Health In China Research Articles

The Impact of Monetary Policy on Healthcare Affordability: A Case Study of China's Urban and Rural Basic Medical Insurance

Longer life expectancy and improved health are key indicators of economic growth. As such, strategies to bolster the medical security system are priorities in government budgeting. The government is dedicating all available resources to better healthcare in rural and underdeveloped areas, narrowing the urban-rural healthcare gap, and achieving equitable healthcare resource distribution. This study examines the effect of monetary policy on healthcare affordability, focusing on China's Urban and Rural Basic Medical Insurance (URRBMI). It investigates how macroeconomic policies, such as interest rates and inflation control, affect healthcare costs and shape URRBMI's financial protection. Using an integrated methodology, including a literature review, theoretical framework, and econometric analysis, the research uncovers how monetary policy impacts healthcare costs and URRBMI's effectiveness. The findings highlight the importance of monetary policy in healthcare affordability. The study recommends collaboration between monetary authorities and healthcare policymakers to improve China's healthcare system's sustainability and effectiveness. Furthermore, these insights are crucial for refining URRBMI and provide new understandings of optimizing macroeconomic policy interactions with social welfare programs.

Changes in the epidemiology of under-5 mortality in China from 2016 to 2022: an observational analysis of population-based surveillance data

Sustainable Development Goal (SDG) 3.2 aims to end preventable deaths of newborns and children younger than 5 years. China's progress towards SDG 3.2 has not been evaluated on multiple dimensions. We aimed to assess mortality rates in children younger than 5 years (hereafter referred to as under-5 mortality) and to quantify preventable child mortality and geospatial and temporal trends in child mortality in China from 2016 to 2022. In this observational analysis, we used data from the Chinese National Maternal and Child Health Surveillance System (MCHSS) for the period Jan 1, 2016, to Dec 31, 2022 and conducted all-cause mortality and cause-specific mortality analyses for different age groups (age 0-6 days, 7-27 days, 0-27 days, 1-5 months, 6-11 months, 12-23 months, 24-59 months, and birth to 59 months) separately at the national, residential (rural vs urban), and regional (eastern vs central vs western China) levels. All mortality rates were adjusted by age group, type of residency, region, and region-residency strata using a 3-year moving average of the under-reporting rates. National deaths were estimated using the number of livebirths from 2016 to 2022 from the Health Statistics Yearbook of China. Estimated national-level and regional-level mortality rates were weighted by the proportion of the population living in urban and rural areas from the 2010 national census. Optimal survival metrics for neonates and children younger than 5 years were calculated by cause of death in 2020-22 (termed the national optimum), on the basis of the lowest mortality observed among the six region-residency strata. In 2022, approximately 65 700 (95% CI 62 700-68 800) children younger than 5 years died in China, with 45·1% (42·7-47·4) of these deaths occurring in the neonatal period (age <28 days). China's under-5 mortality rate decreased from 10·2 deaths (9·9-10·5) per 1000 livebirths in 2016 to 6·8 deaths (6·5-7·2) per 1000 livebirths in 2022; the neonatal mortality rate decreased from 4·9 deaths (4·7-5·1) per 1000 livebirths in 2016 to 3·1 deaths (2·9-3·3) per 1000 livebirths in 2022. The relative risk of death in children younger than 5 years in rural areas compared with urban areas decreased from 2·4 (2·2-2·6) in 2016 to 1·9 (1·7-2·1) in 2022, and in the western region compared with the eastern region decreased from 3·4 (3·0-3·9) in 2016 to 2·3 (1·9-2·8) in 2022. The leading causes of under-5 mortality in 2022 were injuries (23·1% [21·1-25·1] of all-cause deaths), congenital malformations (14·8% [13·1-16·4]), preterm birth complications (14·1% [12·5-15·7]), intrapartum-related events (10·1% [8·7-11·5]), and acute respiratory infections (9·5% [8·2-10·9]). The leading cause of death in the neonatal period was preterm birth complications (12·8% [11·4-14·2] of deaths in children younger than 5 years). Under-5 mortality in China declined between 2016 and 2022. Disparities across regions and in urban versus rural areas narrowed over time, but they still exist. Therefore, efforts should be made to further reduce child mortality in China, including consistent investments and implementing of policies, programmes, and interventions, especially for the western rural areas. None. For the Chinese translation of the abstract see Supplementary Materials section.

Increased impacts of aircraft activities on PM2.5 concentration and human health in China

The rapid development of China’s aviation industry has caused a rapid increase in airport PM2.5 emissions. This study uses the Global Exposure Mortality Model (GEMM) to evaluate the monthly deaths caused by aircraft activities at 164 airports in China from 2015 to 2023, based on the PM2.5 concentration of airport aircraft activities and the detection data of the China National Environmental Monitoring Center, including twenty age groups, six diseases, and gender. This paper presents three main conclusions. Firstly, aviation PM2.5 emissions significantly impact mortality, with notable variations by year and season. The highest cumulative deaths are recorded in 2023, particularly in the third quarter, which peaked at 8,305 deaths. Despite the comparatively modest total of 11,604 deaths in 2022, a mere 0.2965 μg/m3 increase in PM2.5 concentration would precipitate an additional 39,138 deaths, representing a 1.05-fold rise from 2015. Secondly, the 80–84 age bracket exhibited the highest death proportion (16.51 %–18.73 %), while the 5–9 and 10–14 age groups had the lowest (0 %-0.13 %). Males aged 80–84 are the most affected demographic, with each 1 μg/m3 increase in PM2.5 leading to an additional 87 male deaths monthly in 2023, primarily from stroke and ischemic heart disease. In contrast, females only experienced 67 additional deaths per month from the same concentration increase. Lastly, airports in the economically vibrant Beijing-Shanghai-Guangzhou-Shenzhen region showed the highest mortality rates due to PM2.5 emissions. Airports in eastern coastal areas are more severely impacted than those in central and western China, revealing a spatial clustering of high death tolls in developed regions.

How digital infrastructure development affects residents' health: A quasi-natural experiment based on the “Broadband China” strategy

Health not only concerns human well-being but also affects China's long-term development and social stability. Based on the quasi-natural experiment of the “Broadband China” strategy and the data of CFPS from 2010 to 2020, this study examines the underlying mechanism of digital infrastructure development on residents' health, as well as the macro and micro heterogeneity between them. The study finds that digital infrastructure contributes to residents' health. Mechanism tests confirm that increasing residents' income and enhancing medical services are underlying approaches. Digital infrastructure is conducive to the health of middle-aged people and rural residents. In areas with heavy air pollution and the eastern region, the impact of digital infrastructure on residents' health is more prominent. This study breaks through the existing qualitative research on digital technology in the healthcare sector, integrates both micro and macro perspectives, and enriches the empirical evidence in the field of digital health. It also contributes to guiding the in-depth practice of digital health in China, enhancing the digital health management level, thus supporting the realization of “Healthy China” blueprint.

Mental Health in China: Social Change in Life Course Trajectories

AbstractKnowledge about life course trajectories and intercohort changes in mental health is limited mainly to Western populations. To address this gap, our study analyzes mental health trajectories in China, drawing on data on depressive symptoms from the China Family Panel Studies over the period 2012–2020 (N = 31,700 individuals aged 16–70; N = 87,787 person‐years). Employing hierarchical linear regression models, our findings reveal moderate increases in depressive symptoms over the life course and across cohorts. Subgroup analyses indicate that women, people with lower educational attainment, and people with rural hukou experienced more depressive symptoms and a more pronounced increase in depressive symptoms with age. These disparities narrowed across cohorts. We discuss these patterns in the context of Chinese cultural dynamics, including son preference, the impact of education and hukou on the accumulation of stress over the life course, family policy and equity policy transitions, and the changing stigma of mental health.

How significant is cost-shifting behavior under the diagnosis intervention packet payment reform? Evidence from the coronary heart disease market.

Controlling the growth of inpatient costs presents a major challenge in China's healthcare system. China introduced a new case-based payment method, the "Diagnosis Intervention Packet" (DIP), to address the surge in hospitalization expenses. However, the influence of DIP payment reform on cost shifting among coronary heart disease (CHD) inpatients remains unclear. This study focused on Zunyi, a national pilot city for DIP, utilizing inpatient claim data to assess the effects of DIP payment reform. We analyzed the influence on total health expenditures (THE), individual payments excluding reimbursement (IPER), proportion of IPER, copayments for category-B, proportion of copayments for category-B, copayments for category C, and proportion of copayments for category C per case for CHD inpatient. Results indicate a significant reduction in THE per case for CHD inpatients after the DIP reform (β = -0.1272, p < 0.01). Increases in cost shifting were observed in IPER (β = 0.1080, p < 0.05), the proportion of IPER (β = 0.0551, p < 0.01), copayments for category B (β = 0.2392, p < 0.01), and the proportion of copayments for category B (β = 0.0295, p < 0.01), along with the proportion of copayments for category C (β = 0.0255, p < 0.01). However, the copayments for category C did not significantly change. Notable variations in the effects of cost control and shifting were observed across different hospital categories, teaching statuses, hospital grades, and ownership types. The DIP reform significantly reduced the THE per case for CHD inpatients, while shifting in-policy expenditures to IPER, particularly with a greater shift intensity in the proportion of Class B compared with the proportion of Class C.

Self-Management Support (SMS) in Transition: The Case of Osteoporosis Management Support in a Chinese Hospital

AbstractSelf-management has become increasingly important with the growing population living with chronic conditions. Self-Management Support (SMS) provided in healthcare systems is essential for its success. While prior research mainly focuses on Western countries, this paper presents a study of SMS practices for osteoporosis management as part of a Whole Course Management (WCM) program recently implemented in the healthcare system in China, which features a new role called case manager in the hospital dedicated to SMS and related coordination. Based on interviews with 22 participants, including one case manager, two physicians, three nurses, seven patients, and nine caregivers, we highlight the importance of the role of case manager in promoting awareness of osteoporosis and self-management, integrated care coordination, and emotional support. At the same time, it also reveals challenges and promising directions to make SMS more effective, mainly in terms of self-management education, active patient involvement, and coordination among the care network. We ended by reflecting on our findings and discussing implications for SMS and the design of ICTs.

Understanding the Best Nutritional Management for Creutzfeldt-Jakob Disease Patients: A Comparison Between East Asian and Western Experiences.

(1) Background: Creutzfeldt-Jakob disease (CJD) is a rare and fatal neurodegenerative disorder caused by the accumulation of an altered prion protein, which usually leads to death within one year after clinical onset. CJD patients usually present with rapid cognitive impairment associated with declines in cerebellar, motor, visual, behavioral, and swallowing functions. Moreover, CJD patients lose their ability to eat and take medications orally very early on in treatment; nevertheless, there are no specific nutritional guidelines for this disease shared worldwide. (2) Methods: This review aims to describe the nutritional outcomes of CJD patients in Western countries to compare them with those described in East Asian countries and then aims to explore the most recent trends in the nutritional management of CJD patients, including some dietary compounds that present neuroprotective effects. (3) Results: In Japan's, Taiwan's, and China's healthcare systems, CJD patients receive intensive life-sustaining treatment that prolongs their survival (i.e., artificial feeding); conversely, in Western countries, intensive life-sustaining treatments like tube feeding are not commonly provided to CJD patients. (4) Conclusions: It is difficult to pinpoint the reasons for these discrepancies around CJD palliative care supply, but it is clear that specific nutritional guidelines may directly improve the nutritional management of CJD patients and thus allow their families and caregivers to ensure the best end-of-life care for these patients.

Impact of layoffs on mortality and physical health in transitional China 1989–2015

This study examines the long-term health impacts of massive layoffs from State-Owned Enterprises (SOEs) in transitional China, a period characterized by significant economic, cultural, and policy transformation. Utilizing the China Health and Nutrition Survey data from 1989 to 2014, we employ a life course framework to analyze how macro and interpersonal contexts influence mortality and physical health following job loss. Our analysis reveals that, despite short-term income disruptions and persistent income volatility, laid-off workers restored income and gained improved access to various types of health insurance over two decades. In the medium term, we observed increased mortality and cardiovascular diseases, which subsided after a decade. Notably, hypertension emerged as an outcome only after a decade of job loss. While the expansion of urban health insurance schemes contributed to reducing long-term mortality risks, the impact on other health outcomes was marginal. Contrary to patterns observed in Western developed countries, economic mechanisms in transitional China overall played only a minor role in the adverse effects on physical health outcomes. These findings highlight the importance of considering the temporal dynamics and the heterogeneity of impacts across evolving socio-cultural and policy contexts. We also discuss the social-psychological mechanisms that operate within the rich context of transitional China over several decades.

Ageing in China: Comparison of Healthcare Modes for the Elderly Population

Abstract: As China strives to meet the challenges of an ageing population, the need for an effective healthcare system for the elderly is becoming increasingly urgent. The traditional family-centred mode of care, deeply rooted in Chinese filial piety, has become inadequate in the face of modern social change. With a rapid ageing population and a rising incidence of chronic diseases, the demand for healthcare services is expected to grow significantly. This article explores the limitations of the current family-centred mode of ageing care, including the strain placed on families and the lack of adequate healthcare resources, especially in rural areas. The article argues for a shift to a community-based caring mode that provides more comprehensive and sustainable solutions by integrating specialised healthcare services in local communities. Comparing the situation in China to the community healthcare system successfully implemented in Japan, this paper highlights the potential benefits of adopting a similar strategy while taking into account China's unique demographic and regional challenges. Finally, the article argues for a more equitable and efficient healthcare system in China to meet the needs of its rapidly ageing population.

Association of residential greenness exposures on disability: Findings from the cohort study on global AGEing and Adult Health (SAGE) in China

BackgroundWith the accelerating population ageing globally, disability has become a major public concern. Residential greenness may be one of the influencing factors of disability, but epidemiological evidence in the associations of residential greenness exposures with disability is limited. We aimed to investigate the associations of residential greenness exposures with the risk of disability in the elderly. MethodsData of 8408 residents were obtained from the World Health Organization Study on Global AGEing and Adult Health (WHO SAGE) implemented in China during 2007–2018. Participants were matched to the Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) at their residential address. Disability was measured by the 12-item Chinese version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0). The associations were examined using a generalized linear mixed model with stratified analyses by the covariates. ResultsWe observed significantly negative associations of greenness exposures with the summary WHODAS score [NDVI500m: −0.290, 95% Confidence Intervals (95%CI): −0.510, −0.070; EVI500m: −0.453, 95%CI: −0.757, −0.149], and with the score of cognition (EVI500m: −0.472, 95%CI: −0.881, −0.063), mobility (NDVI500m: −0.632, 95%CI: −0.965, −0.299; EVI500m: −0.739, 95%CI: −1.199, −0.280), and participation (NDVI500m: −0.388, 95%CI: −0.651, −0.125; EVI500m: −0.530, 95%CI: −0.893, −0.166). People living alone had a more pronounced association in cognition (NDVI500m: −1.546, 95%CI: −2.471, −0.621). The associations with summary WHODAS score were stronger among participants living in rural areas (NDVI500m: −0.420, 95%CI: −0.683, −0.157), having less education level (NDVI500m: −0.618, 95%CI: −0.982, −0.253), and living in northern China (NDVI500m: −0.381, 95%CI: −0.776, 0.013). ConclusionsResidential greenness may reduce the onset and worsening of disability, particularly for domains of cognition, mobility, and social participation. Because of its stronger influence among people with low socioeconomic status, increasing greenness levels in areas with lower socioeconomic status may promote health equity.

An online review on customer satisfaction of mid-to-high-end health and wellness hotels in China

The rapid development of information technology has enabled the collection of online review data, which provides a more precise representation of hotel guest satisfaction. It is crucial to investigate the factors that impact hotel guest satisfaction as identified through online review content. This study will examine relevant scholarly literature on online reviews and concentrate on 50 mid-to-high-end health and wellness hotels in China. Python is utilized to crawl the online review database, and a comprehensive analysis is conducted on the semantic keywords and categories present in customer online review statements. Service, traffic, catering, and other variables are identified as determinants of customer satisfaction in mid-to-high-end health and wellness hotels through factor analysis. This article will propose specific measures and recommendations to improve customer satisfaction in health and wellness hotels, attract more customers, and contribute to the sustainable development of the industry.

Spatiotemporal Evolution, Driving Mechanisms, and Zoning Optimization Pathways of Ecosystem Health in China

The health status of ecosystems is an important prerequisite for ensuring regional ecological security. Exploring the spatiotemporal patterns, driving mechanisms, and zoning regulation pathways of ecosystem health is of great significance for achieving co-ordinated and sustainable regional ecosystems. This study uses China as a case area and applies the InVEST model to measure integrated ecosystem services and incorporates it into an evaluation framework for ecosystem health based on the “Vigor-Organization-Resilience-Ecosystem Services” (VORS) model. It reveals the spatiotemporal evolution characteristics of ecosystem health in China from 2000 to 2020 and employs the geodetector and spatiotemporal geographically weighted regression model to analyze the main influencing factors and spatial differentiation characteristics, thereby exploring ecological management zoning and optimization pathways. The study results show that (1) during the study period, the overall ecosystem health level in China showed a declining trend, dropping from 0.397 in 2000 to 0.377 in 2020. (2) Overall, China’s ecosystem health exhibits strong spatial positive correlation and spatial clustering characteristics, with a basic pattern of lower values in the northwest and higher values in the southeast. (3) Vegetation coverage, population density, density of road network, and per capita GDP are the main influencing factors of ecosystem health in China. (4) China is divided into five types of Ecological Management Zones: Ecological Conservation Zone, Ecological Enhancement Zone, Ecological Buffer Zone, Ecological Remediation Zone, and Ecological Reshaping Zone, with differentiated strategies proposed for optimizing ecosystem health in each zone.

A cross-sectional study of anesthesia medical staff's occupational and health status in nongovernment medical institutions in China.

Nongovernment medical institutions have gradually become a significant part of China's healthcare system, with a growing numbers of staff. However, the current status of anesthesiology staff in these institutions is unclear. To gain insight into this situation and to compare it with public hospitals, the national anesthesia professional committee of the Chinese Nongovernment Medical Institutions Association (CNMIA) designed and conducted the national cross-sectional survey. We conducted a national cross-sectional study to investigate the occupational and health status of anesthesiology staff in Nongovernment medical institutions. Additional questions were included for the directors of the anesthesiology department to understand their work stress and the reasons for employee turnover. The electronic questionnaire was created using Questionnaire Star and distributed by Anesthesia Professional Committee of the CNMIA through the QR code links and WeChat. A total of 1111 questionnaires were collected, including 989 from anesthesiologists and 122 from nurse anesthetists. The overall job satisfaction score (MSQ) was 75.57 ± 12.32 and the average fatigue score (MFI-20) was 49.10 ± 10.90. High-risk factors for severe fatigue included being aged 31-40, holding a middle title, frequently working night shifts, having long working hours, and participating surgeries classified as ASA III or higher. The most common disease reported was difficulty falling asleep/insomnia. Multivariate logistic regression analysis showed that men (OR = 0.662, 95% CI: 0.482-0.909, p < 0.05), those with a bachelor's degree (OR = 2.152, 95% CI: 1.186-3.903, p < 0.05), individuals with heavy workloads (OR = 2.999, 95% CI: 1.493-6.024, p < 0.01), poor health (OR = 4.280, 95% CI: 1.216-15.057, p < 0.05), and high MFI-20 scores (OR = 1.085, 95% CI: 1.067-1.103, p < 0.001) were more likely to suffer from insomnia. Directors identified medical quality and safety management as their main source of stress and low income as the primary reason for employee resignation. Nongovernment medical institutions have fewer employees, similar workloads, relatively low job stress and higher job satisfaction compared to public hospitals. Low income and difficulty falling asleep/insomnia are significant issues that require attention.

Global Rounds: Advancing Cardiovascular Health in China.

Global Rounds: Advancing Cardiovascular Health in China.

Research on healthcare data sharing in the context of digital platforms considering the risks of data breaches.

Within China's healthcare landscape, the sharing of medical data has emerged as a pivotal force propelling advancements in the insurance sector and enhancing patient engagement with healthcare services. However, medical institutions often exhibit reluctance toward data sharing due to apprehensions regarding data security and privacy safeguards. To navigate this conundrum, our research introduces and empirically validates a model grounded in evolutionary game theory, offering a robust theoretical framework and actionable strategies for facilitating healthcare data sharing while harmonizing the dual imperatives of data utility and privacy preservation. In this paper, we construct an evolutionary game model involving medical institutions, big data innovation platforms, and insurance companies within the context of digital platforms. The model integrates exogenous causes of data breaches, endogenous causes of data breaches, compensation payments, government penalties, subsidies, unreasonable fees, claims efficiency, and insurance fraud. The stability analysis of the evolutionary game identifies eight equilibrium points among medical institutions, platforms, and insurance companies. Numerical simulations demonstrate convergence toward strategy E 7 = (0, 0, 1), suggesting a trend for medical institutions to adopt a fully anonymous information-sharing strategy, platforms to implement strict regulation, and insurance companies to opt for an auditing approach. Sensitivity analysis reveals that the parameters selected in this study significantly influence the players' behavioral choices and the game's equilibria. When breaches occur, medical institutions tend to seek co-sharing between platforms and insurance companies. This promotes enhanced regulation by platforms and incentivizes insurance companies to perform audits. If the responsibility for the breach is attributed to the platform or the insurance company, the liability sharing system will push healthcare organizations to choose a fully anonymous information sharing strategy. Otherwise, medical institutions will choose partially anonymous information sharing for more benefits. In case of widespread data leakage, the amount of compensation shall augment, and the role of compensation shall replace the role of government supervision. Then, the government shall penalize them, which shall reduce the motivation of each subject.

Environmental pollution, trade openness and the health of middle-aged and elderly people: an analysis of threshold effect based on data from 111 prefecture-level cities in China

BackgroundEnvironmental pollution seriously endangers people’s physical and mental health, especially the health of middle-aged and elderly people. Environmental pollution, trade openness, and population health are interconnected. Environmental pollution may have a nonlinear impact on health, and the impact of trade openness on the health effects of environmental pollution may not be a simple strengthening or weakening effect. However, few studies have used threshold effects model to explore the nonlinear mechanisms of environmental pollution’s impact on health in China. As a result, this study incorporates trade openness into the research framework on the health effects of environmental pollution, aiming to study the mechanism of environmental pollution on health.MethodsUsing the China Health and Retirement Longitudinal Study (CHARLS) data from 2013 to 2020 and the data of 111 prefecture-level cities in China, we combine two-way fixed-effects models and threshold models to explore the effects of environmental pollution on the health of middle-aged and elderly people and the role of trade openness in the path of environmental pollution affecting health.ResultsEnvironmental pollution impairs the health of middle-aged and elderly people, and there is a single threshold effect and regional heterogeneity in this negative impact. Trade openness has the effect of first weakening and then strengthening in the inhibitory effect of environmental pollution on health.ConclusionThe negative impact of environmental pollution on health has regional heterogeneity, and there is a nonlinear relationship between environmental pollution and the health of middle-aged and elderly people. The health effect of environmental pollution is mainly long-term effect, and trade openness has a threshold effect on the impact of environmental pollution on health. Therefore, instead of adopting a one-size-fits-all policy, environmental and economic policies should be customized according to the degree of environmental pollution, trade openness, and regional variations, so as to safeguard the health of middle-aged and elderly individuals through effective environmental governance.

Improvement of Care Cascade for Hypertension and Diabetes in Rural China: Protocol for an Implementation Study.

The management of hypertension and diabetes poses significant challenges to China's healthcare system, necessitating seamless patient progression through screening, diagnosis, management, and control. Utilizing the care cascade model, this study aims to systematically identify patient drop-offs and devise strategies to address healthcare delivery bottlenecks for hypertension and diabetes in rural China. This study consists of three phases. In Phase 1, qualitative interviews are conducted to explore healthcare experiences and identify determinants across the care cascade. Phase 2 involves systematically assessing barriers identified in Phase 1 and collaborating with local stakeholders using intervention mapping and co-design to generate interventions and implementation strategies. Phase 3 is a cluster randomized controlled trial involving 48 villages, randomly assigned in a 1:1 ratio, to compare changes in hypertension and diabetes care. Intervention villages will implement interventions developed in Phase 2 for 1 year, while control villages will continue with usual care. Primary outcomes include between-group differences in achieving blood pressure and glycemic targets, along with service and implementation outcomes. This study aims to identify the stage with the largest patient retention gap in the care cascade and develop intervention strategies through participatory co-design with practitioners, emphasizing feasible, low-cost approaches. The pragmatic cluster RCT will assess strategy effectiveness, offering valuable insights for practical interventions to enhance hypertension and diabetes care in rural settings, potentially shaping impactful programs and improving healthcare outcomes. Trial Registration: ClinicalTrials.gov. identifier: NCT06141278.

Retrospective Analysis of the Epidemiological Evolution of Brucellosis in Animals - China, 1951-1989 and 1996-2021.

Brucellosis poses a significant threat to public health in China. This study utilized a range of epidemiological indices, including seroprevalence and the number of reported cases, to illustrate the epidemic profile of the disease. Although the seroprevalence of brucellosis in animals (including sheep, goats, cattle, and swine) steadily decreased from a severe epidemic level in the 1950s to a low endemic level by 1989, the disease reemerged in 2000. Subsequently, there has been a persistent increase in the frequency of outbreaks and the number of reported cases from 2006 to 2021, with over 98% of reported cases occurring in sheep and cattle. During this period, the culling rate declined, while infection rates increased, nearly reversing their respective trajectories. The decrease in the culling rate of positive animals coincided with an increase in infection rates, indicating that infection among these animals was persistent and circulating. In the southern regions of China, 6.34% (34,070 of 537,797) of cases were reported between 2006 and 2021, whereas in the northern regions, 93.67% (503,727 of 537,797) of cases occurred during the same timeframe. Each time cases increased in the south, they lagged 2 to 5 years behind those in the north, suggesting that stringent control measures for sheep and cattle in the north should be prioritized. These findings provide critical insights into developing control strategies to mitigate the spread of the disease.

Big data from population surveys and environmental monitoring-based machine learning predictions of indoor PM2.5 in 22 cities in China

Many studies have confirmed that PM2.5 exposure can cause a variety of diseases. Because people spend most of their time indoors, exposure to PM2.5 in indoor environments is critical to population health. Large-population, long-term, continuous, and accurate indoor PM2.5 data are important but scarce because of the difficulties in monitoring the indoor air quality on a large scale. Model simulation provides a new research direction. In this study, an advanced machine learning model was constructed using environmental health big data to predict the daily indoor PM2.5 concentration data in 22 typical air pollution cities in China from 2013 to 2017. The test R2 value of this model reached as high as 0.89, and the RMSE of the model was 9.13. The predicted annual indoor PM2.5 concentrations of the cities ranged from 54.6 μg/m3 to 82.7 μg/m3, and showed a decreasing trend year by year. The pollution level exceeds the recommended AQG level of PM2.5 and has potential impact on human health. The results could take a breakthrough in obtaining accurate big data of indoor PM2.5 and contribute to research on the indoor air quality and human health in China. SynopsisThis study established a machine learning model and predicted indoor PM2.5 big data, which could support the research of indoor PM2.5 and health.