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Population, Social Services

child immunization, county levels, vocational opportunities, state enterprises, local clinics

The Chinese government seeks to provide for the physical well being of its citizens. Major public welfare programs have included subsidized housing, vocational opportunities, health care, retirement benefits, and the assurance of a paid funeral. Yet services and benefits provided in cities have always been sharply different from those available in the countryside. City dwellers who work for the state have received housing, medical care, and good schooling for their children. The government has also provided benefits for disability, maternity, injury, and old age. Such benefits are part of why many state enterprises are in troubled financial condition and unable to show a profit. In contrast, rural dwellers have been largely on their own for social services. Their well-being has depended on the productivity and wealth of the area in which they live. Since the reforms began in 1978, the level of medical assistance and other social services in rural areas has even been reduced. At the same time, however, rural incomes have risen dramatically, thus better enabling peasants to take care of their own social needs. Farmers do not receive any pension benefits. Under Chinese custom, sons are expected to look after their parents in their declining years.

Health care in China has improved dramatically since the economic reforms began. In 1949 the average life expectancy in China was 45 years. By 2002 the average had risen to 72 years (70 years for men and 74 years for women). During the same period the number of medical doctors increased greatly. Despite an overall rapid population increase, in 2000 China had 1 physician for every 595 inhabitants, as opposed to 1 for every 27,000 in 1949. Clinics typically are found at the village and district levels, and hospitals, in most cases, at the city and county levels.

In the period from 1949 to 1974, a paramedical corps of so-called barefoot doctors played an important role in bringing health services to rural people. These personnel were trained in hygiene, preventive medicine, and routine treatment of common diseases. They serviced rural areas where both Chinese and Western-style doctors were scarce. For millions of peasants, barefoot doctors were their first encounter with anyone trained in health services. In recent years, rural incomes have increased and the rural economy has been virtually privatized. These developments have enabled peasants to use local clinics for less serious illnesses and to use hospitals in neighboring towns and cities for more serious illnesses. Typically, a fee is involved, although the costs for such medical assistance is modest compared to such costs in the United States. Another development in health services has been the renewed interest in traditional Chinese medicine, such as local herbal medication, folk medicine, and acupuncture. In rural areas, herbal medications may represent as much as four-fifths of the medication used.

China has launched mass campaigns in the health-care field. Efforts to promote child immunization, eradicate schistosomiasis, and diminish sexually transmitted diseases have received widespread governmental promotion. Highly successful campaigns have been waged against infectious and parasite-borne diseases that were formerly widespread, such as tuberculosis, malaria, and filariasis (diseases caused by the filaria parasite).

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