China’s post-Cultural-Revolution reform generated rapid economic growth. But it also brought about major negative changes, especially in the early stage, which jeopardised the efforts in improving population health and mortality. These negative developments however were not accompanied by an increase in mortality for the national population. China had achieved the MDG target 4 of reducing U5M by two-thirds well before the target year. Its life expectancy continued to rise and reached 76.6 years by 2018, notably higher than the world average and that recorded in many countries with similar per capita GDP. Through analysing the positive health impacts of China’s recent economic growth, rebuilding nationwide health insurance systems, development of medical financial assistance and the poverty alleviation programs, this paper examines how these efforts have effectively moderated, stopped or surpassed the adverse impacts of the aforementioned negative developments. The evidence shows that these efforts have significantly lowered people’s vulnerability to health and mortality risks, increased the availability of, and people’s access to, health insurance systems, better medical treatments, and health services of other kinds. It is these macro-socioeconomic determinants that have played key roles in further improving population health and mortality in China in the past four decades.
Zhongwei Zhao is an Emeritus Professor at the School of Demography at Australian National University. He graduated from University of Cambridge with a PhD in 1993. Since then he has worked at the East-West Centre in Hawaii, University of New South Wales, Australian National University, and University of Cambridge. Zhongwei Zhao has been doing research in a wide range of areas including Historical demography, Computer microsimulation, Fertility, Mortality, Changes in kinship structure and household composition, Famine demography, Population health and inequality, Environmental impacts on mortality changes, and Population changes in Asia. He has co-edited three books and published a large number of journal articles and book chapters, including many in world leading demography journals, such as Population and Development Review, Population Studies, Demography. He has made presentations at many international conferences and been invited to give lectures and seminars in leading demographic research centres and institutes in many countries.