| Abstract: |
The epidemiological transition, which has already passed the developed world,
is still progressing in many developing countries. A particular problem
associated with this transition is the under-diagnosis and lack of treatment
of chronic diseases, and these may exhibit SES gradients and exacerbate social
inequality. Using hypertension as an example and data from China (CHNS), we
find that the prevalence of hypertension in China is already close to levels
in developed countries, under-diagnosis is pervasive, treatment is rare, and
failure to control is widespread. Consistent with the literature, we find no
income and education gradients in the prevalence of hypertension. However,
there are strong education gradients in diagnosis and treatment in urban
areas. The income gradients in all aspects of hypertension are relatively weak
and sometimes nonexistent. Interestingly, we find that access to health care
does not contribute to the diagnosis of hypertension, nor does it aid much in
the treatment and control of hypertension. Our results suggest that the
epidemiological transition has indeed occurred, but both the Chinese public
and its health care system are ill-prepared. There is an urgent need to
educate the public on chronic illnesses, and to raise the quality of health
care so that patients receive proper diagnoses and guidance on how to treat
and control those chronic illnesses. |