The risk of success: cultural determinants of chronic disease and sexually transmitted infections among urban Chinese men

Abstract

During the 1950s and 1960s, the People's Republic of China successfully waged a series of public health campaigns to control the infectious diseases that were ravaging them as a nation. This included a campaign that targeted the social roots of sexually transmitted infections (STIs). China is now facing a new disease profile that includes emerging epidemics of chronic disease as well as reemerging epidemics of STIs. Many of these diseases are strongly associated with gender and occupation, suggesting need for a critical model of health literacy that recognizes the role of social risk in promoting risky behaviors rather than focusing on a simple model that disseminates knowledge about biomedical risk. Such a model is useful for explaining why people armed with knowledge about biomedical risk continue to engage in risky behaviors. This article focuses on the social risks that wealthy Chinese businessmen and government officials negotiate on a daily basis. It highlights the concept of guanxi that is so central to building relationships in China and explains the traditional process of yingchou used to establish and maintain relationships among this cadre of men who depend on one another for political and economic success. This process, which has become pervasive in China's era of market reform, requires men to engage in frequent practices of smoking, drinking, eating and female-centered entertainment that are contributing both to their success and to their increasing vulnerability to chronic disease and STIs. The paper concludes by offering some alternative approaches to addressing this emerging disease pattern among this particular segment of China's population.