China's poor suffer stark health inequity - report

By Tan Ee Lyn

HONG KONG, Oct 20 (Reuters) - China's economic boom has resulted in stark health inequity between its urban and rural populations and health experts urged the Chinese government to work harder at providing healthcare for everyone.

Infant mortality in China's countryside stands at 123 for every 1,000 live births compared with 26 in the richest counties, the experts wrote in a paper published in The Lancet medical journal.

Of every 1,000 children, 64 in the countryside will not live beyond their fifth birthday, compared with 10 in the cities.

The report, by researchers in China, the United States and Britain as well as from the World Health Organisation, is part of a special series on China's health reforms.

While life expectancy in Shanghai is 78.1 years, that figure is 66.1 in northwestern Gansu, one of the poorest provinces.

The team of experts also highlighted China's "missing women".

"In China, the problem has been exacerbated in recent decades by the practice of sex-specific abortions ... discrimination lasts through infancy and childhood, reflected in higher death rates for girls," they wrote.

"In 2000, infant mortality was 33.7 per 1,000 live births for girls compared with 23.9 per 1,000 for boys."

INSUFFICIENT GOVERNMENT INVESTMENT

The authors blamed the disparities on inadequate government investment in healthcare, which increased "out-of-pocket" costs, hitting the poorest hardest.

There was also insufficient government stewardship, which resulted in "doctors using their knowledge to prescribe inappropriate yet profitable procedures and drugs".

Another paper in the series highlighted the preference among medical and healthcare graduates for joining pharmaceutical and biotechnology companies instead of the medical profession, where they are needed.

This paper, led by Sudhir Anand of Britain's University of Oxford, estimated that 1 million such graduates between 2000 and 2005 were not absorbed into the country's healthcare workforce.

"Although the production of doctors and nurses has greatly expanded in recent years, serious problems of distribution remain ... the goal of its health reform should be to promote equitable and universal access to basic health services," they wrote.

OUT OF THEIR OWN POCKETS

Another paper highlighted how healthcare was taking up the bulk of household incomes, or a whopping 50 percent in 2006 (over 18 times that in 1990) because of inadequate health insurance.

This compares with 45 percent in South Korea, 16 percent in Sweden, 15 percent in Japan and 11 percent in France.

"The average cost of a single hospital admission is now almost equivalent to China's annual income per head and is more than twice the average annual income of the lowest 20 percent of the population," wrote the team, led by Hu Shanlian from Fudan University in Shanghai.

"More than 35 percent of urban households and 43 percent of rural households have difficulty affording healthcare, go without, or are impoverished by the costs," they wrote.

The papers noted recent moves by the Chinese government to modernise the public health system and introduce health-insurance schemes, but much more needed to be done, especially to raise the level of reimbursement and helping people who live in poverty. (Editing by Paul Tait)