Changing health in China: re-evaluating the epidemiological transition model.
Changing health in China: re-evaluating the epidemiological transition model.
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DOI：
10.1016/j.healthpol.2003.07.005
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发表时间：
2004-03
期刊：
影响因子：
--
通讯作者：
Dummer TJ
中科院分区：
文献类型：
--
作者：
Cook IG;Dummer TJ
本文回顾了中华人民共和国成立50年来中国卫生状况的变化。乍一看，这种健康状况的改善符合经典的流行病转变模式。就在30年前，中国的健康特征是高传染病率和早期死亡率（贫困疾病），主要是农民社会。最近，传染病发病率有所下降，而在快速城市化的社会中，与人口老龄化相关的相应和延长的发病率和死亡率。这一过程产生了新的健康问题，包括慢性病和退化性疾病（富裕疾病）。然而，尽管流行病学转变概念的应用有一定的合理性，但进一步的分析表明，中国面临着一个新的流行病学阶段，其特征是预期寿命增加和富裕疾病以及传染病的出现和重新出现。我们证明，中国的国家政策在定义中国背景下的健康参数方面发挥着重要作用。我们的结论是，今天，中国面临着一系列新的健康问题，包括吸烟的影响，高血压，环境污染对健康的影响和艾滋病毒/艾滋病的上升;然而，国家政策对中国广大人口的健康仍然至关重要。政策面临的挑战是保持卫生改革，同时解决与快速城市化、日益扩大的社会和空间不平等以及艾滋病毒/艾滋病和其他传染病的出现有关的问题。
This paper reviews the changing health situation in China, which has shown remarkable improvement in the 50 years since the founding of the People’s Republic of China (PRC) in 1949. At first sight this improving health situation follows the classical epidemiological transition model. Just three decades ago health in China was characterised by high rates of infectious disease and early mortality (diseases of poverty) in a mainly peasant society. More recently infectious disease rates have decreased, with corresponding and extended morbidity and mortality associated with an aging population in a rapidly urbanising society. This process has given rise to new health problems, including chronic and degenerative diseases (diseases of affluence). Nonetheless, while there is some validity in the application of the epidemiological transition concept, further analysis demonstrates that China faces a new epidemiological phase, characterised by increasing life expectancy and diseases of affluence coupled with the emergence and re-emergence of infectious diseases. We demonstrate that China’s state policy plays a major role in defining the parameters of health in a Chinese context. We conclude that, today, China is faced with a new set of health issues, including the impact of smoking, hypertension, the health effects of environmental pollution and the rise of HIV/AIDS; however, state policy remains vital to the health of China’s vast population. The challenge for policy is to maintain health reform whilst tackling the problems associated with rapid urbanisation, widening social and spatial inequalities and the emergence of HIV/AIDS and other infectious diseases.
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