《柳叶刀》文章：慢性病成中国人主要健康隐患

sunsong7

作者：程磊 来源：法制晚报 发布时间：2011-8-12 / H3 ]7 s! Z4 q6 O
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据英国媒体8月11日报道，日前，英国著名的医学杂志《柳叶刀》刊发题为《中国主要健康隐患是慢性疾病》的文章。文章指出，各种慢性疾病已经成为影响中国人生命的最大敌人。
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( p. T# d6 T: a# u9 d% M文章引用世界银行一份题为《创建健康和谐生活：遏制中国慢性病流行》的报告建议，中国要加紧处理日益加重的慢性非传染性疾病。
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6 e$ e. M. g! X1 D7 O数据：慢性病致死 过半因吸烟高糖高盐
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报告中称，全球每年约有1000多万人死于“慢性非传染性疾病”。( D! k- T4 r# y  {  u+ c

" x. h* `" U, ^- ?5 g慢性非传染性疾病主要包括心血管疾病、脑卒中、糖尿病、癌症和慢性呼吸系统疾病，报告预测，如果不进行有效控制和采取有效策略，到2030年，中国40岁以上人群，患这五大疾病的人数将增加2到3倍，糖尿病增加4倍，肺癌增加5倍。
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9 R0 n6 A; y% I6 B$ R* D! `文章称，高盐和高糖每年至少导致1400万人死亡，占慢性非传染性疾病总死亡的40%。& k/ B/ k$ ]$ p+ _

* M1 g% |& ]  `同时，慢性非传染性疾病所致死亡中的六分之一归因于烟草，全世界每天有15000人死于吸烟带来的疾病。因此报告建议，控烟和减盐成为最优先需要考虑的措施。
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! |: b* b4 c* u' L, a* e报告：国民健康与经济发展互相影响. y2 S& D! ]. f4 k; {4 o
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报告称，在2010年至2040年的30年里，如果每年能够将心血管疾病死亡率降低1%，其经济效益就会相当于2010年中国实际GDP的68%，超过10.7万亿美元。
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- c- j) y2 j# N! I' @$ H  L: ]文章称，慢性非传染性疾病的蔓延趋势在中国已经相当明显。目前已经扩展到了中国社会经济环境的各个方面。- d1 T9 Y9 i8 Y

5 |# |0 t# l* V# [/ l9 v1 g文章介绍，近年来，中国卫生部和世界卫生组织举行多次合作，就中国人健康问题进行研究探讨。报告强调，中国的高速发展会影响到国民身体健康，而国民身体状况的下降除了影响到国家GDP之外，对于国民心理的影响同样巨大。
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. d$ R) h$ Q2 ^) U1 q' o尽管长期的高增长和国民身体素质的下降会给中国带来发展瓶颈，但是中国最终还是应该考虑这两者的兼顾性。
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The Lancet, Volume 378, Issue 9790, Page 457, 6 August 2011 Next Article>doi:10.1016/S0140-6736(11)61232-4Cite or Link Using DOI. i  ^6 J1 _  X! K
China's major health challenge: control of chronic diseases
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In Toward a Healthy and Harmonious Life in China, a report issued last week, the World Bank urged China to step up efforts to tackle its rising tide of non-communicable diseases (NCDs), warning of not only the social but the economic consequences of inaction. NCDs are China's number one health threat, contributing to more than 80% of the country's 10·3 million annual deaths and nearly 70% of its total disease burden. Projections made in the report, which was produced in collaboration with the Chinese Ministry of Health and WHO, make for rather grim reading. If effective control and prevention strategies are not implemented, the prevalence of cardiovascular disease, chronic obstructive pulmonary disease, diabetes, and lung cancer in individuals older than 40 years will double or even triple during the next two decades. Resultant increases in treatment costs and a reduction in workforce productivity, the report warns, will increase the chances of future economic slowdown and pose a substantial social problem." X5 X% W$ c" t/ q+ D. A
A headline statistic in the report is that reduction of mortality from cardiovascular disease by only 1% between 2010 and 2040 will save the country a staggering US$10·7 trillion—68% of China's real gross domestic product in 2010. But mortality from NCDs is just the tip of the iceberg. NCD-related morbidity accounts for more than 90% of China's total NCD burden, and the increasing prevalence of disease is likely to severely reduce the number of healthy workers in China. This reduction in productivity does not stop at only those with disease. Their family members—who will also suffer from reduced household income—may need to take time off work to care for their dependants. This knock-on effect is particularly pertinent to China, because its one-child policy means that family carers will have proportionately more added responsibility than would individuals in other countries where care of a sick parent can be shared among siblings.
6 Y3 S( `3 A4 ~5 d$ L" ]The rising trend in NCDs is rooted in social, economic, and environmental changes that have taken place in China during the past couple of decades. China has undoubtedly done an excellent job in lifting many millions of its population out of poverty, but the same efforts have not yet been put into the improvement of population health. Indeed, many people's incomes have risen, which has improved the health status of much of the population, but the trappings of rapid urbanisation have meant increases in unhealthy behaviours and pollution, leading to a sharp rise in NCD-related risk factors, especially among the poor.) I0 v  `7 m* V
China's health-care system—traditionally geared towards the treatment of acute and infectious disorders—has been ill-equipped to deal with NCDs, but is undergoing reform. Central to these reforms are improvements in primary care. In 2010, China issued a capacity-building plan to address its serious shortage of general practitioners—in the next 10 years they plan to train an ambitious 300 000 general practitioners, who will certainly be needed if the reduction of NCDs is to become a priority. Furthermore, much-needed improvement in the professional status of doctors in China could strengthen their political voice. Such political empowerment would improve opportunities to influence public debate about the industries that contribute risk factors to NCDs—tobacco, food, and alcohol manufacturers, in particular. Nationwide reduction of air and water pollution is another area in need of urgent attention.
$ h9 n' y& A; A# V/ WAt this year's World Health Assembly, Chen Zhu, China's Minister of Health, spoke of the great urgency with which China must act to prevent chronic disease—any such actions will certainly need a multisectoral approach. This World Bank report, with its emphasis on the economic effects of these diseases, might just be what is needed to engage all stakeholders in China's economy. Put simply, investment into the prevention of NCDs will not only be good for the health and wellbeing of China's population, but will result in a substantial financial return for the country.: }( i3 S0 R9 c0 q2 f+ _
The report outlines some worrying problems, but presents an exciting challenge. If China—known to be a world leader in business and technology—can achieve progress in the effective prevention and control of NCDs, it can also become a world leader in health. Admittedly, compared with space exploration and advances in biotechnology, the control of NCDs lacks futuristic-chic, but, in the face of this bottleneck to China's social and economic development, it can certainly be considered equally as forward-thinking.
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http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61232-4/fulltext

wolf1978

这也彰显我国进行公共卫生、健康教育等基础性工作的重要性！值得关注！