Hypermarkets

Multinational chains such as Carrefour and Wal-Mart benefit from their reputation for offering better quality products than most domestic retailers, thanks to stricter quality control in a country where food safety is a major concern after several disturbing food scandals in recent years. In food products, especially fresh food, hypermarket retailers benefit from better hygiene controls and a higher volume flow rate, and are thus able to ensure better food safety for consumers. As such, an increasing number of Chinese consumers visit hypermarkets instead of independent food stores for grocery shopping. Fresh produce has become an attractive section to draw in Chinese consumers.

New Trends in Retail

Direct sourcing of food and agricultural products from farm cooperatives has been adopted by most retailers in Shanghai and is growing elsewhere. This allows retailers to address consumers‘ concerns about food safety, reduce cost, and possibly improve product quality. On the imported product side, Wal-Mart started to directly source and import U.S. cherries this year. Neighborhood Supermarkets were opened in Shanghai by Carrefour and Tesco this year. These outlets offer low prices and fresh food as their selling points.

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According to Greenpeace China, they assessed 15 major supermarkets in China from three aspects. First is product tracking and control systems, where consumers can trace the supply chain. Secondly, key policies and commitments on reducing pesticide residue and avoiding GMF, especially fresh fruits, vegetables and rice. Thirdly transparency: the more honest companies are, the more they are willing to be supervised by consumers and capable of meeting their commitments.

The excellent website China Corporate Social Responsibilty also discusses this:

Wang Weikang, the food and agriculture project director of Greenpeace, told local media that the supermarkets that rank at the bottom of the list did not take any action in supervising the quality of the food products they sell, nor did they make any promise to improve. According to Wang, Wal-Mart did not provide any information on the questionnaire regarding gradually banning the use of pesticide or committing to no genetically modified food, nor did it provide any of the necessary information on its Chinese website — even though it has already made a commitment to British consumers on not providing genetically modified food. In addition, there is no such information either on the Chinese language website of Ito-Yokado though the information is offered on the Japanese language website of the company.

So far, supermarkets ranked at the bottom of the list have responded saying that they have always abided by the local laws and regulations and have adopted product quality standards that are up to, or higher than, the local government requirements.

Here’s the original Greenpeace article; it’s a PDF file but only in Chinese. I think this type of analysis does have its own agenda but is still helpful, as it brings to the surface a lot of underlying issues regarding food safety in China.

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I’ve touched a bit on the state of China’s public health care system; now there’s an outstanding 4-part series from China Healthcare Blog discussing the state of rural health care and how it affects the elderly.

The main issues center on the lack of adequate health care for most rural Chinese; the elderly, with far more need for healthcare, are more vulnerable to this lack of services. Here’s a good quote from part 1:

The New Cooperative Medical Scheme (NCMS) has considerably increased access to basic care in rural China. The coverage, however, only extends to inpatient acute care. This results in a system that is not geared to the health profile of a substantial proportion of its population. Thus healthcare costs increase with age, as health insurance coverage effectively decreases. In rural areas where health resources are already lacking in quantity and quality, the prospects of the elderly living a healthy life past sixty are rather bleak.

One interesting fact that people may not know is that China is aging quite rapidly, due to the one-child policy. This is different than most other developing countries, especially India. The long-term problem is that China hasn’t yet developed a good social net of health insurance or social security; China will slowly be losing that proportion of wage-earners who pay into the system that would pay for those services. So, China has a couple decades to really build up their social nets and provide adequate funding, before those added tax stresses start to hit workers.

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The best collection is from the U.S. EPA:

• SmogCity2: a fun and interactive game where you can control your city, like the Sims. There are two versions, one for ozone and another for particulates.
• Environmental Kids Club – they also have a section on air pollution
• AirNow: they have a series of pages for kids, students and teachers

Chinese Versions

I found a site from Taiwan: 空氣品質兒童網站

Anyone have other good links? Please share in the comment section below.

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An estimated 350 million Chinese smoke and 3 million more take up the habit each year. Twenty-two percent of the world’s population is home to a third of its smokers, grows a third of the world’s tobacco and manufactures a third of its cigarettes.

The tobacco industry is China’s single-biggest taxpayer. The government raised 8.3 percent of its entire financial revenue – 513.1 billion yuan – from tobacco taxes in 2009 according to the State Tobacco Monopoly Administration.

The income does not even come close to the health costs, say the anti-smoking experts. About 1.2 million Chinese die from smoking-related diseases every year.

Lung cancer became the top cancer killer in 2008, according to the Ministry of Health, the number of cases quadrupling over the past 30 years.

Cancer, cardiovascular diseases and respiratory diseases cost the country 223.7 billion yuan annually, according to Li Ling, an economics professor at Peking University.

“Add to that the costs of other diseases and indirect costs such as fire and environmental pollution, the amount goes far beyond the tax revenue generated by the industry,” Li told a conference at Tsinghua University in Beijing.

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Our next Beijing Healthcare Forum will be Thursday, January 28th.  It will continue to be at Luce Restaurant. 今晚(1月07号)会议的地点是Luce餐馆, 从鼓楼大街地铁站往南走300米, which is 300m south of the Gulou subway station on the east side of the street.  This week’s presentation will be in English.  这次演讲人要用英文讲话。We will have participant translators available for English speakers.

Meeting Details 会议的细节:

–
http://beijinghealthcareforum.com/
http://groups.google.com/group/beijinghealthcareforum

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One important thing to note first is that this 50% rate is by no means abnormal, in terms of world history. America is furthest along the anti-smoking bandwagon but smoking rates among men in the 1950′s were likely similar to that of China now. And many countries in Asia have similar or higher rates, including Japan. There seem to be common stages of the tobacco epidemic that are highlighted in the fascinating graph below (source: Lopez et al., 1994). As you can see, China is only in stage 2, where a massive percentage of men become addicted, and a couple decades down the line the rate of disease and death will skyrocket. Note how in the first stages, women smoke far less than men in all societies. Much of the west and Europe is already in Stage 4, where smoking levels taper off but the death rates peak.

(source: Lopez et al., 1994)

So, back to the main question; what is the cultural difference? I’m honestly not sure, but I would love to hear other opinions about it. Certainly there is a culture of men trying to act cool as teens, and they get hooked and can’t stop. This is a universal issue for men; but perhaps as adults there is a uniquely Chinese strong culture for businessmen to drink and smoke, especially during meetings, where it may be considered rude to refuse either a toast or a cigarette. And historically, China’s leaders Mao Zedong and Deng Xiaoping were very heavy smokers and always photographed with a cigarette.

Clearly these cultural issues will take decades of public education to change. Much quicker changes, proven in many countries, would be higher tobacco taxes, warning labels on packs with graphic pictures, and the crucial banning of smoking in all public areas. There’s no reason to think China is any different than other countries, and eventually the cultural attitudes will change here as well. Unfortunately, between now and then, millions of people are going to continue to die from this awful addiction.

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There’s an interesting new blog about China healthcare…called, easily enough, China Healthcare Blog. It’s a spinoff of their previous Asia Health Care blog. They have a good group of writers who write original and in-depth articles. One article that caught my eye this week was their mention and ongoing video discussion of a disturbing paper just published in Lancet, which describes the extraordinarily high c-section rate in China, which at almost 50% of all pregnancies is one of the highest rates in the world (China Healthcare Blog | ChinaHB TV, Episode 1, C-Sections in China).

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We all sense that China’s current economic frenzy has led to many people — expats as well as locals — to work extremely long hours and face huge amounts of stress in their jobs. Well, it’s no secret that stress, poor sleep and poor diets can adversely affect your health, but a disturbing new report shows just how serious this is in China. The excellent website China Corporate Social Responsibility discusses a new report on this issue:

The survey report “The Health White Book of Chinese Urban White-collar Workers” — which was jointly published by the Chinese Medical Doctors Association, the Chinese Hospital Association, Beijing Health Insurance Association, and Ciming Checkup — shows that 80% of the white-collar workers surveyed have irregular sleeping or dining schedules and they feel fatigued during the day; 23.7% of them do not take the time to eat breakfast; over 20% of them often eat fast food; 54.4% of them lack sufficient sleep; and 32.4% of them do not get quality sleep; only 46% of them take even occasional exercise. In addition, over half of the white-collar workers often feel irritated, 20% feel lonely, and over 70% feel a lack of happiness and satisfaction.

Yikes! This doesn’t sound too healthy, long-term both for individuals as well as society. Hopefully, surveys such as this can foster a good societal debate as to just what we are sacrificing here, or at least motivate individuals to take their own initiatives. I personally feel that a big portion of the disease and mental health problems I see in my clinic is related to work-related stressors and lifestyle decisions. You can read the full ChinaCSR article here (New Survey: 76% Chinese Office Workers Sub-par – ChinaCSR.com – Corporate Social Responsibility (CSR) and Sustainability News for China.). This website also has a nice weekly free email newsletter that highlights the top stories of the week.

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Today is World AIDS Day, and local newspapers are providing good information online today. The Global Times has a nice series of articles reviewing the situation in China (Global Times – A nation of ghost whispers.) The gist of the story centers on the stigma attached to HIV positive people here, and the strong discrimination they encounter. Another article touches on the UNAIDS update.

The WHO also is taking advantage of the publicity to announce new guidelines for treatment of HIV AIDS.

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