China has had a remarkable period of rapid growth shifting from a centrally planned to a market based economy since the 1978 economic reform. While China has had an enviable economic growth and development performance for more than 30 years, its human development has lagged behind the most advanced economies. China ranked 89th in the 2010 human development index prepared by the United Nations Development Program (UNDP) . The Chinese population’s healthy life expectancy (HALE) at birth is about 10 years shorter than in some of the leading G-20 countries. Why is that? The major cause is health problems, especially emergent non-communicable diseases in the course of economic development.
What are non-communicable chronic diseases (NCD)? What is serious about NCDs in China?
Chronic diseases are diseases of long duration and generally slow progression. Chronic diseases, such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes, are by far the leading cause of mortality in the world, representing 63% of all deaths . In brief, the proportion of NCD in total death rates in China was 85% in 2010, the patients with chronic disease numbered 260 million ; the age-standardized death rates of the major NCDs were increasing; the NCDs prevalence in rural areas was increasing more swiftly than in urban ones; and aging is expected to exacerbate the burden of NCD . At present, the number of NCD patients is alarming, health care costs are very high, patients with chronic diseases suffer for years, and the demand for health services is bigger.
What factors are related to the increasing morbidity and mortality of NCD? There is lot of evidence to link social-environmental tradeoffs: the links between sustainable development, modernization, urbanization and health. Everybody recognizes that good health among a population can also enhance economic performance by improving labor productivity and reducing economic losses that arise from illnesses. In fact, economic development is easy to select, and health concerns can be shortchanged when considering tradeoffs between economic growth and the protection of public health. Below are two cases to explain these points.
Case 1: Water Pollution and Digestive Cancer in the Huai River.
Since the 1970s, along with rapid social and economic development in the Huai River Basin, water pollution has become a new and additional type of water-related disaster in the area.
The “Atlas of the Water Environment and Digestive Cancer Mortality in the Huai River Basin”  was completed amd includes an analysis of data from the series of China Environmental Quality Reports , and published by the State Environmental Protection Administration from 1982-2008, and by the Ministry of Environmental Protection from 2009-2010, along with data from 1973-1975 national cause of death surve y and 2004-2005 survey on the cause of death in Population of the Huai River Basin.
A comparison of cause of death data for the Huai River Basin in 1973-1975 and 2004-2005 shows that mortality rates for digestive cancers, especially liver cancer and gastric cancer, rapidly shifted from low to high in the areas of Shenqiu and Yingdong on the Shaying River, Fugou and Mengcheng in the Guo River Basin, Yongqiao and Lingbi in the Kui River Basin, and Wenshang and Juye on the Yishusi water system. The mortality rate increased several times faster than the national average. These areas were precisely the ones with the most serious and long-term pollution contamination, including the tributary areas of the Hong, Shaying, Guo and Kui rivers. There is a strong spatial consistency between the polluted areas and those in which the rise in digestive cancer incidence was the largest.
Although pollution in the Huai River Basin was basically brought under control after 2005, relatively serious water pollution problems persist in some parts of the tributaries of the Huai River. People in some areas are still faced with a higher risk of contracting and dying from cancer.
Case 2: Tobacco economy and tobacco control
A wealth of epidemiologic evidence suggests that tobacco use can kill. Tobacco use is a risk factor for six of the eight leading causes of death in the world and as a result is the single most preventable cause of death in the world today. This year, tobacco will kill more than five million people. By 2030, the death toll will exceed eight million each year . Unless urgent action is taken, tobacco could kill one billion people during this century. In China, the annual death toll is over 1 million at present, and will increase to 2 million every year during 2020-2030 . Even so, the prevalence of smoking remains high. Moreover, 740 million non-smokers suffer exposure of secondhand smoke each year. Tobacco use is the one of the most important causes of increasing NCD incidence.
The WHO Framework Convention on Tobacco Control (WHO FCTC) came into force on Jan. 8, 2006 in China. However, facts indicate that the tobacco industry has thrived with the connivance of the Chinese government. Instead of decreasing, cigarette production has been increasing, and grew by 25% during the 6 years when FCTC was in effect. The government department (STMA) has not banned the lying propaganda on "low tar, low risk" distributed by the tobacco industry, and also conferred the National Award for Science and Technology Progress to representatives of tobacco industry who helped develop low tar cigarettes, recommended the academician of the Engineering Academy, and so on (see the 2012 Tobacco Control Report). These actions of anti-tobacco control have plagued China's implementation of the WHO FCTC. These enforcement results explain why China’s average enforcement score on the five FCTC policies is a mere 37.3 out of 100.
Good health is an important component of human development, not only because it makes people’s lives better, but also because having a healthy and long life enhances their ability to learn, acquire skills, and contribute to society . The Charter of the United Nations has declared that “Good health is a fundamental right of every human being” . The Chinese government has recognized the relationship between development and health. China’s 12th Five-Year Plan (2011–2015) aims to promote inclusive, equitable growth and development by placing an increased emphasis on human development . In the next 20 years, China could narrow improve human development if it translates awareness into action, focuses on the burden of NCD and related factors by mustering political support to overcome them, and implements appropriate interventions to decrease the overall health risks encountered by its population.
 UNDP. 2010. “The Real Wealth of Nations: Pathways to Human Development.” Accessed December 23,2010, at http://hdr.undp.org.
 WHO. 2010. World Health Statistics Accessed January 4, 2011, at http://www.who.int/whosis/whostat/EN_WHS10_Full.pdf.
 WHO，Chronic Disease，http://www.who.int/topics/chronic_diseases/en/
 HUMAN DEVELOPMENT UNIT East Asia and Pacific Region，Toward a Healthy and Harmonious Life in China: Stemming the Rising Tide of Non-Communicable Diseases, World Bank.
 Yang Gonghuan Lincoln C Chen，Jeffrey P Koplan, et al, Emergence of chronic non-communicable diseases in China, Lancet Health System Reform in China, October, 2008
 China CDC Chinese Academy of Science, Atlas of the Water Environment and Digestive Cancer Mortality in the Huai River Basin，edited by Yang GH Zhuang DF，Star Map Press (forthcoming)
 Editor in chief of the China’s Environmental Monitoring Station, National Environmental Quality Report, the State Environmental Protection Administration (SEPA), 1982-2008.
 Compiled by the Ministry of Environmental Protection of People's Republic of China, National Environmental Quality Report, China Environmental Science Press, 2009-2010
 Office of Cancer Prevention and Treatment Research, the Ministry of Health, survey of China’s deaths from cancers, the People's Health Publishing House, 1979 Beijing
 MOH, P. R. China, the Report on the Third National Retrospective Survey on the Death Causes by Sampling, edited by Chen Zhu, Peking Union Medical College Press, 2008, ISBN: 9787811360769
 WHO REPORT on the global TOBA CCO epidemic, 2008, The MPOWER package, Geneva，World Health Organization，2008.
 Liu B, Peto R, Chen Z, Boreham Z, Wu Y et al. Emerging tobacco hazards in china: I. Retrospective proportional mortality study of one million deaths. BMJ 1998: 317: 1411-1422
 Sen, A. 1999. Development as Freedom New York: Alfred A. Knopf.
 WHO. 1946. Constitution. Accessed on January 4, 2011, at http://apps.who.int/gb/bd/PDF/bd47/EN/constitution-en.pdf.
 China, Center Committee of Chinese Communist Party. 2011. Suggestions on the Development of the 12th Five Year Plan for the Nation’s Economic and Social Development Accessed on December 24, 2010, at http://news.china.com/zh_cn/focus/2010zgqh/11087561/20101028/16211890.html.