Regional Profile: China's health and environment

Overview No country better typifies the confluence of trends discussed in this report – nor the challenges they pose to environmental quality and public health – than does modern China. Since the economic reforms of 1978, China has experienced dramatic industrialization and rising energy use against a backdrop of population growth and unprecedented urbanization. China’s astounding industrial growth over the past two decades has created a country poised to become a major economic power in the 21st Century. Per capita, China is still one of the world’s poorest countries, yet the future looks promising – incomes are rising, poverty rates are falling, and life expectancy is up. Yet, along with these gains, China is grappling with some of the most serious environmental problems on the planet, which in turn could prevent China from sustaining high levels of economic growth in the coming decades. Recognizing the urgency of these problems, the Chinese Government has endorsed a suite of policies to curb air and water pollution. The extent to which these policies are successful has direct bearing on not only the health of the Chinese people and the local environment but the global environment as well. < p> Encompassing a geographically vast area with a number of distinct ecological zones, China extends from the massive and sparsely populated Gobi Desert and the mountains of the southwestern Himalayas to the densely inhabited valleys of the eastern coast. As the world’s most populous country, with more than 1.2 billion people, China’s economic growth is the fastest and most sustained of any major country in the world, rising an average of 10 percent annually over more than a decade [1]. In fact, some autonomous regions in the golden southeastern coastal zones have grown nearly 20 percent annually, doubling in less than 4 years [2]. Industry is China’s largest productive sector, accounting for 48 percent of its gross domestic product (GDP) and employing 15 percent of the country’s total labor force [3]. In the 1990s, the output of China’s 10 million industrial enterprises has increased by 18 percent annually [4]. Without a doubt, Chinese industry is largely responsible for lifting many millions of people out of poverty. It also underlies a huge and growing demand for energy. China’s demand for high-grade energy such as oil and natural gas will increase rapidly, although coal will continue to dominate the energy structure, accounting for more than 75 percent of total energy production. From 1990 to 1995, China’s oil demand grew at 4.3 percent annually, while oil production increased only 1.2 percent each year. As a result of these trends, China has become a net oil importer [5]. Along with industrialization has come rapid urbanization, especially in what is known as the southern coastal crescent that runs from Guangzhou to Shanghai. The proportion of the population living in cities has grown about 50 percent since 1980. Some 370 million people now live in cities, and this number is expected to grow to 440 million by the turn of the century [6]. A World Bank model predicts that by the year 2020, 42 percent of China’s population, more than 600 million people, will live in urban areas overwhelmingly concentrated in the eastern and southern coastal provinces [7]. Since the political transformation of 1949, dramatic and extensive social improvements have accompanied China’s growth. In 1949, the new People’s Republic of China faced a massive burden of nutritional deficiency and infectious and parasitic diseases. More than half the population died as a result of infectious and other nondegenerative diseases before reaching middle age – a pattern still common throughout much of the developing world. Since 1949, the average life span in China has risen from 35 years to the current 70. The infant mortality rate has dropped from 200 per 1,000 to 31 per 1,000. Infectious diseases, while still a serious problem in some parts of the country, claim the lives of a mere 0.0004 percent of the population each year [8]. The decrease in morbidity and mortality rates associated with infectious diseases in China is a remarkable achievement for the world’s most populous country. This decline can be attributed to an aggressive campaign to improve primary health care and tackle infectious diseases [9]. However, over the coming decades, China’s deteriorating environment threatens to undermine the gains that rising incomes would otherwise bring. China’s rapid industrialization, urbanization, and economic growth are contributing to respiratory diseases and chronic illnesses such as cancer. Levels of particulate air pollution from energy and industrial production in several of China’s megacities, such as Shanghai and Shenyang, are among the highest in the world, leading to corresponding problems of lung disease in their populations. Water pollution in some regions, such as in the Huai River Valley, is also without parallel. References and notes 1. The World Bank, World Development Indicators 1997, on CD-ROM (The World Bank, Washington, D.C., 1997). 2. Jonathan Sinton, ed., China Energy Databook, 1996 Revision (University of California at Berkeley, Berkeley, 1996), p. x-12. 3. International Labour Organization (ILO), Economically Active Population, 1950<196>2010: Vol. 1, Asia (ILO, Geneva, 1996), p. 205. 4. The World Bank, World Development Indicators 1997 (The World Bank, Washington, D.C., 1997), p. 130. 5. International Energy Agency, Energy Statistics and Balances: Non-OECD Countries, 1971<196>1995, on diskette (Organisation for Economic Co-Operation and Development, Paris, 1997). 6. United Nations (U.N.) Population Division, Urban and Rural Areas 1950<196>2030 (1996 Revision), on diskette, (U.N., New York, 1997). 7. Li Junfeng et al., Energy Demand in China: Overview Report, Issues and Options in Greenhouse Gas Emissions Control Subreport Number 2, (The World Bank, Washington, D.C., 1995), p. 17. 8. China Ministry of Public Health, Selected Edition on Health Statistics of China 1991<196>1995, (China Ministry of Public Health, Beijing, 1996), p. 3. 9. Chen Junshi et al., Diet, Lifestyle, and Mortality in China: A Study of the Characteristics of 65 Chinese Counties, published in the U.K. by Oxford University Press, Oxford; in the United States by Cornell University Press, Ithaca; and in China by the People’s Medical Publishing House, Beijing (Oxford University Press, Oxford, 1990), p. 73.