China's life expectancy rises, but health inequalities remain: Lancet

London, Oct 26 : According to a new research, last two decades have seen a rise in the life expectancy in every province of China, but the large inequalities between provinces remain, suggesting that localisation of policies will be crucial to government health reforms

Two new studies reveal for the first time how health in different regions of China has changed in recent decades. The articles analyse life expectancy, causes of death, and child mortality for 31 provinces, municipalities, autonomous regions of China and Hongkong and Macao special administrative regions, finding that in the last two decades, life expectancy has risen and deaths in children under 5 years have fallen in every province.

According to one study, Shanghai City had the highest life expectancy in China in 2013, at 80.2 for men and 85.2 for women. These figures are comparable to countries such as Japan or France, which have the highest life expectancies in the world, and represent a gain of around six years on the highest life expectancies seen in China in 1990.

However, despite the gains in life expectancy seen across China, thought to be linked to increasing GDP and improved maternal education, large inequalities between provinces remain, with life expectancy around 10 years lower for both men and women in some provinces in the west part of China, comparable to less developed countries like Bangladesh.

Moreover, the study reveals striking differences in the leading causes of death in different provinces. Nationwide, cerebrovascular disease (the main cause of stroke) is the leading cause of death for both men and women, and is generally responsible for more deaths in poorer provinces. But some provinces, notably Yunnan province on China's southern border, have much lower rates of death from cerebrovascular disease.

One of the study's lead authors Maigeng Zhou said that there is an ongoing effort by the Chinese Government to reform the health-care system, especially in terms of ensuring equal access for all to basic public health services. Consideration of regional trends will be crucial to tackle the diverse health challenges faced by provincial governments and localised health policies will likely be the key for overall success at the national level.

Another study finds that every province of China has seen falling deaths in children under 5 years since 1970, with most provinces achieving a decrease in child mortality more than twice as fast as the Millennium Development Goal 4 rate of 4.4 percent per annum. The decline in child deaths has been much faster than expected, even after gains in GDP and improvements in education are taken into account.

The study is published in The Lancet.