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Disparities in Health Outcomes Between India and China

Disparities in Health Outcomes Between India and China


There are significant health disparities between India and China as well as within their
populations. At the end of World War I, health outcomes of both China and India were almost
comparable. However, the health system of China improved more tremendously than that of
India roughly thirty years after the war. The health progress in India thirty years ago is
surprisingly better than that of China despite the fact that India is still one of the countries of the
world whose economy is highly impacted by the problem of food insecurity (Yip and Mahal,
2008). Ideally, India and China have had varied experiences in health outcomes in the last 50

Variations in Health Outcomes between China and India

In the last 50 years, China and India have experienced significant differences in life
expectancy rates as well as in rates of parasitic and infectious diseases. The most important
measure of life expectancy is infant mortality, while the measure of infectious disease burden is
adjustments in life years among the population (Bardhan, 2008). Since the early 1970s, India has
been experiencing lower life expectancy, as evidenced by higher infant mortality rates, than
China (Kanjilal, Mazumdar, Mukherjee and Rahman, 2010). By the year 2000, the rate of deaths
among children aged five years and below was 46 percent in India and only 8 percent in China.
These are deaths that resulted from children who are born if they are underweight (Bardhan,
2008). According to Yip and Mahal (2008), the burden of infectious diseases in India is higher
than that of China. Considering these variations, the health care systems of both India and China

can only perform effectively if appropriate actions are taken to improve health outcomes about
life expectancy and burden of parasitic and infectious diseases.

Reasons Behind the Health Outcome Disparities Between India and China
The two leading causes of health outcome disparities between India and China are
variations in health literacy and implementation of public health policies. According to Yip and
Mahal (2008), India has been experiencing low life expectancy over the years because of limited
health literacy among its population. Yip and Mahal (2008) further assert that the health literacy
level in India at the moment is far much lower than it was in China more than ten years ago. Due
to limited health literacy among Indian population, families cannot implement basic health
promotion strategies such as proper nutrition and home hygiene practices. The overall impact is
an increased burden of infectious diseases coupled with high infant mortality rates in the country
(Ma and Neeraj, 2008).
Furthermore, the Chinese government is more committed than the Indian government at
funding public health projects that are aimed at improving health outcomes of its population.
Over the past fifty years, life expectancy in China has been increasing rapidly from
approximately 39 percent to about 68 percent (Tang, Meng, Chen, Bekedam, Evana, and
Whitehead, 2008). This has occurred due to the effort made by the Chinese government to
support the implementation of public health policies. The most recognizable initiative that was
widely supported by the government is the Health China 2020, which was meant to address the
problem of social inequality in health care and to improve the Chinese health care (Tang et al.,
2008). Conversely, India is suffering from inadequate public health support accompanied by
significant disparities in the country’s health care system. Consequently, poor implementation of
public health policies in India is attributed to the higher mortality rates and burden of infectious

diseases in India than in China (Mukherjee, Haddad and Narayana, 2011). Despite these
differences, health outcomes of both India and China are greatly impacted by social and health
care disparities in the two countries (Balarajan, Selvaraj, and Subramanian, 2011; & World
Health Organization, 2005).

Comparison of Health Outcomes in Kerala and India

Kerala state is located in India towards the southern regions of the country. Surprisingly,
the health outcomes of Kerala state are better than those of other parts of India, and this is
evidenced by variations in both health and social indicators. As Mukherjee, Haddad and
Narayana, (2011) explain, Kerala has experienced high life expectancy rates as well as reduced
burden of infectious diseases in the last half century. Kerala became a “model India State”
because of exhibiting a demographic health pattern that matches those of developed countries
like the United States. The main reasons for improved health outcomes in Kerala are educational
equality, increased access to primary health care, and effective implementation of public health
policies (Mukherjee, Haddad and Narayana, 2011). Educational equality in Kerala state
contributes to an increase in health care literacy among the state’s population. Furthermore,
effective implementation of public health policies in the region has greatly improved the quality
of care offered by health care organizations, and this translates into high life expectancy rates
and reduced burden of infectious diseases (Mukherjee, Haddad and Narayana, 2011).


India and China are among countries of the world that are currently experiencing almost
similar rates of economic growth. However, the two nations have experienced different health
outcomes in the last fifty years. The main reasons behind variations in health outcomes between
China and India are differences in health literacy levels and implementation of health care policy

between the two countries. Although Kerala is a state in India, its health outcomes differ
considerably from the rest of India.


Balarajan, Y., Selvaraj, S. & Subramanian, S. V. (2011). Health care and equity in India. Lancet,
377(9764): 505-515.
Bardhan, P. (2008). The state of health services in China and India in a larger context. Health
Affairs, Nutritional status of children
in India: Household socio-economic condition as the contextual determinant.
International Journal for Equity in Health, 9(1): 19-31.
Ma, S. & Neeraj, S. (2008). A comparison of the health systems in China and India. Santa
Monice, CA: RAND Corporation.
Mukherjee, S., Haddad, S. & Narayana, D. (2011). Social class related inequalities in household
health expenditure and economic burden: Evidence from Kerala, South India.
International Journal for Equity in Health, 10(1):1-13.
Tang, S., Meng, Q., Chen, L., Bekedam, H., Evana, T. & Whitehead, M. (2008). Tackling the
challenges to health equity in China. Lancet, 372(9648): 1493-1501.
World Health Organization. (2005). China: Health, poverty, and economic development.

Yip, W. & Mahal, A. (2008). The health care systems of China and India: Performance and
future challenges. Health Affairs, 27(4): 921-932.

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