Global Health: Approaches to improving the Quality of Life in the US and China

1. Global Health: Approaches to improving the Quality of Life in the US and China

2. Basic concepts • Life expectancy: The average number of years of life remaining at a given age • Mortality or death rate: The average annual number of deaths during a year per 1,000 population at midyear; also known as crude death rate • Morbidity: A diseased state, disability, or poor health due to any cause. The term may be used to refer to the existence of any form of disease, or to the degree that the health condition affects the patient.

3. Demographics: Life Expectancy Figure Life Expectancy at Birth across the countries in the world

4. Demographics: Death Rate Figure Distributes of death rates across the countries in the world (per 1,000 population)

5. Demographics: Infant Mortality Figure Distributes of infant mortality across the countries in the world (Infant mortality: the number of deaths of infants under one year old in a given year per 1,000 live births in the same year)

6. The United States

7. Life Expectancy Figure Life expectancy at birth, by race and sex: United States, 1975–2007 final and 2008–2009 preliminary

8. Life Expectancy Table Life expectancy at birth by race and sex: United States 2008 and 2009

9. Approaches to Extending Life Expectancy • Living a healthy social and family life • Going outside • Engaging in regular physical activity • Not smoking • Eating a plant-based diet and frequent consumption of legumes and nuts • Limiting alcohol consumption • Sleeping 7 to 8 hours per night • Screening and tests • Not taking unnecessary risks

10. Death Rates Figure Crude and age-adjusted death rates in the United States, 1980–2007 final and 2008–2009 preliminary

11. Leading Causes of Morbidity and Death in the US The leading causes of morbidity and mortality in 2009 in the United States 1. Diseases of heart 2. Malignant neoplasms 3. Chronic lower respiratory diseases 4. Cerebrovascular diseases 5. Accidents (unintentional injuries) 6. Alzheimer’s disease 7. Diabetes mellitus 8. Influenza and pneumonia 9. Nephritis, nephrotic syndrome and nephrosis 10. Intentional self-harm (suicide) 11. Septicemia 12. Chronic liver disease and cirrhosis 13. Essential hypertension and hypertensive renal disease 14. Parkinson’s disease 15. Assault (homicide)

12. Leading Causes of Morbidity and Death in the US Table Deaths and death rates for 2009, and age-adjusted death rates and percent changes from 2008 to 2009 for the 15 leading causes of death

13. Major Risk Factors • Poverty • Tobacco use • Obesity • Physical inactivity

14. Obesity Facts • Percent of adults age 20 years and over who are obese: 34% (2007-2008) • Percent of adults age 20 years and over who are overweight (and not obese): 34% (2007-2008) • Percent of adolescents age 12-19 years who are obese: 18% (2007-2008) • Percent of children age 6-11 years who are obese: 20% (2007-2008) • Percent of children age 2-5 years who are obese: 10% (2007-2008)

15. Obesity Rate (2010) in the US

16. Child Obesity Program • Coordinated School Health(CSH): model of support connecting students’ health and their capacity to learn through the support of families, communities and schools all working together in a coordinated and cost-effective manner

17. Infant Mortality Table Infant deaths and infant mortality rates, by age and race and Hispanic origin: United States (Rates are per 1,000 live births)

18. Leading Causes of Infant Mortality Table Infant deaths and infant mortality rates for the 10 leading causes of infant death: United States (Rates are per 100,000 live births)

19. Approaches to Reducing Infant Mortality • U.S. has made slower progress than most other industrialized countries in reducing infant mortality • Since 2000, progress has stalled. In 2000, the U.S. infant mortality rate was 6.9 deaths per 1,000 live births; in 2009, it declined slightly to 6.4 • Progress in reducing risk has benefited infants mainly after the first month of life. There has been less improvement in newborns’ chances of surviving the first days and weeks of life

20. Approaches to Reducing Infant Mortality • Take A lifespan approach to maternal and infant health • Make infant and maternal health a priority of health care reform • Provide effective monitoring and treatment of chronic diseases in women • Provide health education and preconception counseling • Increase awareness among prospective parents that good decision-making begins before their babies are born • Ensure timely prenatal care for all women • Address the barriers to prenatal care • Fully implement and enhance Medicaid policies and other programs that provide health care to women of childbearing age • Focus on timing and content of prenatal care • Help women make behavioral changes

21. Approaches to Reducing Infant Mortality • Address racial and ethnic disparities in infant mortality • Expand access to high-quality neonatal intensive care • Increase understanding of racial and ethnic disparities • Illuminate the relationship between low birthweight and infant mortality • Increase understanding of economic and educational factors • Support research that takes into account the multiple factors that affect infant mortality • Support research that links environmental and cultural factors with individual characteristics

22. Approaches to Reducing Infant Mortality • Sustain efforts to prevent infant mortality after the first month of life • Sustain efforts to promote breastfeeding, especially among African American mothers • Ensure access to well-baby and sick-baby care • Sustain SIDS public education campaigns and intensify information campaigns for child care providers • Expand programs for the prevention of child abuse and neglect

23. People’s Republic of China

24. Life Expectancy in China

25. Life Expectancy in China Table Comparison of life expectancy in China, US and world, 2009

26. Increasing Elderly Population in China Figure Percentage of 65+ years old population in China

27. Death Rates in China Figure Death rate (deaths/1,000 population)

28. Leading Causes of Death in China

29. Strategies to reduce mortality in China • Reduce pollution • Water pollution • Air pollution • Reduce smoking

30. Water Pollution Facts • About one third of the industrial waste water and more than 90 percent of household sewage in China is released into rivers and lakes without being treated • One sixth of China’s population is threatened by seriously polluted water • A study by China’s Environmental Protection Agency in February 2010 said that water pollution levels were double what the government predicted them to be mainly because agricultural waste was ignored • An estimated 980 million people drink water every day that is partly polluted, containing dangerous levels of arsenic, fluorine and sulfates • 68 percent of the Chinese interviewed said they were concerned about water pollution

31. Water Pollution

32. Air Pollution Facts and Details • One third of 113 cities surveyed failed to meet national air standards in 2009 • According to the World Bank 16 of the world’s 20 cities with the worst air are in China • Only 1 percent of the China’s 560 million city dwellers breath air considered safe by European Union standards according to a World Bank study • Coal is the number one source of air pollution in China • 74 percent of the Chinese interviewed said they were concerned about air pollution based on a survey by the Pew Research Center

33. Air Pollution in China

34. Smoking Problems • 320 million people in China are current smokers • Estimated 28.1% of adults in China (52.9% of men and 2.4% of women) were current smokers • 23% physicians are current smokers (41% males and 1% females) • Estimated 20.6 % of US adults aged >18 years are current smokers (23.5% men and 17.9% women) • 3.3% physicians in the US are current smokers

36. Regulations on No-Smoking in Public Places in Beijing Smoking is forbidden in the following public places: • Indoor areas of medical organizations • Infant institutions and kindergartens • Middle schools, primary schools, mid-level vocational schools • Universities and other teaching areas of educational and training organizations • Theatres, music halls, exhibition halls, museums, art galleries, libraries, science and technology museums, archives, children’s palaces, memorial halls and other places for science & teaching, culture and art • Business center of commerce, finance, post and tele-communications • Inside buses, taxis, rail transits and other public transportation tools, related ticket offices and indoor platforms • Cultural relics protection units open to the public • Gymnasiums • Contest area and seating area of stadium These regulations are enacted from May 1st, 2008

37. Tobacco Control Organizations in China • Ministry of Health • China CDC- National Tobacco Control Office • WHO Collaborating Center for Tobacco or Health • China Association On Tobacco Control • National Health Education Institute

38. Infant Mortality

39. Trends in Child Mortality Figure Trends in mortality rates (per 1000 livebirths) in China during 1990-2008 in neonates (<1 month), postneonatal infants (1—11 months), and all children (<5 years)

40. Leading Causes of Child Death in China • Pneumonia • Birth asphyxia • Preterm birth complication • Congenital abnormality • Accidents • SIDs • Diarrhea

41. Leading Causes of Child Death in China Figure Trends in proportional contribution of most common causes of child deaths in China to the total number of deaths during 2000–08

42. Strategies to reduce Child Mortality • I want to leave this to our discussion