Since the 1949 revolution and the
consequent establishment of the People's
Republic of China, the improved health
status of the Chinese people has been
dramatic. The significant achievements in
this regard, both nationally and in some
specific localities such as Shanghai,",2 have
been widely acknowledged and documented.3'4
Those achievements have been
measured by increased life expectancy,
decreased infant mortality, and reduced
morbidity. Specifically, life expectancy
increased from about 35 to 70 years
between 1949 and 1990, and the overall
death rate declined from approximately
20% to 6% of the population per year
during the same period.5 This decline in
deaths appears to be primarily owing to
the reduction in infectious diseases.6
Despite these improvements, health
status varies markedly in different parts of
China. Deaths due to all major causes are
from 10% to 100% higher for specific age
groups in rural as compared with city
populations. In addition, deaths due to
infections remain high in many provinces.
These variations may be explained by the
substantial differences in both geography
and socioeconomic development across
China.