Over the last two decades there has been a rise in the life expectancy in every province of China. However, the large inequalities between provinces still remain. Thus, suggesting that localization of policies will be crucial to government health reforms.
Two new studies have revealed for the first time how health in different regions of China have changed in recent decades. Both the articles analyze life expectancy, causes of death, and child mortality for 31 provinces, municipalities, autonomous regions of China and Hongkong and Macao special administrative regions. The findings suggest that in the last two decades, life expectancy has risen and deaths in children under five years have fallen in every province.
The study revealed that Shanghai City had the highest life expectancy in China in 2013, at 80.2 for men and 85.2 for women. These figures are comparable to countries with the highest life expectancies such as Japan or France. It represents a gain of around six years on the highest life expectancies seen in China in 1990.
These gains in life expectancy seen across China have been thought to be linked to increasing GDP and improved maternal education. However, large inequalities between provinces remain, with life expectancy around 10 years lower for both men and women in some provinces in the west part of China, comparable to less developed countries like Bangladesh.
Moreover, the study also reveals striking differences in the leading causes of death in different provinces. Nationwide, cerebrovascular disease (the main cause of stroke) was observed to be the leading cause of death for both men and women. It is responsible for more deaths in poorer provinces. But some provinces, notably Yunnan province on China's southern border, have reported much lower rates of death from cerebrovascular disease.
One of the study's lead authors Maigeng Zhou said, "There is an ongoing effort by the Chinese Government to reform the health-care system, especially in terms of ensuring equal access for all to basic public health services. Consideration of regional trends will be crucial to tackle the diverse health challenges faced by provincial governments and localized health policies will likely be the key for overall success at the national level."
The second study suggested that every province of China has seen falling deaths in children under 5 years since 1970, with most provinces achieving a decrease in child mortality more than twice as fast as the Millennium Development Goal 4 rate of 4.4% per annum. The decline in the number of child deaths has been much faster than expected, even after gains in GDP and improvements in education are taken into account.
The study is published in The Lancet.