A RECIPE FOR GOOD HEALTH

By Wang Hairong

Eat at least 12 varieties of food per day， and 25 per week. Consume at least 500 grams of vegetables and fruits daily， but no more than 25 grams of added sugar， 30 grams of edible oils and 5 grams of salt. Take 6，000-10，000 steps every day， and keep your waistline under 85 cm for men and under 80 cm for women.

These are some of the health tips provided in the Healthy China Action Plan for 2019-30， a document released by the State Council on July 15. The plan states that everyone should take primary responsibility for their own health.

The action plan was one of the three documents released by the Chinese Government to implement the Healthy China Initiative， which was elaborated in a central government blueprint titled Healthy China 2030 promulgated in 2016. It was subsequently made a national strategy at the 19th National Congress of the Communist Party of China（CPC） in October 2017.

The initiative is an important decision by the CPC Central Committee and the State Council to enhance peoples happiness and health and promote national renewal， said Yu Xuejun， deputy head of the National Health Commission at the press conference for the release of the three documents.

Strategic shifts

The central piece of the three documents， the guideline to implement the Healthy China Initiative， proposes 15 campaigns to promote healthy lifestyles and health at various stages of life， and to control major diseases and set health targets.

The campaigns address major public health concerns， such as mental health， student myopia， smoking and major chronic diseases， and offer dietary and fitness advice.

The second document， released by the General Office of the State Council， stipulates that the Healthy China Initiative Promotion Committee， comprised of an advisory body and special action groups， should be set up for pushing forward the initiative and evaluating relevant results. It stresses that major health indicators will serve as yardsticks for measuring the performance of various Party and government organizations and their leaders.

The third document， the Healthy China Action Plan for 2019-2030， details objectives and tasks for each campaign， as well as the responsibilities of various stakeholders including individuals， families， society and the government.

Yu said that in comparison to previous efforts to boost health， these campaigns signal a shift in the focus of health work from treating diseases to promoting health， and a shift from counting mainly on medical institutions to encouraging public participation and action so that people can shoulder responsibility and enjoy the fruits of good health.

In recent decades， China has made great progress in improving peoples health， Yu said， adding that in 2018， the average life expectancy in China was improved to 77 years old， and major health indicators were better than the average level of medium- to highincome countries.

However， with the acceleration of industrialization， urbanization and population aging， the disease spectrum of Chinese residents is changing， and people are confronting new health problems， Yu said.

On the one hand， hepatitis， tuberculosis， and occupational and endemic diseases cannot be neglected， and the prevention and control of major infectious diseases such as AIDS is still challenging， he said.

But on the other hand， relatively poor health knowledge and unhealthy lifestyles， which include smoking， alcohol abuse， lack of exercise and an unbalanced diet， have resulted in increasingly salient health problems， especially chronic diseases such as cardiovascular and cerebrovascular diseases， cancer， chronic respiratory diseases and diabetes， he pointed out.

Chronic diseases have caused 88 percent of the total deaths in China and incurred more than 70 percent of the total burden of diseases， Yu noted.

Unhealthy lifestyles can be changed and main health risk factors are preventable and controllable， he said. Personal behaviors and lifestyles can affect 60 percent of a persons health， according to the World Health Organization.

The health system is changing its thinking and methods， Yu said. While continuing to deepen medical reform， increasing access to medical treatment and lowering costs， the government will vigorously promote the transformation from “centering on the treat-ment of diseases” to “centering on peoples health.”

As the Healthy China Action Plan for 2019-2030 states， the purpose of the actions is to help everyone learn， understand and master information and skills related to disease prevention， early detection， emergency rescue， timely medical treatment， rational drug use and other aspects of health maintenance； enhance health awareness； and constantly improve health management capabilities.

Setting targets

The guideline on implementing the Healthy China Initiative and the two supporting documents put forward the overall objectives of the Healthy China Action by 2022 and 2030， Yu said.

Of the 15 campaigns proposed in the guideline， the first group of six covers health influencing factors ranging from popularization of health knowledge， a balanced diet， national fitness， tobacco control， mental health and a healthy environment. The second group of four campaigns focuses on health issues of key demographic groups such as mothers and children， primary and secondary school students， and workers. The third group of five campaigns addresses chronic diseases including cardiovascular and cerebrovascular diseases， cancer and chronic respiratory diseases， and diabetes， as well as infectious and endemic diseases.

The guideline states that by 2030， main health indicators for residents in China will reach the levels of high-income countries and health equity will be basically realized. Specific health targets have been set for all 15 campaigns.

For instance， by 2022 and 2030， life expectancy will increase from the current 76.7 to 77.7 and 79， respectively； the infant mortality rate will be controlled at or below 7.5 and 5 per 1，000 live births， respectively； and the maternal mortality ratio will be reduced to below 18 and 12 per 100，000 live births， respectively.

The level of residents health literacy will be raised from 14.18 percent in 2017 to 22 percent in 2022 and 30 percent in 2030.

Poor knowledge about health is reflected in a poor diet and other unhealthy lifestyles. Many people have a diet rich in sugar， fat and salt， which is leading to obesity and chronic diseases.

It has been reported that Chinese peoples waistline has been expanding at a rate much faster than the countrys economic growth rate， and China has exceeded the U.S. as the country with the largest number of overweight people. Data in the Healthy China Action by 2022 and 2030 show that as of 2012， 30.1 percent of Chinese adults were overweight and 11.9 were obese， up 32 percent and 67.6 percent， respectively， from 2002. Among children aged between 6 and 17， the overweight and obesity rate was 9.6 percent and 6.4 percent， respectively， doubling and tripling that of 2002.

On the other hand， malnutrition still has not been eliminated. The action plan showed that during the 2010-12 period， 6 percent of adults suffered from malnutrition， and 8.1 percent of children under the age of 5 suffered from growth retardation. Moreover， the anemia rate among pregnant women， children and the elderly was still high. Deficiencies in micronutrients such as calcium， iron， and vitamins A and D still existed， and peoples intake of dietary fiber was insufficient.

Lack of physical exercise is also a reason for a high incidence of chronic diseases. According to the national fitness survey conducted by the General Administration of Sport of China， the proportion of urban and rural residents who often took part in physical exercise was 33.9 percent in 2014. In particular， only 14.7 percent of residents aged 20 to 69 regularly exercised.

The documents aim to lower the obesity rate and increase the proportion of people engaging in regular exercises to at least 37 percent and 40 percent by the year 2022 and 2030， respectively， while offering dietary and fitness advice.

Furthermore， the action plan has set binding targets to ensure the health of primary and middle school students. For instance， primary and middle schools are mandated to offer physical education and health courses and eyesight protection exercises， and let students have at least one hour of physical activities on campus every day. By 2030， 90 percent of these schools must have full-time or part-time health teachers and professional health workers as well as full-time or part-time psychological consultants.

In addition to physical fitness goals， the documents also addressed mental health. Currently， the prevalence of depression and anxiety disorders is 2.1 percent and 4.98 percent， respectively， according to the action plan. By the end of 2017， 5.81 mil- lion people with severe mental disorders had been registered， but because of lack of awareness of and prejudice against these diseases， many people do not seek medical help.

The action plan set mental health targets for the years 2022 and 2030， stating that the prevalence of insomnia， anxiety disorders and depression will decrease； the number of psychiatrists per 100，000 people will reach 3.3 and 4.5， respectively； the treatment rate of depression will increase by 30 percent and 80 percent， respectively； and the treatment rate of registered schizophrenia patients will reach 80 percent and 85 percent， respectively.

The three documents are based on scientific research and practices， Yu said at the press conference， calling on the general public to participate in the initiative. “By taking part in the Healthy China Initiative， you will benefit from it and so will your family and our country，” he said.

Major Health Targets for 2022 and 2030

The growth rate of adult obesity will continue to slow down， and the growth retardation rate of children under 5 years old will be kept under 7 percent and 5 percent， respectively.

The proportion of urban and rural residents who meet the National Physical Fitness Standard will be no less than 90.86 percent and 92.17 percent， respectively. The proportion of people who regularly take part in physical exercise will be at least 37 percent and 40 percent， respectively.

The proportion of people protected by smoke-free regulations will be at least 30 percent and 80 percent， respectively.

The level of residents mental health literacy will increase to 20 percent and 30 percent， respectively， and the rising trend of mental health-related diseases will slow down.

The quality of drinking water for residents will improve significantly and continuously.

The infant mortality rate will be kept at or below 7.5 and 5 per 1，000 live births， respectively， while the maternal mortality ratio will be reduced to below 18 and 12 per 100，000 live births， respectively.

At least 50 percent and 60 percent of students， respectively， will be able to meet the national students physical health standards. The overall myopia rate of children and adolescents in China will be lowered by more than 0.5 percentage points annually.

The proportion of new cases of pneumoconiosis reported by workers with less than five years of exposure to dust will decline significantly and continuously.

The incidence of disability in seniors aged 65 to 74 will decrease， and the incidence of dementia in seniors aged 65 and above will decline.

The mortality rate of cardiovascular and cerebrovascular diseases will decrease to or be under 209.7 and 190.7 per 100，000 people， respectively.

The overall five-year survival rate for cancer will be no less than 43.3 percent and 46.6 percent， respectively.

The mortality rate of chronic respiratory diseases among people aged 70 and younger will drop to or below 9 and 8.1 per 100，000 people， respectively.

At least 60 percent and 70 percent of diabetic patients， respectively， will be subject to standardized disease management.

The coverage rate of immunization programs for school-age children will stay above 90 percent in every township （town， neighborhood）.

（Source： The Guideline to Implement the Healthy China Initiative）