Some of these achievements have been a model for developing countries worldwide.

Children's vulnerability to pollution stems from differences in their physiology, growth characteristics and diet.

Gains in the health sector, however, are being curtailed by the environmental consequences of the rapid economic expansion of the country.

To continue the country’s economic growth — while at the same time protecting people’s health — is one of the main challenges facing Chinese authorities today.

China’s achievements

In the last two decades, China has had average economic growth of 9.4%. For the last 50 years, it has also made impressive advances in public health by improving access to health care and tackling infectious diseases with remarkably good results.

The average life expectancy is now 71.8 years, up from 35 in 1949. Immunization coverage is over 95% for those under age one.

From 1960 to 2003, China’s infant mortality rate fell from 150 to 30 per 1,000 live births, and the under-five mortality rate dropped from 225 to 37 per 1,000 live births. Both rates are used as indicators of access to basic health services. At the same time, there has been a sustained increase in the number of community service networks, which provide basic health services to the population.

UNICEF has found that since 1978, the number of health facilities in China has increased by 82% and the number of health staff by 88%.

China’s challenges

In spite of these improvements, significant challenges for maternal and child health care remain. For example, emergency obstetric and newborn care is deficient, particularly for people living in remote areas. Child mortality rates in remote areas are several times higher than those in urban areas. Also, many poor rural families and migrants in China’s urban areas simply cannot afford health services.

Besides access issues, many health problems are caused by a polluted environment. In this regard, children are particularly vulnerable. This greater vulnerability stems from differences in their physiology, growth characteristics and diet.

Gains in the health sector are being curtailed by the environmental consequences of the rapid economic expansion of the country.

Vulnerability to environmental hazards is also related to their developmental stage. Children differ from adults in their degree of exposure to those environmental hazards, on how contaminants are absorbed and distributed in the body, and in their capacity to transform and eliminate different chemicals.

Water pollution is a serious environmental concern. Sewage and agricultural wastes contaminate water supplies and provoke a host of waterborne illnesses. In addition, rivers that are used as a source of drinking water are contaminated with heavy metals such as lead, cadmium and arsenic from industrial discharges.

UNICEF reports that China is one of the countries in the world most seriously affected by arsenic contamination. Several studies carried out on the effects of drinking arsenic-contaminated water show serious effects on children’s intelligence and intellectual development.

Toxic compounds in air and water affect the health of children and adults alike. However, because children are still growing and their immune system and detoxification mechanisms are not fully developed, toxic agents have a more serious impact on them than in adults.

Exposure to high levels of lead at an early age, for example, is responsible for children’s low intellectual development. Lead poisoning is probably the most serious chronic environmental illness now affecting children.

Chinese authorities have been trying to limit the damage caused by environmental pollution and have set guidelines in a document entitled "Priority Activities for Sustainable Development." However, despite new policies and regulations, compliance remains low.

UNICEF reports that China is badly affected by arsenic contamination — which has been found to have serious effects on children’s intellectual development.

It is estimated that 40% of Chinese cities suffer from medium to high levels of air pollution.

According to a World Bank assessment, projected health effects of air pollution in urban China by 2020 will include: 600,000 premature deaths in urban areas, 20 million cases of respiratory illness per year, 5.5 million cases of chronic bronchitis and health damages valued at 13% of Chinese GDP.

To overcome the effects of pollution and a contaminated environment, China needs to continue developing energy-efficient technologies and implementing cheap and environmentally responsible transportation systems.