The document discusses the environmental and health consequences of China's rapid economic growth, emphasizing the transition from a planned economy to a market-oriented one since 1978. It highlights the severe pollution problems resulting from urbanization and industrialization, alongside the deterioration of public health services amidst economic reforms. The text also touches on China's evolving environmental policies and the role of NGOs in advocating for better ecological and health standards.

1. China’s Development Model
Consequences for the Environment and Health
Outline of the lectureChina’s development model: changing
goals and priorities (economic growth and globalisation)The
consequences of structural reform on the environment and the
provision of public services (health care)Reconciling economic
growth with sustainability and the right to health
Development as a Value SystemCompeting developing models
throughout the 20th Century (achieve different forms of
modernity):
Capitalism and Western liberal democracy and
CommunismCollapse of the USSR and China’s adoption of a
market economy: the end of history? Does China offer a new
model of development?
Fukuyama (1989) All viable alternatives to Western liberal
democracy have failed.
Capitalism is ultimately the only viable economic system in the
modern world and all states must ultimately adopt free market

2. capitalism.
All human societies, regardless of their cultural or historical
make-up, are inevitably drawn into a global consumer culture.
*
The Implications of Development & Economic Growth
Development (with economic growth at its core) implies
industrialization, urbanization and intensification of resource
usePopulation growth; increased demand for food, housing,
water supply, electricity supply, etc. Land conversion, loss of
biodiversity, pollution, etc.
China’s Rapid TransformationRapid urban growth:
1978 – 17% (urban)
2007 – 42% (urban)
2011 – urban population passes the
50% mark for the first time in Chinese history
2030 – 70% (urban)Since 1978 China’s urban population has
grown by about 430 millionEnormous use of resources:
infrastructure, housing, services, etc. (China’s second wave of
industrialisation)
*
China’s Rapid TransformationRapid integration with the global
economy; China becomes the ‘factory of the world’China’s
population reaps the benefits of economic growth (better living
standards)While developing a taste for conspicuous

3. consumption
Fuelling China’s economic growthChina: largest energy
consumer in the world; second oil consumer after the USAnnual
energy consumption growth rate:
1980-1999: 4%
2000-2005: 10%
2006-2010: 6.6%
Goal: 4.3% annual growth rateChina is the largest CO2
emitterInefficient use of resources: water, electricity, oil, coal
Energy Consumption
Australia is the largest exporter of liquefied natural gas (30% of
China’s imports) and of coal (Australia and Indonesia provide
50% of China’s coal imports); Australia is also the largest
exporter of coal in the world
*
Environmental Consequences of Economic Growth
China’s Environmental Crisis - The New York Times#Air
pollution: (CO2 & SO2 emissions from coal and fuel)Water
pollution/water scarcity: (industrial and human waste) More
than 70% of China’s lakes and rivers are highly pollutedLand
erosion and desertification: (climate change, agricultural land
conversion, deforestation)
Develop first, clean up later?Given the emphasis on economic
growth, until recently there was little incentive for local
officials to protect the environmentStringent environmental

4. laws – poor enforcement: Fines for polluters tended to be lower
than the cost of investing in clean technologies Local
governments allowed industries to pollute if they brought
investment and created jobsElectricity, water and coal prices
kept artificially low (to keep production costs low, particular ly
for export industries)
No incentive to make a more efficient use of these inputs
China - Energy - Regulation - Choking on Growth Part V - The
New York Times#story3#story3
China’s early stance on environmental protectionCritics:
environmental damage poses major long-term challenges to
domestic and global economic growth, social development and
healthAs a developing country China insisted on its right to
growChina: responsibility for fighting global warming rests
primarily with industrialized countries (since they emerged as
major economic powers leaving behind a legacy of
environmental damage)
Until recently, Chinese officials had argue that rich countries
were the main contributors to global warming and
environmental degradation, and that therefore they should find a
way to solve the environmental problems without impinging on
China’s economic development
Developed countries and their MNCs have carried out natural
resource exploitation, land acquisition, dirty manufacturing, and
have for decades shifted environmental pollution to the
developing world
*

5. China: common but differentiated responsibilities
‘Typically, industrial countries deal with green problems when
they are rich…we have to deal with them while we are poor.
There is no model for us to follow’
(Ren Yong, Chinese climate expert)
Developing nations, particularly those with large
populations and limited infrastructure, argue for the principle of
common but differentiated responsibilities in regards to the
environment (Vogler 2008: 363).
Cross-national Environmental InjusticeApprox. 25% - 33% of
China’s total national CO2 emissions result from production for
export marketsUntil 2000 around 70% of the 20 to 50 million
tons of e-waste produced globally each year ended up in
ChinaChina itself has become a large producer of e-waste
(due to growing domestic consumption and disposal of
electronic appliances)
These are “embodied” emissions that have largely been
“displaced” to China from countries that formerly manufactured
but now import these goods.
Guiyu China: e-waste capital of China. Made infamous by a
documentary made by a Chinese MA student (Michael Zhao)
studying in the US, which traces the “export” of Californian e-
waste to China
China put in place in 2000 a law to ban the import of e-waste,
though it still comes in blended in other waste material (e.g.
metal scraps) Also, e-waste can still be legally imported into
Hong Kong and then re-exported to China but without needing a

6. waste import/export permit.
China’s exports of small household appliances accounted for 60
per cent of the global market, with the shares for microwave
ovens, air conditioners, refrigerators and washing machines
standing at 72 per cent, 54 per cent, 27
per cent and 21 per cent, respectively
*
Environmental challenges
faced by China
World Bank – Chinese Government joint report (2007)The
combined health and non-health cost of outdoor air and water
pollution for China's economy comes to around $US100 billion
a year or about 5.8% of the country's GDP (e.g. China’s GDP
growth rate in 2003 was 10%)About 750,000 people die
prematurely in China each year, mainly from air pollution in
large citiesWater pollution: growing levels of cancer and
diarrhea
Around 191 million people drink contaminated water,
causing around 60,000 premature deaths each year (severe
diarrhea, and stomach, liver and bladder cancers)Water
pollution further exacerbates China's severe water scarcity
problems (overall cost of water scarcity- about 1% of
GDP)Large-scale power blackouts (due to boom in heavy
industry and manufacturing) (electricity and coal insecurity)
Joint World Bank-Government of China report entitled Cost of
Pollution in China – Economic Estimates of Physical Damages.
China approached the World Bank in 2003 to develop an
estimate of how much environmental air and water pollution
costs China – including in human health impact terms. This was
triggered by a growing concern on China's part that its rapid

7. economic growth was carrying a large environmental and human
health cost. The World Bank put together a joint Chinese and
international expert team that developed a new model to
estimate these costs and impacts largely based on China's
unique circumstances. Building on scientific work undertaken in
recent years, in particular by China's Environmental Protection
Agency (SEPA), but also the Ministries of Health and Water
Resources, the research project is the first of its kind in a
developing country.
*
China’s New Environmental PoliciesChina realises that it is in
its own interest to address environmental degradation
(otherwise its exports are doomed and its population cannot
tolerate much more environmental degradation)State investment
into alternative forms of energy: China is now the largest
producer of green technologies, and the largest investor into
renewable energy production and on R&D of green
technologiesChina’s cities though still polluted are no longer
the most polluted in the world
The most polluted city in the world is Ahwaz (Iran) with 373
Particulate matter per cubic meter; in contrast Lanzhou (China’s
most polluted city) had 150 pm/m3 (2009); Beijing 121 pm/m3;
LA 25 pm/m3
*
Other domestic
pressuresEnvironmental NGOs were the earliest NGOs to

8. emerge in China (mid-1980s – environmental and social impact
of the Three Gorges Dam)Growing awareness of the damaging
effects of pollution (e.g. protests against polluting industries)
Largest growing section of the NGO sector in China (alliances
between activists and scientists) 9% of reported ‘mass
incidents’ in 2012 were related to environmental rights issues
In 2010 there were 700,000 reported complaints related to
pollution, polluting industries and environmental disasters.
(official statistics 2010 Environmental Statistical Yearbook)
*
ENGOs &
Broader Political Reform‘Greening of the Country’: monitor
and protect the environment; but keeping the work of ENGOs
localized and fragmentedAttempts to co-opt NGOs: funding
pressures faced by NGOs; need for personal connections with
the local Party-state to influence policy ENGOs have
nonetheless played a crucial role in fostering local activism in
community issuesAnti-PX plant cases in
Dalian, Kunming and
Maoming
PX – paraxylene, used in the manufacturing of plastics and
polyester. Latest protest in Maoming, Guangdong (March 2014).
New PX plant is being proposed to feed from the local refinery
plant run by the local government and Sinopec
http://thediplomat.com/2014/04/guangdongs-environmental-
protests-turn-violent/
*

9. Health in Reform China
China’s development strategy has affected health provision and
outcomes in several ways:Market incentives: Health - from
public to private goodDemographic composition: family
planning and population ageing (higher incidence of chronic
disease)Changing lifestyles: different health care needs; higher
demand for health servicesInternal migration (challenges to how
health services are provided) Rising health problems due to
pollution
Health Care Provision
in Maoist ChinaMedical services provided by urban work units
(danwei) (included free health care for dependants)Rural
communes ran a cooperative medical system staffed by ‘bare
foot’ doctors (emphasis on preventive care)Over 95% of the
population had access to basic medical care1979: while China’s
per capita GDP remained one of the lowest in the world
(alongside countries such as Malawi and Burundi), China’s life
expectancy (68 years) ranked near that of middle income
countries
Market incentives in health care provisionReduction of
government funding for public hospitalsDismantling of the ‘iron
rice bowl system’: SOEs wanting to reduce the burden of
workers’ benefits (pension and medical expenses in
particular)Introduction of market incentives to make the sector
more efficient: move towards a fee-for-service modelPublic
hospitals acting as for-profit entitiesIncentives for doctors to
over prescribe and to require expensive tests and treatments

10. Urban health care provisionBy the late 1990s less than 40% of
the urban population had any medical insuranceMedical
expenditures one of people’s main concernsPeople resent
medical personnel for unethical behavior (refusing care to those
who can’t pay; over prescription; malpractice; demanding ‘hong
bao’; getting quick backs from pharmaceutical companies)Basic
medical insurance schemes put in place since 1998 (employees
and urban residents)Rural migrant workers not
covered
Health care in rural areasWith the dismantling of the communes
in the early 1980s so too the rural Cooperative Medical System
(RCMS) is dismantled Village clinics privatized: the rural
population has to pay for all medical care out of their own
pocketBy the mid-1990s medical expenses (from catastrophic
illness) became one of the main causes of poverty in rural
ChinaAfter various pilot experiments in 2003 the RCMS is
reinstated with Central government support
Health Consequences of Population Policy & Demographic
ChangePopulation Policy
Gender imbalance (117:100) and changing population pyramid
(less young people, more elderly)
2010 – 8% over 65; projection 2030 – 20%
Problem of care for the elderlyEpidemiological transition
Higher incidence of chronic disease and obesity; higher demand
for medical services and pharmaceuticalsPopulation mobility
Rural migrant workers not covered in the cities; rural medical

11. facilities of lesser quality
Around 16 million children are born in China every year (2010)
China’s over 65s:
1980 – 5%, 2010 – 8%, 2030 – 20%
Japan
1980 – 9%, 2010 – 23%, 2030 – 32%
Korea
1980 – 4%, 2010 – 12%, 2030 – 21%
*
Other pressures on the health systemSARS and HIV/AIDS
epidemicsPerverse relationship between poverty and disease
(e.g. blood contamination case)Malpractice sees hundreds of
thousands of donor infected with hepatitis, HIV/AIDS and other
communicable diseases
MoH establishes blood banks where people can sell their blood;
red blood cells separated, blood pooled together, injected back
into patients
*
Concluding summary1980s-1990s China’s reform process
prioritised market competition and economic growth over the
environment and the provision of social services
(health)Pollution and its health effects pose an important
economic and human costRaising income inequalities and the
commodification of health services meant only those who could
pay can access medical careChina is now prioritising clean

12. energy and environmental conservation and is gradually
building social safety nets for its population
Will we see a qualitative change in China’s development
model?
Towards the environment, social safety nets
and public delivery
Running Head: QUALITY AND SAFETY INITIATIVE THAT
ADDRESSES A SHORTFALL IN QUALITY FOR FREQUENT
DETOX READMISSION 1
QUALITY AND SAFETY INITIATIVE THAT ADDRESSES A
SHORTFALL IN QUALITY FOR FREQUENT DETOX
READMISSION 2
Title: QUALITY AND SAFETY INITIATIVE THAT
ADDRESSES A SHORTFALL IN QUALITY FOR FREQUENT
DETOX READMISSION
Student’s Name:
Institution:
There are different quality or safety initiatives that address a
shortfall in quality and/or safety in your current precepted
experience environment In this case frequent detox readmission.
One of the quality initiatives to be used by different people is
boosting readiness and change competences for the purposes of

13. ensuring that the unnecessary issues experienced in the
readmission of the detox are reduced effectively. As a result of
this initiative, quality improvement will be achieved as the
detox is provided by experienced healthcare officers (Bui,
2021). Moreover, the initiative will ensure that the integration
of the provided information is carried out in a consistent
manner. On the other hand, boosting readiness and change
competences will play important roles in ensuring that the
readmission of the detox is carried out in the expected time.
Timeliness in the readmission of the detox will play important
roles in ensuring that the toxic substances in the people’s bodies
are removed. The health care policy considered by this initiative
is a policy which ensures that safe substances are given to the
people in the right time (Martin, 2021).
During the readmission of the detox to the people, ethical and
legal considerations should be analyzed effectively. Some of the
ethical and legal considerations include; access to care and
doctor and patient confidentiality. This will ensure that the
effectiveness in the readmission of detox is enhanced.
Moreover, the initiative will be cost effective therefore ensuring
that the detox is readmitted to large numbers of the people in
the country. Finally, the mean to monitor the initiative over
time is ensuring that experts in supervision of healthcare
processes are employed. The experts will be in a position to
ensure that the right processes are carried out during the
detoxification processes (Melber, 2021).
References
Bui, Q., & Moriuchi, E. (2021). Economic and Social Factors
That Predict Readmission for Mental Health and Drug Abuse
Patients. Sustainability, 13(2), 531.
Martin, L. T., Berdahl, C., Burns, R. M., Hoch, E., Peet, E. D.,
& Hussey, P. S. (2021). Measures and Methodology for
International Comparisons of Health Care System Performance.
Melber, H., & Southall, R. (2021). Zimbabwe’s Foreign Policy
Under Mnangagwa. Journal of Asian and African Studies, 56(2),

14. 234-250.
CHNS1601
Understanding Contemporary China
Tutorial Presentation – Written Report (5%)
Student: Marks:
Criteria 1 2 3 4 5 6 7 8 9 10
Understanding of the topic (1 point)
Factual accuracy (0.5 point)
Extent of reading (0.5 point)
Structure and organisation (1 point)
Analysis and insight (0.5 point)
Coherence of the argument (1 point)
Clarity, grammar and expression (0.5
point)