China’s environment puts a heavy toll on children’s health

New York       By Dr Cesar Chelala

In recent times, China has sustained significant economic expansion although the worldwide recession is a cause for concern. At the same time China has greatly improved the health status for the majority of the population. Some of these achievements have been a model for developing countries worldwide. Gains in the health sector, however, are being curtailed by the environmental consequences of the rapid economic expansion of the country. To continue the country’s economic growth while at the same time protecting people’s health is one of the main challenges facing Chinese authorities today.

In the last two decades, China has had an average economic growth of 9.4%. For the last 50 years it has also made impressive advances in public health, improving health care and tackling infectious diseases with remarkably good results. The average life expectancy is now 71.8 years, up from 35 in 1949. Immunization coverage is over 95% for those under one.

From 1960 to 2003 the infant mortality rate fell from 150 to 30 per 1,000 live births, and the under-five mortality rate dropped from 225 to 37 per 1,000 live births. Both rates are used as indicators of access to basic health services. At the same time, there has been a sustained increase in community service networks, which provide basic health services to the population.

Since 1978 the number if health facilities in China has increased by 82 per cent and the number of health staff by 88 percent, notes UNICEF. In spite of that, significant challenges for maternal and child health care remain. For example, emergency obstetric and newborn care is deficient, particularly for people living in remote areas. Child mortality rates in remote areas are several times higher than those in urban areas. Many poor rural families and migrants in urban areas cannot afford health services.

China still faces important health challenges, many of which are caused by a polluted environment. Children are particularly vulnerable to environmental hazards. This greater vulnerability stems from differences in their physiology, growth characteristics and diet. Children’s vulnerability to environmental hazards is also related to their developmental stage. Children differ from adults in degree of exposure, absorption pathways, tissue distribution, capacity to transform and eliminate different chemicals and body response to environmental threats.

Water pollution is a serious environmental concern. Sewage and agricultural waste contaminate water supplies, and provoke a host of waterborne illnesses. In addition, rivers that are used as a source of drinking water are contaminated with heavy metals such as lead, cadmium and arsenic from industrial discharges, negatively affecting people’s health.

China is one of the countries in the world most seriously affected by arsenic contamination, reports UNICEF. Several studies carried out on the effects of drinking arsenic contaminated water showed serious effects on children’s intelligence and intellectual development.

Toxic compounds in air and water affect the health of children and adults alike. However, because children are still growing and their immune system and detoxification mechanisms are not fully developed, toxic agents have a more serious impact on them than in adults.

Chinese authorities have been trying to limit the damage caused by environmental pollution and have set guidelines in a document entitled ‘Priority Activities for Sustainable Development’. However, despite new policies and regulations, compliance remains low. On a World Bank list of 20 cities with the worst air quality, 16 of them are Chinese cities. It is estimated that 40% of Chinese cities suffer from medium to high-levels of air pollution.

According to a World Bank assessment, projected health effects of air pollution in urban China by 2020 will include: 600,000 premature deaths in urban areas, 20mn cases of respiratory illness per year, 5.5mn cases of chronic bronchitis and health damages valued at 13% of its GDP.

To overcome the effects of pollution and a contaminated environment China needs to continue developing energy-efficient technologies and implementing cheap and environmentally responsible transportation systems. Even more critically, China needs to enforce more stringently its own environmental regulations.

Dr. Cesar Chelala is an international public health consultant and the author of Environmental Impact on Child Health, a publication of the Pan American Health Organization. He is the foreign correspondent of the Middle East Times International (Australia).