Urbanisation and health in China

Abstract

China has seen the largest human migration in history, and the country's rapid urbanisation has important consequences for public health. A provincial analysis of its urbanisation trends shows shifting and accelerating rural-to-urban migration across the country and accompanying rapid increases in city size and population. The growing disease burden in urban areas attributable to nutrition and lifestyle choices is a major public health challenge, as are troubling disparities in health-care access, vaccination coverage, and accidents and injuries in China's rural-to-urban migrant population. Urban environmental quality, including air and water pollution, contributes to disease both in urban and in rural areas, and traffic-related accidents pose a major public health threat as the country becomes increasingly motorised. To address the health challenges and maximise the benefits that accompany this rapid urbanisation, innovative health policies focused on the needs of migrants and research that could close knowledge gaps on urban population exposures are needed.

Figure 1

China's urban area expansion from 1990 to 2010 The area of China's largest 654 cities was estimated from Landsat Thematic Mapper and Enhanced Thematic Mapper Plus imagery acquired in 1990, 2000, and 2010. Urban area in each province was estimated as the sum of the areas of the individual cities in that province. The large map depicts the size of urban areas in 2010, whereas the two smaller maps are for 1990 and 2000. The pillar in each province represents the ratio of the growth of urban area in that province between 1990 and 2000, to growth between 2000 and 2010. The height of the scale bar is equivalent to a 1·5-times change in area within that period. Data from Wang and colleagues, 2011.

Figure 2

Age distribution profiles of six countries in 2010 Data from US Census Bureau. Figures have been rounded up or rounded down as appropriate.