China must act now to tackle the growing challenges posed by injuries, mental illness, obesity, smoking, environmental pollution and other public health threats.

Alternatively, China can face the huge toll of largely preventable health loss suffered by high-income countries, warn experts in a Review published as part of a Lancet themed issue on China.

Shocking statistics on death and illness in China

1. Injuries cause around 800 000 deaths a year and are the leading cause of death in people aged 1 to 39 years old.

2. Millions of adults in China have a mental health disorder but only 8% have ever received professional help. The number of people living with dementia has more than doubled during the two decades between 1990 and 2010.

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3. Ambient air pollution kills over a million people a year, while indoor air pollution from solid fuels accounts for a further million premature deaths a year.

4. Tobacco kills roughly one million people each year, and if present trends continue, this is expected to rise to three million by 2040.

5. Finally, there have been alarming increases in levels of obesity, with the number of overweight or obese adolescents rising by 25% in just the single decade from 2000 to 2010.

Inadequate coverage of basic chronic disease interventions by China

In this Review, Dr Jeffrey Koplan, Vice President for Global Health at Emory University, Atlanta, USA and colleagues take a critical look at Chinaâ??s progress in tackling chronic diseases since the 1990s. They lament the inadequate coverage of basic interventions by China that could make a massive difference to the shocking statistics.

The researchers urge China to urgently adopt a number of cost-effective interventions to improve individual and population health (e.g., increasing taxes on tobacco and alcohol and introducing regulations for seat belts and helmets for cyclists).

China faces new challenges

According to Professor Koplan, China has had remarkable success against infectious diseases, but now faces a new challenge of trying to prevent escalating health problems with regard to chronic diseases largely resultant from unhealthy lifestyle choices.

â??If China takes advantage of lessons learnt in other countries (including taxation, regulation or legislation, and information or education) and uses its own scientific and creative resources to increase our knowledge of better disease control and prevention, it will provide a health model for the world,â? concludes Professor Koplan.

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