China must act now to tackle the growing challenges posed by injuries, mental illness, obesity, smoking, environmental pollution and other public health threats or face the huge toll of largely preventable health loss suffered by high-income countries, warn experts in a Review published as part of a Lancet themed issue on China.
Rapid and extraordinary economic growth over the past few decades has resulted in some shocking statistics on death and illness from injuries and chronic diseases in China. Injuries cause around 800 000 deaths a year and are the leading cause of death in people aged 1 to 39 years old. Some 173 million adults have a mental health disorder but the vast majority (92%; 159 million) have never received professional help. The number of people living with dementia has more than doubled from about 3.68 million in 1990 to 9.2 million in 2010. Ambient air pollution kills more than 1.2 million people a year, while indoor air pollution from solid fuels accounts for a further 1 million premature deaths a year. Tobacco kills roughly 1 million people each year, and if present trends continue, this is expected to rise to 3 million by 2040. Finally, there have been alarming increases in levels of obesity, with the number of overweight or obese adolescents rising from 16.1 million in 2000 to 20.4 million in 2010.
In this Review, Dr Jeffrey Koplan, Vice President for Global Health at Emory University, Atlanta, USA and colleagues take a critical look at progress in tackling chronic diseases since the 1990s, lament the inadequate coverage of basic interventions that could make a massive difference, and urge China to urgently adopt a number of cost-effective interventions to improve individual and population health (eg, increasing taxes on tobacco and alcohol and introducing regulations for seat belts and helmets for cyclists).
According to Professor Koplan, "Similar to the focus on prevention, which was the hallmark of China's remarkable success against infectious diseases, its new challenge will be to make this progress in chronic disease control in a much shorter time-frame than high-income countries. If China takes advantage of lessons learnt in other countries (including taxation, regulation or legislation, and information or education) and uses its own scientific and creative resources to increase our knowledge of better disease control and prevention, it will provide a health model for the world."*