Compare and Contrast China Preventive Health Services and US Preventive Health Services

¶ … China Preventive Health Services and U.S. Preventive Health Services

The objective of this study is to compare and contrast China preventive health services and U.S. preventive health services.

The work of Clarke (2010) reports that prevention "was a prominent feature of the health care reforms that took place in the late 1960s through the early 1970s. During that time strategies such as universal vaccination, promotion f lifestyle changes, population screenings, and safety regulations were introduced and became widely accepted as means to improve public health while reducing health care expenditures." (p.3) The U.S. while one of the world's richest and most technologically advanced nations, is experiencing a severe lack in meeting expectations for health status and the costs are reported as "alarmingly high." (Clarke, 2011, p.3)

Specifically, the age-adjusted prevalence of obesity in the United States in 2007-2008 is reported to have been 33.8% overall, 32.2% among men and 35.5% among women." (Clarke, 2011, p.3) In addition, 23.6 million Americans or 7.8% of the population are reported as having diabetes. More than 26 million Americans are reported to have chronic kidney disease with millions more reported to be at risk. The American Heart Association reports that 53.7% of men in the U.S. And 55.8% of women in the U.S. have developed hypertension by the time they are between 55 and 64 years of age.

In addition, at least fifty percent of cancer deaths "could be prevented by more systematic efforts to reduce tobacco use, improve diet and physical activity, and expand the use of established screening tests." (Clarke, 2011, p.3) Preventive health care in China is reported as being a "40 billion yuan ($6.3 billion) annual industry in China…growing around 15% a year." (Aldred, 2012, p.1)

I. Description of Group

The population of China is reported in the CIA Factbook to be 1,343,239,923. Of these 17.4% are between the ages of 0 and 14 years of age; 73.5% are between the ages of 15 and 64 years of age; and 9.1% are 65 years of age and over. There are reported to be 12.31 births per 1,000 population and 7.17 deaths per 1,000 populations. According to a U.S. News report by Robert Schlesinger the United States entered 2012 "with a population of roughly 312.8 million people.

II. Leading Morbidity and Mortality Indicators

The leading causes of death and disabilities in China are reported to include the number one cause of death and disability, which is stated to be cerebrovascular disease resulting in 17.7% of deaths and 6.5% of disabilities in China. It is reported that there are geographical differences "in disease control expenditure. Apart from the significant decline in government spending on disease control, there are significant geographical differences in disease control expenditure as a result of the financial decentralization." (Claesen, Wang, and Hu, 2004)

Specifically reported is that the central government "…finances only the national hospitals, research institutes, and medical schools. Each province or county is responsible for its own public services, including health care education and welfare, thus, a prosperous locality is able to provide generous health care and a poor locality has to settle for less." (Claesen, Wang, and Hu, 2004) The entire list of causes of death and disabilities in China is shown in the following table labeled Figure 1.

Figure 1 -- Leading Causes of Death and Disability -- Adjusted Life Years, China 2000

Source: Claesen, Wang, and Hu (2004)

The following table shows the proportion of total health expenditure by clinical and preventive services in China.

Figure 2 -- Proportion of Total Health Expenditures by Clinical and Preventive Services

Source: Claesen, Wang, and Hu (2004)

In the United States, health care preventive services are scattered and applied randomly and the truth is that little can be found on actual preventive health care services. In 2010 the administration announced regulations that require new health insurance plans to provide free preventive care including the elimination of cost sharing requirements for these services. The report states that presently

"too many Americans do not get the high-quality preventive care they need to stay healthy, avoid or delay the onset of disease, lead productive lives, and reduce health care costs, Chronic diseases, such as heart disease, cancer, and diabetes, are responsible for 7 of 10 deaths among Americans each year and account for 75% of the nation's health spending -- and often are preventable." (U.S. Department of Health and Human Services, 2010)

It is additionally reported that on a national basis, Americans use preventive services "at about t half the recommended rate. An estimated 11 million children and 59 million adults have private insurance that does not adequately cover immunization, for instance. Cost sharing, including deductibles, coinsurance, or copayments, has been found to reduce the likelihood that preventive services will be used." (U.S. Department of Health and Human Services, 2010)

The work of Maciosek, et al. (2008) relates that a greater level of use of preventive services in health care in the United States could well serve to save lives and to do so with very little in the way of cost for such services. Preventive services that have the most potential in saving life years are stated to include such as "childhood immunization series, smoking cessation advice and assistance, discussion of daily aspirin use to prevent cardiovascular disease and breast and colorectal cancer screening." (Maciosek, et al., 2008) Reported as clinical preventive services that produce the most in net medical savings from the perspective of the budget are those of "childhood immunization series, pneumococcal immunization for adults, discussion of daily aspirin use, smoking cessation advice and assistance, vision screening in older adults, alcohol screening and brief advice, and obesity screening." (Maciosek, et al., 2008)

It is related that the health services system in China has been affected by the "re-organization, financing, and management of public health services have resulted in "inefficiencies stated to be "partly due to the lack of clarity in functions and duplication between the tiers. The overlap of roles and responsibilities is in particularly evident in those activities that generate user charges." (Maciosek, et al., 2008)