Content area
Full Text
The establishment of the Shanghai Municipal Center for Disease Control and Prevention (Shanghai CDC) in 1998 marked a significant step forward in improving public health in China. The Shanghai CDC, which was based on the example of the US Centers for Disease Control and Prevention (US CDC), was the first such center to be established in China and can be considered a model program. In fact, it was the precursor to the Chinese Center for Disease Control and Prevention (China CDC), which was created in Beijing in January 2002, and to similar entities in 28 province-level regions in China. The creation of these centers reflects much more than mere organizational restructuring. It was a policy response to the shifting of disease patterns, perception of disease, and governmental changes in China.
BACKGROUND
Over the last 50 years, the life expectancy of China's citizens has increased significantly, and mortality rates, particularly those related to infectious disease, have declined. Although life expectancy in China varies by province, municipality, and region, on average, people are expected to live to be 70 years old.1 In Shanghai, that figure is even higher-up from an average of about 58 years in 1957 to about 79 years in 2001, quite similar to the pattern seen in the developed nations. Thus, not only are people living longer, but the kinds of health problems they face are also different from those faced in the past.
Shanghai is one of the 4 municipalities that have an independent government structure and report directly to Chinese central government. It is divided into 19 administrative areas (18 districts and 1 county). In 2001, Shanghai's total population was slightly greater than 16 million (including 3.05 million migrant workers from other provinces). The birth rate is 4.35 per 1000 and the mortality rate is 7.05 per 1000, resulting in a negative natural growth rate of 2.70 per 1000. People aged 60 years and older constitute 18.60% of the population; in certain communities in Shanghai, people aged 60 years and older constitute as much as 24% of the population. In 2001, the infant death rate was 5.71 per 1000, and the maternal death rate was 8.95 per 100000.
A review of the 10 leading causes of death in Shanghai reveals that infectious...