Lancet Commission 2018: Healthy Cities in China

This report from The Tsinghua-Lancet Commission on Healthy Cities in China, led by Tsinghua University in Beijing, examines the challenges and opportunities faced by China’s cities with regard to health risks, health promotion, environmental health, and health-care delivery. The report describes how rapid urbanization in China has brought unprecedented health benefits to urban residents—for example, city-dwellers live longer and have greater access to health services and improved sanitation. However, the changes associated with that urbanization—such as large-scale migration, aging, pollution, shifts in diet and lifestyle, and social inequality—have led to new and different health challenges, such as an increased burden on senior care, a rise in noncommunicable diseases, and widening health inequalities. To address these issues, China has implemented strict environmental regulations, invested in urban infrastructure and improved sanitation systems, increased coverage of and accessibility to health services, and piloted strategies to improve urban health management and service delivery.

This Commission report, developed by a wide range of experts from numerous disciplines, examined the environmental and social determinants of health that characterize the unique context of China’s urban development, identified key stakeholders, and assessed actions for the prevention, management, and control of negative health outcomes related to the country’s rapid urbanization. The authors argue that key efforts are needed to combat the urban health challenges faced by China, and that those should be unified with the systems-based Healthy Cities movement. Their recommendations include: integrate health into all policies; increase participation by residents, the private sector, non-governmental organizations (NGOs), and community groups in health management; promote intersectoral action in the design, building, and management of healthy cities; set local goals for 2030 and assess progress periodically as part of the national efforts to achieve long-term goals articulated in the Healthy China 2030 plan; and enhance research and education on healthy cities by investing in and partnering with universities, research institutes, and the private sector.