Week 10: Environmental Health

This week’s topic of environmental health in China was more discussion-based than previous weeks and thus we were able to draw out several themes from the presentations. These themes included rural-urban disparities in health and health care and the burden of chronic disease in China. We began with a very brief overview of the Chinese health care system, then discussed common pollutants in China and their effects on human health. We very roughly divided our presentations by water versus air pollution. Sulfur dioxide, acid rain, and cancer were three topics that we explored more in depth.

The gap between quality of life in rural and urban areas is a topic that has been discussed throughout our course, but in this class we examined disparities in health. In 2005, the New Rural Co-operative Medical Care System provided more affordable health care for rural inhabitants, but also gave steeper discounts for people who elected to go to clinics in rural areas. This discourages rural residents from seeking care in urban hospitals, which often have better resources and can provide better care. Additionally, rural industry, because it is often subject to fewer enforced regulations than urban industry, generates rampant pollution in the countryside. Rural residents often are forced to tolerate exposure to pollutants because they depend on the factories for the livelihoods. Additionally, because fewer epidemiological and medical surveys are conducted in rural areas, it is difficult to quantify location-based differences in health.

Interestingly, China is more like a developed country in the sense that chronic disease is the most common cause of death. Developing country problems like water-borne diarrheal diseases are in fact relatively scarce, even in the sub-tropical regions of southern China. Disease is still a huge problem in rural areas, but it seems to stem from different sources that one would expect, Pollution is obviously a key factor in chronic disease, and particulate matter is the largest contributor to chronic respiratory diseases. Water and air pollution are difficult to control, and several maps we examined in class displayed pollution’s indiscriminate crossing of borders in China, even traveling to Japan and Los Angeles. Cancer is a growing problem in China, evidenced by the expose on “cancer villages” by a Chinese investigative journalist and the growing number of epidemiological studies on this subject. Will China follow the Kuznets Curve and drive back disease as income steadily grows? Professor Karp pointed out that as China adopts Western eating habits, chronic cardiovascular disease and obesity may emerge as new killers. The fact that chronic disease and cancer are already prevalent in still-developing China does not seem to bode well for future epidemiology, as cancer and other such diseases are often slow to emerge, only appearing decades after an exposure. What will the epidemiology of cancer in China look like in 50 years?

Powerpoint

Week 9: Urbanization

Urbanization in China is a fascinating topic with respect to environmental protection for reasons. On one hand, urbanization is considered by Chinese government as part of the solution for environmental degradation because of the low ecological footprint of urban citizen, which is argued by some scholars. The recent Shanghai Expo expresses the message of building green cities. On the other hand, as we have seen in this lecture, urbanization is accountable for some of the environmental problems in China. The fact that urbanization is a double-edge sword makes it a particularly interesting issue to discuss in this class.

Although China has the largest urban population in the world, its urbanization level is actually lower than the world average. However, it is urbanization level is growing at a rapid pace, from lower than 20% in 1978 to more than 40% today, and it is expected to continue at this rate for the next few decades. However, internal migration is China is limited because of the hukou system that binds individual to his/her birth place. This has several important implications on the characteristics of China's urbanization, and it leads to some social problems in China such as the discrimination against migrant worker in cities.

Urbanization is most dramatic in the region that is also the agricultural base in China. As a consequence, growing cities are eating up farm land around them, exerting a big pressure on agricultural land in China, which is already a scarce resource as we have discussed in previous lectures. Chen's paper offers a good look on this issue. The paper also elaborate on the abuse of land in the process of urbanization, which is evident in the comparison between development area and old town. The characters of those development areas seem to suggest that China is implementing the US model in building new cities, which can be an interesting hypothesis for future studies.

In my lecture I tie up our reading with some background information on land management in China because of its high relevance for our discussion. The discussion on land property in China is of great importance, especially in a comparison between China and the US. The Land Administration Law is the most important central policy on land management, and it reveals how cities in China actually acquire land from its rural surroundings. An overview on the LAL also reflects upon some of the themes we have observed again and again in the course, such as the conflict in interests between the central government and local governments, the lack of an independent legal system, and the widespread existence of government failure.

Slides: http://groups.google.com/group/chinaenvirogisp/web/Urbanization and Land Management in China.ppt