Addressing Noncommunicable Diseases in China

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Global health is now facing a dramatic transition. For the first time in human history, around the world more people are overweight than underweight, and more deaths occur among adults than children. China, with the world’s largest population, represents a microcosm of this global health transition and is now poised to address the world’s greatest emerging health threat—Noncommunicable diseases (NCDs). NCDs like diabetes, heart attacks, stroke, and cancer, kill more people globally and in China than infectious diseases.

China faces a remarkably severe threat from NCDs. An estimated 82% of China’s disease burden is due to NCDs—a number that is expected to grow over time. In China, there are high levels of salt intake and tobacco use, which greatly increase the risk of heart attacks and stroke. Stroke takes an especially heavy toll among Chinese due largely to hypertension which is associated with high dietary salt (sodium) intake. According to the Global Adult Tobacco Survey conducted by China CDC in collaboration with U.S. CDC, WHO, and the Bloomberg Global Tobacco Control Initiative, among adults older than 15 approximately 52% of men are current smokers contrasted to only 3% of women. This work has highlighted the tobacco issue in China. Therefore, U.S. CDC has focused initial NCD projects in China on sodium reduction and tobacco use.

“The need to address NCDs is a really big issue,” says Mike Engelgau, Senior Scientific Advisor for NCDs in China. “The country’s public health focus has been mostly on communicable diseases to date, and rightly so, but what’s happening in China is that the population is aging and NCDs are becoming more common. People don’t have the information to prevent diseases, maybe don’t understand the harm that tobacco brings, and their need for chronic care can over stretch the primary care system and their household budgets.”

In 2009, China requested U.S. CDC’s help to address NCDs. U.S. CDC retooled its signature Field Epidemiology Training Program (FETP) in China to include a NCD track to train officers within the country’s National Center for Chronic and Noncommunicable Disease Control and Prevention. The FETP officers’ studied a provincial salt reduction program and tobacco control adherence in public places in Beijing. U.S. CDC is also offering NCD courses for public health professionals in China. (.)

In the spring of 2011, U.S. CDC co-hosted China’s first Symposium on Salt Reduction, bringing together a global group of experts to highlight its importance in public health policy. In addition, U.S. CDC is collaborating with the U.S. National Institutes of Health, National Heart Lung and Blood Institute and the George Institute (China) on the China Rural Health Initiative to lower heart disease and stroke risk in rural Chinese populations. This initiative targets both improving blood pressure control in those already affected and preventing hypertension among the general rural population by reducing salt (sodium) intake. (.)

“China CDC is fully committed to NCD efforts,” says Engelgau. “They have enthusiastically cooperated with U.S. CDC. We are confident that together we can address the emerging public health threat of NCDs.”