Abstract
Objectives
The Coronary Heart Disease (CHD) Policy Model-China, a national scale cardiovascular disease computer simulation model, was used to project future impact of urbanization.
Methods
Populations and cardiovascular disease incidence rates were stratified into four submodels: North-Urban, South-Urban, North-Rural, and South-Rural. 2010 was the base year, and high and low urbanization rate scenarios were used to project 2030 populations.
Results
Rural-to-urban migration, population growth, and aging were projected to more than double cardiovascular disease events in urban areas and increase events by 27.0–45.6 % in rural areas. Urbanization is estimated to raise age-standardized coronary heart disease incidence by 73–81 per 100,000 and stroke incidence only slightly.
Conclusions
Rural-to-urban migration will likely be a major demographic driver of the cardiovascular disease epidemic in China.
This is a preview of subscription content, log in via an institution to check access.
References
Cao GY, Chen G, Pang LH, Zheng XY, Nilsson S (2012) Urban growth in China: past, prospect, and its impacts. Popul Environ 33:137–160
Goel MS, McCarthy EP, Phillips RS, Wee CC (2004) Obesity among US immigrant subgroups by duration of residence. JAMA 292(23):2860–2867
Gu D, Wu X, Reynolds K, Duan X, Xin X, Reynolds RF, Whelton PK, He J (2004) Cigarette smoking and exposure to environmental tobacco smoke in China: the international collaborative study of cardiovascular disease in Asia. Am J Public Health 94(11):1972–1976
Gu D, Gupta A, Muntner P, Hu S, Duan X, Chen J, Reynolds RF, Whelton PK, He J (2005) Prevalence of cardiovascular disease risk factor clustering among the adult population of China: results from the International Collaborative Study of Cardiovascular Disease in Asia (InterAsia). Circulation 112(5):658–665
He J, Klag MJ, Whelton PK, Chen JY, Mo JP, Qian MC, Mo PS, He GQ (1991) Migration, blood pressure pattern, and hypertension: the Yi Migrant Study. Am J Epidemiol 134(10):1085–1101
He J, Klag MJ, Whelton PK, Chen JY, Qian MC, He GQ (1994) Body mass and blood pressure in a lean population in southwestern China. Am J Epidemiol 139(4):380–389
He J, Klag MJ, Wu Z, Qian MC, Chen JY, Mo PS, He QO, Whelton PK (1996) Effect of migration and related environmental changes on serum lipid levels in southwestern Chinese men. Am J Epidemiol 144(9):839–848
He J, Gu D, Wu X, Reynolds K, Duan X, Yao C, Wang J, Chen CS, Chen J, Wildman RP et al (2005) Major causes of death among men and women in China. New Engl J Med 353(11):1124–1134
Liu S, Li X, Zhang M (2003) Scenario analysis on urbanization and rural-urban migration in China. International Institute for Applied Systems Analysis, Interim Report IR-03-036. Interim Report IR-03-036
Lozano R, Murray CJL, Lopez AD, Satoh T (2001) Miscoding and misclassification of ischaemic heart disease mortality. Global Programme on Evidence for Health Policy Working Paper No. 12. World Health Organization, Geneva
Moran A, Zhao D, Gu D, Coxson P, Chen CS, Cheng J, Liu J, He J, Goldman L (2008) The future impact of population growth and aging on coronary heart disease in China: projections from the Coronary Heart Disease Policy Model-China. BMC Public Health 8:394
Moran A, Gu D, Zhao D, Coxson P, Wang YC, Chen CS, Liu J, Cheng J, Bibbins-Domingo K, Shen YM et al (2010) Future cardiovascular disease in china: markov model and risk factor scenario projections from the coronary heart disease policy model-china. Circ Cardiovasc Qual Outcomes 3(3):243–252
Poulter N, Khaw KT, Hopwood BE, Mugambi M, Peart WS, Rose G, Sever PS (1984) Blood pressure and its correlates in an African tribe in urban and rural environments. J Epidemiol Community Health 38(3):181–185
Poulter NR, Khaw KT, Hopwood BEC, Mugambi M, Peart WS, Rose G, Sever PS (1990) The Kenyan Luo Migration Study—observations on the initiation of a rise in blood-pressure. British Med J 300(6730):967–972
Sanchez-Vaznaugh EV, Kawachi I, Subramanian SV, Sanchez BN, Acevedo-Garcia D (2008) Differential effect of birthplace and length of residence on body mass index (BMI) by education, gender and race/ethnicity. Soc Sci Med 67(8):1300–1310
Stamler J (1991) The Yi Migrant Study: population exposures influencing blood pressure patterns. Epidemiology 2(2):83–87
United Nations, Department of Economic and Social Affairs, Population Division (2010) World Urbanization Prospects: The 2009 Revision
World Health Organization (2010) Global Adult Tobacco Survey (GATS)
Acknowledgments
Grants and financial support: This study was supported by a Columbia University Earth Institute Cross-Cutting Initiative grant to Drs. Adamo and Moran and Mentored Career Development Award number K08HL089675 from the United States National Heart, Lung, and Blood Institute of the NIH to Dr. Moran.
Conflict of interest
The authors have no conflicts of interest to report.
Author information
Authors and Affiliations
Corresponding author
Additional information
All authors contributed equally to this work.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Chan, F., Adamo, S., Coxson, P. et al. Projected impact of urbanization on cardiovascular disease in china. Int J Public Health 57, 849–854 (2012). https://doi.org/10.1007/s00038-012-0400-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00038-012-0400-y