Mortality Change and the Epidemiological Transition Beijing, 1644-1990

Abstract

Abstract Describing and explaining China’s mortality decline was until recently a straight forward task, if only because a lack of data has prevented it from being analyzed in as much detail as Europe’s. First, until the middle of this century, death rates in China were high because infectious diseases were endemic and malnutrition was widespread (Banister, 1987: 50; Jamison et al., 1984: 1, 11). Second, death rates began to fall rapidly after 1949. An epidemiological transition (Omran, 1971) took place, with chronic, non-communicable diseases such as cancer and heart disease replacing communicable diseases as the leading causes of death. By the late 1970s China had a life expectancy at birth that was high not only by the standards of other countries at similar levels of development, but also by the standards of much wealthier countries (Caldwell, 1986). Third, resource allocations and policy interventions by the post-1949 mainland Chinese government were largely responsible for improvements in health (Bumgarner, 1992; Halstead et al., 1985; Jamison et al., 1984; Lavely et al., 1990; Banister, 1987: 83-5). The state devoted a relatively large share of the country’s limited resources to the health sector, focusing on the prevention of disease, the provision of primary health care, and the delivery of services to rural areas. At the same time, it improved nutrition and education through other policy interventions.

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