Skip to main content
SpringerLink
Log in

Healthcare, Inequality, and Epidemiologic Transition: Example of China

  • Reference work entry
  • First Online:
Handbook of Famine, Starvation, and Nutrient Deprivation

Abstract

China has achieved great improvements in population and public health, such as a dramatically lower mortality rate, increased life expectancy, and extensive immunization coverage. However, new health challenges emerge in China today. Noncommunicable diseases such as cardiovascular diseases have become the leading cause of deaths, while there still are serious malnutrition issues among poor segments of the population. New health problems and increased income inequality have both emerged during the period of economic reform and market transition of healthcare systems. This chapter aims to give an overview of three possible factors that influence population health in transitional China. This includes (1) the healthcare system, (2) income inequality, and (3) epidemiological transition.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 869.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 549.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

NCDs:

Noncommunicable diseases

References

  • Bakkeli NZ (2016a) Income inequality and health in China: a panel data analysis. Soc Sci Med 157:39–47

    PubMed  Google Scholar 

  • Bakkeli NZ (2016b) The price of inequality. In: Privatisation, health and wellbeing in China. University of Oslo, Oslo

    Google Scholar 

  • Bloom G, Xingyuan Gu (1997) Introduction to health sector reform in China. IDS Bull 28(1):1

    Google Scholar 

  • Blumenthal D, Hsiao W (2005) Privatization and its discontents – the evolving Chinese health care system. N Engl J Med 353(11):1165–1170

    CAS  PubMed  Google Scholar 

  • CGMH (2011) Chinese guidelines for the management of hypertension (CGMH), 3rd edn. MoH Centers for Disease Control and Prevention, China Hypertension Association, National Center for Cardiovascular Diseases, Beijing

    Google Scholar 

  • Chan CK, King Lun Ngok, Phillips D (2008) Social policy in China: development and well-being. Policy Press, Bristol

    Google Scholar 

  • Chang S, Wu He, Chun-ming Chen (2006) The growth characteristics of children under 5 in the past 15 years. J Hyg Res 35(6):768–771

    Google Scholar 

  • Chen Z (ed) (2012) Healthy China 2020: strategic research report. People’s Medical Publishing House, Beijing

    Google Scholar 

  • Chen Z, Meltzer D (2008) Beefing up with the chans: evidence for the effects of relative income and income inequality on health from the China health and nutrition survey. Soc Sci Med 66(11):2206–2217

    PubMed  Google Scholar 

  • Chinanews (2014) Health reform profit contributes to a new round of privatisation of healthcare, professionals called on return to government responsibility. China News. Retrieved http://www.chinanews.com/gn/2014/06-13/6275883.shtml

  • Cook IG, Dummer TJB (2004) Changing health in China: re-evaluating the epidemiological transition model. Health Policy 67(3):329–343

    PubMed  Google Scholar 

  • Djukanovic V, Mach EP, UNICEF, World Health Organization (1975) Alternative approaches to meeting basic health needs in developing countries: A joint UNICEF/WHO study. Geneva: World Health Organization

    Google Scholar 

  • DPES (Department of Population and Employment Statistics of National Bureau of Statistics of China) (ed) (2005) China population statistics yearbook. Beijing: China Statistics Press

    Google Scholar 

  • DRC (ed) (2005) An evaluation of and recommendations on the reforms of the health system in China: executive summary. Project team of DRC, Beijing

    Google Scholar 

  • Fang H, Rizzo JA (2011) Does inequality in China affect health differently in high-versus low-income households? Appl Econ 44(9):1081–1090

    Google Scholar 

  • FAO (2010) The state of food insecurity in the world addressing food insecurity in protracted crises. Food and Agriculture Organization of the United Nations, Rome

    Google Scholar 

  • Gao Q (2008) The Chinese social benefit system in transition. Ann N Y Acad Sci 1136(1):342–347

    PubMed  Google Scholar 

  • Gaylin DS, Kates J (1997) Refocusing the lens: epidemiologic transition theory, mortality differentials, and the AIDS pandemic. Soc Sci Med 44(5):609–621

    CAS  PubMed  Google Scholar 

  • Gong L, Yuyun Xu, Weizhong Zhang, Wangpeng Liu, Xinfang Wang (2006) Chinese guideline for early vascular disease detection (first report). Med J Chin People’s Health 9:323–331

    Google Scholar 

  • Gu D et al (2003) Prevalence of diabetes and impaired fasting glucose in the Chinese adult population: international collaborative study of cardiovascular disease in Asia (InterASIA). Diabetologia 46(9):1190–1198

    CAS  PubMed  Google Scholar 

  • Horton R (2015) Offline: China – the triumph (and danger) of transition. Lancet 386(10006):1808

    Google Scholar 

  • Lei X, Nina Yin, Yaohui Zhao (2010) SES health gradients during the epidemiological transition: the case of China. Social Science Research Network, Rochester. Retrieved 15 Mar 2016 http://papers.ssrn.com/abstract=1599012

  • Leueng JCB (2005) Social welfare in China. In: Walker A, Wong C-K (eds) East Asian welfare regimes in transition, from confucianism to globalisation. The Policy Press, Bristol

    Google Scholar 

  • Li H, Yi Zhu (2006) Income, income inequality, and health: evidence from China. UNU-WIDER. Retrieved http://www.wider.unu.edu/publications/working-papers/discussion-papers/2006/en_GB/dp2006-07/

  • Li G, Hu Y, Pan X (1996) Prevalence and incidence of NIDDM in Daqing City. Chin Med J 109(8):599–602

    CAS  PubMed  Google Scholar 

  • Liang, R (2013) Fighting child malnutrition in rural China. UNISEF East Asia and Pacific. Retrieved 9 Sept 2015 http://www.unicef.org/eapro/media_20532.html

  • Liu X, Huaijie Cao (1992) China’s cooperative medical system: its historical transformations and the trend of development. J Public Health Policy 13(4):501–511

    CAS  PubMed  Google Scholar 

  • Liu Y, Keqin Rao, John Fei (1998) Economic transition and health transition: comparing China and Russia. Health Policy 44(2):103–122

    CAS  PubMed  Google Scholar 

  • Liu Y, Keqin Rao, Hsiao WC (2003) Medical expenditure and rural impoverishment in China. J Health Popul Nutr 21(3):216–222

    PubMed  Google Scholar 

  • Liu J et al (2011) Mental health system in China: history, recent service reform and future challenges. World Psychiatry 10(3):210–216

    PubMed  PubMed Central  Google Scholar 

  • Ma RCW, Xu Lin, Weiping Jia (2014) Causes of type 2 diabetes in China. Lancet Diabetes Endocrinol 2(12):980–991

    PubMed  Google Scholar 

  • Meng Q, Shenglan Tang (2013) Universal health care coverage in China: challenges and opportunities. Procedia Soc Behav Sci 77:330–340

    Google Scholar 

  • Miller G et al (2012) Effectiveness of provider incentives for Anaemia reduction in rural China: a cluster randomised trial. BMJ Br Med J 345:1–10

    Google Scholar 

  • MoF (Ministry of Finance of the People’s Republic of China) (2014) On the issuance of promoting comprehensive reform of the county public hospital. Ministry of Finance of the People’s Republic of China. Retrieved http://www.mof.gov.cn/zhengwuxinxi/zhengcefabu/201404/t20140408_1064889.htm

  • MoH (2012) The nutrition development report of Chinese children aged 0–6 (2012). Ministry of Health, Beijing

    Google Scholar 

  • MoH (Ministry of Health of the People’s Republic of China) (2010) On the issuance of public hospital reform guidance. Ministry of Health of the People’s Republic of China

    Google Scholar 

  • Mok KH, Yu Cheung Wong, Richard M. Walker, Xiulan Zhang (2010) Embracing the market: examining the consequences for education, housing, and health in Chinese cities. In: Mok KH, Ku Y-W (eds) Social cohesion in greater China: challenges for social policy and governance. World Scientific Publishing, Singapore, pp 187–224

    Google Scholar 

  • NHFPC (National Health and Family Planning Commission of PRC) (2015a) China family development report 2015. Beijing: China Population Publishing House

    Google Scholar 

  • NHFPC (National Health and Family Planning Commission of PRC) (2015b) Press conference for releasing the “2015 report on Chinese nutrition and chronic disease”. National Health and Family Planning Commision of the PRC. Retrieved 9 Sept 2015 http://www.nhfpc.gov.cn/xcs/s3574/201506/6b4c0f873c174ace9f57f11fd4f6f8d9.shtml

  • Omran AR (2005) The epidemiologic transition: a theory of the epidemiology of population change. Milbank Q 83(4):731–757

    PubMed  PubMed Central  Google Scholar 

  • Ouyang Y (2013) China tackles illness-led poverty as financing gap grows. Lancet Oncol 14(1):19

    PubMed  Google Scholar 

  • Pan XR, Wen Ying Yang, Guang Wei Li, Juan Liu (1997) Prevalence of diabetes and its risk factors in China, 1994. National diabetes prevention and control cooperative group. Diabetes Care 20(11):1664–1669

    CAS  PubMed  Google Scholar 

  • Park A, Sangui Wang (2001) China’s poverty statistics. China Econ Rev 12(4):384–398

    Google Scholar 

  • Pei X, Eunice Rodriguez (2006) Provincial income inequality and self-reported health status in China during 1991–7. J Epidemiol Community Health 60(12):1065–1069

    CAS  PubMed  PubMed Central  Google Scholar 

  • Phillips MR et al (2009) Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey. Lancet 373(9680):2041–2053

    PubMed  Google Scholar 

  • Shan J (2013) Nearly 120,000 new cases of MDR-TB in China every year. China Daily. Retrieved 10 Oct 2014 http://www.chinadaily.com.cn/china/2013-04/19/content_16423914.htm

  • Sidel VW (1993) New lessons from China: equity and economics in rural health care. Am J Public Health 83(12):1665–1666

    CAS  PubMed  PubMed Central  Google Scholar 

  • State Council (2012) State council on issuing the notice of deepening the medical system reform during the 12th five year plan. The Central People’s Government of the People’s Republic of China. Retrieved http://www.gov.cn/zwgk/2012-03/21/content_2096671.htm

  • State Council (2014a) Key tasks of deepening health reform in 2014. The Central People’s Government of the People’s Republic of China

    Google Scholar 

  • State Council (2014b) State council on the issuance of focuses and tasks in medical reform in 2014. The Central People’s Government of the People’s Republic of China. Retrieved http://www.gov.cn/zhengce/content/2014-05/28/content_8832.htm

  • Stoltzfus RJ (2001) Iron-deficiency anemia: reexamining the nature and magnitude of the public health problem. Summary: implications for research and programs. J Nutr 131(2):697–701

    Google Scholar 

  • Tang S, Qingyue Meng (2004) Introduction to the urban health system and review of reform initiatives. In: Bloom G, Tang S (eds) Health care transition in urban China. Ashgate Publishing Limited, Hants, pp 17–38

    Google Scholar 

  • The Central People’s Government of the PRC (2013) Chinese center for disease control and prevention: 24% of people above 15 years diagnosed by hypertension. The Central People’s Government of the People’s Republic of China. Retrieved http://www.gov.cn/jrzg/2013-10/09/content_2502324.htm

  • Wagstaff A, Lindelow M (2008) Can insurance increase financial risk?: the curious case of health insurance in China. J Health Econ 27(4):990–1005

    PubMed  Google Scholar 

  • WHO (1999) World health report 1999. WHO, Geneva

    Google Scholar 

  • WHO (2015) Cardiovascular diseases. World Health Organization, Western Pacific Region, WHO Representative Office China. Retrieved http://www.wpro.who.int/china/mediacentre/factsheets/cvd/en/

  • WHO and DRC (2005) China: health, poverty and economic developement. Beijing: Office of the World Health Organization representative in china and social development department of China state council development research center

    Google Scholar 

  • Wilkinson RG (1996) Unhealthy societies: the afflictions of inequality, 1st edn. Routledge, London/New York

    Google Scholar 

  • Wilkinson RG (1999) Putting the picture together: prosperity, redistribution, health and welfare, Social determinants of health. Oxford University Press, Oxford, pp 256–274

    Google Scholar 

  • Xie Y, Xiang Zhou (2014) Income inequality in today’s China. Proc Natl Acad Sci U S A 111(19):6928–6933

    CAS  PubMed  PubMed Central  Google Scholar 

  • Yang Wei, Panos Kanavos (2012) The less healthy urban population: income-related health inequality in China. BMC Public Health 12(1):1–15

    Google Scholar 

  • Yang G et al (2013) Rapid health transition in China, 1990–2010: findings from the global burden of disease study 2010. Lancet 381(9882):1987–2015

    PubMed  Google Scholar 

  • Yip W (2010) Disparities in health care and health status: the rural-urban gap and beyond. In: Whyte M (ed) One country, two societies: rural-urban inequality in contemporary China. Harvard University Press, Cambridge, MA

    Google Scholar 

  • Yip W, Hsiao WC (2008) The Chinese health system at a crossroads. Health Aff 27(2):460–468

    CAS  Google Scholar 

  • Yip W, Hsiao W (2009) China’s health care reform: a tentative assessment. China Econ Rev 20(4):613–619

    Google Scholar 

  • Yip W, Hsiao W (2014) Harnessing the privatisation of China’s fragmented health-care delivery. Lancet 384(9945):805–818

    PubMed  Google Scholar 

  • Zhang X, Kanbur R (2005) Spatial inequality in education and health care in China. China Econ Rev 16(2):189–204

    Google Scholar 

  • Zhang L, Hongmei Yi, Rozelle S (2010) Good and bad news from China’s new cooperative medical scheme. IDS Bull 41(4):95–106

    Google Scholar 

  • Zhou M et al (2016) Cause-specific mortality for 240 causes in China during 1990–2013: a systematic subnational analysis for the global burden of disease study 2013. Lancet 387(10015):251–272

    PubMed  Google Scholar 

  • Zimmer Z, Kaneda T, Spess L (2007) An examination of urban versus rural mortality in China using community and individual data. J Gerontol B Psychol Sci Soc Sci 62(5):S349–S357

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Sociology and Human Geography, University of Oslo, Oslo, Norway

    Nan Zou Bakkeli

Authors
  1. Nan Zou Bakkeli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nan Zou Bakkeli .

Editor information

Editors and Affiliations

  1. Diabetes and Nutritional Sciences Research Division, Faculty of Life Science and Medicine, King’s College London, London, UK

    Victor R. Preedy

  2. School of Life Sciences, University of Westminster, London, UK

    Vinood B. Patel

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Bakkeli, N.Z. (2019). Healthcare, Inequality, and Epidemiologic Transition: Example of China. In: Preedy, V., Patel, V. (eds) Handbook of Famine, Starvation, and Nutrient Deprivation. Springer, Cham. https://doi.org/10.1007/978-3-319-55387-0_40

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-55387-0_40

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-55386-3

  • Online ISBN: 978-3-319-55387-0

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation