Projected impact of urbanization on cardiovascular disease in China

Abstract

Objectives: The Coronary Heart Disease (CHD) Policy Model-China, a national scale cardiovascular disease computer simulation model, was used to project future impact of urbanization.

Methods: Populations and cardiovascular disease incidence rates were stratified into four submodels: North-Urban, South-Urban, North-Rural, and South-Rural. 2010 was the base year, and high and low urbanization rate scenarios were used to project 2030 populations.

Results: Rural-to-urban migration, population growth, and aging were projected to more than double cardiovascular disease events in urban areas and increase events by 27.0-45.6% in rural areas. Urbanization is estimated to raise age-standardized coronary heart disease incidence by 73-81 per 100,000 and stroke incidence only slightly.

Conclusions: Rural-to-urban migration will likely be a major demographic driver of the cardiovascular disease epidemic in China.

Figure. Past and projected evolution of total, urban and rural populations, China, 1950–2005 assumed for the analysis

Panel A shows United Nations urbanization forecast [logistic regression trend; (Source: 2009 Urbanization Prospects, 2009 revision, United Nations)]. Panel B shows linear trend forecast (Liu 2003).