Page 39 - Genomic Medicine in Emerging Economies

28 CHAPTER 3: Genomics and Public Health: China’s Perspective

combining the latest technologies and traditional knowledge, China is able to
develop a model and make a greater contribution to public health all over the
world. In this chapter we review the history and current state of public health
in China, China’s recent developments and advancements in public health ser-
vices and genomics, and the prospects of integrating new modern technologies
and Traditional Chinese Medicine (TCM). China is already a major contribu-
tor in the control and management of global health burden and disease risks,
as this is an inevitable aspect of China’s growing international participation in
the global trade of goods and services. The integration of traditional knowl-
edge and modern technologies in genomic medicine in China will ultimately
have a profound meaning for the shaping of health care and research policy
while also contributing to health development of other countries, for example,
in the developing world.

THE HISTORY AND CURRENT SITUATION
OF PUBLIC HEALTH IN CHINA

Current Status of Demographics and Family
Planning in China
China is a multicultural country composed of 56 ethnicities, with a diverse
population of over 1.3 billion and an imbalanced economic development.
The demographics of China are uneven, exaggerated by the imbalanced
economy, by the large number of migrant populations, and by rapid aging.
The average life expectancy is 73 years (Peng et al., 2006; Year Book, 2008a;
Zhao, 1999). Compared with developed countries, China’s birth rate is still
high; however, there was a declining trend in the past decade. In particu-
lar, after establishing a basic national policy of family planning, the birth
rate dropped from 36% in 1949 to 12.10% in 2007. Meanwhile, mortal-
ity declined from 20% in 1949 (Year Book, 1991) to 6.93% in 2007 (Year
Book, 2008b). As a result, China’s population has an aging trend. The United
Nations predicts that more than 453 million Chinese will be older than 60
by 2050 (World, 2004).

Since 1978 the large-scale rural labor (nongmingong in Chinese) migration has
become an eye-catching phenomenon in the process of China’s social and eco-
nomic development, with the deepening of reforming the open-door policy
and the improvement of labor markets and related policies. The rural popula-
tion has provided a vast reservoir of people willing to work for low wages in
factories, at construction sites, and wherever another pair of hands is needed.
Thus China’s resulting exceptionally high rate of internal migration is both the
consequence and the cause of economic development. Huge internal migra-
tion from rural to urban areas was estimated at 140 million in 2005—10%
of the total population. Three-quarters of this migration occurred within