Abstract

The Health and Population Health Report of Beijing（referred to as the Health White Paper）is based on the “Healthy Beijing Residents-A Ten-year National Health Promotion Scheme（2009-2018）” issued in 2009 by the Municipal Party Committee and the Municipal Government of Beijing. The Health White Paper annually sheds new light on the health conditions of residents and the development of health in Beijing. It is significant to popularize health knowledge，participate in health action，change unhealthy behaviors，and better implement the Outline of Healthy Beijing 2030 Planning. This is the ninth publication of the Health White Paper. It is a compilation of health-related data from eighteen bureaus or commissions including Beijing Municipal Commission of Health and Family Planning，Beijing Municipal Education Commission，Beijing Municipal Public Security Bureau，Beijing Municipal Civil Affairs Bureau，Beijing Municipal Finance Bureau，Beijing Municipal Human Resources and Social Security Bureau，Beijing Municipal Environment Protection Bureau，Beijing Municipal Commission of City Management，Beijing Municipal Commission of Commerce，Beijing Municipal Administration of Quality and Technology Supervision，Beijing Administration of Work Safety，Beijing Food and Drugs Administration，Beijing Municipal Bureau of Press，Publication，Radio，Film and Television，Beijing Municipal Bureau of Sports，Beijing Municipal Bureau of Statistics，Beijing Municipal Bureau of Landscape and Forestry，Beijing Federation of Trade Union and Beijing Disabled Persons’ Federation. The main content includes demographic profile，chronic non-infectious diseases and related risk factors，incidence of infectious diseases，disability and mental disorders，health status of children and adolescents，healthcare services，and environmental health. The Health White Paper objectively depicts the health condition of residents in Beijing and the development of health in detail and comprehensiveness. The abstracts are as follows.

By the end of 2017，the permanent residential population of Beijing was 21.707 million，decreased by 0.1% over 2016. The immigrant population with residency was 7.943 million，decreased by 1.6% over 2016. The household registered population of Beijing was 13.592 million，decreased by 37，000 over 2016. The population of 60 year-old and older accounted for 24.7% of the household registered population，and that of the 65 year-old and older was 16.4%.

Comparing with those in 2016，the birth rate of household registered population in Beijing in 2017 was 12.59‰，increased by 15.4%；the mortality rate was 6.84‰，increased by 3.3%；the infant mortality rate was 2.29‰，increased by 3.6%；the mortality rate of children under 5 year-old was 2.64‰，decreased by 1.1%；and the maternal mortality rate was 8.17/10 ⁵，decreased by 24.6%.

Chronic non-infectious diseases were the leading causes of death among residents in Beijing in 2017. The top three causes of death were malignant tumors，heart disease and cerebrovascular disease，accounting for 71.7% of all deaths. Comparing with those in 2016，the mortality rate of malignant tumors in 2017 was 183.76/10 ⁵，increased by 3.6%；the mortality rate of heart disease was 179.27/10 ⁵，increased by 5.2%；the mortality rate of cerebrovascular disease was 127.45/10 ⁵，decreased by 2.4%；and the mortality rate of infectious disease was 4.40/10 ⁵，decreased by 0.45%.

In 2017，the probability of premature death in household registered residents of Beijing with chronic non-infectious diseases（malignant tumor，cardiovascular disease，diabetes and chronic respiratory diseases）at the age of 30 to 70 year-old（excl.）was 10.8%，decreased by 0.92% over 2016. The probability of premature death was 14.5% for the male，and 7.1% for the female.

The life expectancy of the registered residents in Beijing in 2017 was 82.15 year-old，increased by 0.12 year over 2016；79.98 year-old for the male，and 84.41 year-old for the female.

In 2016，there were 46，870 cases with newly-diagnosed malignant tumor in the household registered population in Beijing. The incidence was 346.15/10 ⁵，increased by 4.8% over 2015.From 2007 to 2016，the age-standardized incidence increased by annually 1.6% in average. Among newly-diagnosed males with malignant tumors，lung cancer ranked first and followed by colorectal cancer，liver cancer，gastric cancer，and prostatic cancer. And in females，breast cancer ranked first and followed by lung cancer，thyroid cancer，colorectal cancer and uterine cancer.

The number of acute coronary events in 2016 was 36，865 cases in the registered residents aged 25 and above in Beijing，with a standardized incidence of 224.45/10 ⁵，the mortality of acute myocardial infarction within 30 days after onset was 30.8%，the mortality of hospital inpatient was 10.8%；and the number of acute stroke events was 82，107 cases，the standardized incidence was 367.91/10 ⁵，the 30-day mortality was 3.4%，and the hospital mortality was 2.5%.

In 2017，25 notifiable infectious diseases in classes A，B and C with 132，588 cases were identified in Beijing，increased by 10，639 cases over 2016. The top ten diseases of these three classes by incidence were infectious diarrheas of other etiology，influenza，hand-foot-and-mouth disease，dysentery，tuberculosis，syphilis，scarlet fever，viral hepatitis，mumps and gonorrhea，accounting for 99.0% of the total cases. Influenza ranked second in 2017 from third in 2016.

The incidence of notifiable infectious diseases in 2017（including classes A，B and C）was 610.19/10 ⁵，increased by 8.6% over 2016. Compared with 2016，the incidence of the classes A and B was 139.61/10 ⁵，increased by 1.2%；and the incidence of the class C was 470.58/10 ⁵，increased by 11.0%.

In 2017，34，191 disability certificates were issued in Beijing. The total number of the certificate holders was 511，915. Physical disabilities made up the highest proportion（56.4%），then came next visual impairment（10.8%），mental disorders（10.1%），intellectual disability（9.9%），hearing loss（7.2%），speech impairment（0.6%），and multiple disabilities（5.0%）.

In Beijing，the serious psychiatric disorders are registered in a community-based system.The total number of the patients was 73，623 in 2017. 10，707 newly-diagnosed cases in total were reported by healthcare facilities for the diagnosis and treatment of mental disorders，of which 10，233 were registered residents and 474 were the temporary residents. The major diagnosis was schizophrenia with 3，173 cases，accounting for 31.3% of all newly-diagnosed patients；and came secondly bipolar disorders with 2，314 cases，accounting for 22.8% of all newly-diagnosed patients.

In 2017，the incidence of perinatal birth defects was 14.22‰ in the household registered residents，and 27.40‰ in the non-registered，increased by 5.2% and 5.1% over 2016，respectively.In 2017，a total of 263，077 newborns were screened among which 270 were diagnosed. The incidence of low birth weight was 4.2% in the household registered residents，which was the same as 2016.

In 2017，the proportion of the Beijing’s primary and secondary school students who passed the physical fitness test reached 93%，with good rate of 50% and excellent rate of 13%，increased by 0.1%，6.0% and 6.0% over the previous year respectively.

In the 2016-2017 school year，the detection rate of low vision was 58.6% in elementary and secondary school students，which was the same as that in 2015-2016 school year. The detection rate of obesity was 16.8%，increased by 3.1% over 2015-2016 school year.

Beijing Municipal Finance revenue in 2017 allocated 13.72180 billion RMB for public hospitals，decreased by 2.5% over 2016. 5.10052 billion RMB was for primary healthcare facilities，increased by 15.6% over 2016；and 3.99753 billion RMB for public health，increased by 20.1%over 2016.

In 2017，there were 10，986 healthcare facilities in Beijing，increased by 349 over 2016. The total number of health professionals was 346，255，increased by 4.7% over 2016. There were 254，150 medical staffs working in hospitals. 70，802 worked in primary healthcare facilities；and 35，174 in community healthcare service facilities. 3，717 health practitioners were in service in disease prevention and control institutions.

In 2017，the registered beds in Beijing’s healthcare facilities were 127，845，increased by 2.2%over 2016，the number of medical visits was 238，844 million，decreased by 2.9% over 2016. And the number of discharged cases was 3.830 million，increased by 3.6% over 2016.

In 2017，6，197，188 cases were given for routine immunization in Beijing，increased by 13.0%over 2016；and 1，991，540 cases of category II vaccines，increased by 16.2% over 2016.

The compliance rate of family planning policy was 99.3% in the household registered population in Beijing in 2017. In 2017，among 234，204 records of birth registration，150，808 were registered residents of Beijing，83，396 were non-registered residents of Beijing and 97，362 were the second ones（41.6%）.

In 2017，15.6916 million people participated in Urban Employees’ Basic Medical Insurance，increased by 3.4% over 2016. 2，0224 million participated in Urban Residents’ Medical Insurance，increased by 5.8% over 2016. 1，868，832 people participated in New Rural Cooperative Medical Scheme，decreased by 11.8% over 2016.

In 2017，the water quality of centralized drinking water sources in Beijing met the national standard for water quality of drinking water sources with the compliance rate of 100%. The qualified rate of municipal waterworks was 98.5%. It was 97.1% and 100% in the low and high water level period，respectively. 99.9% of peripheral water and 99.6% of the secondary water supply tank outlet was qualified.

According to Beijing’s food and drug safety monitoring system in 2017，172，000 samples were tested. Higher than 99.2% of food，99.9% of drugs（including medical devices and cosmetics）sampled was qualified.

In 2017，Beijing health inspection and supervision officers supervised and inspected various tobacco control locations，totally 121，621 enforcement activities，6，013 unqualified units was identified，with the total qualification rate of 95.06% and 5，359 of them were forced to rectify and reform. 653 administrative penalties were conducted with the organization fine of 1.7667 million RMB. 3，292 individuals were fined with an amount of 0.1716 million RMB. In 2017，tobacco control billboards located in transportation settings such as bus stops，buses，and subway platforms reached an audience of 50.14 million people. No-smoking signs were in presence of 94.7% of all public settings. 61 hospitals set up the clinics offering smoking cessation services.

In 2017，the total number of cigarettes sold in Beijing by wholesalers and retailers above norm was 93.7612431 billion cigarettes，decreased by 0.09% over 2016.

On April 8，2017，Beijing launched the comprehensive reform of “separation of medical service and pharmaceuticals sales”，aiming to promote construction of grading diagnosis and treatment system by collecting medical service fee and adjusting medical service price in more than 3700 medical institutions in Beijing. Since the reform，the patients of emergency departments of tertiary and secondary hospitals decreased by 11.7% and 2.3% respectively over the previous year.The patients of primary hospitals and basic medical and health institutions increased by 16.4%，and the patients of partial urban community health service institutions increased by more than 20%.The average stay in tertiary hospitals is 8.6 days，an decrease of 0.7 day compared with the same period of 2016. The overall reduction of drug price is 8.8%；the proportion of the drugs in secondary and tertiary hospitals decreased to 34% from 43% before the reform. The accumulated medical costs saved after the reform is 6.74 billion yuan. With regard to urban and rural medical insurance，the individual payment by patients keeps stable generally. For subjects of social relief covered by outpatient，hospitalization and major disease relief policies，the individual payment per capita decreased by about 30%. The investigation shows that 91.7% of patients support the comprehensive reform of “separation of medical service and pharmaceuticals sales”，and over 90% of patients are satisfied with the medical service. The separation of medical service and pharmaceuticals sales is proceeding stably and orderly in Beijing.