The Tsinghua–Lancet Commission on Healthy Cities in China: unlocking the power of cities for a healthy China

• Published in: The Lancet Vol. 391; no. 10135; pp. 2140 - 2184
• Main Authors: Yang, Jun, Siri, José G, Remais, Justin V, Cheng, Qu, Zhang, Han, Chan, Karen K Y, Sun, Zhe, Zhao, Yuanyuan, Cong, Na, Li, Xueyan, Zhang, Wei, Bai, Yuqi, Bi, Jun, Cai, Wenjia, Chan, Emily Y Y, Chen, Wanqing, Fan, Weicheng, Fu, Hua, He, Jianqing, Huang, Hong, Ji, John S, Jia, Peng, Jiang, Xiaopeng, Kwan, Mei-Po, Li, Tianhong, Li, Xiguang, Liang, Song, Liang, Xiaofeng, Liang, Lu, Liu, Qiyong, Lu, Yongmei, Luo, Yong, Ma, Xiulian, Schwartländer, Bernhard, Shen, Zhiyong, Shi, Peijun, Su, Jing, Wu, Tinghai, Yang, Changhong, Yin, Yongyuan, Zhang, Qiang, Zhang, Yinping, Zhang, Yong, Xu, Bing, Gong, Peng
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 26.05.2018; Elsevier BV; Elsevier Limited
• Subjects: Air pollution; Biomedical and clinical sciences; Breast cancer; Cardiovascular diseases; China; Chronic obstructive pulmonary disease; Cities; Clinical Research; Disease control; Economic development; Economic growth; Economic impact; Economics; Education; Environmental factors; Environmental regulations; General & Internal Medicine; Grants; Health Policy; Health Promotion; Health sciences; Health services; Heart diseases; Herbal medicine; Humans; Infectious diseases; ITC-ISI-JOURNAL-ARTICLE; Maintenance; Medical and Health Sciences; n/a OA procedure; Objectives; Participation; Particulate emissions; Particulate matter; Pollution effects; Prevention; Public health; R&D; Research & development; Sanitation; Science; SDG 10 - Reduced Inequalities; SDG 11 - Sustainable Cities and Communities; SDG 3 - Good Health and Well-being; Sulfur dioxide; Sustainable development; The Lancet Commissions; Traditional Chinese medicine; Urban areas; Urban Health; Urbanization; Beijing China; China
• ISSN: 0140-6736; 1474-547X; 1474-547X
• DOI: 10.1016/S0140-6736(18)30486-0

Non-communicable diseases have replaced infectious diseases as the leading cause of death among urban residents; the percentage of years of life lost because of such diseases as a fraction of all-cause years of life lost increased from 50·0% (95% CI 48·5–53·0) in 1990 to 77·3% (76·5–78·1) in 2015.4 Health inequality also increased in urban areas.5 China has acted to address urban health challenges by passing strict environmental regulations and investing heavily in urban infrastructure.In traditional chinese medicine, human health is seen as the consequence of harmonisation between human beings and their environments and between the various parts of the human body and the focus is on disease prevention rather than treatment.16 Concepts from traditional Chinese medicine, such as the maintenance of regular daily activities (rest, diet, and exercise) and avoidance of negative health effects from environmental factors (eg, Fengshui) have become essential parts of Chinese culture.In 2007 alone, particulate matter with a diameter of less than 2·5 μm (PM2·5) affected the productivity of about 72 million workers in 30 Chinese provinces, causing an estimated economic loss of ¥346·3 billion (US$44·4 billion, about 1·1% of the national gross domestic product [GDP]).19 Total economic losses attributed to the public health effects of pollution from particulate matter with a diameter of less than 10 μm (PM10) and sulphur dioxide (SO2) pollution in 74 cities were estimated to be as high as ¥439·8 billion ($70·9 billion, about 2·3% of these cities' GDP) in the first half of 2015.20 China will also have a massive future burden of non-communicable diseases—most of which will affect urban areas—that will strain future health systems and limit economic growth in the country.Total annual premature deaths from such diseases are expected to increase from 3·11 million in 2013 to 3·52 million in 2030.21 Between 2012 and 2030, economic losses attributable to five key non-communicable diseases–ischaemic heart disease, cerebrovascular disease, diabetes, breast cancer, and chronic obstructive pulmonary disease–will total $23·03 trillion USD,22 which is more than twice of China's total GDP in 2015 ($11·07 trillion).