A recent WHO report makes Chinese people more concerned about premature death. Photo: Li Hao/GT

This month, the World Health Organization (WHO) dropped a bombshell on the public with a report suggesting that noncommunicable diseases (NCDs), also known as chronic diseases, are responsible for 3 million premature deaths in China, each year.

According to the organization's Global Status Report on Noncommunicable Diseases 2014, chronic diseases, the four main types of which are cardiovascular diseases, cancers, chronic respiratory diseases and diabetes, account for more deaths globally than all other causes combined. Many of these diseases can be directly linked to one's lifestyle choices. 

The report went on to say that of the 38 million deaths due to NCDs in 2012, more than 40 percent were premature, defined in the report as death before the age of 70. The majority of premature NCD deaths are preventable, the report noted, with unhealthy lifestyle choices such as tobacco use, alcohol abuse and poor dietary habits major factors leading to premature mortality.

Joey Fang, a 33-year-old IT worker who smokes and frequently stays up late, posted a Sina Weibo message after reading the news.

"Am I going to die prematurely too?" Fang wrote. "This number [3 million] scares the hell out of me. I could easily be one of them."

For Fang and other Chinese living unhealthy lifestyles, the report is a wake-up call.

Many of the NCDs which lead to premature deaths are linked to one's lifestyle choices, including diet habits, smoking and drinking. Photo: Li Hao/GT

Why we're dying prematurely

Although the average life expectancy at birth of people in China has risen significantly in the past two decades, from 68 in 1990 to 76 in 2013, according to the Institute for Health Metrics and Evaluation, the number of premature deaths as a result of NCDs is worrying.

The WHO report noted that almost four in every 10 deaths caused by NCDs in Chinese men and around three in 10 deaths caused by NCDs in Chinese women are premature. People in China also have a higher probability of dying from an NCD between the ages of 30 and 70 than those in the US or the UK, according to the report, at 19.4 percent in 2012, compared to 14.3 percent in the US and 12 percent in the UK.

Dr. Angela Pratt, technical officer for tobacco control and communications lead at the WHO China Office, told Metropolitan that China's higher rate of premature mortality from NCDs compared to other countries is largely the result of its higher prevalence of major risk factors, including the high rate of smoking among Chinese men.

Another reason is that other countries such as the UK have stronger health systems - especially in the area of primary care, which can help ensure people with chronic diseases are well managed, reducing premature mortality from these diseases, she said.

"With high prevalence of some of the major risk factors for NCDs - for example, smoking, high blood pressure, not enough physical activity - more people will die prematurely from NCDs in the future, without urgent action to reduce the prevalence of these risk factors."

China is making progress in many areas, especially with recent initiatives on tobacco control, said Pratt.

Last November, Beijing's municipal legislature passed a bill to ban smoking in indoor public areas, workplaces and public transportation systems, which is scheduled to take effect in June 2015, the Xinhua News Agency reported.

"But more needs to be done to address other causes of the epidemic of NCDs in China, or China will not meet the global target of reducing premature mortality from NCDs by 25 percent by 2025," said Pratt. 

Invisible killers

Dr. Gilbert Shia, a general practitioner who works at the international health clinic MedicGo in Chaoyang district as well as at a number of local community clinics in Dongcheng district, said that he was not surprised to learn that as many as 3 million people in China died prematurely each year.

"These days, China is no different than developed countries in the West, with most premature deaths the result of chronic diseases," said Shia. The reason for the greater probability of premature deaths caused by NCDs, he said, was that China still lagged behind in certain areas of healthcare.

"We don't do well in prevention, and although chronic disease management has been promoted in communities for a while, it has not quite reached our expectations yet," said Shia, who has tried to introduce standard British medical practices to do with chronic disease management to local Chinese communities. 

"Currently, most people go to a big hospital to be treated for most diseases, where the doctors are too busy to explain how to best manage their chronic diseases," said Shia. "Small things like what a patient eats and having regular checkups can make a big difference, but the importance of these kinds of things haven't yet been taken up by everybody."

Shia said that awareness about NCDs was also a problem. As an example, Shia said that the incidence of diabetes in China was quite high, but the percentage of people who actively sought medical help for the condition remained low.

Statistics published by the Chinese Diabetes Mellitus Association last year showed that China has the largest number of diabetes patients in the world, with up to 11.6 percent of the adults suffering from the disease, and a further 500 million showing symptoms of prediabetes.

Shia told Metropolitan that lack of education and not taking adequate steps to prevent NCDs was a problem that affected everyone, regardless of social or economic status.

"[For people in the middle-class], the reason they give is that they are usually too busy [to educate themselves about risk factors for NCDs]," said Shia.

"They do care about their health, and they often buy nutritional supplements or expensive equipment and gadgets to try to maintain their health,but oftentimes they lack knowledge about the science behind maintaining health or treating chronic conditions," said Shia.

"Only through educating the patients can chronic disease management be achieved." 

Importance of a healthy lifestyle

Shia said that the best way for reducing the likelihood of premature death caused by chronic diseases was to live a healthy lifestyle.

According to an article published in medical journal The Lancet last November, life expectancy at age 60 in "high-income countries" has increased in recent decades. The article attributed the reasons for this rise to lower tobacco use among men and "improvements to the effectiveness and coverage of healthcare."

The message to be taken from this is that Chinese people need to improve their lifestyles.

According to the WHO report, more than 50 percent of men in China still smoke, and the age-standardized prevalence of insufficient physical activity in adults is 24.1 percent.

Even more worrying is the fact that Chinese people appear to be exercising less. An official report on Chinese people's health and nutrition showed that, the percentage of Chinese adults who exercise for more than 30 minutes daily has dropped from around 50 percent in 1997, to less than 33 percent in 2006.

Shia said that at-risk groups, such as those who are overweight and people whose family members have a history of diabetes, should try to live more healthily immediately.

"Although [the medical community] still doesn't fully understand diabetes and some other chronic diseases, there are already medications and strategies to keep these conditions under control," said Shia.

"There's no reason for millions of people to die from NCDs prematurely. It shouldn't happen in any modern country any more."

10 secrets to longevity

Based on the WHO report and suggestions made by doctors, Metropolitan has pulled together some tips for living a longer life.

Stop drinking. In 2012, an estimated 3.3 million deaths, or 5.9 percent of all deaths worldwide, were attributable to alcohol consumption. More than half of these deaths were caused by NCDs linked to drinking, according to the WHO report.

Tobacco kills. Tobacco use is the cause of 6 million preventable deaths per year globally.

Eat less salty food. Reduce salt consumption to less than 5 g (about 1 teaspoon) per day. Globally in 2010, 1.7 million deaths annually from cardiovascular diseases have been attributed to excess salt/sodium intake.

Two and a half hours of exercise per week. WHO recommends at least 150 minutes of moderate-intensity physical activity per week for adults, which will reduce the risk of cardiovascular disease, diabetes and cancer.

Men are more likely to die prematurely than women. Rates of premature mortality are higher among males in all countries.

Think twice before you act. Howard S. Friedman and other research fellows from Standard University found that among all the personality types, conscientiousness people are more likely to live longer.

Have good genes. Studies show that if your family members live to a ripe old age, it means that you are likely to, too. 

A sedentary lifestyle can kill you. In 2011, researcher Lennert Veerman from the School of Population Health at the University of Queensland co-authored a paper which found that for every hour of television watched after the age of 25 could shorten one's lifespan by 22 minutes.

Watch your blood pressure. High blood pressure is one of the leading factors for mortality and is estimated to have caused 9.4 million deaths worldwide.

Watch your waist line. Shia said the waist line was an important indicator to one's health and longevity. According to the US Centers for Disease Control and Prevention, if you are a man with 40-inch or higher waistline, or a woman with 35-inch or higher waistline, you are under higher risk.