-The Health Problems of Urbanisation and Policies of Sustainable Development in China
Abstract:
This project aims to evaluate and analyse the existing policies in China whether they could resolve the urban population's health issues (communicable diseases, non-communicable chronic diseases, undeveloped national health system) or not.
After comparing and contrasting with American medical-care reform, is it the sustainable development for Chinese urban human being? According to the resources collected from official database, I judged these series of policies are not the sustainable plans, so the only thing is that we can implicate both objective and subjective methods for the sake of long - term well-being in China. Finally some limitations and further studies will be conducted in the future.
INTRO:
The majority of the dramatically urbanizing cities probably exist in the least developed countries (LDEC) which was originated from demographic and economic transformations over the past few decades. This phenomenon highlights constantly both adverse and advantage effects on the urban communities. Alternatively, it may lead to housing problem, social crime, traffic congestion or environmental contamination and so on (Vlahov & Galea, 2002).
According to a survey of the United Nation (1990), Urbanisation is the growth in the ratio of population migrating from rural areas into the cities and towns. That is, the sleepy city of thousands which has suddenly mushroomed to a congested area with millions of people crowded in the street (Harpham, 1994). On this account, sustainable development which was defined as the combination of sociology, economy and culture with environment should be adopted in order to address the urban problems. (Hopwood, et al, 2005).
Based on the published literature and evidence in the third world, take China for instance, this paper attempts to analyse and evaluate the dimensions of metropolises that affect human health risks as well as the relevant sustainable policies which could be conducted by the authorities. At the first sight, it reveals the potential causes of human chronic morbidity by virtue of the poor health services around expanded cities of China. Secondly, the essential factors will be specifically discussed in terms of communicable and non-communicable diseases, the undeveloped health care services and systems. Then, it looks into the current policies have adopted of sustainable development to municipal cities in China which compared with the U.S. Medicare Reform; Finally, I will show suggestions and recommendations for tackling the population.
I conclude that the more processes of urbanisation, the worse conditions of public well-being. The sustainable way which aims to improve urban population’s health issues could adopt the reasonable methods both objective (government policies) and subjective (lifestyles, habits, healthy awareness) aspects from long-run.
The People's Republic of China has about 1.3 billion population, which is the largest in the world. Meanwhile, China is confronting the considerable evolution of Urbanisation at present. The percentage of urban inhabitants has expanded from 23% to 42% by 2006(UN, 2007). According to China's government survey (2006), it is likely that this trend will increase further to more than 50% by 2020. As a result, the Chinese mega-cities are suffering a human health crisis for chronic sickness in terms of environmental (physical and social environment) hazards, a multitude of people, lower income communities and poor national health care systems.
Nevertheless, the rapid scientific innovations in health-medical methods and facilities have significantly split the centralized population in urban areas from numerous original infectious diseases which had killed thousands and millions of citizens in historical periods also the industrialization of 18th century in European nations (Rosen, 1993).
BODY PARTS
PROBLEMS:
-Communicable Diseases
Since the immigration of the demographic shifts from rural to urban regions decades ago, compared with other developing countries China has made vital accomplishment in both preventing and controlling communicable diseases by adopting multi-dimensional measures. Nonetheless, with the advancement of global economy, the rebirth of certain communicable morbid symptoms such as tuberculosis, and sexually transmitted diseases (STDs); acquired immune deficiency syndrome (AIDS) and emerging infectious diseases (EIDS) could probably increase the public concerns about the negative influences on public health in China. Nowadays, because of non-ethical behaviours, the figure of citizens infected with STDs has transmitted the constant hazards for infectious communities. In addition, it is evaluated by NHO (National Health Organization) in 2002 that at least around 1.2million population have been infected with Human Immunodeficiency Virus (HIV) in urban regions. Furthermore, the pestilence of tuberculosis (TB) in China has reached plague proportion (Lee, 2004).
In fact of that, owing to the expansion of communicable or non-communicable diseases in the world, yet the prevention and treatment methods of those diseases are by no means appeared so complex in such process of globalization and urbanization, which could embody Severe Acute Respiratory Syndrome (SARS), occurred in 2003.
Figure 0: Diabetes in China -National Well-Being Hazards
‘‘A: Urban diabetic prevalence rates in 2007. B: If all patients diagnosed with diabetes had access to a treatment costing 50 cents a day (with a patient compliance of 60%) the market value would increase from US$1.1billion to $1.7 billion by 2017’’ (Ward, 2008)
-Non-communicable Diseases
Due to the industrialization, urbanization and unhealthy lifestyles, the metropolitan cities have been suffering such the non-communicable diseases as diabetes, mental problems, cardiovascular illness, and chronic obstructive pulmonary disease (COPD). It is the most distinct public health issues that can affect the destroyed human health-systems and the considerable medical expenditures (Lee, 2004).
According to a National Survey of 2002, approximately 20 million diabetes and 17.7 million people are diagnosed with COPD; the number of the people with high blood pressure is over 100 million in Chinese cities. In that sense, the dramatically growing non-communicable diseases could pose the great threat to the health of inhabitants especially the young working communities within varies urban areas, plus the exceedingly high medical fees for such epidemic in the People's Republic of China (Lee, 2004).
Therefore, mental well-being is regarded as an essential issue of human health. Notwithstanding, the large number of adolescents and youngsters are in danger of suffering from mental problems in China currently. "Bad familial environment and social ethos, improper education style, unhealthy media function, and increasingly greater scholastic pressures have made them become the 'psychologically fragile generation (Lee, 2004, p332)'. The Chinese youth mental research of recent years indicated that the number of Chinese youth who have had mental problems was 24%. Furthermore, the proportion of students with such diseases in universities was 29%; while the rate of younger people in high schools was 36% (China Internet Inf. Cent. 2003).
-Undeveloped health care services and systems
Perhaps it is also worth pointing out that the unbalanced distributions of national health care services and systems implemented in different cities, particularly, the divergence of medical-care levels and organizations in China. When it mentioned about health resources issues, we cannot ignore the fact that the more people are living in urban areas, the less health resources to be allocated efficiently in an equal way. Although a few of urban areas have seen the unprecedented changes of public health systems and technologies which could attain such levels of developed countries as Beijing, Shanghai and other coastal cities; On the contrary, certain inland or western areas need medical equipment and the professional doctors(Lee, 2004).
It seem unreasonable that Chinese policies and regulations of health subsidies or welfares Government can provide some free and excellent health services, but the scarce of medical funding, most people should pay for high prices but primary health services or basic social welfares within the back grounds of excessively huge health demands of the urban citizens. Thus, Lee. L (2004) examined that China has burdened a huge economic pressure of medical reform while it is inequitable for poor citizens who cannot afford high expenditures of disease treatment.
SOLUTIONS
-Approaches to Tackle the Health Jeopardy in Mega-cities
-Existing Chinese Policies
The well-being of public is currently a crucial concern for Chinese governments, which have already implemented three holistic strategies and perspectives on health (Corvalán et al, 1999).
The first round of Chinese urban health insurance policy can be traced back to 1960s when co-existed the Labour Insurance Schemes (LIS), and the Government Insurance Schemes (GIS). LIS applied for the enterprises' staffs while GIS just for the employees of the official establishments or governments. Whenever those people were injured or infected diseases, they can obtain 75%-95% subsidies from the government without any contributions to the public health system (Zheng, Jong, et al, 2010). Moreover, the Chinese authorities have funded the stated-owned medical care systems controlled by the Ministry of Central Health. But the biggest obstacle to doing service is a huge burden of national medical costs.
With the improvement of medical systems and the growth of employees, the central government cannot afford the huge expenditures of public health any more. Mainly, majority of urban residents did not have the chances of medical aids or the health insurances during 1951-1978(Zheng&Jong, et al, 2010). So the central state confronted new challenge while public could not obtain the efficient medical care and health insurance in China.
-The Second Round Reform
Accordingly, as the opening reform policy and market-oriented system have conducted, the state government adopted the second reform of ill-functional plan since the 1980s forwards. The amendment of urban health documents described that both employees and employers should pay the health insurance fees in order to transform the collective responsibility into individual protection. Until 1998 Chinese government has performed the urban labour/worker health insurance amendments within the whole cities (Zheng&Jong, et al, 2010) Indeed, such a new cohesive reform strategy as the urban employee basic health insurance scheme (BHIS) has provided the integrated services for civilians (Xu&Wang, et al, 2007).Actually, this kind of health plan was put into practise just for less than nine months which arise from national financial deficits and turmoil of economic market.
-The new wave health reform is an ongoing process
On April 2009, the People's Republic of China has funded $124 billion to the new round health reform plan for the next 3 years. It aimed at overhauling the national medical-care systems, lower costs but higher quality services as well as covering the universal wholesome. Meanwhile, the principles of such a new reform were concerned about ‘Cost, Quality, Efficiency, and Equity (Lawrence, 2009).’ The National State Council claimed that the government would do its utmost to guarantee the distinct community which refers to the poor patients, infants, women and seniors could receive the priority of medical aids and services as soon as possible all around the country. Although flooding migrants rushed into cities nowadays, the gap of health-care systems between urban and rural regions cannot be disregarded.
Figure 1: Medical Insurance Coverage in China from 2003 to 2007(International Social Security Association ISSA, 2009)
-Compared with U.S. Reform Policy
The recent history of the American healthcare system which has undergone the fundamental changes and challenges over the last seven decades may provide a good example for China and other developing countries. Especially, a prominent event of Medicare services is the delivery shift the patient-centred medical home (PCMH) in 2007(Diane & Stephen, 2009). American Medicare Association (AMA) along with other health-care institutions together funded 20, 000 millions in order to execute 9 types of civilian healthy plans and whole states public insurances in 2007, these amendments has been implemented efficiently by diverse profitable organisations (Diane & Stephen, 2009).
While the election of American president Barack Obama proclaimed the new health reform bills in 2009. Since the big failure of the medical-care reform in 1993, this plan has gradually from some degrees, resolved three major constant issues: the lack of insurance, the dramatically increased healthcare expenditures, important errors in service (Victor& Fuchs, 2009).
-Can those measures be sustainable?
RECOMMENDATIONS+ CONCLUSIONS
Therefore, an embarrassing circumstance is that the more development of urbanisation, the worse environment of mankind’s well-beings.
From author’s views, the existing policies are not the sustainable strategy which could tackle population’s healthy issues from long term in China.
China's urban resolutions can tackle the short-run human health hazards. Apart from them, the negative effects may be probably exposed in the future subsequently, for instance, insufficient provision of urgent medical reserves; lack of supervision and laboratory ability; changeable series of workforces; deficiency of competent environment; morbid reporting scheme, which can cause a retardation in news transmission; plus shortage of health funds(Lee, 2004).
-Urbanization & Humanization
Notwithstanding, as the improvement of urbanization and industrialization, the health crisis which human have to deal with seems to be practically complicated than ever. China's public well-being may meet the excessive human requests for medical services which should combine the powerful administration and efficient health services distributed equally in varies provinces of Chinese people.
Hence, the health institutions or charitable organizations could provide comprehensive health (mental, physical) education and consultation. If the National Health System can directly or indirectly embody the features of Lee’s idea of ‘information, technification, globalization and humanization', our people will likely live in a harmonious circumstances whenever social-environment or physical-environment with sustainable development universally.
CONCLUSION
Both of the objective and subjective measures could be adopted, for instance, government should fund certain projects about improving the urban environment for the sake of citizens' insanity; mainly, the health & medicine associations need to conduct scientific research for treatment, anti-biotic drugs and healthcare facilities; the final objective way is to educate and protect three types of people: females, seniors and younger generations whenever it concerned about mental or physical elements.
The key task is depended on public themselves - Prevention. Keep away from morbid lifestyles, and cultivate more positive habits, for example, do more sports and maintain a better state of mind.
Thus, all the above elements could be regarded as the most sufficient and sustainable development for both Chinese and global population. The priority is that public should take preventative measures right now; government ought to carry out more responsible health insurance plans and more affordable medical-care systems in China.
However, the limitation of whole study is the database and evidence which I collected from official resources sometimes maybe not reliable or unbiased. In addition, without the relative backgrounds of medical knowledge, it is totally a tough procedure for me to do this project. Hence, regardless of government benefits and business profits, international cooperation could help to advance with sustainability in years to come.
Bibliography:
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