Presently, China’s environmental pollution problem is increasingly prominent due to the combined effects of rapid economic development, globalization, population growth, urbanization, and changing consumption behaviors. More than 1.7 million people aged 65 years and older in China in 2010 were estimated to have premature mortality related to PM2.5 exposure (2). Water, sanitation, and hygiene (diarrhea only) accounts for 2.5 disability-adjusted life years (DALYs) /1,000 capita/year, and the disease burden caused by environmental pollution accounts for about 21% of the total disease burden in China as estimated by the World Health Organization (WHO) (3). In addition, environmental factors can affect accidental and non-accidental injuries such as traffic accidents, drowning, and poisoning, which accounted for 7.0% of total deaths and 10.0% of all-cause DALYs in China (4) in 2017.
To deal with the severe environmental pollution problem, the National People’s Congress revised and published a series of laws and regulations such as Environmental Protection Law of the People’s Republic of China and Law of the People’s Republic of China on the Prevention and Control of Atmospheric Pollution in 2014and 2015, respectively. In 2013, 2015, and 2016, the State Council issued action plans for the prevention and control of air pollution, water pollution, and soil pollution, respectively. In 2016, the Chinese government held a national health conference and subsequently announced the Outline of the Healthy China 2030 Plan, in which building a healthy environment is one of the five key strategies. The National Health Commission (NHC), the Ministry of Ecology and Environment (MEE), and other relevant government departments have conducted in-depth studies on the relationship between the environment and human health. The monitoring networks on air pollution, drinking water, and rural environmental health have also been established in all provincial-level administrative divisions (PLADs) to improve the capability of monitoring, detecting, preventing, and controlling environment-related diseases in China (5).
Although the government has played a leading role, the health of the society is inseparable from the combined efforts of all communities and members. Chinese citizens, who play a key role in HEPC, lack the necessary personal health protection awareness and knowledge (the residents’ environmental health literacy rate was as low as 12.8% in 2018 as shown in Table 1), which makes it more difficult to solve environmental problems effectively. Thus, HEPC emphasizes not only the actions of the government but also the efforts of individuals, families, and the society overall.
Indices Target date 2022 2030 1. Standards compliance of drinking water quality Significantly improved Continuously improved 2. Residents’ environmental health literacy rate ≥15% Baseline rate:12.5% (2018) ≥25%
Table 1. Major outcome indices proposed by Healthy Environment Promotion Campaign.
HEPC strategies are mainly embodied at three levels: individual/family, society, and government. There are seven strategies at the individual and family level: improve environmental health literacy, enhance clean environments, adopt a simple and healthy lifestyle, reduce indoor air pollution, increase awareness of outdoor health protections, avoid traffic accidents, and avoid drowning accidents.
There are six strategies at the societal level: create healthy and comfortable community environments, increase consciousness of environmental protection for enterprises, reduce damage caused by over-consumption, clean central air conditioning, reduce accidental injury in public buildings, and disseminate environmental health knowledge including regularly conducting emergency response training for natural disasters and emergencies such as fires and earthquakes in schools, hospitals, and other densely populated places.
The HEPC has developed seven strategies for departments in the government, and each strategy is led by one or several departments as shown in Table 2.
Strategies Leading Department 1. Formulate construction norms and evaluation indicators for healthy communities, workplaces (enterprises), and schools. National Health Commission (NHC) 2. Establish environmental and health investigations, monitoring and risk assessment systems, and strengthen the construction of injury monitoring networks. National Health Commission (NHC) 3. Prevent and control environmental pollution. Improve citizens’ environmental and health literacy. Ministry of Ecology and Environment (MEE) 4. Improve drinking water engineering facilities, urban public safety infrastructure, solid waste recycling facilities, and public fire-fighting facilities and improve emergency response capability. 8 Departments include: National Development and Reform Commission (NDRC), MEE, et.al. 5. Conduct life protection projects for traffic safety to reduce traffic injury accidents. Ministry of Transport (MOT) 6. Create safety assessments and supervision of consumer products to improve the product injury monitoring and reporting system. State Administration for Market Regulation (SAMR) 7. Research the health effects of compound pollution and health protection. National Health Commission (NHC)
Table 2. Healthy Environment Promotion Campaign strategies for the government.