The epidemiological transition in Hong Kong : changes in health and disease since the nineteenth century

The changes in health (morbidity and mortality) patterns which often accompany urbanisation and ‘modernisation’ are well recognised and some feel they may be placed in a model of epidemiological transition. This transition can occur at varying speeds and may even be delayed in some countries. Hong Kong, a small but highly- urbanised newly-industrialising country, has experienced its epidemiological transition in a relatively short period and it arguably provides one of the best documented examples of a previously Third World country emerging to a modem health profile. During the first half of the twentieth century, Hong Kong experienced considerable population growth and elements of modernisation were evident. However, until the early 1950s its health record was relatively poor and there was still considerable evidence of a Third World pattern of disease and mortality. It was still subject to many tropical and also non-tropical ailments whilst health care facilities were relatively under-developed. In the period since 1950, however, the territory’s health profile has totally changed. The population has grown threefold during this time and today’s residents have a fairly high standard of living with access to modem Western and some traditional Chinese health services. In a short period, for practical purposes since 1960, Hong Kong has, it seems, become a good example of the accelerated epidemiological transition. Mortality and morbidity patterns are now very similar to those of the developed world; ‘Western’ diseases predominate and infant mortality rates are amongst the lowest in the world. General health standards are constantly improving. These changes have accompanied important improvements in standards of living, including massive government investment in infrastructure, public housing and welfare services. Many health and welfare services are provided by government and publicly-assisted agencies and charities. This monograph explores evidence of an epidemiological transition in Hong Kong. It also includes discussion of the demographic changes associated with the transition and implications for future health and welfare provision. It discusses the extent to which its example may be of relevance to other rapidly urbanising countries and particularly the newly-industrialising countries of Southeast Asia.