Ensuring a healthy environment throughout China is one of the strategic ap-proaches pursued in the “Healthy China 2030”, which also responds to the achievement of the Sustainable Development Goals of 2030 Of United Nations in this case target 3.9 – reduce “mortality from environmental pollution”, 7.1- ensure “clean household energy” and 11.6 – ensure “clean cities” (WHO 2016). The World Health Report (2002) recommends supporting nations to develop strate-gies to decrease risk, if implemented, will lead to significantly more years of healthy living of many, therefore improving environmental conditions as a social determinant of health can reduce the burden of disease.
As the automotive industry continues to enhance, the environmental pollution creates hazardous conditions hence adverse health outcomes to the entire popu-lation(Tan, Wu, and Shao 2018). In order to facilitate the building of a healthy en-vironment, certain aspects concerning air pollution and sanitation are delineated. These aspects are intended to promote health in rural and urban areas of all ag-es by 2030. Strengthening patriotic health campaign and managing environmen-tal problems influencing health are the national objective in HC2030 plan to es-tablish a healthy environment (Yue Xiao, n.d.)
Strengthening Patriotic Health Campaigns
Urbanization influences the health environment in China, China Healthy Cities (CHCs) project was initiated in 1989 to fortify public health campaigns which are initiated to combat the hazardous condition, in order to enhance sanitation and improve air quality in the urban and rural areas (Yue et al. 2017). CHCs strategy is continuously an essential element of HC2030 plan. Most of the chinese cities are polluted as a result of expeditious economic expansion therefore, patriotic health campaigns invest in enhancing air, water and sanitation in urban areas to minimize mortality and morbidity interlinked with bacterially contaminated and industrial applications (Zhang et al. 2010).
The implementation of CHCs includes discard of effluent water, the assemblage and treatment of waste, creation of famer`s markets and the persuading of the farmers through awarding prizes and participation in contests related to keeping cities clean (Yue et al. 2017). This initiative involves cross-sectoral collaboration between various stakeholders as well as increased funding for the development of market infrastructure This intervention of the market infrastructure contradicts the concept of green development which is being initiated in that by 2030 there should be green and low carbon development adapted by the nation.
Managing Air Pollution and Sanitation to Reduce Health Outcomes
The quality of air depends on the “traditional risks”, “modern risks” and other global arising pollutants. Poor sanitation and indoor pollution from incineration of coal, wood, use of stoves, tobacco smoke and crop detritus are China`s ancient environmental risk factors which are detrimental to health and this is due to high level of carbon monoxide in the atmosphere,(Zhang et al. 2010). HC2030 plan intends to manage this condition. To reduce the production of smoke, use of chimneys on stoves as well as conversion from traditional stoves to modernized stoves are recommended. This is reinforced through “National Improved Stoves Program”(NISP-II), Furthermore, the use of household coal is prohibited in urban areas but continues to be used in rural areas (Smith, and Keyun, 2010). New mechanisms and strategy should be implemented nationwide to achieve the ob-jective of significantly reducing indoor pollution in rural areas. “Modern risks” are connected to industrialization and urbanization this include ambient air pollution whereby burning sulfur rich solid fuels to generate electricity, use of formalde-hyde and other synthetic chemicals released from building materials, expansion of transport systems, dust released during construction, combustion of waste from farms among others, HC 2030 strengthens existing concept to minimize sulfur dioxide and dust concentration by installing and running sulfur scrubbers new power station (Zhang et al. 2010). The green development transport system is the main factor on the china plan by 2020, in that increase in rails and water trans-portation means should reduce road transport, to add, the fuel specification is tightened from 1.1.2019 by enforcing a uniform fuel specification code for diesel and strict monitoring of the fuel mixture is required (MarEx 2018)
Studies have shown that air pollutants are circulated from one continent to an-other causing global health outcomes and pollutants of few weeks may reduce air quality in windy countries (Liu et al. 2009) and China contributes to the emis-sion of methan which pollutes other countries. Therefore, air pollution should al-so be tackled at the global level.
Burden of Disease Attributable to Air Pollution and Sanitation
There is a well-established link between Poor air quality, poor sanitation and ad-verse health outcomes in chinese population, although the national health out-comes in china have steadily improved, much needs to be done especially among the poor population in china, (M. Liu et al. 2017) conducted a study which revealed the exact prediction of par-ticulate matter (PM2.5) for lethality in china as a result of urbanization between 2004 and 2012. “A1% increase in urbanization was associated with a 0.32%, 0.14%, and 0.50% increase in PM2.5 related mortality of lung cancer, stroke, and ischemic heart disease”. In 2016 annual median exposure to outdoor PM2.5 in China was 48.8 g/m3, a 17% reduction compared to the previous report but, still four times more than WHO recommendations and about two million deaths occur annually in China due to subjection to indoor and outdoor air pollution(WHO 2018).
There is fundamental link between the prevailing higher prevalence of diabetes and air pollution due to the effects of inflammation associated with PM 2.5 where they affect diet and lifestyle making people susceptible to diabetes, for instance exposure to third hand smoke and oxidative stress due to indoor air pollutants exacerbate insulin resistance ( Liu et al. 2013).
According to (Wang, Bi, and Olde Rikkert 2018) cardiorespiratory health out-comes such as cerebrovascular accidents disease, coronary heart disease, chronic obstructive pulmonary disease (COPD) and lung cancer are associated with air pollutants in china. A study was carried out in 2013 indicating that air pol-lution affected life expectancy at birth of 5.5 years in northern China (Huang 2015).Emission of toxic substances from agricultural works and formaldehyde and other chemicals from industries have also polluted water, air and farms, leading to creation of many new “cancer villages”(Cheng and Nathanail 2019). The objective of HC 2030 to combat these health outcomes should also strengthen the works of health services in order to minimize the respiratory symp-toms as well as prevent the effect of the air pollution, in particular among vulner-able population, this is missing in the plan.
Residents who rely on old and dangerous practice of burning wood and crop res-idues in the household for cooking, the children surrounded them are susceptible to neurotoxic effects and its adverse outcomes (Apte and Salvi 2016). New data surveillance system which are cost effective should be considered to monitor and evaluate stove programs which are still widespread, this would improve achievement of the healthy China plan 2030.