Current situation and progress toward the 2030 health-related Sustainable Development Goals in China: A systematic analysis


Autoři: Shu Chen aff001;  Lei Guo aff001;  Zhan Wang aff001;  Wenhui Mao aff002;  Yanfeng Ge aff003;  Xiaohua Ying aff004;  Jing Fang aff005;  Qian Long aff001;  Qin Liu aff006;  Hao Xiang aff007;  Chenkai Wu aff001;  Chaowei Fu aff004;  Di Dong aff001;  Jiahui Zhang aff003;  Ju Sun aff008;  Lichun Tian aff009;  Limin Wang aff010;  Maigeng Zhou aff010;  Mei Zhang aff010;  Mengcen Qian aff004;  Wei Liu aff009;  Weixi Jiang aff001;  Wenmeng Feng aff003;  Xinying Zeng aff010;  Xiyu Ding aff001;  Xun Lei aff006;  Rachel Tolhurst aff011;  Ling Xu aff012;  Haidong Wang aff013;  Faye Ziegeweid aff013;  Scott Glenn aff013;  John S. Ji aff014;  Mary Story aff002;  Gavin Yamey aff002;  Shenglan Tang aff002
Působiště autorů: Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China aff001;  Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America aff002;  Research Department of Social Development, Development Research Center, State Council of People's Republic China, Beijing, China aff003;  School of Public Health, Fudan University, Shanghai, China aff004;  Institute for Health Sciences, Kunming Medical University, Kunming, Yunnan, China aff005;  School of Public Health and Management, Chongqing Medical University, Chongqing, China aff006;  School of Health Sciences, Wuhan University, Wuhan, Hubei, China aff007;  School of Political Science and Public Administration, Wuhan University, Wuhan, Hubei, China aff008;  School of Public Health, Kunming Medical University, Kunming, Yunnan, China aff009;  National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China aff010;  Faculty of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom aff011;  Center of Health Human Resource Development, National Health Commission, Beijing, China aff012;  Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America aff013;  Environment Research Center, Duke Kunshan University, Kunshan, Jiangsu, China aff014
Vyšlo v časopise: Current situation and progress toward the 2030 health-related Sustainable Development Goals in China: A systematic analysis. PLoS Med 16(11): e32767. doi:10.1371/journal.pmed.1002975
Kategorie: Research Article
doi: 10.1371/journal.pmed.1002975

Souhrn

Background

The Sustainable Development Goals (SDGs), adopted by all United Nations (UN) member states in 2015, established a set of bold and ambitious health-related targets to achieve by 2030. Understanding China’s progress toward these targets is critical to improving population health for its 1.4 billion people.

Methods and findings

We used estimates from the Global Burden of Disease (GBD) Study 2016, national surveys and surveillance data from China, and qualitative data. Twenty-eight of the 37 indicators included in the GBD Study 2016 were analyzed. We developed an attainment index of health-related SDGs, a scale of 0–100 based on the values of indicators. The projection model is adjusted based on the one developed by the GBD Study 2016 SDG collaborators.

We found that China has achieved several health-related SDG targets, including decreasing neonatal and under-5 mortality rates and the maternal mortality ratios and reducing wasting and stunting for children. However, China may only achieve 12 out of the 28 health-related SDG targets by 2030. The number of target indicators achieved varies among provinces and municipalities. In 2016, among the seven measured health domains, China performed best in child nutrition and maternal and child health and reproductive health, with the attainment index scores of 93.0 and 91.8, respectively, followed by noncommunicable diseases (NCDs) (69.4), road injuries (63.6), infectious diseases (63.0), environmental health (62.9), and universal health coverage (UHC) (54.4). There are daunting challenges to achieve the targets for child overweight, infectious diseases, NCD risk factors, and environmental exposure factors. China will also have a formidable challenge in achieving UHC, particularly in ensuring access to essential healthcare for all and providing adequate financial protection. The attainment index of child nutrition is projected to drop to 80.5 by 2025 because of worsening child overweight. The index of NCD risk factors is projected to drop to 38.8 by 2025. Regional disparities are substantial, with eastern provinces generally performing better than central and western provinces. Sex disparities are clear, with men at higher risk of excess mortality than women. The primary limitations of this study are the limited data availability and quality for several indicators and the adoption of "business-as-usual" projection methods.

Conclusion

The study found that China has made good progress in improving population health, but challenges lie ahead. China has substantially improved the health of children and women and will continue to make good progress, although geographic disparities remain a great challenge. Meanwhile, China faced challenges in NCDs, mental health, and some infectious diseases. Poor control of health risk factors and worsening environmental threats have posed difficulties in further health improvement. Meanwhile, an inefficient health system is a barrier to tackling these challenges among such a rapidly aging population. The eastern provinces are predicted to perform better than the central and western provinces, and women are predicted to be more likely than men to achieve these targets by 2030. In order to make good progress, China must take a series of concerted actions, including more investments in public goods and services for health and redressing the intracountry inequities.

Klíčová slova:

Death rates – Global health – Health care policy – Child health – China – Nutrition – Socioeconomic aspects of health – Tuberculosis


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