Health status differentials in the People's Republic of China

Objectives. This study sought to demonstrate that health status varies markedly in different parts of China. Methods. The main source of data was statistics compiled by the Chinese Ministry for Public Health for 1978 to 1990 regarding causes of death. However, because mortality statistics in China are based on localities that have the capacity to provide data, they are not entirely representative. The international classification of disease categories was also used, together with anatomically based disease descriptions. Rates were calculated using the 1982 and 1990 population censuses. Results. Death rates differ markedly between urban and rural areas. Deaths due to infectious diseases, respiratory diseases, pregnancy and childbirth, and injuries and poisoning are much higher in rural areas; those due to pertussis, dysentery, typhoid, hepatitis, rabies, and anthrax are much more common in the apparently poorer provinces. Schistosomiasis remains a major problem in some provinces. Goiter and cretinism are still major diseases in many parts of China, especially those areas with iodine deficiency. Conclusions. Cause-of-death patterns in Chinese cities are similar to those of industrially developed countries such as Australia, Japan, and the United States. Such patterns in the poorer rural areas are much more typical of those of developing countries.