Key Laboratory of Urban Environment & Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, 361021, China.
Environ Sci Technol. 2011 Jun 15;45(12):5099-104. doi: 10.1021/es2004254. Epub 2011 May 4.
China is undergoing a rapid transition from a rural to an urban society. This societal change is a consequence of a national drive toward economic prosperity. Rapid urbanization impacts on infrastructure, environmental health and human wellbeing. Unlike many cases of urban expansion, Chinese urbanization has led to containment, rather than to increase, in the spread of infectious diseases. Conversely, the incidence of chronic conditions such as cardiovascular and metabolic diseases has risen, with higher rates occurring in urban regions. This rural-urban gradient in disease incidence seems not to be a reflection simply of more aggressive diagnosis or healthcare access. Other diseases exhibit little rural versus urban differences (e.g., liver cancer or respiratory disease), or even occur at a higher rate in the rural population (e.g., esophageal cancer). This article examines the impact of this changing demographic on environmental health and human wellbeing in China. Lessons learned from epidemiological studies mostly carried out in Europe and the U.S. may not be directly transferable to China. We advocate that there is now a need to establish robust systems of accurate data collection, a Chinese biobank network to facilitate the profiling of human health effects, and relevant randomized controlled trials to identify effective interventions in the Chinese urbanized setting. Such studies could allow for the future implementation of disease-preventive strategies.
中国正经历着从农村到城市的快速转型。这种社会变革是国家经济繁荣的必然结果。快速的城市化对基础设施、环境健康和人类福祉都产生了影响。与许多城市扩张的情况不同，中国的城市化导致传染病的传播得到了遏制，而不是加剧。相反，心血管和代谢等慢性疾病的发病率有所上升，城市地区的发病率更高。这种疾病发病率的城乡梯度似乎不仅仅反映了更积极的诊断或获得医疗保健的机会。其他疾病在城乡之间差异不大（例如肝癌或呼吸道疾病），甚至在农村人口中的发病率更高（例如食管癌）。本文探讨了这种人口结构变化对中国环境健康和人类福祉的影响。从欧洲和美国进行的流行病学研究中获得的经验教训可能不能直接应用于中国。我们主张，现在有必要建立强大的准确数据收集系统、中国生物银行网络，以促进人类健康影响的特征描述，以及相关的随机对照试验，以确定在中国城市化环境中有效的干预措施。这些研究可以为未来实施疾病预防策略提供依据。
