Hygeine poster
Health conditions have improved greatly in China since 1949, when the Communists took over. Life expectancy has risen by leaps and bounds, and many diseases, including cholera, and typhus, have been eliminated. Smoking has become a health problem in recent decades in part because of large-scale marketing campaigns by American cigarette companies. [Source: Eleanor Stanford, Countries and Their Cultures, Gale Group Inc., 2001]

China has nearly eliminated death by infectious diseases, with mortality rates for these types of conditions falling from 7,000 per 100,000 of the population in 1970 to under 300 per 100,000 in 2008. Traditional killers such as malaria and typhoid are now effectively under control in all but the most remote areas. Less progress has been with chronic conditions — hard-to-treat, long-term, diseases such as cancer, diabetes and heart disease . Around 20 percent of Chinese adults suffer from high blood pressure, a condition associated with a low-nutrition, high-salt diet that significantly increases the likelihood of stroke and heart disease. The incidence of cancer — particularly lung, liver and stomach cancer — have risen at a rate of around 30 percent per decade. Diabetics make up 7 percent of the population; almost 10 percent in many urban areas. More than 3,000 people die every day from smoking-related illnesses. [Source: Iain Mills, Asia Times, April 21, 2010]

In China basic treatment has improved and the country mobilized effectively to combat Covid-19 but Improved health is not being experienced everywhere in China. In some places in the countryside the mortality rate is "as bad as you'll find in the developing world," according to World Bank economists, and four out of five peasants can't afford to see a doctor. Life expectancy in some parts of the country may be falling.

Because of improved nutrition the average Chinese child was 6 centimeters, or 2 inches, taller and 3 kilograms of 7 pounds heavier in 2010 than he or she was in 1980, according to the Chinese Health Ministry.

Health Statistics for China

Life expectancy at birth: total population: 77.72 years, 85th out of 227 countries the world; male: 75 years; female: 80.7 years (2022 est.) Average life expectancy in 2005 was 72 years. Life expectancy increased from 35 in 1949 to 73 today. Between 1963 and 1980 it increased one year a year from 50 to 67. [Source: CIA World Factbook, 2022 +]

In 2006 the life expectancy in China in years for males was 70, compared to 58 in low-income countries 76 in the United States and 75 high-income countries; for females: 73 compared to 60 in low-income countries 82 in the United States and 80 in high-income countries. "Life expectancy" is an abstract and complicated concept a complex formula that attempts to predict the lifespan of children born today by subjecting a hypothetical child born today to the current risk of dying in each bracket he or she mature through until, in effect, the accumulated risk of death is 100 percent. [Source: Junior Worldmark Encyclopedia of the Nations, Thomson Gale, 2007; CIA World Factbook]

Infant mortality rate: total: 6.76 deaths/1,000 live births, 160th in the world; male: 7.19 deaths/1,000 live births; female: 6.3 deaths/1,000 live births (2022 est.). The infant mortality rate in 2005 was about 24 per 1,000 live births. The mortality rate for children under five rate dropped from 200 in 1949 to 173 in 1960 to 44 in 1985 to 32 in 2000. The infant mortally rate for girls is 24.5 per 1,000 births, compared to 20 for boys. +

Children under the age of 5 years underweight: 2.4 percent (2013), 103rd in the world; Maternal mortality rate: 29 deaths/100,000 live births (2017 est.), 111th out of 225 countries. The chances of a woman dying from pregnancy, childbirth or abortion in China in the late 2000s was 1 in 439. In contrast the odds were 1 in 5,669 in the United States; 1 in 7 in Mali (the worst in the world); and 17,361 in Italy (the best in the world). [Source: Population Action Council]

Tobacco use: total: 25.6 percent (2020 est.), 44th in the world; male: 49.4 percent (2020 est.); female: 1.7 percent (2020 est.) +

Health figures from China are often absent or sketchy.

Chinese Health Customs

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One problem with health care in China is that Chinese overwhelm the system by going to the hospital for trifling matters like the sniffles. According to the New York Times: Instead of going to a doctor’s office or a community clinic, people rush to the hospitals to see specialists, even for fevers and headaches. This winter, flu-stricken patients camped out overnight with blankets in the corridors of several Beijing hospitals, according to state media. [Source: Siu-wee Lee, New York Times, September 30, 2018]

In a 1997 survey by the Leo Burnett advertising agency 61 percent of Chinese agreed that sleep equals health (compared to 28 percent of Americans) and 61 percent of Chinese agreed that cleanliness equals health (compared to 31 percent of Americans). Physical examinations have traditionally been a fixture of life in China. They have been required before one can apply for college, get a driver’s license or get married. See Mao and Deng-Era Marriage Physical under WEDDINGS IN CHINA

Chinese have traditionally gone to a pharmacist rather than a doctor when they don’t feel good and have taken large doses of medicine for a short period of time rather than small doses over a long period time. They often take large doses of several kinds of medicine because they don't believe one kind will work.

When they are sick Chinese have traditionally consumed tepid boiled water. Some Chinese light incense in their houses and offices under the belief that it helps kill germs. A new mother sometimes will not bathe for a certain number of days or step outside. Green tea is taken to lower "heat" in the body. People with fevers are discouraged from eating red fruits because they are associated with heat and bad luck from the south. Pineapples and papayas are supposed to cure orange-peel skin. Ground up pearls are sometimes taken as a medicine.

The Chinese are pretty tough. One woman from Shanghai had 1,650 gallstones removed from an inflamed gall bladder the size of a pear and then got of bed, exercised and went home the day after the operation.

Arthur Henderson Smith wrote in “Chinese Characteristics”: ““When he sleeps... an Occidental requires quiet, but most of all when he is sick.... Nothing in the habits of the Chinese presents a greater contrast to those of Westerners, than the behaviour of the Chinese to one another in cases of sickness. The notification of the event is a signal for all varieties of raids upon the patient; from .every quarter, in numbers proportioned to the 'gravity of the disease. Quiet is not for a moment to 'be thought of, and strange to say no one appears to desire it. The bustle attendant upon the arrival and departure of so many guests, the work of entertaining them, the waitings of those who fear that a death is soon to take place, and especially the pandemonium made by priests, priestesses, and others, to drive away the malignant spirits, constitute an environment from which death would be to most Europeans a happy escape. Occidentals cannot fail to sympathize with the distinguished French lady, to whom reference has been already made, who sent word to a caller that she “begged to be excused, as she was engaged in dying." In China such an excuse would never be offered} nor if it were offered, would it be accepted.[Source:“Chinese Characteristics” by Arthur Henderson Smith, 1894. Smith (1845 -1932) was an American missionary who spent 54 years in China. In the 1920s, “Chinese Characteristics” was still the most widely read book on China among foreign residents there. He spent much of his time in Pangzhuang, a village in Shandong.]

Face Masks in China

Traditionally, when they had a cold or a cough Chinese wore surgical masks to keep their germs from spreading to other people, a custom common throughout East Asia and adopted by Michael Jackson. In China , 80 percent of the country's ordinary face masks are made in 300 workshops in Dadian, a village in the eastern province of Shandong.

In China, full-face masks are sometimes worn to the beach. According to Business Insider, “Having a pale complexion has been desired in Chinese culture for years, but the face-kini is a relatively new trend spanning some of the country’s beaches. Created in 2004, the face-kini — a face mask that protects the skin from the sun and from jellyfish stings — started to appear on the beaches of the coastal city of Qingdao and has become popular for some of the women in China.[Source: Talia Avakian, Business Insider, September 3, 2015]

Many Chinese wear face masks as protection against air pollution, with a primary aim being the filtering out of PM2.5 particles. PM2. 5 refers to particles that have diameter less than 2.5 micrometres (more than 100 times thinner than a human hair). They remain suspended for longer periods of time than large particles and regarded as more dangerous because their small size allows them penetrate deep into the the lungs.

In 2014, only nine out of 37 types tested by the China Consumers Association met required standards in terms of filtering particulate matter and enabling easy breathing. Reuters reported: The most expensive, priced at 199 yuan ($32.15), was no better than one of the cheapest, a disposable mask that costs 1 yuan, the association said in a report on the tests. "The vast majority of face masks on the market give no protection against PM2.5, even if the manufacturers claim they do," said Lei Limin, vice chairman of the China Textile Commerce Association, referring to the small particulates that pose the greatest risk to human health because they easily pass into the lungs. “Face masks in China have traditionally been categorized as personal protective equipment mainly used for medical or industrial purposes. The country has no quality standards for face masks for personal use, despite the surge in demand. [Source: Grace Li, Reuters, March 25, 2014]

When Local media questioned the effectiveness of some masks, the state broadcaster China Central Television (CCTV) targeted the mask-producing village of Dadian. Dadian saw face mask output value more than triple from 350 million yuan in 2007 to 1.1 billion yuan in 2012, when the village produced 900 million masks. The CCTV report said some workshops in Dadian had been producing cotton masks with filters in them. The masks were then sold to some companies that claimed they protected people against the effects of pollution. A workshop owner quoted in the report said, however, that the filters might not work.

“The masks were not effective against PM2.5 particles, the CCTV report said. Jiang Xiubin, who owns the BinHai Face Mask factory and who is head of the Dadian face mask association, said the village only produces ordinary face masks, not anti-smog ones. Asked if the producers would consider upgrading their masks to address people's concerns about air pollution, Jiang said that was not yet part of the plan.

Health Problems in China

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In a Chinese hospital with a broken leg in the 1990s
China has health problems that are found in the developing world — malnutrition and communicable diseases — and the developing world — obesity and chronic diseases such as diabetes associated with high fat diets. Matthew Crabbe of the research firm Access Asia told Reuters, “China is more like a set of regions, not one country...On one hand, a massive rural population still has a low income and low caloric intake compared with urban populations where there is a high caloric intake and rising weight.

The food and health standards are generally below those of European or North American countries. Dysentery, hepatitis, stomach parasites and malaria occur in China. Diseases like tuberculosis and measles that were once thought to have been tamed have returned.

In China as in Japan rates of heart diseases are relatively low but are increasing. Chinese between the ages of 35 and 64 are twice as likely as Americans to die of heart disease. One in five Chinese have high blood pressure. Many blame the trend on more fat- and sugar-laden Westernized diet and fast food which causes obesity and made it more likely for people to have high blood pressure and heart disease.

The Harvard School of Public Health has estimated that 65 million people will die from chronic obstructive pulmonary disease and 18 million will die from lung cancer between 2003 and 2033 from smoking and burning fuel indoors with chronic obstructive pulmonary disease accounting for around 19 percent of all deaths and hung cancer, 5 percent.

Cataracts are a serious problem in China. An alarming number of peasants and their children develop them. No one is sure why. Some have speculated it is congenital and related to fact many people in remote areas marry their cousins or perhaps because of way children are carried and exposed to the sun.

Attitudes Towards Sickness and Disease in 19th Century China

In 1899, Arthur Henderson Smith wrote in “Village Life in China”: “In the families of the poor there is no margin of any kind for sickness, but sickness comes impartially to every grade of life. When the bread-winner is laid aside, when the mother of a little flock is no longer able to keep the simple domestic machinery in motion, then indeed trouble has arrived. If a young married woman is sick, the first step is to send for her mother; for ordinarily no one in the family into which she has married has the time or disposition to take care of her, least of all the husband, who regards himself as aggrieved by her disability, and who is often far more inclined to expect the family of his wife to bear all the resultant expenses, than to meet them himself. [Source:“Chinese Characteristics” by Arthur Henderson Smith, 1894]

One of the legal occasions for divorce is chronic illness, although we have never heard of a single instance where formal steps were taken for that reason. It is a current saying that in the presence of a long continued sickness there is no filial son. How great the family strain often is, there are many things to prove. In the midst of it all one is sometimes agreeably surprised to find an amount of tenderness and forbearance worthy of all praise. But in the constitution of Chinese society these exhibitions are and must be in a great minority. A man well known to the writer in speaking of the serious symptoms of a disease of his wife, remarked that he had asked her how long she expected to keep up the groans called forth by the intolerable agonies of terrible and incurable ulcers, and that for his part he had offered to provide her with a rope that she might relieve him of his inconvenience, and herself of her miseries, though upon being remonstrated with for such an inhuman view of the case, he frankly admitted that his troubles had made him “stupid.” It is a significant saying in such instances that the sufferer although poor has contracted a rich man’s malady.

“We have referred to the common neglect of sickness in the family, because the victims are "only women and children." Small-pox, which in Western lands we regard as a terrible scourge, is so constant a visitor in China that the people never expect to be free from its ravages. But it is not much thought of, because its victims are mainly children! It is exceedingly common to meet with persons who have lost the sight of both eyes in consequence of this disease. The comparative disregard of the value of infant life is displayed in ways which we should by no means have expected from the Chinese, who object so strongly to the mutilation of the human body. Young children are often either not buried at all, an ordinary expression for their death being the phrase "thrown out," or if rolled in a mat, they are so loosely covered, that they soon fall a prey to dogs. In some places the horrible custom prevails of crushing the body of a deceased infant into an indistinguishable mass, in order to prevent the "devil" which inhabited it from returning to vex the family!

“While the Chinese are so indifferent to small-pox, the foreign fear of which they fail to appreciate, they have a similar dread of typhus and typhoid fevers, which are regarded much as we regard the scarlet fever. It is very difficult to get proper attention, or any attention at all, if one happens to be taken with either of these diseases when away from home. To all. appeals for help, it is a conclusive reply, "that disease is contagious." While this is true to some extent of many fevers, it is perhaps most conspicuous in a terrible scourge found in some of the valleys of Yunnan, and described by Mr. Baber. "The sufferer is soon seized with extreme weakness, followed in a few hours by agonizing aches in every part of the body; delirium shortly ensues, and in nine cases out of ten the result is fatal." According to the native accounts, " all parts of the sick-room are occupied by devils; even the tables and mattresses writhe about and utter voices, and offer intelligible replies to all who question them. Few, however, venture into the chamber. The missionary assured me that the patient is, in most cases, deserted like a leper, for fear of contagion. If an elder member of the family is attacked, the best attention he receives is to be placed in a solitary room with a vessel of water by his side. The door is secured, and a pole laid near it, with which twice a day the anxious relatives, cautiously peering in, poke and prod the sick person, to discover if he retains any symptoms of life."

High Rates of Nearsightedness in China Linked to Studying All the Time

David Pierson wrote in the Los Angeles Times: “The children at the Bayi Xiwang elementary and middle school are doing something revolutionary by current Chinese standards: They're playing outside. Singing and skipping in the dizzying southern Chinese humidity, these students have been given 45 minutes a day to frolic under the sun while peers across the nation remain indoors, hunched over books or squinting at blackboards. By forcing youngsters to put down their pencils and expose their eyes to natural light, researchers think they can stem an explosion of nearsightedness in China. [Source: David Pierson, Los Angeles Times, July 5, 2012]

“By the time they complete high school, as many as 90 percent of urban Chinese youth are afflicted by the condition known as myopia, in which close objects can be seen clearly but things just a few feet or inches away start to blur. That's about three times the rate among U.S. children. Even more troubling is the severity of the Chinese cases. Between 10 percent and 20 percent of nearsighted Chinese children are expected to develop "high myopia," which is largely untreatable and may lead to blindness.

“The problem for China is really quite massive," said Ian Morgan, a visiting professor at the Zhongshan Ophthalmic Center at Sun Yat-sen University who helped organize the three-year clinical trial in Guangzhou. "Their best-educated kids — kids who are going to be the intellectuals or political leaders — are going to be progressively losing vision as they get older." Even China's authoritarian leaders have had to ask schools to ease off. In 2010, several provinces banned public preschools from instructing 3-year-olds to memorize 10 Chinese characters a day.

Are Genetics a Cause of China’s High Myopia Rates?

David Pierson wrote in the Los Angeles Times: “Experts remain divided on how much genetics is to blame for China's struggle with myopia. Scientists have found more than two dozen genes linked to the problem, especially for the most severe forms of the condition. Children whose parents have myopia are also more likely to develop nearsightedness. [Source: David Pierson, Los Angeles Times, July 5, 2012]

“But Morgan, an Australian, is trying to prove its origins are largely environmental and linked to schooling. Nearsightedness is rampant in the Asian Tiger economies of Hong Kong, Taiwan and Singapore where academics are similarly rigorous, even among children who aren't ethnic Chinese. For example, research has shown that students of Indian ancestry living in Singapore have rates of myopia eight to nine times higher than their peers living in India, Morgan said. Myopia is also prevalent in Orthodox Jewish schools where reading requirements are intense.

“Fishing for older records in China, Morgan and his colleagues found studies that showed the condition affected about 20 percent to 30 percent of young adults in Guangzhou in the early 1970s, near the end of Mao's violent Cultural Revolution. Schools and universities were closed, intellectuals purged. Some victims were targeted for merely wearing spectacles.

Eyeglasses Companies Cashing in on China’s High Myopia Rates

David Pierson wrote in the Los Angeles Times: “The epidemic has provided optical companies with an opportunity to serve a need — and to cash in. China's market for spectacles and contact lenses is expected to double to $5.3 billion in 2012 year from just four years ago, according to Euromonitor International, a consumer research firm. [Source: David Pierson, Los Angeles Times, July 5, 2012]

“Many new shopping malls feature a floor dedicated to eyewear where anyone can buy the latest Prada or Hugo Boss frames. Getting lenses measured and fitted can take as little as an hour. Mason, Ohio-based LensCrafters recently expanded its network of 200 outlets in China by opening special luxury-branded stores named LC+ in Hong Kong, Shanghai and Beijing. For those on a budget, state-owned optical shops can still be found in any city charging as little as $10 for a new pair of glasses.

“China has also become one of the world's fastest-growing markets for foreign contact lens makers. Although U.S. sales have flattened, Bausch & Lomb estimates the overall market in China will grow 10 percent to 15 percent a year for ordinary vision-correcting lenses, and 20 percent to 30 percent annually for cosmetic lenses that enable users to change the color of their pupils or give the appearance of larger eyes.

“The market will grow since contact lens penetration rates in China are much lower than the rest of the world," said Ian Dolling, business unit director for Bausch & Lomb in Shanghai. "As the economy develops, more people can afford to purchase contact lenses." The same can be said for laser corrective surgery, which was introduced to China in the mid-1990s and has grown steadily to 1 million procedures a year.

Image Sources: 1) Landsberger Posters; 2) Beifan. com; 3) Cgstock ; 4) Bucklin archives; 5) Asia Obscura

Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, National Geographic, The New Yorker, Time, Newsweek, Reuters, AP, Lonely Planet Guides, Compton’s Encyclopedia and various books and other publications.

Last updated September 2022

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