Diabetes is a significant problem worldwide and especially for developing countries including Thailand, where the disease has increased in prevalence rapidly, resulting in high healthcare expenditure and loss of productivity due to illness and premature death. Thailand has adopted multiple policies to control diabetes, such as screening through annual health checkups for people aged 35 and over, increasing healthcare access in rural communities, and developing diabetes clinical practice guidelines to improve the quality of care. However, multiple national health surveys still showed a rising pattern of diabetes in the country. To help understand and tackle the problem, we created a 10-year cohort using data from the national health exam survey (NHES) as a starting point and followed the population by linking to healthcare utilization and expenditure data from the universal health coverage scheme, the main health insurance program in Thailand. With this cohort, we study 3 topics. The first is to understand the burden of diabetes in the Thai health service system by calculating incidence of diabetes and its complications. Furthermore, we will identify factors which affect diabetes incidence and therefore can be used to create evidence-based control policies. Second, we seek to identify the bottleneck between each step in the “cascade of care” (screening, starting and adhering to treatment, and controlling disease). Finally, we will compare healthcare utilization patterns, expenditure, and outcomes related to diabetes between the overall population and vulnerable subgroups to identify factors that prevent vulnerable populations from obtaining better health outcomes.

Wasin Laohavinij is a physician at King Chulalongkorn Memorial Hospital and a research assistant at Department of Preventive Medicine, Faculty of Medicine, Chulalongkorn University. His research focus on non-communicable disease prevention policies and economic evaluation of health promotion and prevention. Wasin Laohavinij completed his MD at Chulalongkorn University.

Celebrated for its natural beauty and its abundance of wildlife, the Mekong River runs thousands of miles through China, Myanmar, Laos, Thailand, Cambodia, and Vietnam. Its basin is home to more than 70 million people and has for centuries been one of the world's richest agricultural areas and a biodynamic wonder. Today, however, it is undergoing profound changes. Development policies, led by a rising China in particular, aim to interconnect the region and urbanize the inhabitants. A series of dams will harness the river's energy.  But they will also disrupt its natural cycles and cut off food supplies for swathes of the population.  Based on conversations with the diverse people he has encountered from the Mekong’s headwaters in China to its delta in southern Vietnam, Eyler will review and assess the urgent struggle to save the Mekong and its unique ecosystem.  Copies of his latest book, Last Days of the Mighty Mekong (2019), will be available for sale.

Brian Eyler is an expert on transboundary issues in the Mekong region, a specialist on China's economic cooperation with Southeast Asia, and co-founder of the website http://eastbysoutheast.com/.  Of his more than 15 years living and working in the PRC, he has spent the last ten doing research with stakeholders in the Mekong region. In China, before coming to the Stimson Center, he directed the IES Kunming Center at Yunnan University and served as a consultant to the UNDP Lancang-Mekong Economic Cooperation program.  His degrees are from UC-San Diego and Bucknell.

 

This seminar will present empirical evidence about policies to promote healthy lifestyles in China from a professor and a policymaker from the PRC.

As a result of economic growth, urbanization, lifestyle change, and population aging, Noncommunicable Diseases (NCDs) have become China’s leading cause of death, accounting for 86.6% of annual deaths. Almost two-thirds of NCDs can be prevented by reducing unhealthy lifestyle choices such as tobacco use, physical inactivity, harmful use of alcohol, and unhealthy diets. In particular, dietary risk factors and insufficient physical activity increasingly contribute to the surging burden of obesity in China and globally.

In 2016, President Xi Jinping announced the “Healthy China 2030” Blueprint. Three years later, a corresponding action plan was released and encompassed 15 goals, including reducing obesity, increasing overall physical activity, and preventing NCDs. The presenters will discuss results of research on the determinants of healthy diet, physical activity, obesity, and noncommunicable diseases, and provide evidence for implementation of Healthy China 2030. Their research includes aspects on (1) unhealthy food and beverage marketing to children; (2) the link between green space, physical activity, and health outcomes; (3) a strategy to involve government and non-health sectors in the prevention and control of NCDs in China; and (4) preventive vaccinations and primary care management for individuals living with NCDs like diabetes.

Juan Zhang is Associate Professor at School of Public Health, Peking Union Medical College (PUMC) & China Academy of Medical Science (CAMS). She conducts research on risk factors of noncommunicable disease (NCD), such as obesity, hypertension, diabetes, nutrition, physical activity, using policy, socio-ecological, and behavioral approaches. She currently is principal investigators to (1) assessing mass media (mainly television) food advertisement, (2) investigate underlying family environment, school policy and environment of preschool children overweight and obesity, (3) evaluate the implementation and impact of government-led programs to prevent and control NCD. Prior to joining PUMC, Dr. Zhang has had diverse working experience over 10 years across national government agency, WHO, academic institutions, and multinational pharmaceutical company.

Dr. Juan ZHANG holds a Ph.D. in Health Behavior from the Indiana University Bloomington. She has published in the areas of chronic disease epidemiology, economic cost and behavioral determinants of obesity, and public health program evaluation. She serves as members of several professional societies, like Committee of Diabetes Prevention and Control of Chinese Preventive Medicine Association (CPMA), Committee of NCD Disease Prevention and Control of CPMA, Committee of Health Communication of China Health Education Association, and Committee of Student Nutrition and Health, Chinese Student Nutrition and Health Promotion Federation.

Xiangyu Chen is a working staff from Non-communicable Disease (NCDs) Control and Prevention Department in Zhejiang Provincial Center for Disease Control and Prevention. He is a public health physician and his ongoing areas of research include development of risk prediction models using health check-up data, and cost-effectiveness evaluation for flu shots among the diabetes. He completed his MS in Epidemiology and BA in Preventive Medicine at Soochow University.