD as well as health care professionals in China are facing distinctive challenges, including the fragmented and inconsistent health insurance, social support system, and three-tiered health care service. Financial burden remains to be a tremendous obstacle to the management of IBD. In addition, poor rapport between patients and clinicians, and the lack of properly trained IBD specialists makes a noticeable gap in the management of IBD between China and Western countries. The China Crohn's &Colitis Foundation (CCCF), closely following the successful model of CCF, was established under the same doctrine, and served as a non-profit, volunteer-driven organization dedicated to improving quality of life of patients in by IBD through education and training.

  1. Effects of Living Alone on Social Capital and Health Among Older Adults in China.

    Science.gov (United States)

    Xu, Qingwen; Norstrand, Julie A; Du, Yan

    2015-12-01

    Social capital has been connected with positive health outcomes across countries, including China. Given the rise in the number of seniors living alone, there is a need to examine the health benefits of social capital, accounting for living arrangements. Data from the 2005 Chinese General Social Survey were used to test research hypotheses. Controlling for demographics, elders living alone possessed similar level of social capital compared with elders living with others. While bonding and linking social capital were significant factors in urban areas and linking social capital was a significant factor in rural areas, the relationship between living alone and health did not differ based on the level of social capital possession. When the traditional intergenerational living arrangement has not been a valid option for many older adults in China, seeking new way of family caring, and developing appropriate social and institutional structures to assist elders living alone, becomes critical. © The Author(s) 2016.

  2. Determinants of Medical and Health Care Expenditure Growth for Urban Residents in China: A Systematic Review Article.

    Science.gov (United States)

    Zhu, Xiaolong; Cai, Qiong; Wang, Jin; Liu, Yun

    2014-12-01

    In recent years, medical and health care consumption has risen, making health risk an important determinant of household spending and welfare. We aimed to examine the determinants of medical and health care expenditure to help policy-makers in the improvement of China's health care system, benefiting the country, society and every household. This paper employs panel data from China's provinces from 2001 to 2011 with all possible economic variations and studies the determinants of medical and healthcare expenditure for urban residents. CPI (consumer price index) of medical services and the resident consumption level of urban residents have positive influence on medical and health care expenditures for urban residents, while the local medical budget, the number of health institutions, the incidence of infectious diseases, the year-end population and the savings of urban residents will not have effect on medical and health care expenditure for urban residents. This paper proposed three relevant policy suggestions for Chinese governments based on the findings of the research.

  3. Partner violence and psychosocial distress among female sex workers in China.

    Directory of Open Access Journals (Sweden)

    Yan Hong

    Full Text Available Despite recognized vulnerability of female sex workers (FSW, most data on this population are focused on their HIV and STI prevalence; studies on their experience of partner violence and psychosocial distress are limited, especially FSW in China.A cross-sectional survey was administered among 1,022 FSW recruited from 9 different types of commercial sex venues in Southwest China. Partner violence scales were adapted from WHO's Women's Health and Domestic Violence scale and psychosocial distress was measured by five indicators, including alcohol intoxication, drug use, suicidal behavior, depression, and loneliness. Random effects modeling was used to control for cluster effects.About 58% of FSW ever experienced violence from their stable partners, and 45% suffered it from their clients. Partner violence was strongly associated with each of the five measures of psychosocial distress, even after controlling for potential confounders.This study is one of the first to examine the association between partner violence and psychosocial distress among FSW in China. The high prevalence of violence experience and distress in this population suggests urgency for intervention. The public health programs targeting FSW should go beyond the focus on HIV/STI prevention and care for the fundamental health and human rights of millions of FSW in China.

  4. Evaluating impacts of air pollution in China on public health: Implications for future air pollution and energy policies

    Science.gov (United States)

    Wang, Xiaoping; Mauzerall, Denise L.

    Our objective is to establish the link between energy consumption and technologies, air pollution concentrations, and resulting impacts on public health in eastern China. We use Zaozhuang, a city in eastern China heavily dependent on coal, as a case study to quantify the impacts that air pollution in eastern China had on public health in 2000 and the benefits in improved air quality and health that could be obtained by 2020, relative to business-as-usual (BAU), through the implementation of best available emission control technology (BACT) and advanced coal gasification technologies (ACGT). We use an integrated assessment approach, utilizing state-of-the-science air quality and meteorological models, engineering, epidemiology, and economics, to achieve this objective. We find that total health damages due to year 2000 anthropogenic emissions from Zaozhuang, using the "willingness-to-pay" metric, was equivalent to 10% of Zaozhuang's GDP. If all health damages resulting from coal use were internalized in the market price of coal, the year 2000 price would have more than tripled. With no new air pollution controls implemented between 2000 and 2020 but with projected increases in energy use, we estimate health damages from air pollution exposure to be equivalent to 16% of Zaozhuang's projected 2020 GDP. BACT and ACGT (with only 24% penetration in Zaozhuang and providing 2% of energy needs in three surrounding municipalities) could reduce the potential health damage of air pollution in 2020 to 13% and 8% of projected GDP, respectively. Benefits to public health, of substantial monetary value, can be achieved through the use of BACT; health benefits from the use of ACGT could be even larger. Despite significant uncertainty associated with each element of the integrated assessment approach, we demonstrate that substantial benefits to public health could be achieved in this region of eastern China through the use of additional pollution controls and particularly from the

  5. Trends in access to health services and financial protection in China between 2003 and 2011: a cross-sectional study.

    Science.gov (United States)

    Meng, Qun; Xu, Ling; Zhang, Yaoguang; Qian, Juncheng; Cai, Min; Xin, Ying; Gao, Jun; Xu, Ke; Boerma, J Ties; Barber, Sarah L

    2012-03-03

    In the past decade, the Government of China initiated health-care reforms to achieve universal access to health care by 2020. We assessed trends in health-care access and financial protection between 2003, and 2011, nationwide. We used data from the 2003, 2008, and 2011 National Health Services Survey (NHSS), which used multistage stratified cluster sampling to select 94 of 2859 counties from China's 31 provinces and municipalities. The 2011 survey was done with a subset of the NHSS sampling frame to monitor key indicators after the national health-care reforms were announced in 2009. Three sets of indicators were chosen to measure trends in access to coverage, health-care activities, and financial protection. Data were disaggregated by urban or rural residence and by three geographical regions: east, central, and west, and by household income. We examined change in equity across and within regions. The number of households interviewed was 57,023 in 2003, 56,456 in 2008, and 18,822 in 2011. Response rates were 98·3%, 95·0%, and 95·5%, respectively. The number of individuals interviewed was 193,689 in 2003, 177,501 in 2008, and 59,835 in 2011. Between 2003 and 2011, insurance coverage increased from 29·7% (57,526 of 193,689) to 95·7% (57,262 of 59,835, pservices and insurance coverage across and within regions. However, these increases have not been accompanied by reductions in catastrophic health expenses. With the achievement of basic health-services coverage, future challenges include stronger risk protection, and greater efficiency and quality of care. None. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Impact of economic growth on vegetation health in China based on GIMMS NDVI

    NARCIS (Netherlands)

    Jin, X.; Wan, L.; Zhang, Y.K.; Schaepman, M.E.

    2008-01-01

    The negative impact of economic development on vegetation health in China was assessed using gross domestic product (GDP) and the Global Inventory Modelling and Mapping Studies (GIMMS) Normalized Difference Vegetation Index (NDVI) data. Five levels of vegetation changes were established based on the

  7. The effect of health insurance reform on the number of cataract surgeries in Chongqing, China

    Directory of Open Access Journals (Sweden)

    Yuan Rongdi

    2011-03-01

    Full Text Available Abstract Background Cataracts are the leading cause of blindness in China, and poverty is a major barrier to having cataract surgery. In 2003, the Chinese government began a series of new national health insurance reforms, including the New Cooperative Medical Scheme (NCMS and the Urban Resident Basic Health Insurance scheme (URBMI. These two programs, combined with the previously existing Urban Employee Basic Health Insurance (UEBMI program, aimed to make it easier for individuals to receive medical treatment. This study reports cataract surgery numbers in rural and urban populations and the proportion of these who had health insurance in Chongqing, China from 2003 to 2008. Methods The medical records of a consecutive case series, including 14,700 eyes of 13,262 patients who underwent age-related cataract surgery in eight hospitals in Chongqing from January 1, 2003, to December 31, 2008, were analysed retrospectively via multi-stage cluster sampling. Results In the past six years, the total number of cataract surgeries had increased each year as had the number of patients with insurance. Both the number of surgeries and the number of insured patients were much higher in the urban group than in the rural group. The rate of increase in the rural group however was much higher than in the urban group, especially in 2007 and 2008. The odds ratios of having health insurance for urban vs. rural individuals were relatively stable from 2003 to 2006, but it decreased in 2007 and was significantly lower in 2008. Conclusions Health insurance appears to be an important factor associated with increased cataract surgery in Chongqing, China. With the implementation of health insurance, the number of Chongqing's cataract surgeries was increased year by year.

  8. OMI measurements of SO2 pollution over Eastern China in 2005-2008

    Science.gov (United States)

    Krotkov, N.; Pickering, K.; Witte, J.; Carn, S.; Yang, K.; Carmichael, G.; Streets, D.; Zhang, Q.; Wei, C.

    2009-05-01

    The Ozone Monitoring Instrument (OMI) on NASA Aura satellite makes global daily measurements of the total column of sulfur dioxide (SO2), a short-lived trace gas produced by fossil fuel combustion, smelting, and volcanoes. OMI seasonal to multi-year average images clearly show the world-highest consistent SO2 pollution in northeast China. China is the world's largest SO2 emitter, mostly due to the burning of high-sulfur coal in its many coal-fired power plants, which lack the technology used in many other countries to remove sulfur from smoke stack emissions. China's government has instituted nationwide measures to control SO2 emissions through the adoption of flue-gas desulfurization technology on new power plants; and even greater measures were adopted in the Beijing area in anticipation of the Olympic Games. To study the environmental effects of the emission controls we compared OMI SO2 time series over eastern China for 2005 through 2008. The time series have been done as 7-day running means of the cloud-free daily observations. By mid-March we started to see substantial periods of lower SO2 values in 2008 compared to 2007, and by mid June the 2008 values were consistently lower than 2007 and prior years. The decline is widespread with highest SO2 typically located to the south and southwest of Beijing in regions with large clusters of power plants and also around Shanghai. The decline also lasted beyond the Olympic season. We do not yet know to what extent the economic downturn in China (and reduced industrial production) contributed to lower SO2 levels in the fall of 2008. We have also compared the observed and modeled fields using University of Iowa STEM model for the period June - September 2008. The model provided SO2 vertical distributions as well as aerosol vertical profiles that were used to correct OMI operational SO2 retrievals and improve the comparisons. The OMI SO2 changes in 2008 have also been compared with the estimated changes in SO2 emissions

  9. Effectiveness of a workplace-based intervention program to promote mental health among employees in privately owned enterprises in China.

    Science.gov (United States)

    Sun, Jing; Buys, Nicholas; Wang, Xinchao

    2013-12-01

    This study aims to examine the effectiveness of a workplace-based intervention program to improve mental health, work ability, and work productivity in privately owned enterprises in China. A prospective cohort intervention study design was employed in which the intervention program was implemented for 30 months (from July 2009 to December 2012). Nine privately owned retail enterprises in China participated in the intervention study. Researchers administered a self-report survey to 2768 employees. The research team measured participants' job stress, resilience, work ability, absenteeism, depression, and work performance. A comprehensive Health Promotion Enterprise Program was implemented that entailed the following components: policies to support a healthy work environment, psychosocial interventions to promote mental health, provision of health services to people with mental illness, and professional skills training to deal with stress and build resilience. Analysis of variance was used to examine preintervention versus postintervention differences in stress, resilience, and work ability. Logistic regression was used to examine absenteeism related to depression. The results suggest that the intervention program was effective at improving participants' ability to work, their sense of control over their jobs, and, in particular, their ability to meet the mental demands of work. The intervention program also reduced participants' job stress levels and reduced the probability of absenteeism related to depression. The intervention programs incorporating both individual-level and organizational-level factors to promote mental health were effective and have implications for both practice and policy regarding enterprises taking more responsibility for the provision of mental health services to their employees.

  10. Knowledge of Cervical Cancer Screening among Health Care Workers Providing Services Across Different Socio-economic Regions of China.

    Science.gov (United States)

    Di, Jiang-Li; Rutherford, Shannon; Wu, Jiu-Ling; Song, Bo; Ma, Lan; Chen, Jing-Yi; Chu, Cordia

    2016-01-01

    China carries a heavy burden of cervical cancer (CC) and substantial disparities exist across regions within the country. In order to reduce regional disparities in CC, the government of China launched the National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) in 2009. Critical to the success of the program are the health care workers who play a pivotal role in preventing and managing CC by encouraging and motivating women to use screening services and by providing identification and treatment services. This study aimed to assess cervical cancer knowledge among these health care workers at the county level in maternal and child health (MCH) hospitals across different socio-economic regions of China. A cross-sectional survey was conducted and self-administered questionnaires were sent to all health care workers (a total of 66) providing cervical cancer screening services in 6 county level MCH hospitals in Liaoning, Hubei and Shaanxi provinces, representing eastern, central and western regions of China; 64 (97.0%, 64/66) of the workers responded. ANOVA and Chi-square test were used to compare the knowledge rate and scores in subgroups. The knowledge level of the respondents was generally low. The overall combined knowledge rate was 46.9%. The knowledge rates for risk factors, prevention, clinical symptoms, screening and diagnostic tests and understanding of positive results were 31.3%, 37.5%, 18.1%, 56.3% and 84.4%, respectively. Statistically significant differences in scores or rates of CC knowledge were seen across the different regions. The total and sectional scores in the less developed regions were statistically significantly lower than in the other regions. The majority of the health care workers who provide CC screening service in NCCSPRA at county level MCH hospitals do not have adequately equipped with knowledge about CC. Given the importance of knowledge to the program's success in reducing CC burden in rural women in China, efforts are

  11. Widespread usage of infant formula in China: a major public health problem.

    Science.gov (United States)

    Tang, Li; Lee, Andy H; Binns, Colin W; Yang, Yuxiong; Wu, Yan; Li, Yanxia; Qiu, Liqian

    2014-12-01

    The potential health risks of infant formula feeding are well established. This study investigated the opinions and perceptions of mothers and recommendations by hospital staff with respect to infant formula usage in China. A cross-sectional survey of 726 mothers within 6 months postpartum and 241 hospital staff, using structured questionnaires, was conducted in Hangzhou and Shenzhen, China. Overall, 474 of 726 (65.3%) infants aged within 6 months had consumed some infant formula. About 40.0 percent of mothers chose a hybrid brand of formula (manufactured in China but owned by a foreign company), over imported (< 32.0%) and domestic brands (< 28.0%), despite their higher level of confidence on the quality of imported brands. Perceived insufficient breastmilk production (86.2%) was the most common reason for giving infant formula, followed by return to work (24.6%). Of the 241 hospital staff, 97 (40.2%) gave no recommendation about infant formula brand for infants at any age. However, 47.2 percent of the remaining staff recommended a hybrid brand in combination with an imported and/or a domestic product. Perceptions by mothers and recommendations from hospital staff appear to contribute to the widespread usage of infant formula in China. It is important to ensure breastmilk substitutes are prescribed to Chinese infants strictly for medical reasons. Maternal education programs incorporating information on food safety issues and establishment of breastfeeding-friendly workplaces could curtail the common practice of formula feeding in China. © 2014 Wiley Periodicals, Inc.

  12. Prevalence of Frailty and Associated Factors in the Community-Dwelling Population of China.

    Science.gov (United States)

    Ma, Lina; Tang, Zhe; Zhang, Li; Sun, Fei; Li, Yun; Chan, Piu

    2018-03-01

    Frailty in older adults predicts dependence and mortality and is a major challenge for healthcare systems in countries with rapidly aging populations. Little is known about frailty in China. We investigated the prevalence and associated risk factors of frailty in older adults in China. Cross-sectional. Data were obtained from the China Comprehensive Geriatric Assessment Study, conducted in 2011-12, which was the first uniform comprehensive assessment system adopted in China. Older adults from 7 cities were selected based on well-established cluster, stratification, and random selection statistical sampling techniques (N = 5,844). The Comprehensive Geriatric Assessment-Frailty Index was measured based on demographic characteristics, physical health, physical function, living behavior and social function, mental health, and cognitive function. The overall weighted prevalence of frailty was 9.9%: 12.7% in southwestern China, 11.0% in northern China, 5.9% in northwestern China, 5.0% in south-central China, 2.5% in eastern China, and 2.3% in northeastern China. The prevalence of frailty increased with age and was significantly higher in women and those living in rural areas. After adjusting for sex, age, area, region, and education, activity of daily living impairment was the strongest risk factor for frailty. Chronic diseases, depression, poor lifestyle, and geriatric syndromes were also independent risk factors. Our study provides epidemiological characteristics and the risk factors of frailty in China; the findings indicate greater regional disparities. Efforts to promote physical, psychological, and social health in older adults are a core objective of health policy, especially in women and those living in rural areas. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  13. A study on satisfaction with publicly financed health services in China.

    Science.gov (United States)

    Zhai, Shaoguo; Wang, Pei; Wang, Anli; Dong, Quanfang; Cai, Jiaoli; Coyte, Peter C

    2017-08-28

    With implementation of Chinese universal healthcare, the performance of urban and rural residents' healthcare and the degree of satisfaction with publicly financed health services have become a hot issue in assessing health reforms in China. An evaluation model of health services in community and evaluation indexes of health-system performance have been put forward in related researches. This study examines variation in satisfaction with publicly financed health services among urban and rural residents in five Chinese cities and assesses their determinants. The data are derived from a survey of 1198 urban and rural residents from five nationally representative regions concerning their perceptions of satisfaction with China's publicly financed health services. The respondents assessed their degree of satisfaction with publicly financed health services on a 5-point Likert scale. It is a kind of questionaire scale that features the answers for 1-5 points labeled very unsatisfied, unsatisfied, neither unsatisfied nor satisfied, satisfied and very satisfied linking to each factor or variable, where a score of 1 reflects the lowest degree of satisfaction and a score of 5 represents the highest degree. The logistic regression methods are used to identify the variables into its determining components. The overall satisfaction degree representing satisfaction of all factors (variables) is 3.02, which is at the middle level of a 1-5 Likert scale, inferring respondents' neutral attitude to publicly financed health services. According to the correlation test, the factors with characteristic root greater than 0.5 are chosen to take the factor analysis and 12 extracted factors can explain 77.97% of original 18 variables' total variance. Regression analysis based on the survey data finds that health records, vaccinations, pediatric care, elder care, and mental health management are the main factors accounting for degree of satisfaction with publicly financed health services for

  14. The Mental Health of People Living with HIV in China, 1998-2014: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Lu Niu

    Full Text Available Understanding the mental health burdens faced by people living with HIV in China is instrumental in the development of successful targeted programs for psychological support and care.Using multiple Chinese and English literature databases, we conducted a systematic review of observational research (cross-sectional, case-control, or cohort published between 1998 and 2014 on the mental health of people living with HIV in China.We identified a total of 94 eligible articles. A broad range of instruments were used across studies. Depression was the most widely studied problem; the majority of studies reported prevalence greater than 60% across research settings, with indications of a higher prevalence among women than men. Rates of anxiety tended to be greater than 40%. Findings regarding the rates of suicidality, HIV-related neurocognitive disorders, and substance use were less and varied. Only one study investigated posttraumatic stress disorder and reported a prevalence of 46.2%. Conflicting results about health and treatment related factors of mental health were found across studies.Despite limitations, this review confirmed that people living with HIV are vulnerable to mental health problems, and there is substantial need for mental health services among this population.

  15. Systematic review of HIV prevention interventions in China: a health communication perspective.

    Science.gov (United States)

    Xiao, Zhiwen; Noar, Seth M; Zeng, Lily

    2014-02-01

    To examine whether communication strategies and principles have been utilized in the HIV prevention intervention programs conducted in China. Comprehensive literature searches were conducted using PsycINFO, Medline, and Academic Search Complete with combinations of a number of keywords. Studies were included if they (1) were conducted in China and published prior to October 2011; (2) tested interventions promoting HIV/sexual risk reduction; and (3) reported empirical outcome evaluations on HIV knowledge, condom use and other condom-related variables. Data on 11 dimensions were extracted and analyzed, including formative research, theory, message targeting, messenger and channels, process evaluation, evaluation design, outcome measures. The majority of the 45 intervention studies were not theory-based, did not report conducting formative research or process evaluation, used pretest-posttest control group designs, combined nonmedia channels, printed and visual materials, and employed HIV knowledge and condom use as outcome measures. Many HIV prevention interventions in China have been successful in reducing HIV risk-related outcomes. This literature has its weaknesses; however, the current review illuminates gaps in the literature and points to important future directions for research.

  16. Afternoon Napping and Cognition in Chinese Older Adults: Findings from the China Health and Retirement Longitudinal Study Baseline Assessment.

    Science.gov (United States)

    Li, Junxin; Cacchione, Pamela Z; Hodgson, Nancy; Riegel, Barbara; Keenan, Brendan T; Scharf, Mathew T; Richards, Kathy C; Gooneratne, Nalaka S

    2017-02-01

    To examine the cross-sectional associations between self-reported postlunch napping and structured cognitive assessments in Chinese older adults. Cross-sectional cohort study. China. Individuals aged 65 and older from the baseline national wave of the China Health and Retirement Longitudinal Study (CHARLS) (N = 2,974). Interview-based cognitive assessments of orientation and attention, episodic memory, visuospatial abilities, and a combined global cognition score incorporating these assessments. Other self-reported or interview-based assessments included postlunch napping duration, nighttime sleep duration, demographic characteristics, health habits, comorbidities, functional status and social activities. According to reported napping duration, older adults were categorized as non-nappers (0 minutes), short nappers (90 minutes). Postlunch napping was reporting in 57.7% of participants for a mean of 63 minutes. Cognitive function was significantly associated with napping (P napping was significantly associated with better cognition than non- (P = .004), short (P = .04), and extended napping (P = .002), after controlling for demographic characteristics, body mass index, depression, instrumental activities of daily living, social activities, and nighttime sleep duration. A cross-sectional association was found between moderate postlunch napping and better cognition in Chinese older adults. The cross-sectional design and self-reported measures of sleep limited the findings. Longitudinal studies with objective napping measures are needed to further test this hypothesis. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  17. Climate Change Impacts on Central China and Adaptation Measures

    Institute of Scientific and Technical Information of China (English)

    REN Yong-Jian; CUI Jiang-Xue; WAN Su-Qin; LIU Min; CHEN Zheng-Hong; LIAO Yu-Fang; WANG Ji-Jun

    2013-01-01

    In Central China, the obvious climate change has happened along with global warming. Based on the observational analysis, the climate change has significant effects, both positive and negative, in every field within the study area, and with the harmful effects far more prevalent. Under the scenario A1B, it is reported that temperature, precipitation, days of heat waves and extreme precipitation intensity will increase at respective rates of 0.38◦C per decade, 12.6 mm per decade, 6.4 d and 47 mm per decade in the 21st century. It is widely believed that these climate changes in the future will result in some apparent impacts on agro-ecosystems, water resources, wetland ecosystem, forest ecosystem, human health, energy sectors and other sensitive fields in Central China. Due to the limited scientific knowledge and researches, there are still some shortages in the climate change assessment methodologies and many uncertainties in the climate prediction results. Therefore, it is urgent and essential to increase the studies of the regional climate change adaptation, extend the research fields, and enhance the studies in the extreme weather and climate events to reduce the uncertainties of the climate change assessments.

  18. General practice education and training in southern China: recent development and ongoing challenges under the health care reform

    Directory of Open Access Journals (Sweden)

    Wang Jia-Ji

    2013-12-01

    Full Text Available China has launched a general practice (GP-orientated primary care reform in 2009 to develop a more productive, coordinated, and cost-effective system to maintain and improve the health and wellbeing of one-fifth of the world population. The restructure of the health care system with a focus on primary care requires practitioners working on GP as gatekeepers for service delivery that is responsive to the needs of people. It is particularly prioritised to establish a sound education and training system to ensure that the competencies of practitioners are aligned with local health care needs. This article aims to provide a brief review of the development of GP, including exemplary model of education and training currently implemented in southern China, as well as the challenges to be addressed in the next step. There is a shortage of well-trained and qualified general practitioners in China where more than half of the licensed clinicians in primary care are educated below the undergraduate level. Although there is a stepwise increase in recognition that the capacity of GP is pivotal to the success of primary care development in China, challenges coming from resource restriction, rural and urban disparity, social attitude, and community involvement are highlighted as major bottlenecks that currently hinder the rapid development of GP in China. Supportive policy and guidelines are necessary to build up strong GP recognition and ensure adequate resources to underpin a robust primary care system to deliver affordable and effective health care services for the world’s largest population. It might share some similar experiences with other countries that are struggling to develop a GP-based primary care system.

  19. General practice education and training in southern China: recent development and ongoing challenges under the health care reform.

    Science.gov (United States)

    Wang, H H X; Wang, J J; Zhou, Z H; Wang, X W; Xu, L

    2013-01-01

    China has launched a general practice (GP)-orientated primary care reform in 2009 to develop a more productive, coordinated, and cost-effective system to maintain and improve the health and well-being of one-fifth of the world population. The restructure of the health care system with a focus on primary care requires practitioners working on GP as gatekeepers for service delivery that is responsive to the needs of people. It is particularly prioritised to establish a sound education and training system to ensure that the competencies of practitioners are aligned with local health care needs. This article aims to provide a brief review of the development of GP, including exemplary model of education and training currently implemented in southern China, as well as the challenges to be addressed in the next step. There is a shortage of well-trained and qualified general practitioners in China where more than half of the licensed clinicians in primary care are educated below the undergraduate level. Although there is a stepwise increase in recognition that the capacity of GP is pivotal to the success of primary care development in China, challenges coming from resource restriction, rural and urban disparity, social attitude, and community involvement are highlighted as major bottlenecks that currently hinder the rapid development of GP in China. Supportive policy and guidelines are necessary to build up strong GP recognition and ensure adequate resources to underpin a robust primary care system to deliver affordable and effective health care services for the world's largest population. It might share some similar experiences with other countries that are struggling to develop a GP-based primary care system.

  20. China-Africa Health Development Initiatives: Benefits and Implications for Shaping Innovative and Evidence-informed National Health Policies and Programs in Sub-saharan African Countries

    Science.gov (United States)

    Tambo, Ernest; Ugwu, Chidiebere E.; Guan, Yayi; Wei, Ding; Xiao-Ning; Xiao-Nong, Zhou

    2016-01-01

    Background and Introduction: This review paper examines the growing implications of China’s engagement in shaping innovative national initiatives against infectious diseases and poverty control and elimination in African countries. It seeks to understand the factors and enhancers that can promote mutual and innovative health development initiatives, and those that are necessary in generating reliable and quality data for evidence-based contextual policy, priorities and programs. Methods: We examined the China-Africa health cooperation in supporting global health agenda on infectious diseases such as malaria, schistosomiasis, Ebola, TB, HIV/AIDS, neglected tropical diseases (NTDs) prevention, control and elimination spanning a period of 10 years. We reviewed referenced publications, global support data, and extensive sources related to and other emerging epidemics and infectious diseases of poverty, programs and interventions, health systems development issues, challenges, opportunities and investments. Published literature in PubMed, Scopus, Google Scholar, Books and web-based peer-reviewed journal articles, government annual reports were assessed from the first Forum on China-Africa Cooperation (FOCAC) in November 2006 to December 2015 Third Ministerial conferences. Results: Our findings highlight current shared public health challenges and emphasize the need to nurture, develop and establish effective, functional and sustainable health systems capacity to detect and respond to all public health threats and epidemic burdens, evidence-based programs and quality care outcomes. China’s significant health diplomacy emphasizes the importance of health financing in establishing health development commitment and investment in improving the gains and opportunities, importantly efficiency and value health priorities and planning. Conclusions and Global Health Implications: Strengthening China-Africa health development agenda towards collective commitment and investment

  1. Regulation of GMOs in China.

    Science.gov (United States)

    Liu, Yinliang

    2008-12-01

    Genetically modified organisms (GMOs) are created by biotechnology to serve people with much benefit while may impose risks to ecological environment and human health and therefore need careful regulation. During the past two decades, GMOs have been well developed in China and so has their corresponding regulation. This paper reviews and comments the multiple aspects of mainly the agricultural GMOs, including their safety assessment, control measures, trade activities, import, labels, and GM food, which have been prescribed by the corresponding laws, regulations and administrative measures. It is held that till present a framework for regulation of agricultural GMOs and GM food has been established basically in China, while a more comprehensive system for regulation of all kinds of GMOs and all kinds of related activities is still needed at present and in the future.

  2. Income-related health inequality of migrant workers in China and its decomposition: An analysis based on the 2012 China Labor-force Dynamics Survey data

    Directory of Open Access Journals (Sweden)

    Cenyi Shao

    2016-10-01

    Conclusion: It is generally known that there is an unequal socioeconomic distribution of migrant worker health in China. In order to reduce the health inequality, the government should make a substantial effort to strengthen policy implementation in improving the income distribution for vulnerable groups. After this investigation, it is apparent that the findings we have made warrant further investigation.

  3. Evaluation of health care system reform in Hubei Province, China.

    Science.gov (United States)

    Sang, Shuping; Wang, Zhenkun; Yu, Chuanhua

    2014-02-21

    This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based on the "Result Chain" logic model and include the following four domains: Inputs and Processes, Outputs, Outcomes and Impact. Health care system reform was evaluated using the weighted TOPSIS and weighted Rank Sum Ratio methods. Ultimately, the study established a set of indicators including four grade-1 indicators, 16 grade-2 indicators and 76 grade-3 indicators. The effects of the reforms increased year by year from 2009 to 2011 in Hubei Province. The health status of urban and rural populations and the accessibility, equity and quality of health services in Hubei Province were improved after the reforms. This sub-national case can be considered an example of a useful approach to the evaluation of the effects of health care system reform, one that could potentially be applied in other provinces or nationally.

  4. Comparison of two approaches for measuring household wealth via an asset-based index in rural and peri-urban settings of Hunan province, China

    Directory of Open Access Journals (Sweden)

    Balen Julie

    2010-09-01

    Full Text Available Abstract Background There are growing concerns regarding inequities in health, with poverty being an important determinant of health as well as a product of health status. Within the People's Republic of China (P.R. China, disparities in socio-economic position are apparent, with the rural-urban gap of particular concern. Our aim was to compare direct and proxy methods of estimating household wealth in a rural and a peri-urban setting of Hunan province, P.R. China. Methods We collected data on ownership of household durable assets, housing characteristics, and utility and sanitation variables in two village-wide surveys in Hunan province. We employed principal components analysis (PCA and principal axis factoring (PAF to generate household asset-based proxy wealth indices. Households were grouped into quartiles, from 'most wealthy' to 'most poor'. We compared the estimated household wealth for each approach. Asset-based proxy wealth indices were compared to those based on self-reported average annual income and savings at the household level. Results Spearman's rank correlation analysis revealed that PCA and PAF yielded similar results, indicating that either approach may be used for estimating household wealth. In both settings investigated, the two indices were significantly associated with self-reported average annual income and combined income and savings, but not with savings alone. However, low correlation coefficients between the proxy and direct measures of wealth indicated that they are not complementary. We found wide disparities in ownership of household durable assets, and utility and sanitation variables, within and between settings. Conclusion PCA and PAF yielded almost identical results and generated robust proxy wealth indices and categories. Pooled data from the rural and peri-urban settings highlighted structural differences in wealth, most likely a result of localized urbanization and modernization. Further research is needed

  5. Exploring status and determinants of prenatal and postnatal visits in western China: in the background of the new health system reform.

    Science.gov (United States)

    Fan, Xiaojing; Zhou, Zhongliang; Dang, Shaonong; Xu, Yongjian; Gao, Jianmin; Zhou, Zhiying; Su, Min; Wang, Dan; Chen, Gang

    2017-07-20

    Prenatal and postnatal visits are two effective interventions for protection and promotion of maternal health by reducing maternal mortality and improving the quality of birth. There is limited nationally representative data regarding the changes of prenatal and postnatal visits since the latest health system reform initiated in 2009 in Shaanxi, China. The aim of this study was to explore the current status and determinants of prenatal and postnatal visits in the background of new health system reform. Data were drawn from two waves of National Health Service Surveys in Shaanxi Province which were conducted prior and post the health system reform in 2008 and 2013, respectively. A concentration index was employed to measure the degree of income-related inequality of maternal health services utilization. Multilevel mix-effects logistic regressions were applied to study the factors associated with prenatal and postnatal visits. The study sample consists of 2398 women aged 15-49 years old. The data of the 5th National Health Services Survey in 2013 showed in the criterion of the World Health Organization (WHO), the percentage of women receiving ≥4 prenatal visits was 84.79% for urban women and 82.20% for rural women, with women receiving ≥3 postnatal visits were 26.48 and 25.29% for urban and rural women respectively. In the criterion of China's ≥ 5 prenatal visits the percentages were 72.25% for urban women and 70.33% for rural women; 61.69% of urban women and 71.50% of rural women received ≥1 postnatal visits. As for urban women, the concentration index of postnatal visit utilization was -0.075 (95% CI:-0.148, -0.020) after the health system reform. The determinants related to prenatal and postnatal visits were the change of reform, women's education, parity and the delivery institution. This study showed the utilization of prenatal and postnatal visits met the requirement of the WHO, higher than other areas in China and other developing countries after

  6. Study on sexual and reproductive health behaviors of unmarried female migrants in China

    NARCIS (Netherlands)

    He, D.; Zhou, Y.; Ji, N.; Wu, S.; Wang, Z.; Decat, P.; Moyer, E.; Minkauskiene, M.; Pang, C.; Cheng, Y.

    2012-01-01

    Aim: The purpose of this study was to broadly assess the level of knowledge, attitude and behaviors related to sexual and reproductive health (SRH) among unmarried female migrants in China. Material and Methods: This cross-sectional study was conducted and a self-administered questionnaire was

  7. Sewage Sludge Treatment for Energy Purpose in China : Waste Treatment in China

    OpenAIRE

    Nyyssönen, Ville

    2015-01-01

    This thesis is made for ANDRITZ China Technology to find out sludge incineration potential in China. ANDRITZ is looking for markets and customers for ANDRITZ sewage sludge incineration technology in China. In addition ANDRITZ China manufactures centrifuges, skeleton model filter presses, belt presses and rotatory drums to treat the sludge. Sludge in China has become a major problem. It is considered to be toxic waste, because it contains pathogens, which are dangerous for human health. Th...

  8. Job satisfaction and its modeling among township health center employees: a quantitative study in poor rural China.

    Science.gov (United States)

    Liu, Jun A; Wang, Qi; Lu, Zu X

    2010-05-10

    Job satisfaction is important to staff management of township health centers (THCs), as it is associated with organizational performance, quality of care and employee retention. The purpose of this study was to measure job satisfaction level of THC employees in poor rural China and to identify relevant features in order to provide policy advice on human resource development of health service institutions in poor regions. A self-completion questionnaire was used to assess the job satisfaction and relevant features (response rate: 90.5%) among 172 employees (i.e., clinic doctors, medico-technical workers and public health workers) of 17 THCs in Anhui and Xinjiang provinces of China. The study covered a time period of two months in 2007. The mean staff job satisfaction scored 83.3, which was in the category of "somewhat satisfied" on a scale ranging from 0 (extremely dissatisfied) to 100 (extremely satisfied) by employing Likert's transformation formula. Exploratory factor analysis (EFA) revealed eight domains involved in modeling of job satisfaction, among which, the caregivers were more satisfied with job significance (88.2), job competency (87.9) and teamwork (87.7), as compared with work reward (72.9) and working conditions (79.7). Mean job satisfaction in Xinjiang (89.7) was higher than that in Anhui (75.5). Employees of THCs have moderate job satisfactions in poor areas, which need to be raised further by improving their working conditions and reward.

  9. Job satisfaction and its modeling among township health center employees: a quantitative study in poor rural China

    Directory of Open Access Journals (Sweden)

    Lu Zu X

    2010-05-01

    Full Text Available Abstract Background Job satisfaction is important to staff management of township health centers (THCs, as it is associated with organizational performance, quality of care and employee retention. The purpose of this study was to measure job satisfaction level of THC employees in poor rural China and to identify relevant features in order to provide policy advice on human resource development of health service institutions in poor regions. Methods A self-completion questionnaire was used to assess the job satisfaction and relevant features (response rate: 90.5% among 172 employees (i.e., clinic doctors, medico-technical workers and public health workers of 17 THCs in Anhui and Xinjiang provinces of China. The study covered a time period of two months in 2007. Results The mean staff job satisfaction scored 83.3, which was in the category of "somewhat satisfied" on a scale ranging from 0 (extremely dissatisfied to 100 (extremely satisfied by employing Likert's transformation formula. Exploratory factor analysis (EFA revealed eight domains involved in modeling of job satisfaction, among which, the caregivers were more satisfied with job significance (88.2, job competency (87.9 and teamwork (87.7, as compared with work reward (72.9 and working conditions (79.7. Mean job satisfaction in Xinjiang (89.7 was higher than that in Anhui (75.5. Conclusions Employees of THCs have moderate job satisfactions in poor areas, which need to be raised further by improving their working conditions and reward.

  10. Co-benefits from CO{sub 2}-emission reduction measurements in Shanxi, China - a first assessment

    Energy Technology Data Exchange (ETDEWEB)

    Aunan, Kristin; Fang, Jinghua; Li, Guanghai; Seip, Hans Martin; Vennemo, Haakon

    2000-05-01

    The largest local and regional air pollution problems are usually found in countries without emission reduction obligations in the Kyoto protocol. Thus, in many Chinese cities the concentrations of SO{sub 2} and particulates in the air by far exceed the WHO air quality guidelines. This report analyses a set of CO{sub 2}-reducing abatement options related to coal consumption in Shanxi, China. The costs and potential for abatement are investigated for different economic sectors and the entailed emission reductions are estimated in terms of CO{sub 2}, SO{sub 2} and particles. The present population-weighted exposure level for particles and SO{sub 2} is estimated and the reduced population exposure resulting from the abatement measures is assessed. Exposure-response functions from Chinese and international epidemiology are used to indicate the health effects of applying the measures. An economic evaluation of the reduced health effect is made by applying unit prices of health impacts based on the damage cost approach. The present agricultural crop loss due to enhanced levels of surface ozone are estimated. It is found that the CO{sub 2}-reducing abatement options in Shanxi are profitable in a socioeconomic sense. But there is a certain lack of synergy between the options with respect to their effectiveness in meeting local, regional and global environmental concerns.

  11. Health-Related Quality of Life in Patients with Arthritis: A Cross-Sectional Survey among Middle-Aged Adults in Chongqing, China

    Directory of Open Access Journals (Sweden)

    Yunshuang Rao

    2018-04-01

    Full Text Available Background: Arthritis is a common disease in China, but few studies have been conducted to explore the associated health-related quality of life (HRQoL and its influencing factors in Chongqing, China. This study aimed to explore the association of arthritis and HRQoL and probe factors affecting HRQoL among arthritis patients. Methods: A cross-sectional survey was conducted in Chongqing, China. A total of 1224 adults were included in the analysis. Medical Outcomes Study Short Form 36 Health Survey (SF-36 was used to measure HRQoL. Multiple linear regression models (stepwise and covariance analysis models were used to examine the association of arthritis with HRQoL and analyze factors associated with HRQoL among arthritis patients. Results: Participants with arthritis had poorer HRQoL than those without. Among arthritis patients, the female was associated with a poorer state of physical functioning (p < 0.05; unemployed patients had a poorer state of role-physical than employed patients (p < 0.05; low average monthly income was associated with a poorer state of physical functioning (p < 0.01; childhood non-breastfeeding history was associated with a poorer state of social functioning (p < 0.01; average or dissatisfied attitude to current living conditions was associated with a poorer state of vitality and mental health (p < 0.05 for all; moreover, poor or general appetite was associated with a poorer state of role-physical, general health, social functioning, bodily pain, and role-emotional (p < 0.01 for all. Conclusions: Arthritis patients have worse HRQoL than those without in the Chinese population. Female, low socioeconomic status, childhood non-breastfeeding history, average or dissatisfied attitude to current living conditions and poor or general appetite were associated with poorer state of HRQoL among Chinese arthritis patients.

  12. Investigation and Analysis of Hemoglobin A1c Measurement Systems' Performance for 135 Laboratories in China

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    Hai-Jian Zhao

    2017-01-01

    Conclusions: This study indicated that, although participating laboratories were laboratories with better performance in China, the performances were still unsatisfactory. Actions should be taken to improve HbA1c measurement performance before we can include HbA1c assays in diabetes diagnosis in China.

  13. Development of the neutron technology for measuring the moisture content in China

    International Nuclear Information System (INIS)

    Zhao Jingwu; Liu Shengkang; Zhang Zhiping

    2011-01-01

    According to measuring mode (in-hopper, surface, sampling neutron moisture gauge), the development and application of neutron moisture gauge in china were introduced, which include the following course from only measuring moisture content of soil to monitoring moisture content of farmland and saving water for irrigating farmland, from measuring moisture content of pellet to coke and coal material, from only measuring moisture content to computerized neutron moisture gauges with density compensation and o f high precision. (authors)

  14. Occupational health and safety in China: the case of state-managed enterprises.

    Science.gov (United States)

    Chen, Meei-Shia; Chan, Anita

    2010-01-01

    The widely held image, inside and outside China, of the total absence of an occupational health and safety (OHS) system in that country is not an accurate picture. This article argues that the unsafe working conditions and prevalent occupational diseases and injuries widely reported in the Chinese and foreign media occur mostly in private mines and in the Asian foreign-funded and domestic private manufacturing sectors. In contrast, the capital-intensive, larger state-owned enterprises and enterprises that have been transformed from state enterprises generally have better OHS systems. An in-depth study of two such enterprises reveals viable OHS systems, worker-management OHS committees, regular health and safety inspections, and trade unions' and workers congresses' oversight and supervision. Above all, there is an enterprise culture that regards accidents as avoidable, and both workers and management feel distressed and guilty when accidents happen. The authors believe it is important to acknowledge and champion these positive examples of "best practices" that can be emulated in workplaces throughout China, which is under great pressure from competitive domestic and global forces to relax its OHS standards.

  15. The Structure and Effectiveness of Health Systems: Exploring the Impact of System Integration in Rural China

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    Xin Wang

    2016-08-01

    Full Text Available Introduction: Facing the challenges of aging populations, increasing chronic diseases prevalence and health system fragmentation, there have been several pilots of integrated health systems in China. But little is known about their structure, mechanism and effectiveness. The aim of this paper is to analyze health system integration and develop recommendations for achieving integration. Method: Huangzhong and Hualong counties in Qinghai province were studied as study sites, with only Huangzhong having implemented health system integration. Questionnaires, interviews, and health ­insurance records were sources of data. Social network analysis was employed to analyze integration, through structure measurement and effectiveness evaluation. Results: Health system integration in Huangzhong is higher than in Hualong, so is system ­effectiveness. The patient referral network in Hualong has more “leapfrog” referrals. The information sharing ­networks in both counties are larger than the other types of networks. The average distance in the joint ­training network of Huangzhong is less than in Hualong. Meanwhile, there are deficiencies common to both systems. Conclusion: Both county health systems have strengths and limitations regarding system integration. The use of medical consortia in Huangzhong has contributed to system effectiveness. Future research might consider alternative more context specific models of health system integration.

  16. Health of midlife and older adults in China: the role of regional economic development, inequality, and institutional setting.

    Science.gov (United States)

    Ding, Xuejie; Billari, Francesco C; Gietel-Basten, Stuart

    2017-11-01

    To document the association between economic development, income inequality, and health-related public infrastructure, and health outcomes among Chinese adults in midlife and older age. We use a series of multi-level regression models with individual-level baseline data from the China Health and Retirement Longitudinal Survey (CHARLS). Provincial-level data are obtained both from official statistics and from CHARLS itself. Multi-level models are estimated with different subjective and objective health outcomes. Economic growth is associated with better self-rated health, but also with obesity. Better health infrastructure tends to be negatively associated with health outcomes, indicating the likely presence of reverse causality. No supportive evidence is found for the hypothesis that income inequality leads to worse health outcomes. Our study shows that on top of individual characteristics, provincial variations in economic development, income inequality, and health infrastructure are associated with a range of health outcomes for Chinese midlife and older adults. Economic development in China might also bring adverse health outcomes for this age group; as such specific policy responses need to be developed.

  17. Noticing cigarette health warnings and support for new health warnings among non-smokers in China: findings from the International Tobacco Control project (ITC China survey

    Directory of Open Access Journals (Sweden)

    Zejun Li

    2017-05-01

    Full Text Available Abstract Background Health warnings labels (HWLs have the potential to effectively communicate the health risks of smoking to smokers and non-smokers, and encourage smokers to quit. This study sought to examine whether non-smokers in China notice the current text-only HWLs and whether they support adding more health information and including pictures on HWLs. Methods Adult non-smokers (n = 1324 were drawn from Wave 4 (September 2011–November 2012 of the International Tobacco Control (ITC China Survey. The proportion of non-smokers who noticed the HWLs, and supported adding more health information and pictures to the HWLs was examined. Additionally, the relation between non-smokers’ demographic characteristics, including whether they had a smoking partner, their number of smoking friends, and noticing the HWLs and support for adding health information and pictures was examined. Because the HWLs changed during the survey period (April 2012, differences between non-smokers who completed the survey before and after the change were examined. Results 12.2% reported they noticed the HWLs often in the last month. The multivariate model, adjusting for demographics showed that respondents with a smoking partner (OR = 2.41, 95% CI 1.42–4.13, p = 0.001 noticed the HWLs more often. 64.8% of respondents agreed that the HWLs should have more information, and 80.2% supported including pictures. The multivariate model showed that non-smokers who completed the survey after the HWLs were implemented (OR = 0.63, 95% CI 0.40–0.99, p = 0.04 were less likely to support adding more health information. The multivariate model showed a significant relation between having a smoking partner and supporting pictorial HWLs (OR = 2.03, 95% CI 1.24–3.33, p = 0.005. Conclusions The findings indicate that the Chinese HWLs are noticed by a minority of non-smokers and that non-smokers strongly support strengthening the Chinese warning labels with more health

  18. Air pollution-induced health impacts on the national economy of China: demonstration of a computable general equilibrium approach.

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    Wan, Yue; Yang, Hongwei; Masui, Toshihiko

    2005-01-01

    At the present time, ambient air pollution is a serious public health problem in China. Based on the concentration-response relationship provided by international and domestic epidemiologic studies, the authors estimated the mortality and morbidity induced by the ambient air pollution of 2000. To address the mechanism of the health impact on the national economy, the authors applied a computable general equilibrium (CGE) model, named AIM/Material China, containing 39 production sectors and 32 commodities. AIM/Material analyzes changes of the gross domestic product (GDP), final demand, and production activity originating from health damages. If ambient air quality met Grade II of China's air quality standard in 2000, then the avoidable GDP loss would be 0.38%o of the national total, of which 95% was led by labor loss. Comparatively, medical expenditure had less impact on national economy, which is explained from the aspect of the final demand by commodities and the production activities by sectors. The authors conclude that the CGE model is a suitable tool for assessing health impacts from a point of view of national economy through the discussion about its applicability.

  19. Strategies to address mental health through schools with examples from China.

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    Whitman, Cheryl Vince; Aldinger, Carmen; Zhang, Xin-Wei; Magner, Elizabeth

    2008-06-01

    The World Health Organization estimates that approximately one in five young people under the age of 18 experiences some form of developmental, emotional or behavioural problem, and one in eight experiences a mental disorder. Because research shows that half of adult mental disorders begin before the age of 14 and that early intervention can prevent and reduce more serious consequences later in life, it is critical to expand the role of mental health professionals with schools worldwide. Schools have the potential to affect the mental health of millions of young people, as well as those who work in schools. Research indicates that programmes promoting mental health are among the most effective of health promoting school efforts. This paper discusses the health promoting schools framework, reviews effective strategies for promoting mental health in schools, and provides examples from Zhejiang Province, China. This article also discusses the key roles that mental health professionals can play in promoting mental health through schools. As advocates, policy makers, researchers and teachers, mental health professionals can bridge the sectors of education, mental health and public health. Developing common frameworks and interdisciplinary training will create a foundation of shared understanding to achieve this goal.

  20. Economic costs and health-related quality of life for hand, foot and mouth disease (HFMD patients in China.

    Directory of Open Access Journals (Sweden)

    Yaming Zheng

    Full Text Available Hand, foot and mouth disease (HFMD is a common illness in China that mainly affects infants and children. The objective of this study is to assess the economic cost and health-related quality of life associated with HFMD in China.A telephone survey of caregivers were conducted in 31 provinces across China. Caregivers of laboratory-confirmed HFMD patients who were registered in the national HFMD enhanced surveillance database during 2012-2013 were invited to participate in the survey. Total costs included direct medical costs (outpatient care, inpatient care and self-medication, direct non-medical costs (transportation, nutrition, accommodation and nursery, and indirect costs for lost income associated with caregiving. Health utility weights elicited using EuroQol EQ-5D-3L and EQ-Visual Analogue Scale (VAS were used to calculate associated loss in quality adjusted life years (QALYs.The subjects comprised 1136 mild outpatients, 1124 mild inpatients, 1170 severe cases and 61 fatal cases. The mean total costs for mild outpatients, mild inpatients, severe cases and fatal cases were $201 (95%CI $187, $215, $1072 (95%CI $999, $1144, $3051 (95%CI $2905, $3197 and $2819 (95%CI $2068, $3571 respectively. The mean QALY losses per HFMD episode for mild outpatients, mild inpatients and severe cases were 3.6 (95%CI 3.4, 3,9, 6.9 (95%CI 6.4, 7.4 and 13.7 (95%CI 12.9, 14.5 per 1000 persons. Cases who were diagnosed with EV-A71 infection and had longer duration of illness were associated with higher total cost and QALY loss.HFMD poses a high economic and health burden in China. Our results provide economic and health utility data for cost-effectiveness analysis for HFMD vaccination in China.

  1. Economic costs and health-related quality of life for hand, foot and mouth disease (HFMD) patients in China.

    Science.gov (United States)

    Zheng, Yaming; Jit, Mark; Wu, Joseph T; Yang, Juan; Leung, Kathy; Liao, Qiaohong; Yu, Hongjie

    2017-01-01

    Hand, foot and mouth disease (HFMD) is a common illness in China that mainly affects infants and children. The objective of this study is to assess the economic cost and health-related quality of life associated with HFMD in China. A telephone survey of caregivers were conducted in 31 provinces across China. Caregivers of laboratory-confirmed HFMD patients who were registered in the national HFMD enhanced surveillance database during 2012-2013 were invited to participate in the survey. Total costs included direct medical costs (outpatient care, inpatient care and self-medication), direct non-medical costs (transportation, nutrition, accommodation and nursery), and indirect costs for lost income associated with caregiving. Health utility weights elicited using EuroQol EQ-5D-3L and EQ-Visual Analogue Scale (VAS) were used to calculate associated loss in quality adjusted life years (QALYs). The subjects comprised 1136 mild outpatients, 1124 mild inpatients, 1170 severe cases and 61 fatal cases. The mean total costs for mild outpatients, mild inpatients, severe cases and fatal cases were $201 (95%CI $187, $215), $1072 (95%CI $999, $1144), $3051 (95%CI $2905, $3197) and $2819 (95%CI $2068, $3571) respectively. The mean QALY losses per HFMD episode for mild outpatients, mild inpatients and severe cases were 3.6 (95%CI 3.4, 3,9), 6.9 (95%CI 6.4, 7.4) and 13.7 (95%CI 12.9, 14.5) per 1000 persons. Cases who were diagnosed with EV-A71 infection and had longer duration of illness were associated with higher total cost and QALY loss. HFMD poses a high economic and health burden in China. Our results provide economic and health utility data for cost-effectiveness analysis for HFMD vaccination in China.

  2. Perceived challenges to achieving universal health coverage: a cross-sectional survey of social health insurance managers/administrators in China.

    Science.gov (United States)

    Shan, Linghan; Wu, Qunhong; Liu, Chaojie; Li, Ye; Cui, Yu; Liang, Zi; Hao, Yanhua; Liang, Libo; Ning, Ning; Ding, Ding; Pan, Qingxia; Han, Liyuan

    2017-06-02

    China has achieved over 96% health insurance coverage. However, universal health coverage (UHC) entails population coverage and the range of services covered and the extent to which health service costs are covered. This study aimed to determine the performance of the health insurance system in China in terms of its role in UHC and to identify challenges in the progress of UHC as perceived by health insurance managers/administrators. A cross-sectional questionnaire survey was conducted in Beijing, Ningbo, Harbin and Chongqing over the period of 2014 and 2015. A stratified cluster random sampling strategy was adopted to select study participants. A total of 1277 (64.8%) respondents who reported familiarity with the current health insurance system and the requirements of UHC provided valid data for analyses. They gave a rating on the role of the current health insurance system in achieving UHC. A multivariate logistic regression model was developed to determine the associations between the rating and the features of insurance arrangements. There was consensus among the respondents on the performance of the current health insurance system in terms of its role in UHC, regardless who they were and what responsibility they held in their organisation (ie, policy development, managing fund transactions, and so on). Overall, about 45% of the respondents believed that there is a long way to go to achieve UHC. The low rating was found to be associated with limited financial protection (OR=1.656, 95% CI 1.279 to 2.146), healthcare inequity (OR=1.607, 95% CI 1.268 to 2.037), poor portability (OR=1.347, 95% CI 1.065 to 1.703) and ineffective supervision and administration of funds (OR=1.339, 95% CI 1.061 to 1.692) as perceived by the respondents. Health insurance managers/administrators in China are pessimistic about the achievements of the current health insurance system. They are concerned about the overall lack of benefit that insurance programmes bring to members

  3. Burden of Disease Measured by Disability-Adjusted Life Years and a Disease Forecasting Time Series Model of Scrub Typhus in Laiwu, China

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    Yang, Li-Ping; Liang, Si-Yuan; Wang, Xian-Jun; Li, Xiu-Jun; Wu, Yan-Ling; Ma, Wei

    2015-01-01

    Background Laiwu District is recognized as a hyper-endemic region for scrub typhus in Shandong Province, but the seriousness of this problem has been neglected in public health circles. Methodology/Principal Findings A disability-adjusted life years (DALYs) approach was adopted to measure the burden of scrub typhus in Laiwu, China during the period 2006 to 2012. A multiple seasonal autoregressive integrated moving average model (SARIMA) was used to identify the most suitable forecasting model for scrub typhus in Laiwu. Results showed that the disease burden of scrub typhus is increasing yearly in Laiwu, and which is higher in females than males. For both females and males, DALY rates were highest for the 60–69 age group. Of all the SARIMA models tested, the SARIMA(2,1,0)(0,1,0)12 model was the best fit for scrub typhus cases in Laiwu. Human infections occurred mainly in autumn with peaks in October. Conclusions/Significance Females, especially those of 60 to 69 years of age, were at highest risk of developing scrub typhus in Laiwu, China. The SARIMA (2,1,0)(0,1,0)12 model was the best fit forecasting model for scrub typhus in Laiwu, China. These data are useful for developing public health education and intervention programs to reduce disease. PMID:25569248

  4. Identifying determinants of socioeconomic inequality in health service utilization among patients with chronic non-communicable diseases in China.

    Science.gov (United States)

    Xie, Xin; Wu, Qunhong; Hao, Yanhua; Yin, Hui; Fu, Wenqi; Ning, Ning; Xu, Ling; Liu, Chaojie; Li, Ye; Kang, Zheng; He, Changzhi; Liu, Guoxiang

    2014-01-01

    People with chronic non-communicable diseases (NCD) are particularly vulnerable to socioeconomic inequality due to their long-term expensive health needs. This study aimed to assess socioeconomic-related inequality in health service utilization among NCD patients in China and to analyze factors associated with this disparity. Data were taken from the 2008 Chinese National Health Survey, in which a multiple stage stratified random sampling method was employed to survey 56,456 households. We analyzed the distribution of actual use, need-expected use, and need-standardized usage of outpatient services (over a two-week period) and inpatient services (over one-year) across different income groups in 27,233 adult respondents who reported as having a NCD. We used a concentration index to measure inequality in the distribution of health services, which was expressed as HI (Horizontal Inequity Index) for need-standardized use of services. A non-linear probit regression model was employed to detect inequality across socio-economic groups. Pro-rich inequity in health services among NCD patients was more substantial than the average population. A higher degree of pro-rich inequity (HI = 0.253) was found in inpatient services compared to outpatient services (HI = 0.089). Despite a greater need for health services amongst those of lower socio-economic status, their actual use is much less than their more affluent counterparts. Health service underuse by the poor and overuse by the affluent are evident. Household income disparity was the greatest inequality factor in NCD service use for both outpatients (71.3%) and inpatients (108%), more so than health insurance policies. Some medical insurance schemes, such as the MIUE, actually made a pro-rich contribution to health service inequality (16.1% for outpatient and 12.1% for inpatient). Inequality in health services amongst NCD patients in China remains largely determined by patient financial capability. The current

  5. [Sampling and measurement methods of the protocol design of the China Nine-Province Survey for blindness, visual impairment and cataract surgery].

    Science.gov (United States)

    Zhao, Jia-liang; Wang, Yu; Gao, Xue-cheng; Ellwein, Leon B; Liu, Hu

    2011-09-01

    To design the protocol of the China nine-province survey for blindness, visual impairment and cataract surgery to evaluate the prevalence and main causes of blindness and visual impairment, and the prevalence and outcomes of the cataract surgery. The protocol design was began after accepting the task for the national survey for blindness, visual impairment and cataract surgery from the Department of Medicine, Ministry of Health, China, in November, 2005. The protocol in Beijing Shunyi Eye Study in 1996 and Guangdong Doumen County Eye Study in 1997, both supported by World Health Organization, was taken as the basis for the protocol design. The relative experts were invited to discuss and prove the draft protocol. An international advisor committee was established to examine and approve the draft protocol. Finally, the survey protocol was checked and approved by the Department of Medicine, Ministry of Health, China and Prevention Program of Blindness and Deafness, WHO. The survey protocol was designed according to the characteristics and the scale of the survey. The contents of the protocol included determination of target population and survey sites, calculation of the sample size, design of the random sampling, composition and organization of the survey teams, determination of the examinee, the flowchart of the field work, survey items and methods, diagnostic criteria of blindness and moderate and sever visual impairment, the measures of the quality control, the methods of the data management. The designed protocol became the standard and practical protocol for the survey to evaluate the prevalence and main causes of blindness and visual impairment, and the prevalence and outcomes of the cataract surgery.

  6. Maternal lifestyle and nutritional status in relation to pregnancy and infant health outcomes in Western China: protocol for a prospective cohort study.

    Science.gov (United States)

    Tang, Li; Pan, Xiong-Fei; Lee, Andy H; Binns, Colin W; Yang, Chun-Xia; Sun, Xin

    2017-06-19

    Improving the health and nutrition of women and children is a priority for Western China, where the economy is less developed. Due to the dynamic nature of lifestyle, modern food habits and nutrition, there is a need to update our limited knowledge and understanding of maternal lifestyle and nutritional status and their impact on pregnancy and infant health outcomes. While breast milk is the preferred feeding option, infant formula use is widespread in China. It is thus necessary to examine the effects of formula consumption on growth and morbidity. This is an ongoing prospective cohort study started in 2015 in Chengdu, Sichuan Province. A sample of 1901 pregnant women at 15-20 weeks of gestation were recruited from four maternal and child health hospitals and are followed prospectively to 12 months post partum. Detailed information on maternal lifestyle and nutritional status, obstetric complications, pregnancy outcomes, infant feeding practices, illnesses of the mother and infant and growth trajectory is collected through personal interviews, anthropometric measures and medical records and local health management system records retrieval. Multilevel mixed regression models, adjusted for clustering, will be applied to investigate the association between various exposure variables of interest and the longitudinal outcomes, taking into account the correlated data structure and the nesting of observations. Kaplan-Meier test and Cox regression analysis will be used to analyse the time-to-event data. Ethical approval has been obtained from the ethics committee of West China School of Public Health, Sichuan University and the Human Research Ethics Committee of Curtin University. Results will be presented at national and international conferences and published in peer-reviewed journals. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Prevalence of Breastfeeding: Findings from the First Health Service Household Interview in Hunan Province, China

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    Hong Qin

    2017-02-01

    Full Text Available Background: With the development of economy and urbanization, methods of child-feeding have significantly changed in China over the past three decades. However, little is known about breastfeeding in China since 2009. This study aims to update information on the prevalence of breastfeeding in China. Methods: Data were obtained from the first Health Service Household Interview Survey of Hunan Province, China. Of 24,282 respondents, 1659 were aged five years or younger. We ran multivariable logistic regression to examine the impact of urban/rural setting, gender, age and household income per capita on the use of breastfeeding. Results: A total of 79.4% of children aged 5 years or younger had been breastfed at some point and 44.9% been breastfed exclusively in the first 6 months of life. After controlling for setting urban/rural setting, gender and child age, children from households with average family income were more likely to be breastfed than those from households with the lowest family income (adjusted odds ratio: 2.28. Children from households with higher and the highest family income were less likely to be exclusively breastfed in the first 6 months of life compared to those from households with the lowest family income (adjusted odds ratio: 0.51 and 0.68, respectively. Conclusions: It is encouraging that the prevalence of exclusive breastfeeding for infants in the first 6 months of life in Hunan Province, China is approaching the goal of 50% proposed by the World Health Organization (WHO. Nevertheless, more efforts are needed to further promote exclusive breastfeeding in the first 6 months after birth.

  8. Measuring the impact of air pollution on respiratory infection risk in China

    International Nuclear Information System (INIS)

    Tang, Sanyi; Yan, Qinling; Shi, Wei; Wang, Xia; Sun, Xiaodan; Yu, Pengbo; Wu, Jianhong; Xiao, Yanni

    2018-01-01

    China is now experiencing major public health challenges caused by air pollution. Few studies have quantified the dynamics of air pollution and its impact on the risk of respiratory infection. We conducted an integrated data analysis to quantify the association among air quality index (AQI), meteorological variables and respiratory infection risk in Shaanxi province of China in the period of November 15th, 2010 to November 14th, 2016. Our analysis illustrated a statistically significantly positive correlation between the number of influenza-like illness (ILI) cases and AQI, and the respiratory infection risk has increased progressively with increased AQI with a time lag of 0–3 days. We also developed mathematical models for the AQI trend and respiratory infection dynamics, incorporating AQI-dependent incidence and AQI-based behaviour change interventions. Our combined data and modelling analysis estimated the basic reproduction number for the respiratory infection during the studying period to be 2.4076, higher than the basic reproduction number of the 2009 pandemic influenza in the same province. Our modelling-based simulations concluded that, in terms of respiratory infection risk reduction, the persistent control of emission in the China's blue-sky programme is much more effective than substantial social-economic interventions implemented only during the smog days. - Highlights: • Quantify the dynamics of air pollution, evaluate impact on respiratory infection. • Present a novel methodology through integrating statistic and dynamic models. • The respiratory infection risk has increased with increased air quality index. • Persistent control of emission in China's blue-sky program is much more effective. - This study presented a novel methodology to quantify the dynamics of air pollution and evaluate its impact of on the risk of respiratory infection, and hence to suggest interventions for China's blue-sky programme.

  9. Economic impacts from PM2.5 pollution-related health effects in China's road transport sector: A provincial-level analysis.

    Science.gov (United States)

    Tian, Xu; Dai, Hancheng; Geng, Yong; Wilson, Jeffrey; Wu, Rui; Xie, Yang; Hao, Han

    2018-06-01

    Economic impact assessments of air pollution-related health effects from a sectoral perspective in China is still deficient. This study evaluates the PM 2.5 pollution-related health impacts of the road transport sector on China's economy at both national and provincial levels in 2030 under various air mitigation technologies scenarios. Health impacts are estimated using an integrated approach that combines the Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) model, a computable general equilibrium (CGE) model and a health model. Results show that at a national level, the road transport sector leads to 163.64 thousand deaths per year, increases the per capita risk of morbidity by 0.37% and accounts for 1.43 billion Yuan in health care expenditures. We estimate 442.90 billion Yuan of the value of statistical life loss and 2.09 h/capita of work time loss in 2015. Without additional control measures, air pollution related to the transport sector will cause 177.50 thousand deaths in 2030, a 0.40% per capita increase in the risk of morbidity, accounting for 4.12 billion Yuan in health care expenditures, 737.15 billion Yuan of statistical life loss and 2.23 h/capita of work time loss. Based on our model, implementing the most strict control strategy scenario would decrease mortality by 42.14%, morbidity risk by 42.14%, health care expenditures by 41.94%, statistical life loss by 26.22% and hours of work time loss by 42.65%, comparing with the no control measure scenario. In addition, PM 2.5 pollution from the road transport sector will cause 0.68% GDP loss in 2030. At a provincial level, GDP losses in 14 out of 30 provinces far exceed the national rate. Henan (1.20%), Sichuan (1.07%), Chongqing (0.99%), Hubei (0.94%), and Shandong (0.90%) would experience the highest GDP loss in 2030. Implementing control strategies to reduce PM 2.5 pollution in the road transport sector could bring positive benefits in half of the Chinese provinces especially in

  10. Outline of the report on cardiovascular disease in China, 2010.

    Science.gov (United States)

    Hu, Sheng Shou; Kong, Ling Zhi; Gao, Run Lin; Zhu, Man Lu; Wang, Wen; Wang, Yong Jun; Wu, Zhao Su; Chen, Wei Wei; Liu, Ming Bo

    2012-06-01

    Major and profound changes have taken place in China over the past 30 years. Rapid socioeconomic progress has exerted a great impact on lifestyle, ranging from food, clothing, working and living conditions, and means of transportation to leisure activities and entertainment. At the same time, new health problems have emerged, and health services are facing new challenges. Presently, cardiovascular diseases (CVD) are among the top health problems of the Chinese people, and pose a serious challenge to all engaged in the prevention and control of these diseases. An epidemic of CVD in China is emerging as a result of lifestyle changes, urbanization and longevity. Both national policy decision-making and medical practice urgently need an authoritative report which comprehensively reflects the trends in the epidemic of CVD and current preventive measures. Since 2005, guided by the Bureau of Disease Prevention of the Ministry of Health of the People's Republic of China and the National Center for Cardiovascular Diseases of China, nationwide experts in the fields of epidemiology, clinical medicine and health economics in the realms of CVD, cerebrovascular disease, diabetes and chronic kidney disease, completed the Report on Cardiovascular Diseases in China every year. The report aims to provide a timely review of the trend of the epidemic and to assess the progress of prevention and control of CVD. In addition, as the report is authoritative, representative and readable, it will become an information platform in the CVD field and an important reference book for government, academic institutes, medical organizations and clinical physicians. This publication is expected to play a positive role in the prevention and control of CVD in China. We present an abstract from the Report on Cardiovascular Diseases in China (2010), including trends in CVD, morbidity and mortality of major CVDs, up-to-date assessment of risk fa