China California Heart Watch

Description

The impact of recent Chinese economic reforms is known above all for its positive effects: the development of agricultural production and of industry, the creation of wealth in the industrial and banking centers and the creation of a Chinese middle class. However vast regions of the Chinese countryside are in social decline. Evidence for a growing economic gap between the well to do of the cities and impoverished farmers is omnipresent. At the base of the glass towers of Shanghai, the rag tag peasants from the western provinces and regions drag their enormous loads. In the freeway underpasses of Beijing, they sleep, half frozen in the icy winter. But as miserable as these migrants from the rural provinces seem in the prosperous metropolises, their impoverishment is even worse in the places they came from. Their villages have no running water or electricity, no paved roads, often no schools and most importantly for this observer, no doctor, no clinic, nowhere to turn when illness strikes. The poorer peasants in the west see their situation getting worse every year. The Chinese country health care delivery system has not escaped the upheaval caused by the privatization of the economy. It charges fees, while disregarding any aspects of its task that do not bring in cash. Median family incomes in many parts of western China are less than $100 per year yet a day in the hospital can cost $25 and when medicines, procedures and other services are added this can exceed $50. Health insurance is western provincial country side is non-existent. Cardiac disease in China is on the rise. Though increases in heart disease incidence have increased faster in the city than in the country side, rural morbidity and mortality rates are now on the rise as well. This rate has approximately doubled since 1988. Unlike in the United States and western Europe, there is no preventive or primary health care system in place to stop this rise. In fact, the real extent of heart disease in rural China is unknown because statistics like these are fraught with error and bias due to difficulties in ascertaining cause of death in places where 90% die without seeing a doctor. A lot clearly needs to be done to ascertain the real incidence and prevalence of heart disease and to develop adequate preventive and primary care in the Chinese countryside.