Abstract
The trends of diversified diets in China have generated a growing number of nutritional health problems, and healthcare investment is bearing a large burden from the diets, hindering the economic progress of the country and its residents toward affluence. This study linked the evolution of the Chinese dietary structure to changes in health expenditures and predicts future dietary patterns and their impact on health costs over the next 30 years. We found that in the past 30 years, the Chinese dietary structure has shifted towards a nutritional surplus type, and the structure of health expenditures has also shown a trend of two increases and one decrease. The consumption of plant-based foods is significant correlated with lower health expenditures, and animal-based foods show a significant impact on increase of health expenditures. Among nutrients, fat is significant correlated with increased health expenditures, whereas calorie intake is significant correlated with lower health expenditures. By 2030, the Chinese dietary structure will still evolve to a high-protein and high-fatty type. This shift will result in a decrease in per capita healthcare expenditure by 41.66 yuan and increases in household, state, personal, and total healthcare expenditures by 76.83 yuan, 18.76 billion yuan, 95.28 billion yuan, and 17.67 billion yuan, respectively. These findings demonstrate that adjusting dietary structures will bring the dual benefits of improved national health status and a favorable cycle of health expenditures.
Generated Summary
This research investigates the link between the evolution of the Chinese dietary structure and healthcare expenditures. The study employs a fixed-effects model to analyze the impact of dietary structure on healthcare expenditures, considering various factors across 31 provinces in China from 1992 to 2021. Using peer pressure and gray prediction models, the study forecasts future changes in China’s diet and medical expenditure. The methodology involves analyzing changes in dietary structure, focusing on macronutrients and food diversity, and correlating these changes with healthcare expenditure data. The research aims to contribute to the goals of “Healthy China 2030” and the development of global health by aligning national healthcare spending with population health needs. Data on food consumption and healthcare expenditure from various sources, including statistical yearbooks, were utilized to create the model.
Key Findings & Statistics
- In 2021, China’s total health expenditure reached 7684.499 billion yuan, a 69.06-fold increase from 1992.
- Government health expenditure grew from 22.861 billion yuan in 1992 to 2067.606 billion yuan.
- Social health expenditure increased from 43.155 billion yuan to 3496.326 billion yuan.
- Individual cash health expenditure rose from 43.67 billion yuan in 1992 to 2.2120.567 billion yuan.
- Per capita healthcare costs rose from 50.29 yuan to 2115.00 yuan.
- State financial expenditure on healthcare increased from 5838 million yuan to 1,914,268 million yuan.
- The diversity index of the Chinese dietary structure increased from 0.46 in 1992 to 0.84 in 2021.
- Caloric intake decreased from 2436.1 kcal in 1992 to 2187.4 kcal in 2021.
- Protein intake fell from 90.3 g to 84.9 g, while fat intake increased from 50.7 g to 84.5 g.
- Dietary fiber intake decreased from 98.8 g to 81.3 g, and carbohydrate intake decreased from 392.8 g to 274.5 g.
- By 2030, the Chinese dietary structure is projected to result in a decrease in per capita healthcare expenditure by 41.66 yuan.
- Household, state, personal, and total healthcare expenditures are expected to rise by 76.83 yuan, 18.76 billion yuan, 95.28 billion yuan, and 17.69 billion yuan, respectively, by 2030.
- By 2050, per capita foodborne expenditure will decrease by 2217.79 yuan.
- Household expenditure will decrease by 2535.20 yuan by 2050.
- Personal expenditure will decrease by 512.20 billion yuan by 2050.
- Total expenditure will decrease by 484.46 billion yuan by 2050.
- National financial health expenditure is projected to increase by 182.13 billion yuan.
- Grain consumption is projected to decline, reaching 139.2 kg in 2025, 144.11 kg in 2030, and 144.63 kg in 2035.
- Vegetable consumption is projected to reach 113.06 kg by 2030 and 122.76 kg by 2050.
- The per capita GDP of China was $10,234 in 2021.
- The Chinese dietary structure exhibits a limited variety in grain intake, insufficient vegetable and fruit consumption, and excessive intake of livestock and meat, compared to the balanced dietary pattern.
- Protein intake by 4.36 g, fat intake by 3.29 g, and carbohydrates by 33.04 g, exceeding the recommended levels.
- Dietary fiber intake was 23.03 g below the recommended level.
Other Important Findings
- The consumption of plant-based foods is significantly correlated with lower health expenditures.
- Animal-based foods show a significant impact on the increase of health expenditures.
- Fat intake is significantly correlated with increased health expenditures.
- Calorie intake is significantly correlated with lower health expenditures.
- At the government level, grains, vegetables, fruits, eggs, and dairy were associated with lower local financial health expenditures.
- Oilseeds, fish, and meat were significantly associated with increased local financial health expenditures.
- The mortality, aging, and disposable income have a more significant impact on healthcare expenditures.
- Plant-based diets predominantly had a significant effect on increased healthcare expenditures, whereas oilseeds and meats predominantly had an effect on lower healthcare expenditures.
- The structure of healthcare expenditures by province shows a highly balanced structure in the east and a less balanced structure in the west.
- The elasticity of China’s total health expenditure growth relative to GDP has remained high, around 2, over the past 30 years.
- China’s total health investment remains low compared to the WHO’s target of at least 5% of GDP for government health spending.
- China’s per capita, household, and government health expenditures are expected to increase.
Limitations Noted in the Document
- The study’s dietary structure analysis is based on 13 common foods, with limited data on sugars.
- The analysis primarily focuses on five major nutritional elements, potentially overlooking micronutrients like iron, zinc, and calcium.
- The study did not consider the health impacts of food processing additives.
- National healthcare expenditure is influenced by various factors, and the model does not account for unforeseen events or changes in the healthcare system’s elasticity.
- The gray forecasting model used assumes exponential growth in healthcare expenditures.
- The study has not investigated a threshold effect between health expenditure and diet.
Conclusion
The evolution of the Chinese dietary structure, characterized by a shift towards high-protein and high-fat diets, is linked to increased healthcare expenditures. The study reveals a complex interplay between dietary choices and healthcare costs, emphasizing the need for proactive measures. Plant-based diets are associated with lower healthcare expenditures, while animal-based diets correlate with higher costs. The research underscores that, while dietary adjustments can influence healthcare expenditure, economic developments and medical advancements also play significant roles. The findings indicate that promoting dietary changes and optimizing the structure of national healthcare expenditures are essential. The forecasted decline in per capita healthcare expenditure, coupled with rising household, state, personal, and total healthcare expenditures, highlights the need for policy interventions. These interventions include promoting plant-based diets, which can contribute to improved health and reduced healthcare expenditures. The study supports the importance of food-as-medicine and highlights the need to include considerations such as regional diet culture, economic effects, and environmental factors in the “diet-healthcare system.” The transition to a plant-based diet will be crucial for reducing personal costs and optimizing medical expenditure. The study suggests that, while changes in dietary structure affect healthcare expenditure, future economic development and advances in medical technology also significantly influence healthcare costs. In the future, proactive investment in dietary adjustments can yield dual benefits, namely improved health and reduced curative expenditures.