What Really Matters: Living Longer or Living Healthier; Comment on “Shanghai Rising: Health Improvements as Measured by Avoidable Mortality Since 2000”

Document Type : Commentary


Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China


The decline in Avoidable Mortality (AM) and increase in life expectancy in Shanghai is impressive. Gusmano and colleagues suggested that Shanghai’s improved health system has contributed significantly to this decline in AM. However, when compared to other global cities, Shanghai’s life expectancy at birth is improving as London and New York City, but has yet to surpass that of Hong Kong, Tokyo, and Paris. Over the past decade, the reduction in AM of Shanghai is just in line with the international experience in reducing avoidable premature deaths. We suggest that a more elaborate research design is needed to examine the impact of the improvement in Shanghai’s health system on its population health status.


Main Subjects

  1. Gusmano MK, Rodwin VG, Wang C, Weisz D, Luo L, Hua F. Shanghai rising: health improvements as measured by avoidable mortality since 2000. Int J Health Policy Manag 2015; 4: 7-12. doi: 10.15171/ijhpm.2015.07
  2. Shanghai Bureau of Statistics. Shanghai Statistical Yearbook 2014. Shanghai; 2015.
  3. Norheim OF, Jha P, Admasu K, Godal T, Hum RJ, Kruk ME, et al. Avoiding 40% of the premature deaths in each country, 2010–30: review of national mortality trends to help quantify the UN Sustainable Development Goal for health. Lancet 2015; 385: 239-52. doi: 10.1016/S0140-6736(14)61591-9
  4. Wang CW, Chan CL, Yip PS. Suicide rates in China from 2002 to 2011: an update. Soc Psychiatry Psychiatr Epidemiol 2014; 49: 929-41. doi: 10.1007/s00127-013-0789-5
  5. Verbrugge LM. Longer life but worsening health? Trends in health and mortality of middle-aged and older persons. Milbank Mem Fund Q Health Soc 1984; 62: 475-519.
  6. Rechel B, Grundy E, Robine JM, Cylus J, Mackenbach JP, Knai C, et al. Ageing in the European Union. Lancet 2013; 381: 1312-22. doi: 10.1016/S0140-6736(12)62087-X
  7. Salomon JA, Wang H, Freeman MK, Vos T, Flaxman AD, Lopez AD, et al. Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the Global Burden Disease Study 2010. Lancet 2013; 380: 2144-62. doi: 10.1016/S0140-6736(12)61690-0
  8. Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: the challenges ahead. Lancet 2009; 374: 1196-208. doi: 10.1016/S0140-6736(09)61460-4
  9. Gruenberg EM. The failures of success. Milbank Mem Fund Q Health Soc 1977; 55: 3-24.
  10. Gruenberg EM. Epidemiology of senile dementia. Adv Neurol 1978; 19: 437.
  11. Kramer M. The rising pandemic of mental disorders and associated chronic diseases and disabilities. Acta Psychiatr Scand 1980; 62: 382-97. doi: 10.1111/j.1600-0447.1980.tb07714.x
  12. Fries JF. Aging, natural death, and the compression of morbidity. Bull World Health Organ 2002; 80: 245-50.
  13. Hong Kong Census and Statistics Department. Hong Kong Annual Digest of Statistics (2014 Edition). Hong Kong; 2015.
  14. Basten S, Yip P, Chui E. Remeasuring ageing in Hong Kong SAR; or ‘keeping the demographic window open’. J Popul Res (Canberra) 2013; 30: 249-264. doi: 10.1007/s12546-013-9113-1