**: Surging News reporter Ji Jingjie.
In recent years, China has made tremendous economic progress in terms of economic development, and the huge financial burden of noncommunicable diseases such as lung disease and hypertension is stealing this gain. Rapid population aging and global climate change are also exacerbating this process. ”
In recent years, epidemic infectious diseases have occupied most of people's vision in the field of public health, and behind them, the number of non-communicable diseases such as hypertension and obstructive pulmonary disease is quietly increasing.
On December 2, 2023, The Lancet published an editorial review titled "Non-communicable diseases in China: a rising tide". Based on the content of the 9th Lancet-Chinese Academy of Medical Sciences Medical and Health Conference 2023, which was held in Beijing on November 22-23, the article points out that noncommunicable diseases are bringing unprecedented challenges to China's healthcare system and people's health, and puts forward several recommendations, including promoting healthy lifestyles, emphasizing prevention, and improving the medical system.
Noncommunicable diseases, also known as chronic diseases, tend to last longer and mainly include cardiovascular diseases (such as heart disease and stroke), cancer, chronic respiratory diseases (such as chronic obstructive disease and asthma), and diabetes. These diseases kill 41 million people each year, accounting for 74% of global deaths.
According to a report by the World Health Organization (WHO), the top four causes of death among Chinese in 2017 were noncommunicable diseases: stroke, ischemic heart disease, chronic obstructive pulmonary disease and lung cancer.
These diseases are closely related to many behavioural factors, including unhealthy diet, physical inactivity, exposure to tobacco smoke, and harmful use of alcohol. Therefore, long-term prevention of NCDs from aspects such as lifestyle Xi is more important than direct prevention. In the article, The Lancet argues that advocacy should be stepped up and prevention-related health policies should be developed.
The number of chronic diseases is increasing, and the medical expenses are huge.
The Lancet pointed out in the article that the current trend of increasing non-communicable diseases in China is a "milestone". According to research by Professor Zhang Lei of Xi'an Jiaotong University, the financial burden of diabetes will exceed GDP growth between 2020 and 2030. According to a June 2023 article published in The Lancet**, the number of people with diabetes in China increased from 35.5 million in 2018 to 11.8 billion people. At this rate, by 2050, China will have 25.7 billion people with diabetes.
High blood pressure is strongly associated with cardiovascular disease. Professor Winnie Yip of Harvard University pointed out that in the 10 years from 2007 to 2017, the prevalence of hypertension in China increased from 257% rose to 315%, of which only 342% of patients received **, while the proportion of patients with effective blood pressure control was only 92%。According to the data provided by Li Xi, a researcher at Fuwai Hospital of the Chinese Academy of Medical Sciences, there is a huge gap between different regions of China in terms of awareness and means of prevention and treatment of hypertension and the control methods provided by primary medical care.
Professor Chen Simiao of the Chinese Academy of Medical Sciences and Peking Union Medical College compared the spending on chronic obstructive pulmonary disease (COPD) in 204 countries and regions, with China ranking first in the world. The main reason for this is that China is the world's largest producer and consumer of tobacco, with more than 300 million smokers and 700 million people exposed to second-hand smoke, including 1800 million children. In 2019, China had the highest number of COPD deaths in the world. Some studies predict that 2 million people will die a year from smoking in China by 2030, and that number could reach 3 million a year by 2050.
In addition to COPD, cancer also poses a heavy burden on public health expenditures. In China, lung cancer is one of the leading causes of death. From 2005 to 2020, deaths from cancer rose by 216%, to 2 million people.
Improve lifestyles, pay attention to prevention, and strengthen medical insurance.
How should China respond to these challenges?
The Lancet gives three suggestions. Social behavioural risk factors, including smoking, diet, and sedentary lifestyle Xi, must be taken into account. Diseases caused by these factors account for the majority of the financial burden on public health. In China, the tobacco industry is monopolized by the state, which has far-reaching implications for tobacco control policy: tobacco taxes are very low, and products lack labels warning of the dangers of cigarettes. In order to limit the adverse effects of tobacco, certain food and alcohol industries, non-health sectors, such as the Ministry of Industry and Information Technology, also need to be involved.
Second, the healthcare system needs to be transformed from a focus to prevention, while strengthening primary care. China's medical resources are unevenly distributed, mainly concentrated in tertiary hospitals, while basic medical care is relatively weak. The lack of motivation for large hospitals to transform from first-class services to universal health prevention services is one of the reasons why China's progress in the prevention and treatment of non-communicable diseases is not ideal. To this end, new strategies should be adopted to improve healthcare practices in terms of funding, performance, service delivery and information technology for primary care.
Finally, universal health coverage must be strengthened. Professor Ye Zhimin put forward six specific recommendations: establishing a medical delivery system based on population distribution, using digital tools to support healthier lifestyles, increasing the dissemination of health risk factors, improving economic protection for vulnerable populations, advocating "health in all policies" that take health factors into account when formulating policies, and establishing a monitoring and evaluation system for universal health insurance. Although China is increasing its investment in health, public health spending is only 6% of GDP, which many scholars believe is grossly insufficient.
In recent years, China has made tremendous gains in economic development, but the huge financial burden of non-communicable diseases such as lung disease and hypertension is stealing this gain. Rapid population aging and global climate change are also exacerbating this process. "Noncommunicable diseases not only threaten people's health and the country's economy, but also undermine the proper functioning of the healthcare system." These issues require not only the awareness and adaptation of health systems, but more importantly, the need for further regulation of health-related market behaviors, as well as the development of policies for disease prevention and the promotion of healthy behaviors. ”
References: 1 non-communicable diseases in china: a rising tide
2. global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the global burden of disease study 2021
3.World Health Organization: Noncommunicable Diseases.