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