Chinese Counties Research Articles

Changes in Geographic Variation and Socioeconomic Inequalities in Esophageal Cancer Mortality in China, 1973-2017.

Geographic variability in esophageal cancer has been reported in China, but data are lacking at the local level. We aimed to investigate changes in disparities in esophageal cancer-related mortality among Chinese counties and whether county-level socioeconomic status was associated with this variation. We used data from a nationwide survey and population-based cancer registries to calculate esophageal cancer-related mortality rates for 782 Chinese counties for the periods of 1973-1975 and 2015-2017. We performed hotspot analysis to identify spatial clusters. We used a multivariable negative binomial regression model to estimate the associations between county-level socioeconomic factors and mortality. From 1973-1975 to 2015-2017, the age-standardized esophageal cancer-related mortality rate decreased from 27 to 8 per 100,000 person-years in China. By county, 577 (74%) of 782 counties experienced decreasing mortality. Geographic disparities in mortality substantially narrowed, with the gap in mortality rates between 90th and 10th percentile counties decreasing from 55 per 100,000 person-years in 1973-1975 to 16 in 2015-2017. However, clusters of elevated rates persisted across north-central China. Rurality [adjusted mortality rate ratio (MRR) 1.15; 95% confidence interval (CI), 1.10-1.21], per capita gross domestic product (adjusted MRR, 0.95; 95% CI, 0.91-0.98), and percentage of people with a high-school diploma (adjusted MRR, 0.86; 95% CI, 0.84-0.87) in a county were significantly associated esophageal cancer-related mortality rates. China has made substantial progress in reducing esophageal cancer-related mortality and disparities, but the intercounty differences remain large. Continued efforts are needed to address the geographical and socioeconomic disparities in esophageal cancer.

Rapid socioeconomic change represented by catering industry contributes to poverty eradication in China

Poverty is a severe problem faced by all nations. Eradicating poverty tops first in the Sustainable Development Goals. The elimination of poverty requires an understanding of what are the key contributors to poverty reduction, which makes it crucial to track the progress of poverty elimination for effective policy intervention and adjustment. Nevertheless, most present studies are limited to poverty prediction at a certain point in time, with less research conducted to investigate the dynamic spatial determinants of poverty eradication. China successfully eliminated extreme poverty at the end of 2020, and thus is a good example to investigate what causes poverty and how it is eradicated. Concerning the poverty reduction in China from 2014 to 2020, we combine multi-source geospatial data and random forest to answer what spatial factors cause poverty and which ones contribute most to poverty eradication. Results indicate that urbanization level and commercial development are the top two contributors to poverty identification, and they inherently determine the occurrence of poverty. It is interesting to observe that the rapid change of socioeconomic features represented by the restaurants is the major determinant in the process of poverty elimination. We suppose the multiple poverty alleviation pathways have led to the development of the catering industry, which helps lift the counties out of poverty. Overall, all the Chinese counties are moving towards a more balanced development with decreasing differences between poverty-stricken and non-poverty counties plus a decreased Gini index from 2014 to 2020. This comprehensive analysis benefits us in the understanding of the spatial determinants of poverty identification and elimination in China, which provides a solid example of poverty reduction in other developing countries.

Spatiotemporal evolution pattern and simulation of the coupling of carbon productivity and land development in the Yangtze River Delta, China

It is important to explore the spatiotemporal characteristics of the coupling of carbon productivity (CP) and the land development degree (LD) in Chinese counties and to simulate the development trend of their collaborative evolution. In this study, first, the spatiotemporal evolution patterns of the regional CP and LD in the Yangtze River Delta from 2003 to 2017 were analyzed. Then, the coupling coordination model and kernel density estimation method were used to reveal their coupling characteristics. Finally, two types of Markov transition matrices were constructed to empirically analyze the dynamic change rule of their coordinated development, and their long-term evolution trends were simulated under different neighborhood characteristics. The results revealed that the CP initially decreased and then rapidly increased from 2003 to 2017, while the LD continuously decreased from 13.2 thousand people/km2 in 2003 to 10.9 thousand people/km2 in 2017. The coupling coordination degree (CCD) between the CP and LD exhibited a two-stage decline, followed by a rise over the past 15 years, with the CCD level shifting downward in 19.68% of the counties and upward in 19.05% of the counties. The transition of the CCD level had a significant spatial spillover effect. If adjacent to counties with a low CCD for a long period of time, the proportion of the counties with a low CCD would increase to 61.65%, while long-term neighboring counties with a high CCD would eventually stabilize the percentage of counties with a high CCD at 61.83%. Incorporating the spatial spillover effect into low-carbon land management at the county level can offer scientific direction for advancing low-carbon land development.

Poverty alleviation and rural revitalization: Perspective of fiscal spending and data evidence from 81 Chinese counties

This paper builds a theoretical model of government performance functions for poverty alleviation using county-level panel data from 81 counties in China from 2014 to 2019. It uses a Panel-Tobit model and mechanism tests to verify the effect of fiscal policies on poverty reduction, and consolidates the robustness of the results through a series of extended methods, such as endogeneity treatment, robustness tests, and heterogeneity analysis. The results show that (1) poverty-related allocations can significantly reduce poverty incidence, and the effect of poverty reduction is more pronounced in poor counties; (2) public spending can significantly reduce poverty incidence, and the effect of poverty reduction through public spending is more pronounced in the sample of poor counties and nonfunded pilot counties; (3) poverty reduction can affect poverty incidence through primary and secondary industry development, and the effect of poverty reduction through primary industry development is more significant, while public spending does not affect poverty incidence through primary and secondary industries; and (4) improving health services can reduce poverty to a large extent, while education development has no effect on poverty reduction due to the long return cycle. This study suggests increasing the size of poverty-specific allocations and public spending, strengthening industry support, and implementing differentiated policy initiatives according to local conditions to improve the impact of poverty reduction.

The local technology spillovers of multinational firms

This study examines how innovation by U.S. multinational firms affects the productivity of domestic Chinese firms in the same counties as the U.S. subsidiaries. After manually matching U.S. multinational firms with their manufacturing subsidiaries in China, I use citation-weighted patent stock to measure U.S.-produced external knowledge in Chinese counties and employ an instrumental variable strategy based on U.S. R&D tax credit policies to address potential endogeneity concerns. Findings suggest that innovation by U.S. multinational firms improves the productivity of domestic Chinese firms co-located with their subsidiaries, indicating a local technology spillover effect. Domestic firms with high-wage workers, high innovation capacity, and private ownership are better equipped to absorb these spillovers. In addition, domestic firms in industries with closer technological ties to U.S. multinational firms benefit more from their innovation, suggesting that technological proximity amplifies the spillover effect.

Understanding land-use sustainability with a systematical framework: An evaluation case of China

Appraisals of land-use sustainability (LUS) are indispensable for the attainment of sustainable land-use planning and management. At present, China is experiencing a pivotal phase of comprehensive reform in land-use policy, engendering a practical necessity for system-oriented land evaluations. Despite this, studies focused on national-scale systematic LUS evaluation remain scarce. Within this context, we developed a hierarchical structural framework for land-use systems based on the assumption that sustainable land-use systems adapted to development needs have mutually adaptable internal subsystems and fewer conflicting system elements. Employing this framework, we assessed the LUS across Chinese counties from 2000 to 2015 by using a newly introduced static equilibrium equation；we also analyzed the natural and socioeconomic influences and driving effect of land-use change to LUS. Findings reveal a significant spatial clustering and urban-rural differentiation within the LUS spatial pattern. Five LUS hot and cold spots and eight metropolitan areas with poor LUS were identified. Furthermore, conflicting land capability elements and the non-adaptability of land function subsystems with capability subsystems are the primary constraints on LUS; gross domestic product (GDP), population growth, and the GDP growth per unit land area had the most significant impacts on LUS; The transformation of construction and cropland into ecological land and the re-purposing of grassland into building land are primary drivers of LUS. Our findings highlight the prospective utility of the proposed LUS framework in integrated natural resource management and territorial spatial planning. Meanwhile, Insights from this evaluation case could be harnessed to optimize land-use in critical regions (including northern arid and semiarid regions, the Qinghai–Tibet Plateau region, the poverty belt around the capital, Yangtze River Delta and Pearl River Delta metropolitan areas, as well as Fuzhou and Xiamen metropolitan areas), thereby enhancing land management decision-making processes.

Bridging the gap between smallholders and modern agriculture: Full insight into China's agricultural cooperatives

Smallholders are prevalent worldwide. Agricultural cooperatives are often considered an effective instrument for bridging the gap between smallholders and modern agriculture because they enable large-scale production and ensure the quality of agricultural products. This study aims to provide quantitative evidence on the role of cooperatives in boosting macro-level agricultural economic growth using unbalanced panel data of 1866 Chinese counties between 2007 and 2019. The results show that the number of cooperatives at the county level exerts an ‘inverted U-shaped’ effect on agricultural economic growth, while the average membership size of cooperatives has a ‘U-shaped’ effect on agricultural economic growth. Cooperatives with no farmer members or capital contribution can be considered ‘fake’ cooperatives. However, these ‘fake’ cooperatives do not hamper the agricultural economy. Furthermore, capital accumulation is a critical mechanism through which agricultural cooperatives bridge the gap between smallholders and modern agriculture. On the contrary, government subsidies to agricultural cooperatives do not contribute to agricultural development. Based on the findings, this study recommends to drive out ‘fake’ cooperatives without farmer members or accumulated capital to promote the development of ‘genuine’ cooperatives. Moreover, establishing an appropriate membership size and promoting capital accumulation are also important to enhance the effectiveness of agricultural cooperatives in developing modern agriculture.

The Impact of Rural Enterprise Park Policy on the Income of Rural Residents: Evidence from China

Improving the income of rural residents plays an important part in sustainable rural development. Using a difference-in-difference (DID) approach and Chinese counties’ data from 2014 to 2019, this paper evaluates the effects of the rural enterprise park policy on the income of rural residents. We find that the policy significantly promotes rural residents’ income, and a series of additional tests suggest that the effects appear robust. We also find that stimulating entrepreneurial activities serves as a channel through which the policy affects rural incomes. Finally, the policy effects are mainly significant for counties with a higher level of human capital, a younger demographic age structure, and a higher level of financial development.

4세기 초․중반 慕容部․前燕과 高句麗의 유이민 수용

This article examines the cases of Murong Bu, Former Yan, and Goguryo's acceptance of Wandering people in the early and mid-4th century, and uses this as a basis to examine the backgrounds and modes of acceptance, and the impact of the Wandering people on both countries. Murong Bu sought to seize hegemony in East Asia through the establishment of a Chinese ruling order that claimed loyalty to Xi Jin, and actively accepted Hanren as one of the measures of the loyalty policy. Murong Bu appointed a number of key Hanren figures to government positions based on their merit and led the country with them, and established the Qiao Jun to keep Hanren migrants in line. Through this loyalty policy and the active acceptance of Koreans, Murong Bu was able to establish the political organization of Western Jin and build the foundation of an agrarian economy. Goguryeo took advantage of the competitive acquisition of Hanren by the states of Huabei in the early fourth century to accommodate them. However, compared to other countries, it was relatively difficult to expect voluntary migration, so it mainly secured Hanren through plunder of Chinese counties (Junxian), and strongly controlled and managed them while locating them near the cities, and mobilized them for Yaoyi. Goguryeo wanted to achieve national development by securing Hanren, but securing Hanren through plundering Chinese counties was limited. Therefore, they sought to secure the people of Murong Bu and Former Yan on behalf of the Hanren to disrupt them internally and increase military power.

고고자료로 본 3~6세기 고성지역 정치체의 성장과 변천

Through archaeological data, this paper attempted to examine the process of transitional changes according to changes in the spatial domain of political bodies originating and growing in the Goseong area from the 3rd to the mid-to-late 6th century. Since about 1,800 years ago, the sea level in the Goseong area has risen again, making it possible to call port through Goseong Bay, and in the Goseongcheon alluvial plain area, freshwater lakes were formed, securing temporary land. Dongoe-dong Shell Mound is a central settlement formed around the 3rd and 4th centuries in Goseong Bay, and it can be seen that contemporary people divided the space according to functions such as squares, residences, steel facilities, and shell mounds. From the relics identified in the nearby Goseong-eup Fortress Site, the Samhan people who formed the Dongoe-dong Shell Mound were able to grow into a dominant group that integrated the Goseong Basin through active external trade with Nakrang in the north and Guju groups in the Japanese archipelago. In the 4th century, the remote trading system between politicians in the Yeongnam region, such as the expulsion of Chinese counties and prefectures and the growth of Geumgwan Gaya, will face major changes among diversified centers. By the 5th century, the trading system with neighboring countries was reorganized again, and with the emergence of central tombs, the formation of a resinous relationship in which a specific political body took the dominant position became clear. Foreign relics excavated from the ancient tomb group in the center of Goseong area are changed around the metalwork and harness for dressing in the dynamics of the surrounding forces, and at the same time, their identity and orientation are projected. In particular, Manlimsan Saturn, built around the early 6th century, can be seen as a structure that reflects the ruling control of Sogaya and the best civil engineering technology, and as a robustness of Sogaya politics.

Study on the Trade-Off Synergy Relationship of “Production-Living-Ecological” Functions in Chinese Counties: A Case Study of Chongqing Municipality

The trade-off and coordinated development of the “production-living-ecological” functions (PLEFs) of an area is an important basis for the optimization of the spatial pattern of the land, and helps to promote the harmonious symbiotic relationship between human beings and nature. This paper combines ecological niche theory, a coupling coordination model, and a trade-off synergy model to construct an evaluation index system for Chinese county PLEFs. Quantitative methods were used to measure spatiotemporal evolution characteristics, trade-off synergy of PLEFs in 38 counties in Chongqing, China, and the coupling coordination degree between PLEFs. The results showed that the ecological niche width of the “production-ecological” function revealed an overall growth trend. However, there was a mismatch in regional development of the “production-ecological” function, showing dislocation characteristics of “high in the west and low in the east” and “high in the east and low in the west.” The niche width of the life function is similar to the comprehensive niche width of PLEFs, showing the characteristics of fluctuation and partition change. PLEFs and both the aforementioned functions showed distribution characteristics of “high in the west and low in the east,” with the whole moving towards the stage of coordinated coupling, of which the “production-living” function has the highest coupling level. The functional coupling coordination degree of “production-living-ecological” is generally manifested as “high in the west and low in the east,” and changing from the primary stage of imbalance to well-coordinated development. The “production-ecological” and “living-ecological” functions are in low-level imbalance in the primary and moderate coordination stages. Additionally, the evolution trend of the “production-ecological” and the “living-ecological” functions are similar, showing alternating and fluctuating development characteristics. Overall, in the past 20 years, Chongqing’s “living-production” function has changed from a trade-off model to a collaborative development relationship, and the “living-ecological” function is generally based on a collaborative development relationship. The “ecological function” is manifested as a trade-off constraint relationship. Moreover, the coordinated development level of “living-production,” “living-ecological,” and “production-ecological” functions in the central urban area has been greatly improved, while counties have gradually shown different degrees of trade-offs.

Spatiotemporal patterns and mechanisms of land-use conflicts affecting high-quality development in China

Rapid urbanization in China led to widespread land-use conflicts (LUCs), requiring understanding the spatiotemporal patterns and mechanisms to support the high-quality development (HQD). This study evaluated the evolution and association mechanisms of LUCs and HQD in Chinese counties from 2000 to 2020 by developing a theoretical framework comprising of land-use structural conflict (SC), functional conflict (FC), HQD, and their relationship, based on the geographically weighted regression models, a coupling relationship matrix, and change scoring methods. Results show that the average HQD improved (12.85% change rate) and LUCs reduced (−3.63%) simultaneously, mainly contributed by FC reconciliation (−9.33%). SC was correlated with FC (average R2 = 0.13, p < 0.05), which directly and significantly affected HQD (average R2 = −0.16, p < 0.05). Furthermore, comprehensive land-use conflict had significant positive and negative effects on HQD in the Yellow River and Yangtze River basins, respectively (p < 0.1). Additionally, coupling relationships between LUCs and HQD would affect subsequent changes, particularly from 2000 to 2010, counties with low-middle FC and HQD tended to shift to low-high. Finally, four geographic area types (i.e., urban agglomeration, high-intensity agricultural, ecological functional, and ecologically fragile areas) with unique LUCs affecting HQD mechanisms were identified. Our findings can provide targeted optimization suggestions for land-use policies under diverse regional contexts.

Quantifying the spatiotemporal dynamics and impact factors of China's county-level carbon emissions using ESTDA and spatial econometric models

China currently has the largest total CO2 emissions and is one of the countries that has made the most efforts to cut these. Anthropogenic emissions from county-level districts play a pivotal role in meeting carbon neutral due to the favorable breakdown of reduction targets into sub-national units, whereas limited work has been done related to those features and determinants. Here, we attempted to quantify the spatiotemporal dynamics of county carbon emissions and their drivers in China between 2000 and 2020 using an exploratory space-time data analysis (ESTDA) and spatial econometric method based on a remote sensing image inversion dataset. The results showed that emissions per capita and per unit of GDP in Chinese counties took on drastically opposite stances amid a trend of increasing carbon emissions. Meanwhile, their carbon emissions exhibited a pronounced regional disparity and spatially positive autocorrelation, characterized by sharp spatial heterogeneity and clustering. Local indicators of spatial association implied that the patterns of county carbon emissions had certain spatial integration, and that locally correlated forms were represented by deep path dependence and spatial locking effects. Besides, a range of panel regression models provided evidence of endogenous interactions of county carbon emissions, notably where every 1% increase in the neighboring emissions induced a local emissions increase by at least 0.4%. Various factors employed not only exerted a direct impact on local carbon emissions, but had spatial spillover effects on neighboring districts. Of these, economic level and industrial structure presented a significantly positive relationship with carbon emissions, while population clustering, financial input and technological advance had clear inhibitory effects. Our findings cast fresh light on the importance of the socioeconomic diversity of a district and its neighbors for government policy decisions related to carbon abatement at the county level.

Regional allocation of industrial land in industrializing China: does spatial mismatch exist?

Understanding how industrial land is spatially allocated across regions is crucial for formulating more optimised land policies and regional development strategies, especially in industrialising countries. By exploiting a unique county-level cadastral dataset covering the whole China from 2009 to 2018, this paper analyzes the spatiotemporal allocation of industrial land and the potential spatial mismatch in China. We find that industrial land constituted the largest single type of urban land use in China (27%) and its absolute area and allocative share expanded during the period 2009–2018. Both the incremental and the stock of the industrial land were mainly concentrated in the coastal metropolitan regions but with a greater tendency to allocate more industrial land in inland regions. Further, we provide robust evidence of the existence of a spatial mismatch of industrial land allocation across Chinese counties, although the efficiency of regional allocations did not deteriorate over time.

Ambient PM2.5 and acute incidence of myocardial infarction in China: a case-crossover study and health impact assessment

Background and purpose: Evidence investigating the association between ambient fine particulate matters (PM2.5) and acute incidence of myocardial infarction in developing countries is limited. This study aims to investigate linear and nonlinear patterns for the association between PM2.5 and acute incidence of myocardial infarction based on multicounty registry dataset and evaluate the reduction of premature myocardial infarction incidence under different pollution control objectives in China. Methods: Thirty-six thousand six hundred and seventy-nine registered myocardial infarction incidence cases from 15 Chinese counties from January 1, 2013, to December 31, 2017, were obtained. We adopted a time-stratified case-crossover design with conditional logistic regression models. Results: With a 10 μg/m3 increase in PM2.5 exposure, there was an increase of 0.98% (95% CI: 0.40%–1.57%) in acute incidence risk of myocardial infarction. The corresponding values for males and individuals aged over 74 years were 1.58% (95% CI: 0.82%–2.35%) and 1.19% (95% CI: 0.35%–2.05%) respectively, indicating higher risks than other groups. The nonlinear concentration–response curve indicated a steeper slope under daily exposure below 50 μg/m3 and the marginal avoided premature morbidity became larger under the current air quality standard. Conclusions: The robust findings from this study may suggest the necessity for a continuous reduction of PM2.5 exposure concentration from the perspectives of public health.

Inhibit or promote: The inverse-U-shape effect of greenspace on economic growth

Discovering a nature-friendly economic growth pattern is a critical issue in the development of human society. This paper combines satellite remote sensing data and economic statistics of 1843 counties in China from 1999 to 2019 to identify the impact of greenspace on county-level economic growth. The findings are as follows: First, It is the cutting-edge evidence of an inverted U-shaped impact of greenspace on economic growth, with the inflection point between 0.5 and 0.55. A higher level of greenspace positively impacts economic growth and vice inhibits, as long as it is below the inflection point. Second, economic growth requires a co-effort between construction and greenspace maintenance. On average, the greenspace level in Chinese counties falls below the inflection point. By bringing the average greenspace level to the inflection point, the average GDP of each county in China could increase by approximately 1.38 billion yuan, resulting in a per capita GDP increase of 342.13 yuan. Third, the impact of greenspace on the primary and tertiary industries is more significant. The results provide theoretical and empirical support for the win-win situation of environmental protection and economic growth.

Differentiated agricultural sensitivity and adaptability to rising temperatures across regions and sectors in China

Prioritizing efforts that adapt agriculture to a warmer climate requires understanding how different regions and sectors of the agricultural system respond to warming. We assess the regional and sectoral responses in agriculture to rising temperatures using a rich and comprehensive panel of Chinese counties over more than two decades. We leverage temperature variations both from year to year and over multiple-year periods to separately identify short-run and intermediate-run responses. We find that temperature effects vary between northern and southern China, and between sectors (cropping, livestock, forestry, and fisheries). Warming's impacts are concentrated in the cooler northern region, where contemporaneous high temperatures depress both the cropping and livestock sectors but benefit the forestry sector. When intermediate-run adaptations are accounted for, the negative short-run impact of extreme temperatures on the cropping sector can be largely mitigated. But the mitigating effect is limited in the livestock sector. These findings inform the design and ranking of region and sector-specific policies and investments for agricultural adaptation to climate change.

Efficiency and Potential Evaluation to Promote Differentiated Low-Carbon Management in Chinese Counties.

Low-carbon management plays an important role in mitigating climate change and adapting to it. Localities should adopt differentiated low-carbon management policies according to the state of their environment. To help formulate specific and realistic low-carbon management policies, this paper took into account specific low-carbon management sectors. Likewise, it carefully considered the differences in various resource endowments and proposed a method for evaluating low-carbon management efficiency and potential. The method was applied to an empirical study from 2015 conducted on 1771 Chinese counties. Significant spatial heterogeneity was found during the research. The counties bordering central and Western China and the ones in the southeast coastal areas showed higher efficiency in the industrial sector. Southern and Northern China had higher efficiency in the housing and transportation sector, respectively. Moreover, counties in remote areas showed more potential in the industrial sector. Central China had higher potential in the housing sector, while counties bordering provinces had more potential in the transportation sector. Therefore, Chinese counties were divided into eight management zones where differentiated management strategies were identified to shape low-carbon management policies.

Analysis of County-Scale Eco-Efficiency and Spatiotemporal Characteristics in China

Eco-efficiency is a key indicator to measure the level of regional sustainable development. The county is the basic spatial unit of socio-economic activities and sustainable policy implementation in China. Hence, this paper conducts eco-efficiency analysis at the county scale in order to provide reference for the central and local governments to formulate differentiated eco-efficiency enhancement policies, further promote Chinese ecological sustainable development, and advance the construction of ecological civilization with high quality. Based on the Super-Slacks-Based Measure (SBM) model and the Malmquist index, the paper constructed an eco-efficiency measurement method and analyzed the variation characteristics, influencing factors, spatial pattern of eco-efficiency in Chinese counties from 2000 to 2020. The results showed that: (1) The eco-efficiency of the county unit was generally low in China and was roughly distributed in a pyramid. The county-level eco-efficiency had a spatial distribution pattern of being high in the west and low in the east, and high in the south and low in the north, with significant non-equilibrium. There was a positive correlation between eco-efficiency of neighboring counties in China. (2) The per-capita GDP has a significant positive correlation with eco-efficiency, while energy consumption, arable land area and eco-efficiency have a negative correlation. The redundancy rate of input indicators was high in Chinese counties. (3) During the study period, the eco-efficiency of most counties displayed a fluctuating growth trend. The growth was mainly driven by technological progress.

Cardiovascular mortality risks during the 2017 exceptional heatwaves in China

Climate change has made disastrous heatwaves more frequent. Heatwave-related health impacts are much more devastating for more intense heatwaves. In the summer of 2017, exceptional heatwaves occurred in many regions, including China. This study aims to evaluate the cardiovascular mortality risk associated with the 2017 exceptional heatwaves and compare the mortality risk of the severe heatwaves with those in other years. Using daily data for a spectrum of cardiovascular mortality and temperature for 102 Chinese counties (2014–2017), we estimated the association between heatwave and mortality by generalized linear mixed-effects models. Compared with matched non-heatwave days, mortality risks on heatwaves days in 2017 increased 27.8% (95% CI, 14.8–42.3%), 26.7% (8.0–48.5%), 30.1% (10.2–53.7%), 27.3% (1.4–59.9%), 32.2% (3.4–68.4%), and 25.2% (1.0–57.7%) for total circulatory diseases, cerebrovascular disease, ischemic heart disease (IHD), acute IHD, chronic IHD, and myocardial infarction. The 2017 exceptional heatwaves impacted ischemic heart disease mortality and myocardial infarction mortality more than heatwaves in 2014–2016. Here we show that the severe heatwaves in 2017 posed catastrophic death threats for those under-studied cardiovascular diseases.