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China, health and us.

I came across two articles [vaguely] related to the 2008 Olympics, China and health. The first is an article from ‘The Guardian‘, ‘A cultural revolution to make London sit up and take notice‘ [2008.8.13], written by Marina Hyde, and the second is an item from the Reuters news agency, written by Belinda Goldsmith, ‘Armchair Olympics fuels obesity fears‘ [2008.8.15]. Although, on the face of it, they seem to be at odds with each other on closer inspection they are both correct.

The substance of the Reuters report is China is facing a [potential] obesity crisis. Work patterns have changed, average family spending power has risen and there is an increasing demand for western style foods so is it any surprise that some of the problems which have bedevilled western societies for some time are now cropping up in Eastern Asia. Over the last two decades fast food chains [MacDonald’s, KFC etc] have found their way into the middle kingdom and have been enjoying considerable success. They are quite expensive compared with normal run of the mill Chinese restaurants and dining there is something of a mark of status; children from middle class families are often taken to fast food eating places for birthdays or other treats, so the habit is established at a very early age. In the early days, shortly after Deng Xiaoping opened up China to the outside world, someone in the Politburo made the mistake of thinking that such chain restaurants represented the very highest in western cuisine and as result they were allowed in to China to trade. One hopes that after the mistake was discovered the culprit was taken away and sent on a suitable programme of re-education or at the very least, shot.

At present approximately 14% of Chinese adults are overweight and about 3% are obese [ref BMJ August2006], compared with 21% of men and 23% of women in the UK, but these figures do not paint the full picture. In China obesity is more likely to be found amongst younger people than the older generation, in the UK the reverse is true, the older the age range examined the more prevalent obesity becomes. This is good news for China as it shows the problem is a recent one, new problems are more easily remedied than those long standing, but not so good for the UK. Perhaps the most worrying thing for China, and for anyone else interested, is just how fast the population changed from one of the slimmest and most sveldte in the world to its present position. Another interesting twist to the picture is that in China obesity is more common amongst the middle classes while in the UK it occurs most frequently amongst unskilled working classes, although it must be stressed that no sector of society is free of the problem. In China most children have enough to eat but an increasing number of families have the spending power to buy more meat and to overfeed and having only one child per family, who is often tended by both parents and grandparents, the child, especially if it is a boy, is spoilt beyond belief. In the old days to be overweight was a status symbol, as it demonstrated your wealth and showed you did not have to work and this is now being re-echoed in modern China. Similar things have been happening in the UK for much longer, although one observation I would make is that with the UK, and other western nations, it is the coming of industrialised foods which has been our final undoing. Make of all that what you will but one thing which cannot be avoided is that we are faced with a health problem which, if unchecked, will become more than just a nuisance in the future.

The gist of The Guardian article is that the Chinese people take responsibility for looking after their own health and many are quite fanatical about staying fit and healthy. The main reason is quite simple; no-one else is going to do it for them.  There is no free health service in China to sort out all your ails.  The phenomenon observed by the writer Marina Hyde in her Guardian article is something which can be found all over China, in cities, towns, villages, taking place in parks, near lakes, in back-streets or on any convenient patch of ground. Reading her article the reader may be excused for thinking that only older people are involved, in fact at schools, colleges and universities morning exercise periods are as fixed a part of the day as the sunrise. Every morning at different places around the campus where I taught people would gather for exercise, sometimes individually but more often in groups. Almost every activity could be seen, taijiquan, sword dancing, fan-dancing, wushu, or just a routine of faithfully repeated exercises. All of which goes a long way towards persuading people that they have a responsibility to look after their health and giving them the means of doing just that. In the evenings, in the Peoples’ Square, similar things took place, although these were usually of a more social nature, line-dancing, ball-room dancing. At weekends, in the park, clusters of people would gather for more of the same thing, more practice on the communal exercise parks, Peking Opera, more ballroom dancing, group singing, traditional music – I was captivated and awed by the range of activities which the people would organise on their own initiative. When it comes to looking after themselves and their peers, and with the minimum of resources, the Chinese people win hands down.

As Ms. Hyde says, “Mao declared that the Chinese should civilise their spirits and be brutal on their bodies. “; he may not have been right about everything but this is one gem of wisdom which seems to ring true, judging by what can be seen in China and the contrast which can be found in “London: that far-off land where the increasingly familiar sight of mobility scooters outside pubs suggests that late-capitalism is either a mixed blessing, or bold initiatives are called-for in the run-up to the [2012] Games“

It is hard to see how a couple of weeks of elite sportsmanship in 2012 could alter the health of the British nation or have any impact on the growing obesity problem. As quickly as the 2012 games come they will go, and so will the euphoria and any nine-minute wonders that the government dreams up. If we are not to end up glued even more firmly to our remote controls and TV sets [see “Success will inspire us … to pick up the remote” in The Guardian, written by Emma John] drastic action is required. As stated in The Guardian, free swimming for the over-60s is a start, but measures need to go a little further and deeper than that. At the very least we could take a leaf from the PRC government and invest in low cost, low grade exercise equipment such as is found in Chinese towns and cities and restore playing fields to all schools; these are relatively superficial things but could be part of an overall scheme. Reaching out to the population with more funding for games and sports probably wouldn’t be a bad thing either, but relies on people being willing to respond. Are those most in need of shaping up most or least likely to respond? This is not just a matter of offering opportunity and providing the hardware and infrastructure but one of culture and attitude, neither of which are easy to influence. Or maybe we must turn to Chairman Mao once again and be more brutal with the population and give people no option other than to take responsibility for their own health or suffer the consequences.