Healthy China Research Articles

Can China’s national comprehensive medical reform increase medical resources and reduce healthcare burden: evidence from Chinese provinces

ObjectivesChina’s national comprehensive medical reform (NCMR) is an important attempt in the reform of healthcare system, and quantitative evaluation of its effect is of great significance for continuously deepening medical reform, grasping the reform direction, and building a healthy China. Therefore, focusing on medical resources and medical burden, this study aims to systematically explore the policy effectiveness and the provincial heterogeneity of NCMR, as well as the potential influencing factors.MethodsUtilizing the collected multi-period panel data of 31 provinces in mainland China in 2006–2021, we regarded the release of the two batches of pilot provinces in NCMR as a quasi-natural experiment and comprehensively adopted a Staggered difference-in-differences (DID) model and Synthetic Control Method (SCM), combined with word frequency statistics and grouping regression analysis.ResultsNCMR can effectively increase the number of licensed physicians by 12.6% and reduce the per capita medical expense for in-patients by 7.2% in the pilot provinces. Furthermore, the NCMR policy effect in different pilot provinces shows various characteristics, and only Jiangsu, Zhejiang, and Chongqing achieve both the growth of medical resources and the reduction of medical expenditure. Meanwhile, word frequency statistics are conducted based on related policy descriptions and news reports on the official websites, so as to summarize the specific policy means in the three provinces, and provide a reference for other provinces to practice the healthcare reforms. Besides, extensibility analysis shows that the effect of NCMR is affected by the population aging and health status. Groups with low degree of population aging (low-AG)/high population health status (high-HE) performed a more obvious reform effect.ConclusionThis study provides beneficial policy implications for increasing medical resources, reducing medical burden, and promoting medical reform process.

Development of Learning Activities Using Layered Teaching Methods and Taekwondo Abilities of First-year Students at Luzhou Vocational and Technical College

Background and Aims: Taekwondo is a martial art that originated on the Korean Peninsula and has since spread across the country as a movement that emphasizes moral development and physical fitness. The "Healthy China 2030 Planning Outline" intends to support youth sports, guaranteeing young people's daily physical activity and competency in a variety of sports. Thus, this paper aims (1) To develop learning activities and the layered teaching method for the Taekwondo course. (2) To compare Taekwondo abilities using a layered teaching method between the pre-test and the post-test. And (3) To study the students’ satisfaction with the layered teaching method for the Taekwondo course. The sample group is 45 first-year students at Luzhou Vocational and Technical College. Methodology: The population is 3 classrooms of students, totaling 180 students with similar knowledge and abilities, and the first-year students at Luzhou Vocational and Technical College in the first semester of the academic year 2023. The sample group is 45 first-year students at Luzhou Vocational and Technical College, in the first semester of the academic year 2023, obtained from the cluster sampling technique. Results: The results of the study were as follows;1) The development of layered teaching methods for the Taekwondo course has an average suitability value for all plans equal to 4.23, which is at a high level. (2) Students who studied using the layered teaching method for the Taekwondo course had higher Taekwondo abilities post-test than pre-test at a statistical significance of.05, and (3) Students who learned using the layered teaching method for the Taekwondo course had overall satisfaction at a very high level. Conclusion: The Taekwondo course's layered teaching approach proved to be very effective, greatly enhancing students' post-test performance and resulting in extremely high levels of overall student satisfaction. This technique successfully raises student engagement in Taekwondo as well as skill acquisition.

A Metaanalysis of the relationship between growth mindset and mental health in Chinese samples

Innovations in mental health are desperately needed in Healthy China with increasing benefits of a growth mindset on mental health among Chinese. Currently, empirical research in China reveals significant discrepancies in the correlation between growth mindset and mental health. To elucidate this discrepancy, we conducted a meta-analysis on 59 studies utilizing a random-effects model, with 68 effect sizes and 54,302 participants included. The main effects revealed a significantly positive correlation between growth mindset and positive indicators of mental health (r = 0.36, [0.27, 0.45]), as well as a significantly negative correlation between growth mindset and negative indicators of mental health (r = −0.25, [−0.31, −0.20]). Subgroup test and meta-regression results indicated that age, economic region, and measurement instruments moderated the growth mindset and positive indicators of mental health. In contrast, negative indicators were moderated by gender and measurement instruments. The above findings suggest that a growth mindset significantly correlates with mental health. Consequently, it can be developed into an effective psychological service strategy in Healthy China. Future empirical studies should continue to examine this relationship and explore additional potential moderating variables. Furthermore, the clinical effects of growth mindset interventions in mental health should be tested.

A measurement study of the environmental quality and medical expenditures of elderly individuals: causal inference based on machine learning

BackgroundThe global surge of environmental pollution exacerbates health issues, disease incidence, and economic strain. In China, the increasing healthcare costs of the elderly population necessitate addressing this challenge as part of the “Healthy China” strategy. We explore the impact of environmental quality on elderly healthcare expenses.MethodsThis study devised a comprehensive environmental quality index for 30 Chinese provinces, excluding Tibet, which was correlated with medical expenses for individuals older than 60 years, using China Family Panel Studies (CFPS) data. Because the traditional econometric model cannot solve the endogeneity problem and the selection of instrumental variables is subjective, a new machine learning algorithm is adopted based on the traditional ordinary least squares (OLS) model and the fixed effect model to conduct causal analysis to ensure the reliability of the results. Finally, heterogeneity analysis was conducted based on the generalized random forest algorithm.ResultsSouthern provinces such as Jiangxi and Guangxi exhibited superior environmental qualities. A regional analysis revealed a gradient where environmental quality decreased from west to east and from south to north. Both conventional and machine learning methodologies underscored a pivotal finding: enhanced environmental qualities significantly curtail elderly healthcare expenses. A heterogeneity assessment revealed that such improvements predominantly benefit elderly people in the eastern and central regions, with marginal impacts in the west. For different groups, the improvement of environmental quality can significantly reduce the medical expenditure of people aged 60 to 75, with bedtime hours between 9 and 11 PM and a lower household income.ConclusionsThis study, employing machine learning and traditional models, demonstrates that enhancements in environmental quality significantly reduce medical costs for the elderly in China, especially in the eastern and central regions, and among demographics such as individuals aged 60–75 and low-income households. These findings underscore the potential of environmental policies to lower medical costs within the “Healthy China” initiative framework. However, the study’s scope is limited by the environmental quality index and the extent of data coverage, indicating a need for further research expansion.

Bridging the gap: how education transforms health outcomes and influences health inequality in rural China.

This study focuses on the impact of education on health and health inequalities in rural areas of China. Education significantly enhances economic status and health, driving economic growth and improving public health standards. Integral to the "Healthy China Strategy," it provides essential guidance for public policy and underscores the need for strategic human capital investments to achieve these goals. The study utilizes data from the China Family Panel Studies (CFPS) spanning 2010-2020 and employs the average educational level within counties as an instrumental variable. The causal impact of education on health and health inequalities is estimated using the two-stage least squares (2SLS) method. The findings reveal a significant positive correlation between enhancing education levels and health improvements. Specifically, after controlling for endogeneity, the duration of individual education significantly improves both subjective and objective health outcomes. It reduces health inequalities, with these effects being more pronounced among women and low-income groups. Mechanistically, education positively impacts health primarily by altering health behaviors and social network levels and reducing health inequalities through socio-economic factors. This paper provides important implications for public policy, suggesting that enhancing educational investments can drive economic development and improve population health standards.

Can public hospital reform reduce medical resource mismatches? Evidence from China

BackgroundThe mismatch of medical resources is a significant issue in global healthcare, undermining both service accessibility and system efficiency. In China, despite the implementation of the “Healthy China” strategy, persistent mismatches remain due to factors such as industrialization, urbanization, and population aging. This study empirically evaluates the impact of Public Hospital Reform (PHR) on mitigating these mismatches.MethodsA Difference-in-Differences (DD) approach is applied to panel data from 300 cities spanning 2010 to 2021, using the phased implementation of PHR as a quasi-natural experiment. This allows for a comparative analysis of changes in resource allocation between cities that adopted the reform and those that did not. Quantile regression assesses the effects of PHR across varying levels of resource mismatch, while mechanism tests investigate how PHR influences mismatches through cost reduction and supply expansion.ResultsPHR is found to reduce medical resource mismatches by 13.9%, primarily driven by cost reductions and increased resource supply. The effects are more pronounced at both lower and higher levels of mismatch, with a limited impact at mid-levels. Furthermore, the reform’s effectiveness diminishes as it is extended to more cities, suggesting a potential saturation effect.ConclusionsThis study demonstrates that PHR significantly alleviates medical resource mismatches in China. The findings underscore the need to focus on cost control and resource supply in future healthcare reforms, providing key insights for policymakers in developing countries facing similar healthcare resource challenges.

Research on the relationship between physical literacy and demographic variables and interpersonal support for physical exercise among adolescents in China.

In recent decades, the concept of "Physical Literacy" has emerged as a significant breakthrough in enhancing the physical health of children and adolescents. This concept has become the guiding principle and future direction for physical education reform in Western countries. As China's economic and social development enters a new phase, the negative impact of insufficient physical activity on adolescent health remains a significant challenge to the strategies of "Healthy China" and "A Leading Sports Nation." The unique value of physical literacy, which emphasizes the importance of regular physical activity, aligns perfectly with the developmental needs of the nation, the era, and individuals. Given the crucial role of interpersonal support in the development of adolescents' physical literacy, this study employs questionnaire surveys and statistical analysis to investigate the current state of physical literacy among Chinese adolescents. It explores the predictive relationship between parental support, teacher support, and peer support on physical literacy, aiming to provide guidance for the future development of adolescents' physical literacy. The research findings indicate significant differences in the five dimensions of physical literacy (attitude, sports knowledge, emotion, athletic ability, and physical fitness) among adolescents of different grades and residence type. Additionally, there are notable gender differences in the dimensions of sports knowledge, emotion, and athletic ability. The interaction effect of gender and grade is particularly evident in the emotional and physical fitness dimensions. There is a significant correlation between interpersonal support and all dimensions of physical literacy. After controlling for variables such as gender, grade, and family background, interpersonal support for adolescent physical exercise was found to have a significant impact on all dimensions of physical literacy. Among the forms of support, peer support was identified as a more powerful predictor of physical literacy compared to parental and teacher support.

An Overview of Tobacco Control Policies in China

The tobacco epidemic is a global public health concern as the toxic substances in tobacco pose a severe threat to human health. In response to this issue, countries around the world have adopted various strategies to control tobacco use. The Chinese government began to pay attention to the health hazards of smoking in the 1970s and joined the international community in tobacco control endeavors by becoming a signatory of the World Health Organization Framework Convention on Tobacco Control in the early 21st century. It has further intensified its tobacco control measures in recent years with its “Healthy China” strategy. This article gives an overview of tobacco control policies released by the Chinese government over the years, with a separate analysis of the provisions on smoking control stipulated in the Health China Action Plan (2019-2030). Also discussed are the outcomes of those policies and the challenges China faces in tobacco control, as well as the lessons China can learn from international experiences in this regard.

Landscape Design Strategies for Healthy Aging-in-Place in Communities: Case Studies from Suzhou, China

As the global population ages, the World Health Organization promotes “Healthy Aging” to enhance the quality of life for the elderly. In China, with its substantial aging population, the “9073” elderly care mode, which prioritizes community-based care, was implemented in 2011. However, the specific needs of elderly residents in different climatic and cultural contexts are often overlooked. This study addresses this gap by examining how community green space design can support healthy aging, using Suzhou as a case study due to its significant elderly population. This research examines the relationship between community environments, elderly needs, and behaviors. Our findings reveal that elderly residents have complex needs, seeking safety, comfort, health, social interaction, and spiritual richness simultaneously. A mismatch was observed between their stated preferences for features like seating and shade and their actual usage patterns, suggesting that existing green spaces may not fully meet their needs. This study underscores the importance of incorporating both expressed preferences and proactive design strategies to enhance the healthy benefit of community green spaces. These insights support the “Healthy China 2030” strategy and promote the well-being of elders, contributing to sustainable urban regeneration.

COVID-19 drives medical education reform to promote "healthy China 2030" action plan.

In June 2019, the Chinese government proposed the Healthy China Action Plan (2019-2030) development strategy, which focuses on disease prevention and health promotion. It is expected that by 2030, the national health literacy level will be significantly improved, premature mortality caused by major chronic diseases will be significantly reduced, the average healthy life expectancy will be greatly improved, and the main health indicators of residents will enter the ranks of high-income countries. Unfortunately, at the end of 2019, COVID-19 began to break out in Wuhan, China, which had a huge impact on China's economy and people's health. A series of problems in China's health care and medical education were exposed in the prevention and treatment of the epidemic. How to reform medical education and build a medical talent training system with Chinese characteristics is the key to achieving China's Health 2030 strategy. This article will explore the direction of medical education reform in China under the background of the "Healthy China 2030" strategy and the post pandemic era.

Promotion Strategies of Traditional Chinese Sports and Sports Commitment of Athletes in Selected Universities in Henan, China

This study evaluates the implications of strategic initiatives in cultural preservation, modernization, public awareness, policy support, international collaboration, and health and wellness integration on student engagement, drawing from the "Healthy China 2030 Plan Outline" and the cultural significance of traditional Chinese sports. Enjoyment, organizational support, and psychological interventions are crucial in maintaining sports commitment. The research identifies a substantial positive association between effective promotional techniques, especially those emphasizing cultural preservation and public knowledge, and increased levels of sports commitment. The results indicate that promotional strategies consistent with the core values of traditional Chinese sports can increase student engagement, so supporting the overarching objectives of the "Healthy China" project by fostering physical and mental wellness. The study suggests that focused, culturally aware promotional techniques are vital for maintaining and enhancing interest in traditional Chinese sports in the collegiate context.

Expert consensus on sequential surgery following conversion therapy based on combination of immune checkpoint inhibitors and antiangiogenic targeted drugs for advanced hepatocellular carcinoma(2024 edition)

Up to half of hepatocellular carcinoma(HCC) cases are diagnosed at an advanced stage,for which effective treatment options are lacking,resulting in a poor prognosis. In recent years,the combination of immune checkpoint inhibitors and anti-angiogenic targeted therapy has demonstrated high efficacy in treating advanced HCC,significantly extending patients' survival,and providing a potential for sequential curative surgery. After sequential curative hepatectomy or liver transplantation following conversion therapy,patients can obtain long-term survival benefits. In order to improve the long-term survival rate of the overall population with liver cancer and achieve the goal of a 15% increase in the overall 5-year survival rate outlined in the "Healthy China 2030" blueprint,the Professional Committee for Prevention and Control of Hepatobiliary and Pancreatic Diseases of Chinese Preventive Medicine Association,Chinese Society of Liver Cancer,and the Liver Study Group of Surgery Committee of Beijing Medical Association organized in-depth discussions among relevant domestic experts in the field. These discussions focus on the latest progress since the release of Chinese expert consensus on conversion therapy of immune checkpoint inhibitors combined antiangiogenic targeted drugs for advanced hepatocellular carcinoma(2021 Edition) and have reached new consensus on the modifications and supplements to related key points. This consensus aims to further guide clinical practice,standardize medical behavior,and promote the development of the discipline.

The impact of green low-carbon development on public health: a quasi-natural experimental study of low-carbon pilot cities in China.

In recent years, climate change and environmental pollution have posed significant threats to public health. As environmental policies such as low-carbon city initiatives are progressively implemented, their role in enhancing public health has become a topic of growing interest. This study aimed to investigate the relationship between green low-carbon development and public health and to analyze the underlying mechanisms. We utilized data from 271 prefecture-level cities in China spanning from 2007 to 2020, focusing on green low-carbon development, climate change, environmental pollution, and public health. Employing the quasi-natural experimental framework of China's low-carbon city pilot projects, we constructed a multi-site difference-in-differences (DID) model for empirical analysis. Various robustness checks, including parallel trend tests, placebo tests, sample selection bias checks, and adjustments to the temporal and spatial scope of the samples, were conducted to ensure the reliability of the results. Additionally, we explored the positive effects of green low-carbon development on public health through dual mediation pathways involving climate change mitigation and pollution reduction. Finally, we examined the heterogeneity of the results across different city tiers, economic growth rates, levels of technological investment, and green finance development. The findings indicate that green low-carbon development significantly enhances public health, a conclusion supported by robustness tests. Mechanism analysis reveals that the benefits of green low-carbon development on public health are realized through mitigating climate change and reducing environmental pollution. Further analysis reveals that the positive impact on public health is more pronounced in first-and second-tier cities, as well as in cities with faster economic growth, greater technological investment, and more developed green finance sectors. This study highlights the crucial role of urban green low-carbon development in improving environmental quality and public health. In addition to providing empirical evidence that supports the promotion of green low-carbon development in cities, the results point to policy recommendations for enhancing public health. Moreover, the findings contribute to the development of environmental policies and the implementation of the "Healthy China" strategy.

Reflections on the positioning and implementation pathways of adult vaccine prescriptions

The innovation of integrating medical treatment and prevention mechanisms is a key task deployed by the government, aiming to promote the construction of a Healthy China and address the prevalent "treatment over prevention" mindset in healthcare services and society. Vaccination is an effective strategy for preventing and controlling infectious diseases; however, adult vaccination rates in China remain low due to insufficient awareness and enthusiasm among the public and healthcare professionals. In recent years, various regions have begun to explore the model of physicians in medical institutions prescribing vaccines to improve vaccination rates. This article analyzes the positioning, current implementation status, and challenges of vaccine prescriptions, and proposes recommendations advocating policy formulation, improving service models and supporting measures, improving funding mechanisms, and strengthening publicity and education to promote the widespread implementation and effectiveness of vaccine prescriptions.

Expert consensus on the construction and improvement of adult vaccination service system at medical institutions

The "Healthy China 2030" plan outlines the goal of providing equitable, accessible, and continuous health services to achieve overall health for the population. However, with the increasing aging population in China, the burden of chronic non-communicable diseases and infectious diseases negatively impacts public health. The elderly population has high hospitalization rates due to infections from influenza virus, respiratory syncytial virus, and Streptococcus pneumoniae, which can even lead to death, posing a heavy economic burden on the healthcare system. Meanwhile, the prevalence of chronic diseases and multimobidity among adults are continuously rising, and infections could attack the high-risk groups which cause comlicaitons and severe outcomes. Vaccination is considered as most cost-effective measure for preventing infectious diseases, significantly reducing the disease burden on individuals while effectively controlling the spread of epidemics within the community. Currently, the adult vaccination service system in China is significantly lagging, making it difficult to fully utilize the health protection benefits of vaccines throughout the entire lifecycle. Therefore, to improve adult vaccination services and increase the vaccination rate among high-risk populations for severe diseases, this expert consensus analyzes the current status and challenges of adult vaccination services based on literature reviews and expert discussions. To provide suggestions for the establishment and improvement of adult vaccination service system, and reference health authorities and disease control and prevention departments to formulate relevant policies.

Research on the Effect of the Healthy Cities Pilot Policy on the Labor Supply Time of Middle-Aged and Elderly Workers in China

Against the backdrop of Healthy China and an aging population, there is an urgent need to explore the effect of the Healthy Cities Pilot Policy (HCPP) on residents’ labor supply. This study integrates the HCPP, residents’ health, and labor supply time into a unified analytical framework. Using data from the China Health and Retirement Longitudinal Study (CHARLS) spanning the period 2011–2020 and leveraging the quasi-natural experiment provided by China’s 2016 HCPP, we empirically investigate its effects on labor supply time among middle-aged and elderly workers. Our findings indicate: (1) HCPP increases average weekly working hours by 2.834 h in pilot cities. (2) HCPP significantly enhances residents’ health status in pilot cities, extending their healthy time. (3) Middle-aged and elderly workers allocate more of their extended healthy time to labor rather than leisure, potentially influenced by traditional Chinese perceptions of “ceaseless toil”. (4) The impact of HCPP on labor supply time exhibits group heterogeneity, with stronger promotion effects observed among vulnerable middle-aged and elderly groups characterized by older age, rural household registration, lower educational attainment, and lower income levels. This research offers insights for policymakers aiming to optimize health policies and promote sustainable development within Chinese society.

Impact of Chronic Disease Shocks on Household Consumption in China: The Role of Multi-Level Health Insurance

Expanding and enhancing the quality of consumption is crucial to satisfy the increasing demand for a higher standard of living. However, the rising risk of chronic diseases impacts not only the level of consumption but also impedes the optimization of consumption patterns. This research utilizes Staggered Difference-in-Differences (DID) and Difference-in-Differences-in-Differences (DDD) models to evaluate the effects of chronic disease shocks on both the levels and structures of household consumption, leveraging data from the China Family Panel Studies (CFPS) across four survey waves from 2012 to 2018. Additionally, the study examines the effects and mechanisms of the multi-level health insurance system in mitigating the impact of chronic disease shocks. The study discerns a significant decrease in household consumption expenditure, obstruction in the enhancement of consumption structures, and a constriction of consumption diversity attributable to chronic disease shocks. Heterogeneous analysis reveals that the impact of chronic shocks varies across factors such as age, capital endowment, urban versus rural residence, and the availability of healthcare resources. Moreover, the analysis highlights the heterogeneous mitigating effects of the multi-level health insurance system, particularly through diminishing out-of-pocket medical expenses and the propensity for precautionary savings. The findings accentuate the imperative for the enhancement and equalization of the multi-level health insurance system to fortify household consumption, offering significant policy insights for the realization of the “Healthy China” vision. JEL Classification: P36, D12.

Topic identification and content analysis of internet medical policies under the background of Healthy China 2030.

This study aims to analyse the content of internet medical policies, grasp the inherent laws of the development of internet medical policies and provide references for improving the policy system. On the basis of web crawler technology, 436 internet medical policies issued by the central and local governments after the Healthy China Strategy was proposed were collected. The BERTopic model was used to extract topics, and a comprehensive analysis of China's internet medical policy texts was conducted through the analysis of topic content, topic hierarchy and topic clusters. A total of 27 topics were identified in China's internet medical policies, mainly focussing on five topic clusters: medical service regulation, elderly nursing and children's healthcare using traditional Chinese medicine, user safety guarantees, health education and communication and infectious disease treatment and recovery guidance. Different topic contents play a role in promoting the comprehensive and standardized development of internet medical services. However, there is still room for further improvement in policy integrity, consideration of multiple types of users, and implementation effectiveness. Continuous efforts are needed to optimize the effectiveness of policies.

Analysis of the Current Situation of Service Capacity of Medical Social Workers in Shanxi Province and the Conception of Cultivation Pathway

Objective: This study aims to analyze the current status of service competence of medical social workers in Shanxi Province and to conceptualize the cultivation path. Methods: A questionnaire survey was conducted among 88 staff members and 120 residents of eight community health service centers in Shanxi Province to understand the population’s knowledge of the connotation of medical social workers and their needs. Results: Currently, the staff and residents of the community health service centers in Shanxi Province have a low level of knowledge and a high demand for medical social workers. It is recommended to expand the scope of practice of medical school students and design a series of training programs for medical social workers to better meet the needs of community healthcare and promote the implementation of the Healthy China Strategy.

Research on the “1+1+1” Physical Intelligence Curriculum System under the Background of Healthy Children Action Plan

“14th Five-Year Plan” period is the first five years to the second century goal, but also the key period for the development of children’s health cause. “Healthy China 2030” plan outline “clearly put forward the implementation of healthy children plan [1]. Although the national level attaches great importance to children’s health, there are still many factors that affect children’s healthy growth in daily life, such as various diseases in children’s physical health, developmental delays in various physiological functions, insufficient exercise ability, obesity, etc., as well as mental health problems such as stuttering, night terrors, fear, anxiety, rage, lying, autism and hyperactivity. To solve these problems, not only the attention and deployment of the country and the government, but also the understanding and cooperation at the social level and the family level, in order to better promote the healthy growth of children under the joint efforts of everyone. The “1+1+1” “Body intelligence” curriculum system research includes a healthy child’s physical development system, a healthy child’s psychological (mental) development system, and a healthy child’s ability development system. Aiming at the problems of physical and mental development and ability development in the healthy growth of children, service programs are scientifically and rationally formulated, and implemented from the social level and family level to effectively improve children’s health level [2].