The pathways to living longer and healthier
Print Edition
THE theme of the 2010 Shanghai Expo, “better city, better life,” was not a cosmetic platitude. The city has undertaken strenuous efforts to improve the living condition of its residents, and good public health forms an important plank of that strategy.
In 2003, Shanghai initiated its Healthy City campaign, based on five lifestyle pillars: proper exercise, tobacco control, food safety, quality healthcare services and a wholesome environment. These aspects are now embedded in government policymaking and urban planning.
In tandem with the Healthy City campaign, the city government has enhanced environmental protection efforts and expanded the public healthcare system.
The city’s efforts are in line with the “Healthy Cities and Villages” global strategy initiated by the World Health Organization in 1986.
WHO defines a healthy city as one that continually creates and improves physical and social environments, and expands community resources to enable people to mutually support one another in developing their maximum potential.
“Healthy City is actually a broad concept requiring multi-departmental cooperation,” said Li Zhongyang, head of the Shanghai Health Promotion Association, which is responsible for the Healthy City campaign. “Authorities like health, environmental protection, transportation, sports and urban planning have made it a priority and are working together to attain that goal.”
In addition to governmental support, the campaign needs the participation of the public. The first lines of defense against poor health are people themselves, people embracing a healthy lifestyle and sticking to it — not always an easy task.
“Research shows that a person’s health is determined by several key factors: 15 percent from genetics, 17 percent from the environment, 8 percent from healthcare services and 60 percent from lifestyles,” Li said. “How to educate people on healthier lifestyles is a top task for us. So we have devised ‘tools,’ like salt spoons, oil bottles, diet pyramid refrigerator magnets, to help families design and control their food intake.”
To address chronic disease, Shanghai set up a community-based chronic disease management network, encouraged the emergence of family doctors to relieve the burden in hospitals, established community health clinics, upgraded surveillance of workplace health and safety, and promoted the message of healthy lifestyle choices in schools and neighborhoods.
“The chronic disease management network encourages people, especially the elderly, to form groups where they can together learn about disease prevention and get advice from medical personnel,” Li said. “It makes a health lifestyle a social undertaking, where people can help people. Such a network has been recognized by WHO and called ‘the Shanghai model.’”
The efforts are paying off. Shanghai’s health statistics are at the top of the chart nationwide and meet international standards.
The city has had 5,016 medical facilities by the end of 2015, with 122,800 beds and 208,600 staff.
Life expectancy in Shanghai last year was 82.75 years — 80.47 for men and 85.09 for women.
The mortality rate of pregnant women fell to as low as 4.16 for every 100,000 women holding residency permits. The rate for migrant women was higher because of poorer awareness about prenatal health.
The infant mortality rate was as low as 2.46 for every 1,000 registered households.
Hospitals in Shanghai are among the biggest and most advanced in China, serving not only local residents but also out-of-towners seeking the best medical care the country has to offer. In fact, at some leading hospitals, more than half of patients come from other provinces.
Local hospitals and clinics offered 265 million individual services last year, including 247 million outpatient and emergency services.
But the city has not rested on its laurels in pursuing health reforms. It has phased out the practice of hospitals selling medicine for profit and increased some patient fees to compensate for the lost revenue.
In addition, it has encouraged a comprehensive system of public and private hospitals, including foreign-owned and joint-venture facilities.
Two international medical zones are now under construction. There, international and domestic hospitals and clinics will offer high-end services to expatriates and to Chinese with specialized medical needs.
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