China’s resurgence of chronic illnesses, including heart disease and lung cancer, are now leading causes for premature death in the country, according to a recent study by the Global Burden of Disease (GBD). The advent of non-communicable diseases reflects a decline in maternal and child mortality over some three decades due to rapid economic and educational growth, despite national programs initiated to tackle them.

A near 30-year study in local health has led the GBD to produce comparable estimates of mortality, disability and associated risk factors for 34 provinces by age and sex. From an estimated 359 diseases/injuries and 84 risk factors, stroke and ischemic heart disease has been noted to be the leading causes of disease burden between 1990 and 2017, in place of lower respiratory infections and neonatal disorders.

Further, China has unusually high levels of chronic obstructive pulmonary disease (COPD), lung cancer, liver cancer, neck pain and stomach cancer – all studied provinces had similarly higher-than-average cases of liver cancer. Liver cancer had rates of disability-adjusted life years (DALYs) between two and seven times more than expected, and ranked among the top five causes of DALYs in seven provinces. Smoking was also a top risk factor in 21 provinces and a close second- or third- leading risk in the remaining provinces, and while hypertensive heart disease saw variation in rank order among the provinces, it was nevertheless prominent.

The GBD’s analysis shows considerable differences in provincial health problems and thus confirms that one’s health depends on where one lives. People in urban, coastal, and wealthier provinces in eastern China are generally healthier than those in the rural and poorer west, but changes in development and lifestyles are fast altering exposure to risks amongst the whole nation.

Dr. Zhou Maigeng, the Deputy Director of the National Center for Chronic Non-Communicable Disease Control and Prevention in China, laments that the burden of chronic health problems, especially among the elderly, will far exceed infectious diseases in the near future.

However, Dr. Liang Xiaofeng, also from the centre, said the detailed provincial findings will direct policies suitable to the health needs of local communities, in concert with the Healthy China 2030 Plan announced back in 2016 to improve health, control risk factors, and enlarge the nation’s health care system.