Strengthening the primary health care for non-communicable disease prevention and control in the post-pandemic period: a perspective from China

Non-communicable diseases (NCDs) have become the leading cause of deaths in China and many other countries worldwide. To call for actions in strengthening primary health care (PHC) and accelerate NCD prevention and control in the post-pandemic era in China, the 2023 Duke Kunshan Health Forum focused on innovative approaches and lessons learned during the pandemic that can be applied in addressing NCD challenges. In this article we summarize key points discussed by the participants in three areas: PHC as the foundation and ultimate solution for NCD prevention and control, post-pandemic opportunities to accelerate the NCD program with innovative approaches, and an action framework proposed by the Forum collaborators to address remaining challenges and achieve NCD control objectives in China. The core of the suggested action framework is to offer people-centered, lifetime, comprehensive, continued, and quality NCD prevention and control services, which rely on an integrated healthcare system connecting the primary, secondary, and tertiary levels of care. To achive this objective, six interconnected actions are recommended in the framework: prioritizing and integrating NCD in PHC and Universal Health Coverage (UHC) framework, engaging multiple stakeholders, directing resources to PHC for quality NCD services, leveraging advantages of new technology, encouraging the use of PHC and improving services, and strengthening best practice sharing.

Insights from COVID-19: Reflecting on the Promotion of Long-Term Health Policies in China

China announced the Healthy China Initiative (2019-2030) in 2019, an action program aimed to support the country's current long-term health policy, Healthy China 2030, which focuses on public health promotion and health awareness. Following the implementation of the policy, China had the COVID-19 pandemic, which had an influence on both the public's degree of health awareness and the adoption of the HCI. This research examines whether the COVID-19 epidemic has increased public understanding and acceptance of China's long-term health policy. In addition, it analyzes whether the Chinese public's awareness of health policy has been impacted by China's usage of smart healthcare in its response to the pandemic. To correspond to these study aims, we used a questionnaire based on the research questions and recent relevant research. The results of the study, based on an examination of 2488 data, demonstrate that the Healthy China Initiative is still poorly understood. More than 70% of respondents were unfamiliar with it. However, the results imply that respondents are becoming more aware of smart healthcare and that public acceptance of official health policies can be aided by the sharing of knowledge about this. As a result, we examine the situation and draw the conclusion that the spread of cutting-edge health-related technology can enhance the communication of health policy and provide participants and policymakers with fresh insights. Finally, this study also can provide lessons for other countries in the early stages of policy dissemination, particularly health policy advocacy and promotion during epidemics.

The implementation of "integration of sports and medicine" in China: Its limitation and recommendations for model improvement

The "integration of sports and medicine" (ISM) under the "Healthy China 2030" strategy can alleviate the contradiction between residents' health needs and medical supply. Under the "Healthy China 2030" strategy, the government-initiated calls and measures for the integration of sports and medical institutions based on the actual region conditions. This article outlines the "Sports-Medical Integration" program implemented in the coastal cities of China's southeast, Suzhou and Shanghai. We described the specific implementation modes and related deficiencies of the ISM, taking Suzhou and Shanghai as examples. Through three policy recommendations, we put forward the idea of promoting the development of a new model of ISM in China.

The Political Determinants of China'S New Health Constitution

The Basic Healthcare and Health Promotion Law 2019 became the new constitution of China's health system in June 2020, giving legal effect to ambitious health reform programmes like Healthy China 2030. The concurrent outbreak of coronavirus disease 2019 must not distract us from appreciating the fact that this Law will comprehensively overhaul the health regulatory framework of the world's most populous country during the coming decade, if not beyond. This article offers an original evaluation of the Law in its political context. The Law commendably promises to safeguard the right to health, assist citizens to live a 'complete cycle of life', and promote health using the resources of the public health system. However, it is also deeply politicised, guaranteeing extensive and penetrative political control in health campaigns, digitalised health data, the governance of health institutions, and the resolution of medical disputes. This can be explained by the consequential roles played by epidemics in China's historical dynastic cycles, but even more so by powerful tendencies of centralisation on the part of the Leninist Party-state. The Law's potential is thus subject to the overriding caveat that the Party-state's existence and influence over law and public health must be secured.

Adolescent Health and Healthy China 2030: A Review

PURPOSE

This article explores differences between the current health status of adolescents and the targets set in Healthy China 2030 (HC2030).

METHODS

Global and domestic policies and strategies relating to adolescent health were reviewed. Data from the Global Burden of Disease Study (1990-2016) and the Chinese National Survey on Students' Constitution and Health (1985-2014) were used to analyze time trends and geographical distributions of health indicators for adolescents aged 10-19 years in China.

RESULTS

The Chinese government has released many health policies over the past 3 decades. In this context, there has been a major decline in all-cause mortality and stunting. However, gaps between the current health status of adolescents and the targets set in HC2030 were numerous. The prevalence of obesity and poor vision increased rapidly, and few adolescents meet the physical activity and fitness targets set in HC2030. Urban/rural differences were marked for some indicators such as obesity, whereas for other indicators (e.g., stunting), there remained notable differences across provinces.

CONCLUSIONS

Many long-standing health problems of adolescents have improved, but new problems related to noncommunicable disease risks have emerged and should be a prominent focus for policy action under HC2030.

A Comprehensive Evaluation of China's TCM Medical Service System: An Empirical Research by Integrated Factor Analysis and TOPSIS

Objectives: This paper constructs a comprehensive evaluation index of the traditional Chinese medicine (TCM) medical service system and summarizes the development of TCM medical services in China.

Methods: We chose 31 provinces' TCM hospitals as research objects. The data were obtained from the Health Statistics Yearbook from 2013 to 2018 and from the National Statistics of Chinese Medicine from 2012 to 2017. The approaches to factor analysis and TOPSIS are used in this paper. It is found that the comprehensive evaluation indexes of the TCM medical service system can be divided into 4 first-level indicators and 14 second-level indicators.

Results: The development of the TCM medical service system in China is unbalanced and inadequate. North China and East China are generally superior to Northwest and Southwest China in terms of revenue and expenditure for TCM medical services. The per capita of medical resources in the Southwest and Northwest are stronger than those in Central and South China, but overall medical resources are weaker than those in East China and North China. TCM medical service institutions in East China, South China and Central China have achieved better service results and higher economic benefits with less resource input, which further indicates the efficient allocation of resources and the balanced operation of TCM medical service institutions.

Conclusion: The development of China's TCM medical service system shows the imbalance and inadequacy of “East is strong, West is weak” and “South is superior, North is inferior.”

Cardiovascular medicine in China: what can we do to achieve the Healthy China 2030 plan?

Cardiovascular diseases (CVDs) represent the leading cause of death in China. The Chinese government approved the Healthy China 2030 plan (jiànkāng zhōngguó 2030), emphasizing the strategic role of health in China's development. As morbidity and mortality from CVDs are constantly increasing in China, the prevention and treatment of CVDs are vital to achieve this plan. Following the major principles of health priority, science and technology innovation, scientific development, and balanced medical resource allocation outlined in the Healthy China 2030 plan, this Commentary briefly introduces the current status of CVDs in China and marks the important events undertaken to achieve this plan.

Global commitments and China's endeavors to promote health and achieve sustainable development goals

BACKGROUND

With its immense population and as the largest developing country in the world, China has made remarkable achievements in health promotion at a relatively low cost. However, China is still faced with challenges such as changes of disease spectrum, the coming era of an aging society, and the risk of environmental pollution.

MAIN TEXT

On October 25, 2016, China formally passed the blueprint of "Healthy China 2030," working towards the national goal of reaching a health standard on par with developed countries by 2030, which was also a response to realize the 2030 United Nations Sustainable Development Goals. "Healthy China 2030" is comprised of 29 chapters that cover five health areas. China is sparing no effort to transfer from being merely the most populous country, to becoming a leading nation in health education. In "Healthy China 2030," collaborated construction and resource sharing were clearly stated as the core strategy. A shift in concentration towards coordinated development of health-based economy from a previous pursuit of rapid economic growth was also underlined. There are also several major issues, such as severely aging population, the burden of chronic diseases, the insufficiency of health expenditure, and the great demand on health protection, waiting to be dealt with during the implementation process of "Healthy China 2030".

CONCLUSIONS

"Healthy China 2030" is a momentous move to enhance public health, which is also a response to the global commitments. We also need to rethink our approach to reach the living standards and maintain a better environment.