- Open Access
Urbanization and health in China, thinking at the national, local and individual levels
© Li et al. 2016
- Published: 8 March 2016
China has the biggest population in the world, and has been experiencing the largest migration in history, and its rapid urbanization has profound and lasting impacts on local and national public health. Under these conditions, a systems understanding on the correlation among urbanization, environmental change and public health and to devise solutions at national, local and individual levels are in urgent need.
In this paper, we provide a comprehensive review of recent studies which have examined the relationship between urbanization, urban environmental changes and human health in China. Based on the review, coupled with a systems understanding, we summarize the challenges and opportunities for promoting the health and wellbeing of the whole nation at national, local, and individual levels.
Urbanization and urban expansion result in urban environmental changes, as well as residents’ lifestyle change, which can lead independently and synergistically to human health problems. China has undergone an epidemiological transition, shifting from infectious to chronic diseases in a much shorter time frame than many other countries. Environmental risk factors, particularly air and water pollution, are a major contributing source of morbidity and mortality in China. Furthermore, aging population, food support system, and disparity of public service between the migrant worker and local residents are important contributions to China’s urban health.
At the national level, the central government could improve current environmental policies, food safety laws, and make adjustments to the health care system and to demographic policy. At the local level, local government could incorporate healthy life considerations in urban planning procedures, make improvements to the local food supply, and enforce environmental monitoring and management. At the individual level, urban residents can be exposed to education regarding health behaviour choices while being encouraged to take responsibility for their health and to participate in environmental monitoring and management.
- Food Safety
- West Nile Virus
- Migrant Worker
- Healthy City
- Insufficient Physical Activity
Urbanization is an important social process underpinning the dynamics of human society, and it is especially impactful in the 21st Century. Generally, urbanization is accompanied by an increase in the proportion of urban to rural population, population growth in built-up areas; with urbanism referring to the urban lifestyle and its associated social and behaviour features . Contemporarily, world urbanization has entered a special period with some new features including information cities or smart cities, multi-centred metropolitan areas, and further globalization involving the transmission of novel ideas and risk behaviours beginning in cities .
In China, urbanization has entered a period of accelerated development since the 1990s. Urban population growth in China is characterized by rural-to-urban migration. Nearly 40 % of people living in urban areas are migrants, with migrant populations numbering roughly 260 million . To accommodate this significant immigration and population growth within cities, China’s urban area has increased rapidly, with large areas of farmlands converted to urban use. However,the urbanization process has progressed faster than economic growth since 2004, and it is now time to consider urbanization quality rather than a continuation of the spatial expansion from large scale “destroy and build” . In March 2014, China unveiled the New-style Urbanization Plan (2014–2020) in an effort to steer the country’s urbanization onto a more human-centered and environmentally friendly path .
Despite numerous benefits originating from urbanization, as with other countries that are urbanizing rapidly, China also faces intensified resource scarcity and environmental degradation , . Rapid urbanization impacts on natural and built infrastructure, environmental health and human wellbeing . In this paper, we provide a systems overview of the relationship between urbanization, urban environmental change and health, and put forward possible solutions at national, local and individual levels based on evidence-based understandings of the links between urbanization and health in contemporary China.
Figure 1 illustrates in particular how systemic changes in the environment as a result of urbanization pose numerous threats to human health. Rapid and often unplanned, urban growth is a source of environmental hazards, which have direct and indirect effects on human health. Urban expansion is one of the major driving factors of land use/coverage change in China, with extensive effects on local ecological systems through reducing biodiversity, air deterioration and contributing to water shortages . Accelerated urbanization along with explosive economic growth has further worsened the shortage of agricultural land over the last two decades  with possible consequences for food security and nutritional deficiencies threatening the overall health status of the population. Reduced cultivated land places pressures to intensify agricultural production which depends on both the progress of agricultural technology and deeper dependence on usage of fertilizer and pesticides. Such inputs have repercussions for the availability of safe food, and also for the price of food, as fertilizer costs increase in line with oil prices.
Urban environmental change includes air pollution and noise caused by construction and transportation, and soil pollution and water pollution caused by waste disposal. Soil and water pollution can compound the problems and can cause human diseases directly . Studies indicate that urban noise has adverse effects on human health, which may result in behavioural, psychological and physiological processes that pose risks to health. Noise exposure can impair the hearing system, producing temporary or permanent deafness . China does not regulate the noise produced by construction activities and motor vehicles, to which urban residents are particularly exposed.
Urbanization not only transforms the urban environment, but encourages changes to people’s lifestyle, which is recognized by researchers as a key determinant of human health –. Growing numbers of people become reliant on automobile use and they can afford to buy computers; and high levels of car and computer use displaces more vigorous physical activity with passive activity. Fast food with high calories becomes more readily available as the numbers of time-poor but income-wealthier consumers grow, and is an increasing source of lunch food for urban workers. Reduced physical activity and high-calorie foods are the major contributing factors to the rise in body overweight and obesity world-wide, and China is no exception. Moreover, the fast-paced life in cities brings mental stress to residents, which like noise exposure can result in changed physiologic, psychological and behavioural processes .
Strategy at national level
Through its control of national legislation and policy instruments, the central government is best placed to enact strong environment policies, food safety laws and regulations, review the coverage of the health care system, and make gradual adjustments to demographic policies. Evidence suggests that it is urgent to replace the current quantity-oriented environment campaign targets with targets emphasizing ecosystem function, as discussed in the Jianguo Wu’s paper . Urban ecologists recognise that healthy cities and a healthy planet are part of the same system, and that it will not only be necessary to reduce the resource throughput of cities but new socio-technical systems are required that are capable of recycling wastes and capturing pollution . In China, there are calls to reduce the subsidies allocated to high carbon content fuels , and to incorporate environmental and health co-benefits into climate policies . Regarding PM2.5, the pursuit of low-carbon electricity generation would be cost-effective if the costs of pollution-related health problems under existing energy generation technologies are taken into account . Forging links between energy and water policy and overall development planning are also under discussion, as it is in United Nations agencies with the UN declaring 2005–2015 as the Water for Life decade , and it is expected that this initiative will drive more effective multi-sector action. The next step would be to create links to urban agricultural and food policy. In one meta-review of studies which examine sources of pollution and chemical contamination of city-grown foods across China, polycyclic aromatic hydrocarbons recur as a major contaminant, which is in part due to coal fired combustion . Based on the Food Safety Law, China has established a food safety insurance system, but more efforts at responsibility clarification in relation to policy insurance are needed. In this regard, China’s food safety laws could be influenced by the One Health movement which is based on the principle that healthy agricultural ecosystems produce healthy animals and together they produce healthy populations . To establish a universal coverage basic healthcare system, providing affordable basic health care to everyone in the country, the Chinese central government launched a national health reform plan in 2009. Two years later, China achieved basic healthcare coverage for over 90 % of the population, which was realized through a universal health insurance system . There is still room for improvement in terms of health equity, especially in relation to health care accessibility and affordability for the aging population and the migrant workers. Finally, population policies need to be redesigned for the inevitable trend towards an aging population and the profound effects of the one-child policy for labour market functioning and national prosperity. The challenge for the Chinese government is to fine-tune support for mobile populations in ways that are environmentally sustainable, culturally acceptable and deliver the best outcomes for health and well-being of the mobile population.
Strategy at local level
As the policy implementers, local governments can shape city eco-systems and population health by improving urban planning , establishing local food supplies which are safe and offer sources of diverse nutrition , and enforcing environmental monitoring and management . Each local planning agency could forge close partnerships with urban health and wellbeing planners, thereby moving the public health function into local authorities. Small food producers can be empowered to learn from one another about how to improve food safety through improving agricultural environments . Local government could become members of the Global Healthy Cities movement to share ideas about how urban planning can be used to shape health promoting physical and social environments , and take advantage of research on urban environmental health and sustainability developed by the Healthy-Polis consortium. In this way, cities can foster simultaneously sustainable development and public health. Health-centred local planning would involve focusing urban design on more open green space and outdoor recreational facilities, building design for more physical activity and high temperature mitigation . Through the provision of more diverse and easily accessible cultural and exercise opportunities, the building of harmonious communities or neighbourhoods can result and thus reduce urban-related mental stress and aloneness. In terms of advancing healthy dietary behaviours, local authorities can support local food systems through allocating space to urban gardens and agriculture. There are some notable examples where local authorities are combining agro-tourism with sustainable urban food systems which involve waste recycling . Local government can also create physical spaces for people to shop for healthy foods including safeguarding or providing spaces for fresh food markets. Access to fresh food markets has been shown in other Asian countries to be important for low income communities given that plant based foods are generally cheaper in traditional retail formats than in supermarkets . In addition, local government can use planning tools to provide food environments which encourage people to eat together, rather than alone. In many cultural contexts, eating together can have health benefits . In relation to food safety, local government is the relevant authority for enforcing food safety laws. In particular, local government should consider leading the reconstruction of the local food supply system for the following reasons: Firstly, much food contamination harmful to health takes place during the storage and transport stages , which could be reduced through establishing a local food supply system. Secondly, a local food supply system could provide more fresh fruits and vegetables which are good for health. Thirdly, participation in the labour-force at urban farms could increase physical activity and reduce mental stress. Labour force participation also brings household incomes which in turn can be allocated to healthier diets. China is well-placed to consolidate its encouragement of household food production and could draw upon experience with urban agriculture elsewhere . With the development of the information technology and the internet, local government could introduce action research methods involving local residents combined with food or green space mapping using GIS technologies to monitor and manage the urban environment. The International Centre for Sustainable Cities has an urban greening partnership program which has supported local authorities in several Asian cities to work with residents on environmental improvements including using urban spaces for food production . China has long been regarded as a centralized society where the public has little influence on decision-making; and there is a view that a lack of public participation in environmental monitoring and environmental management make responses less efficient. Given that urban residents directly suffer urban environmental pollution they have a stake in becoming more active in alerting authorities to immediate harmful environmental pollution. Fortunately, there is a precedent: the recent popular struggle against PM2.5 has opened a door to public participation for addressing environmental issues in China .
Strategy at the individual level
Individuals too should be encouraged to take responsibility for their health within the context of a supportive regulatory and policy environment, as outlined above. According to the Global Burden of Diseases data base, much of the disease burden in China’s urban areas is associated with individual behaviours and practices, such as diets low in fruit, high in sodium and low in whole grains, consumption of alcohol, smoking and insufficient physical activity, which is steadily rising in China . Before they can make behavioural choices however, urban citizens require facts about their environment and food supply. Just as consumers in other nations are demanding more information on food producers, production methods and product quality of their food, so Chinese consumers need access to such information . There is also a case for improving nutrition literacy through government campaigns, backed up by fiscal and regulatory measures in relation to food advertising . Health promotion activities aimed at individuals will be most successful if they take into account household resources, education and local area facilities and services . Possibly the most important health promoting mechanism is investments in high levels of education, labour market opportunities and housing which has clean water, electricity and has good access to public transport. Under this set of conditions, individuals have greater choices available to them to adopt healthy lifestyles. This is the logic which has underpinned the Healthy Cities program since it began in 1986 , with the China Hong Kong chapter sponsoring the most recent Conference of the Global Alliance for Healthy Cities.
Urbanization in China, accompanied by increasing economic growth and consumerism, overwhelms and marginalises numerous ecological and social issues, which in effect lead to problems in public safety, public health, and social equity. Other than learning from those developed countries which have experienced rapid urbanization, China is also challenged by an unprecedented complicated situation, because of a large and aging population, significant environmental degradation brought about by rapid industrialization, and frequently reported food safety issues. Based on systems thinking, and scientific evidence of the links between broad trends, including public health risks, it is possible to propose solutions at national, local, and individual levels. Most importantly, the central and local governments and the public need to work together to advance the common goal of urban health and human wellbeing. At the national level, the central government should act on current environment policies, food safety laws, and the health care system, while incrementally adjusting demographic policy. At the local level, the local government is well-placed to shape the city ecology towards healthy life by using urban planning, establishing a local food supply system, and enforcing environmental monitoring and management. Within the context of government regulations and investments in improvements to urban infrastructure, individuals should be encouraged through health education to take responsibility for their health behaviours. Moreover, they should be encouraged to participate in environmental monitoring and management by using portable monitoring equipment or just smartphone app. Classified as an upper-middle-income country by the World Bank in 2011, China could play a more important role in global health , . This leadership potential could be strengthened through its institutions promoting the type of systems thinking outlined in this paper, which links an understanding of urbanization, demographic and socio-economic trends and health at the national, local and individual levels.
This work was supported by National Science Foundation of China (No. 41371540, No. 41201598, No. 41201155, No. 41101551), Chinese Academy of Sciences(No.KFJ-EW-STS-088), and Major Special Project-The China High-Resolution Earth Observation System. We also thank professor Zhu YG for suggestions on the writing.
Funding for the publication fee of this article was provided by the Institute of Urban Environment, Chinese Academy of Sciences.
This article has been published as part of Environmental Health Volume 15 Suppl 1, 2016: Healthy-Polis: Challenges and Opportunities for Urban Environmental Health and Sustainability. The full contents of the supplement can be found at http://www.ehjournal.net/supplements/15/S1.
Peer review reports for this article are attached as Additional file 1.
- Gu CL, Wu LY, Cook L: Progress in research on Chinese urbanization. Front Archit Civil Engin Chin. 2012, 1 (2): 101-49.Google Scholar
- Li XH, Gao LL, Dai L, Zhang GQ, Zhuang XS, Wang W, et al: Understanding the relationship among urbanisation, climate change and human health: a case study in Xiamen. Int J Sust Dev World. 2010, 17 (4): 304-10. 10.1080/13504509.2010.493711.View ArticleGoogle Scholar
- Gong P, Liang S, Carlton EJ, Jiang Q, Wu J, Wang L, et al: Urbanisation and health in China. Lancet. 2012, 379 (9818): 843-52. 10.1016/S0140-6736(11)61878-3.View ArticleGoogle Scholar
- Chen MX, Liu WD, Tao XL: Evolution and assessment on China’s urbanization 1960–2010: Under-urbanization or over-urbanization?. Habitat Int. 2013, 38: 25-33. 10.1016/j.habitatint.2012.09.007.View ArticleGoogle Scholar
- China daily. 2014 http://www.gov.cn/zhuanti/xxczh/ (accessed 15 January 2016).
- Li XH, Liu JL, Gibson V, Zhu YG: Urban sustainability and human health in China, East Asia and Southeast Asia. Curr Opin Env Sust. 2012, 4 (4): 436-42. 10.1016/j.cosust.2012.09.007.View ArticleGoogle Scholar
- Li XH, Wang CP, Dixon J, Zhang GQ, Xiao LS: Urbanization and human health in China: Spatial features and a systemic perspective. Environ Sci Pollut R. 2012, 19 (5): 1375-84. 10.1007/s11356-011-0718-7.View ArticleGoogle Scholar
- Zhu YG, Loannidis JPA, Li H, Jones KC, Martin FL: Understanding and harnessing the health effects of rapid urbanization in China. Environ Sci Technol. 2011, 45: 5099-101. 10.1021/es2004254.View ArticleGoogle Scholar
- Popkin BM, Du SF: Dynamics of the nutrition transition toward the animal foods sector in China and its implications: a worried perspective. J Nutr. 2003, 133: 3898S-906.Google Scholar
- Moore M, Gould P, Keary BS: Global urbanization and impact on health. Int J Hyg Envir Heal. 2003, 206 (4–5): 269-78. 10.1078/1438-4639-00223.View ArticleGoogle Scholar
- Lin T, Gibson V, Cui SH, Yu CP, Chen SH, Ye ZL, et al: Managing urban nutrient biogeochemistry for sustainable urbanization. Environ Polluti. 2014, 192: 244-50. 10.1016/j.envpol.2014.03.038.View ArticleGoogle Scholar
- Rayner G, Lang T: Ecological public Health. 2012, Routledge, LondonGoogle Scholar
- Liu G, Yang Z, Chen B, Ulgiati S: Emergy-based dynamic mechanisms of urban development, resource consumption and environmental impacts. Ecol Model. 2014, 271 (10): 90-102. 10.1016/j.ecolmodel.2013.08.014.View ArticleGoogle Scholar
- Jiang L, Deng XZ, Seto KC: The impact of urban expansion on agricultural land use intensity in China. Land Use Policy. 2013, 35: 33-9. 10.1016/j.landusepol.2013.04.011.View ArticleGoogle Scholar
- Li ZY, Ma ZW, van der Kuijp TJ, Yuan ZW, Huang L: A review of soil heavy metal pollution from mines in China: pollution and health risk assessment. Sci Total Environ. 2014, 468–469: 843-53. 10.1016/j.scitotenv.2013.08.090.View ArticleGoogle Scholar
- Van Kamp I, Davies H: Noise and health in vulnerable groups: a review. Noise Health. 2013, 15 (64): 153-9. 10.4103/1463-1741.112361.View ArticleGoogle Scholar
- Dixon J, Omwega AM, Friel S, Burns C, Donati K, Carlisle R: The health equity dimensions of urban food systems. J Urban Health. 2007, 84 (1): 118-29. 10.1007/s11524-007-9176-4.View ArticleGoogle Scholar
- Li GW, Zhang P, Wang JP, Gregg EW, Yang W, Gong Q, et al: The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study. Lancet. 2008, 371: 1783-9. 10.1016/S0140-6736(08)60766-7.View ArticleGoogle Scholar
- Lin T, Yu Y, Bai X, Feng L, Wang J: Greenhouse gas emissions accounting of urban residential consumption: a household survey based approach. PLoS One. 2013, 2: e55642-10.1371/journal.pone.0055642.View ArticleGoogle Scholar
- Liu JL, Li XH, Lin T, Dai L, Zhang GQ, Zhang CS, et al. Spatial analysis of gastric cancer morbidity in regions of rapid urbanization: a case study in Xiamen, China. Stoch Environ Res Risk Assess. 2015, DOI: 10.1007/s00477-015-1141-2.Google Scholar
- Yang G, Wang Y, Zeng Y, Gao GF, Liang XF, Zhou MG, et al. Rapid health transition in China, 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2013;381(9882):1987–2015.Google Scholar
- Yang WY, Liu JM, Weng JP, Jia W, Ji L, Xiao J, et al: Prevalence of diabetes among men and women in China. New Engl J Med. 2010, 362: 1090-101. 10.1056/NEJMoa0908292.View ArticleGoogle Scholar
- Zhang J, Mauzerall DL, Zhu T, Liang S, Ezzati M, Remais JV: Environmental health in China: progress towards clean air and safe water. Lancet. 2010, 375 (9720): 1110-9. 10.1016/S0140-6736(10)60062-1.View ArticleGoogle Scholar
- Jahn HJ, Schneider A, Breitner S, Eißner R, Wendisch M, Krämer A: Particulate matter pollution in the megacities of the Pearl River Delta, China - a systematic literature review and health risk assessment. Int J Hyg Environ Health. 2011, 214 (4): 281-95. 10.1016/j.ijheh.2011.05.008.View ArticleGoogle Scholar
- Pui DYH, Chen SC, Zuo Z: PM2.5 in China: Measurements, sources, visibility and health effects, and mitigation. Particuology. 2014, 13: 1-26. 10.1016/j.partic.2013.11.001.View ArticleGoogle Scholar
- Valavanidis A, Vlachogianni T, Fiotakis K: Pulmonary oxidative stress, inflammation and cancer: respirable particulate matter, fibrous dusts and ozone as major causes of lung carcinogenesis through reactive oxygen species mechanisms. Int J Environ Res Public Health. 2013, 10 (9): 3886-907. 10.3390/ijerph10093886.View ArticleGoogle Scholar
- Zhang X, Zhuang D, Ma X, Jiang D: Esophageal cancer spatial and correlation analyses: water pollution, mortality rates, and safe buffer distances in China. J Geogr Sci. 2014, 24 (1): 46-58. 10.1007/s11442-014-1072-8.View ArticleGoogle Scholar
- Ministry of Environmental Protection, MEP: Bulletin of China’s environmental conditions. Beijing: 2012. http://jcs.mep.gov.cn/hjzl/zkgb/. (accessed 15 January 2015).
- Li L, Liu L: Made in China: cancer villages. Environ Sci Poli Sust Dev. 2010, 52 (2): 8-21. 10.1080/00139151003618118.View ArticleGoogle Scholar
- Tian D, Zheng W, Wei X, Sun X, Liu L, Chen X, et al: Dissolved microcystins in surface and ground waters in regions with high cancer incidence in the Huai River Basin of China. Chemosphere. 2013, 91 (7): 1064-71. 10.1016/j.chemosphere.2013.01.051.View ArticleGoogle Scholar
- Liu JR, Pang YX, Tang XL, Dong HW, Chen BQ, Sun CH: Genotoxic activity of organic contamination of the Songhua River in the north-eastern region of the People’s Republic of China. Mutat Res-Gen Tox En. 2007, 634 (1): 81-92. 10.1016/j.mrgentox.2007.06.002.View ArticleGoogle Scholar
- Liu JR, Dong HW, Tang XL, Song XR, Han XH, Chen BQ, et al: Genotoxicity of water from the Songhua River, China, in 1994–1995 and 2002–2003: Potential risks for human health Original Research Article. Environ Pollut. 2009, 157 (2): 357-64. 10.1016/j.envpol.2008.10.004.View ArticleGoogle Scholar
- Wang C, Feng Y, Zhao S, Li BL: A dynamic contaminant fate model of organic compound: a case study of Nitrobenzene pollution in Songhua River, China. Chemosphere. 2012, 88 (1): 69-76. 10.1016/j.chemosphere.2012.02.065.View ArticleGoogle Scholar
- Mishra V, Ganguly AR, NijssenB, Lettenmaier DP. Changes in observed climate extremes in global urban areas. Environ Res Lett 2015;10(2): doi:10.1088/1748-9326/10/2/024005Google Scholar
- Xinhuanet. http://news.xinhuanet.com/politics/2012-07/24/c_123458067.htm 2012. (accessed 15 January 2016).
- Haines A, Kovats RS, Campbell-Lendrum D, Corvalan C: Climate change and human health: impacts, vulnerability, and mitigation. Lancet. 2006, 367 (9528): 2101-9. 10.1016/S0140-6736(06)68933-2.View ArticleGoogle Scholar
- Bezirtzoglou C, Dekas K, Charvalos E: Climate changes, environment and infection: facts, scenarios and growing awareness from the public health community within Europe. Anaerobe. 2011, 17 (6): 337-40. 10.1016/j.anaerobe.2011.05.016.View ArticleGoogle Scholar
- McMichael AJ, Woodruff RE, Hales S: Climate change and human health: present and future risks. Lancet. 2006, 367 (9513): 859-69. 10.1016/S0140-6736(06)68079-3.View ArticleGoogle Scholar
- Arbuthnott K, Hajat S, and Heaviside C, Vardoulakis S. Changes in population susceptibility to heat and cold over time: assessing adaptation to climate change. Environ Health. 2016;15:Suppl 1.Google Scholar
- Heaviside C, Cai XM, Vardoulakis S. The contribution of the Urban Heat Island to heat related mortality during the 2003 heatwave and for projected future climate in the West Midlands, UK. Environ Health. 2016;15(Suppl 1):xx.Google Scholar
- Semenza JC, Tran A, Espinosa L, Sudre B, Domanovic D, Paz S. Climate change projections of West Nile Virus infections in Europe: Implications for blood safety practices. Environ Health. 2016;15(Suppl 1):xx.Google Scholar
- Steptoe A, Deaton A, Stone A: Subjective wellbeing, health, and ageing. Lancet. 2015, 385 (9968): 640-648. 10.1016/S0140-6736(13)61489-0.View ArticleGoogle Scholar
- National Bureau of Statistics. Communique of the People’s Republic of China on population census. 2011. http://www.gov.cn/gzdt/2011-04/28/content_1854048_2.htm (accessed March 19, 2015)
- Zhao Y, Smith JP, Strauss J: Can China age healthily?. Lancet. 2014, 384 (9945): 723-4. 10.1016/S0140-6736(14)61292-7.View ArticleGoogle Scholar
- Qiu J: Ticking time bomb faced by China’s ageing population. Lancet Neurol. 2007, 6 (7): 582-3. 10.1016/S1474-4422(07)70162-X.View ArticleGoogle Scholar
- Berrío Valencia MI: Aging population: a challenge for public health. Rev Colomb Anestesiol. 2012, 40 (3): 192-4. 10.1016/j.rca.2012.04.001.View ArticleGoogle Scholar
- Hou JW, Li K: The aging of the Chinese population and the cost of health care. Soci Sci J. 2011, 48 (3): 514-26. 10.1016/j.soscij.2011.06.002.View ArticleGoogle Scholar
- Beard JR, Bloom DE: Towards a comprehensive public health response to population ageing. Lancet. 2015, 385 (9968): 658-61. 10.1016/S0140-6736(14)61461-6.View ArticleGoogle Scholar
- The Lancet: The two-child policy in China: what to expect?. Lancet. 2013, 382: 1758-Google Scholar
- Feng W. What will happen if China adopts a two-child policy? NewScientist 2014, Avaible online:http://www.newscientist.com/article/mg22129615.200-what-will-happen-if-china-adopts-a-twochild-policy.html?full=true#.VRkC-OOSztA. (accessed 15 January 2016).
- Mou J, Cheng J, Zhang D, Jiang H, Lin L, Griffiths SM: Health care utilisation amongst Shenzhen migrant workers: does being insured make a difference?. BMC Health Serv Res. 2009, 9: 214-10.1186/1472-6963-9-214.View ArticleGoogle Scholar
- Mou J, Griffiths SM, Fong HF, Dawes M: Defining migration and its health impact in China. Public Health. 2015, 129: 1326-10.1016/j.puhe.2014.01.010.View ArticleGoogle Scholar
- National Bureau of Statistics of the People’s Republic of China. The report on the national monitor and survey of migrant workers in 2013. Beijing; 2014A vailable online: http://www.stats.gov.cn/tjsj/zxfb/201405/t20140512_551634.html. (accessed 15 January 2016).
- Yip WCM, Hsiao WC, Chen W, Hu S, Ma J, Maynard A: Early appraisal of China’s huge and complex health-care reforms. Lancet. 2012, 379 (9818): 833-42. 10.1016/S0140-6736(11)61880-1.View ArticleGoogle Scholar
- Meng X: People flocking to China’s cities. Science. 2014, 343: 138-9. 10.1126/science.1244814.View ArticleGoogle Scholar
- Lu Y, Song S, Wang R, Liu Z, Meng J, Sweetman AJ, et al: Impacts of soil and water pollution on food safety and health risks in China. Environ Int. 2015, 77: 5-15. 10.1016/j.envint.2014.12.010.View ArticleGoogle Scholar
- Lam HM, Remais J, Fung MC, Xu L, Sun SSM: Food supply and food safety issues in China. Lancet. 2013, 381 (9882): 2044-53. 10.1016/S0140-6736(13)60776-X.View ArticleGoogle Scholar
- Lu F, Wu X: China food safety hits the “gutter”. Food Control. 2014, 41: 134-8. 10.1016/j.foodcont.2014.01.019.View ArticleGoogle Scholar
- Jia C, Jukes D: The national food safety control system of China: A systematic review. Food Control. 2013, 32 (1): 236-45. 10.1016/j.foodcont.2012.11.042.View ArticleGoogle Scholar
- The Lancet: Food safety in China: a long way to go. Lancet. 2012, 380 (9837): 14-20.Google Scholar
- Wu JG, Urban ecology and sustainability: The state-of-the-science and future directions. Landscape Urban Plan. 2014, 125: 209-21. 10.1016/j.landurbplan.2014.01.018.View ArticleGoogle Scholar
- Lin B, Ouyang X: A revisit of fossil-fuel subsidies in China: challenges and opportunities for energy price reform. Energy Convers Manage. 2014, 82: 124-34. 10.1016/j.enconman.2014.03.030.View ArticleGoogle Scholar
- Yang X, Teng F, Wang G: Incorporating environmental co-benefits into climate policies: a regional study of the cement industry in China. Appl Energ. 2013, 112: 1446-53. 10.1016/j.apenergy.2013.03.040.View ArticleGoogle Scholar
- Markandya A, Armstrong BG, Hales S, Chiabai A, Criqui P, Mima S, et al: Public health benefits of strategies to reduce greenhouse-gas emissions: low-carbon electricity generation. Lancet. 2009, 374 (9705): 1917-29. 10.1016/S0140-6736(09)61713-X.View ArticleGoogle Scholar
- UN. http://www.un.org/waterforlifedecade/water_and_energy.shtml. 2015 (accessed 15 January 2016).
- Hamilton AJ, Burry K, Mok HF, Barker SF, Grove JR, Williamson VG: Give peas a chance? Urban agriculture in developing countries. A review. Agron Sustain Dev. 2014, 34: 45-73. 10.1007/s13593-013-0155-8.View ArticleGoogle Scholar
- Wieler LH: “One Health” – Linking human, animal and environmental health. Int J Med Microbiol. 2014, 304 (7): 775-776. 10.1016/j.ijmm.2014.08.014.View ArticleGoogle Scholar
- Liu H, Emsley R, Dunn G: China’s 2009 health reform: what implications could be drawn for the NHS Foundation Trusts reform?. Health Polis Tech. 2009, 2013 (2): 61-8.Google Scholar
- Barton H, Tsourou C: Healthy urban planning: A WHO guide to planning for people. 2000, Spon Press, LondonGoogle Scholar
- Toronto Food Policy Council. Municipal food policy entrepreneurs. A preliminary analysis of how Canadian cities and regional districts are involved in food system change, Toronto Food Policy Council, 2013. http://tfpc.to/wordpress/wp-content/uploads/2013/05/Report-May30-FINAL.pdf. (accessed 15 January 2016).
- Perez-Alaman P: Global standards and local knowledge building: upgrading small producers in developing countries. PNAS. 2012, 109 (31): 12344-9. 10.1073/pnas.1000968108.View ArticleGoogle Scholar
- Leeuw E: Global and Local (Glocal) Health: The WHO Healthy Cities Programme. Global Change Human Health. 2001, 2 (1): 34-45. 10.1023/A:1011991014805.View ArticleGoogle Scholar
- Norton BA, Coutts AM, Livesley SJ, Harris RJ, Hunter AM, Williams NSG: Planning for cooler cities: a framework to prioritise green infrastructure to mitigate high temperatures in urban landscapes. Landscape urban plan. 2015, 134: 127-38. 10.1016/j.landurbplan.2014.10.018.View ArticleGoogle Scholar
- Yang Z, Cai J, Sliuzas R: Agro-tourism enterprises as a form of multi-functional urban agriculture for peri-urban development in China. Habitat Int. 2013, 34 (4): 374-85. 10.1016/j.habitatint.2009.11.002.View ArticleGoogle Scholar
- Banwell C, Dixon J, Seubsman S, Pangsap S, Kelly M, Sleigh A: Evolving food retail environments in Thailand and implications for the health and nutrition transition. Public Health Nut. 2012, 16 (4): 608-15. 10.1017/S1368980012004223.View ArticleGoogle Scholar
- Dixon J, Ballantyne-Brodie E. The role of planning and design in advancing a bio-nutrition sensitive food system. In Barton, H., Thompson, S. et al. The Routledge Handbook of Planning for Health and Well-being. Routledge, 2015: 178–194.Google Scholar
- Rydin Y, Bleahu A, Davies M, Dávila J, Friel S, De Grandis G, et al: Shaping cities for health: complexity and the planning of urban environments in the 21st century. Lancet. 2012, 379 (9831): 60435-8. 10.1016/S0140-6736(12)60435-8.View ArticleGoogle Scholar
- Seymoar NK, Ballantyne E, Pearson CJ: Empowering residents and improving governance in low income communities through urban greening. Int J AgrSust. 2010, 8 (1&2): 26-39.Google Scholar
- Huang GL: PM2.5 opened a door to public participation addressing environmental challenges in China. Environ Pollut. 2015, 197: 313-5. 10.1016/j.envpol.2014.12.001.View ArticleGoogle Scholar
- Mol APJ: Governing China’s food quality through transparency: a review. Food Control. 2014, 43: 49-56. 10.1016/j.foodcont.2014.02.034.View ArticleGoogle Scholar
- Lehnert T, Sonntag D, Konnopka A, Riedel-Heller S, König HH: The long-term effectiveness of obesity-prevention interventions: systematic literature review. Obes Rev. 2012, 13 (6): 537-53. 10.1111/j.1467-789X.2011.00980.x.View ArticleGoogle Scholar
- Beauchamp A, Backholer K, Magliano D, Peeters A: The effect of obesity prevention interventions according to socioeconomic position. Obes Rev. 2014, 15 (7): 541-54. 10.1111/obr.12161.View ArticleGoogle Scholar
- Duhl LJ: The healthy city: Its function and its future. Health Promo Int. 1986, 11 (1): 55-60. 10.1093/heapro/1.1.55.View ArticleGoogle Scholar
- Ren MH, Lu GP: China’s global health strategy. Lancet. 2014, 384 (9945): 719-21. 10.1016/S0140-6736(14)61317-9.View ArticleGoogle Scholar
- Liu P, Guo Y, Qian X, Tang S, Li Z, Chen L: China’s distinctive engagement in global health. Lancet. 2014, 384: 793-804. 10.1016/S0140-6736(14)60725-X.View ArticleGoogle Scholar
- Bai XM, Nath I, Capon A, Hasan N, Jaron D: Health and wellbeing in the changing urban environment: complex challenges, scientific responses, and the way forward. Curr Opin Env Sust. 2012, 4 (4): 465-72. 10.1016/j.cosust.2012.09.009.View ArticleGoogle Scholar
This article is published under license to BioMed Central Ltd. Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.