ND&P President Susan Dubuque discusses the health system in China in this second installment of a three-part series. Click here for Part 1.
Longevity is a common theme in Chinese culture, art, philosophy and religion. Images representing long life – the turtle, peaches, pine trees, cranes, butterflies and dragons – abound.
Many improvements instituted by the government over the past 60 years have resulted in dramatic increases in the average life expectancy of the Chinese people – from 31 years in 1949 to more than 75 years in 2011.
I applaud these very significant public health gains, but are they sustainable? Today, 60% of the men in China smoke cigarettes – and they smoke everywhere – in restaurants, on the streets, in elevators. Add all that smoke to the smoggy, polluted air, and the entire population is likely to be suffering from COPD in the not too distant future.
Then, there is the risk of head injury. Motorcycles, motor scooters and bikes are the principal mode of transportation for the whole family. Grandma, mom and baby – sitting astride a scooter – and not a helmet among them. I must confess, I was tempted to snatch more than a few bareheaded babies off those scooters.
Sadly, there is suicide. Every year about 250,000 people commit suicide in China. Killing oneself has become the top cause of death among people aged 15 to 34. Our guide anecdotally reported that intense pressure on young people to succeed in school and in their early careers often leads to depression and suicide.
And what about obesity? With fast food restaurants on every corner, Chinese kids and adults alike are experiencing the same weight problems and increased incidence of diabetes as Americas.
The Long and The Short of It.
In 1978, the People's Republic of China imposed severe limits on the number of children being born. Each woman was to have only one birth (we can't say one child since twins were OK). This policy was enacted to alleviate a variety of social, environmental and economic problems and avert political revolt.
So what are the outcomes of this dramatic social policy? The average number of births per women in 1978 was close to 6. In the ensuing 20 years, the rate of births dropped to 1.2 per woman. A middle class emerged. Quality of life improved. Life spans increased. But it’s not all roses. Negative consequences include gender discrimination and a generation of spoiled children.
But What About Grandma?
Combine longer life expectancy with the “one-child” policy and it is easy to see how China now finds itself in a conundrum. People are living longer, and there are fewer children to take care of them. This has in turn fueled the development of yet another new health-related industry – nursing homes. I can’t help but think how this shift will change the very fabric of Chinese culture – as we see the demise of extended family and the tradition of honoring and caring for the older generation.