237947 Projected impact of urbanization on cardiovascular disease in China

Wednesday, November 2, 2011

Faye Chan, MD, MPH , Department of Internal Medicine, Columbia University, New York, NY
Petra Rasmussen, BA , Mailman School of Public Health, Columbia University, New York, NY
Pamela Coxson, PhD , School of Medicine, University of California, San Francisco, San Francisco, CA
Lee Goldman, MD, MPH , College of Physicians and Surgeons, Columbia University, New York, NY
Dongfeng Gu, MD, PhD , Department of Evidence Based Medicine, Fu Wai Hospital & Cardiovascular Institute, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
Dong Zhao, MD, PhD , Department of Epidemiology, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
Chung-Shiuan Chen, MS , Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
Jiang He, MD, PhD , School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
Valentina Mara, BS, MA , Center for International Earth Science Information Network, Columbia University, New York
Susana Adamo, PhD , Center for International Earth Science Information Network, Columbia University, Palisades, NY
Andrew Moran, MD, MPH , Division of General Internal Medicine, Columbia University, New York, NY
Background: The influence of urbanization on cardiovascular disease in China has not been projected in detail. Objective: Project the impact of urbanization on cardiovascular disease using a national-scale computer model. Methodology: The Coronary Heart Disease (CHD) Policy Model-China is a computer simulation model of CHD and stroke in Chinese adults age 35-84 years old. Populations, risk factor distributions, and cardiovascular disease event and death 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. Event rates and age structures within geographic strata were assumed constant. Results: In 2010, China is predominantly rural and cardiovascular disease event rates are generally higher in the urban North and South compared to their rural counterparts (349 versus 279 per 100,000 and 180 versus 111 per 100,000, respectively). From 2010 to 2030, China's urban populations will grow by 50% or more, while rural populations will decline or increase slightly. Comparing 2030 with 2010, 85100% of excess cardiovascular disease events were projected to occur in cities. Driven by urbanization, age-standardized CHD event rates were projected to increase from 213 to 219233 per 100,000; stroke rates did not change. Conclusions: By 2030, more than 60% of China's population will live in cities, and urbanization may contribute to the epidemic of cardiovascular disease. Cardiovascular disease health care services and prevention may be more efficiently and effectively targeted toward China's cities.

Learning Areas:
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Program planning
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
To describe the projected trend of urbanization in China over the next twenty years Explain the potential impact of urbanization on absolute numbers of cardiovascular events and cardiovascular event rates in China Identify locations in which cardiovascular disease health care services and prevention efforts should be focused

Keywords: International Public Health, Heart Disease

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have completed an MPH and have been involved in multiple research projects related to disease prevalence and management both in the US and abroad.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.