It's a good time to be alive in China, according to a report in Lancet detailing how health trends in the east Asian country have changed from 1990 to 2010. The findings show that China has the least number of years lost to disability (YLDs) of all the G20 countries, whose economies account for more than 80 percent of the gross world product.

The analysis is part of the Institute for Health Metrics and Evaluation's (IHME's) quest to measure all of the world's health loss caused by disease and injuries, known as the Global Burden of Disease study. It is the largest, systematic investigation ever conducted on the global distribution and causes of major diseases and health risk factors. Lancet published the first series of results from this international effort last December.

The latest release is a China-centric follow-up, which outlines the tremendous health gains that the nation has made over the last two decades, along with the unique problems that it may face during its new industrial revolution.

The greatest improvements were recorded in children's health. Death by diarrhea and respiratory disease in children has declined by 90 percent since 1990, mainly due to fewer cases of intenstinal worms and chest infections like tuberculosis. China's growing economy undoubtedly led to better sanitation and less hunger; both of which factor into communicable disease rates.

Overall, China's child mortality rate has declined by 6 percent each year for two decades.

"The speed of decline in numbers of premature deaths resulting from infectious diseases and neonatal causes in China over the last two decades could provide a model for other developing countries," said co-lead author Professor Yang of the Peking Union Medical College, Beijing. "But there are still challenges to be met, including rising rates of HIV infection, and tackling disease burden and child malnutrition in some poor provinces, where the burden of communicable diseases is still high."

Female health has also improved dramatically with a 34 percent drop in anemia due to iron deficiency and better than G20-average performance with breast cancer and preterm birth complications.

Other postive trends include a five percent drop in drug use, while the rest of world witnessed a 38 percent increase, and a steep decline in suicides for both men and women.

The prevalence of cardiovascular disease (stroke and heart attacks) has risen dramatically since 1990 and is now the leading causes for disability in China. Poor diet was the leading risk factor for disability and death in this study.

Smoking remains a serious problem in China with deaths attributable to tobacco use rising by almost 30 percent since 1990. While Chinese women have one of the lowest rates of cigarette consumption in the world, over half of the male population smokes. The incidence of respiratory disease has also been magnified by China's ballooning issue with air pollution, outdoors and indoors. A 2004 World Health Organization study found indoor air pollution was responsible for over half a million deaths per year in China.

"The burden of diseases attributable to individual behaviours and practices is steadily rising in China," said co-lead author Dr. Yu Wang, of the Chinese Center for Disease Control and Prevention. "The most important behaviours resulting in increased illness and deaths included diets low in fruit, high in sodium, and low in whole grains, smoking, alcohol, and physical inactivity, and the Chinese government needs to take responsibility for expansion of prevention strategies for behavioural risks. Even small reductions in these risks could generate substantial benefits."

China's life expectancy has expanded from 69.3 years to 75.7, another sign of its economic success, but it is linked to an increase in aging-related disorders, like Alzheimer's, Parkinson's, and diabetes.

These trends place China in the unique position of prevailing against health problems that are more associated with developing nations — viral and bacterial infections, malnutrition — but being blitzed by conditions prevalent in developed nations, such as age-related disorders.

"Health loss and health-care costs from mental disorders, musculoskeletal disorders, neurological disorders, and vision and hearing loss will continue to rise," said co-author Dr. Christopher Murray, IHME Director. "Policies to help prevent and manage these disorders cost-effectively will be critical."

Murray continued that China has had remarkable accomplishments in reducing deaths and disability from certain communicable diseases, and annual assessment of disease burden will allow China to track its progress against other countries and set its priorities.

Source: Gonghuan Yang G, Wang Y, Zeng Y, et al. Rapid health transition in China, 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet. 2013.