Operation Healthy China
(2019-2030)
Healthy China Action Promotion Committee
July 9, 2019
Healthy China Action (2019-2030)
introduction
People’s health is an important symbol of national prosperity and national prosperity. Since the 18th National Congress of the Communist Party of China, China has made remarkable achievements in health care, the level of medical and health services has been greatly improved, and the main health indicators of residents are generally better than the average level of middle-and high-income countries. With the development of industrialization, urbanization, population aging and changes in ecological environment and lifestyle, chronic non-communicable diseases (hereinafter referred to as chronic diseases) have become the main cause of death and disease burden of residents. Cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, diabetes and other chronic diseases account for more than 70% of the total disease burden, which has become an important factor restricting the improvement of healthy life expectancy. At the same time, the prevention and control situation of hepatitis, tuberculosis, AIDS and other major infectious diseases is still grim, mental health, occupational health, endemic diseases and other issues can not be ignored, major production safety accidents and traffic accidents occur from time to time. The 19th National Congress of the Communist Party of China made a major decision to implement the strategy of healthy China, which fully reflected the firm determination to safeguard people’s health. In order to actively deal with the current outstanding health problems, we must move forward and take effective intervention measures to make people not get sick, improve their quality of life and prolong their healthy life. This is an effective strategy to achieve higher health performance at a lower cost, a realistic way to solve the current health problems, and an important measure to implement the healthy China strategy. Therefore, the Healthy China Action (2019-2030) (hereinafter referred to as the Healthy China Action) is formulated.
I. General requirements
(1) Guiding ideology.
Guided by Socialism with Chinese characteristics Thought of the Supreme Leader in the New Era, fully implement the spirit of the 19th National Congress of the Communist Party of China and the Second and Third Plenary Sessions of the 19th Central Committee, conscientiously implement the decision-making arrangements of the CPC Central Committee and the State Council, adhere to the people-centered development thought, firmly establish the concept of "great health and great health", adhere to the principle of putting prevention first and combining prevention with treatment, focus on the grassroots, take reform and innovation as the driving force, pay equal attention to Chinese and Western medicine, and integrate health into all policies. Focusing on major diseases and some outstanding problems, we will implement a number of major actions, and the government, society and individuals will work together to establish and improve a health education system, guide the masses to establish a correct concept of health, form a healthy lifestyle, ecological environment and social environment, and promote the transformation from treatment-oriented to health-oriented to improve people’s health.
(2) Basic path.
-Popularize health knowledge. Taking improving health literacy as the premise of improving the health of the whole people, we should strengthen health education and promotion according to the characteristics of different groups of people, so that health knowledge, behavior and skills can become the universal quality and ability of the whole people, and realize health literacy for everyone.
-participate in health actions. Advocate the idea that everyone is the first responsible person for their own health, stimulate residents’ enthusiasm for health, develop a healthy lifestyle that conforms to their own and family characteristics, and achieve a healthy life with reasonable diet, scientific exercise, smoking cessation and alcohol restriction, and psychological balance.
-providing health services. Promote the structural reform of the supply side of health services, improve prevention and control strategies, institutional arrangements and security policies, strengthen the connection between medical security policies and public health policies, provide systematic and continuous integrated services of prevention, treatment, rehabilitation and health promotion, improve the fairness, accessibility and effectiveness of health services, and realize early diagnosis, early treatment and early rehabilitation.
-prolong healthy life. Strengthen cross-departmental cooperation, encourage and guide units, communities, families and individual residents to take action, and take effective interventions on major health problems and influencing factors, so as to form a good situation in which the government actively leads, the society widely participates, and individuals are independent and self-disciplined, and continuously improve healthy life expectancy.
(3) Overall objectives.
By 2022, a health promotion policy system covering all relevant economic and social fields will be basically established, the health literacy level of the whole people will be steadily improved, the promotion of healthy lifestyles will be accelerated, the rising trend of major chronic diseases such as cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases and diabetes will be curbed, key infectious diseases, serious mental disorders, endemic diseases and occupational diseases will be effectively prevented and controlled, the risk of disability and death will be gradually reduced, and the health status of key populations will be significantly improved.
By 2030, the health literacy level of the whole people will be greatly improved, the healthy lifestyle will be basically popularized, the main health influencing factors of residents will be effectively controlled, the premature mortality rate caused by major chronic diseases will be significantly reduced, the average healthy life expectancy will be greatly improved, the main health indicators of residents will rank among high-income countries, health equity will be basically realized, and the relevant goals of the "Healthy China 2030" Planning Outline will be achieved.
Second, the main indicators
Main Indicators of Healthy China Action
Note: (1) Unless otherwise specified, the relevant survey data in this document are mainly official sample survey statistics; (2) In this main indicator table, the baseline level values with no year specified are all in 2017; (3)# is the target value in 2020.
III. Major actions
(1) Health knowledge popularization action.
Everyone is the first responsible person for his own health, and he has a health responsibility for his family and society. Popularizing health knowledge and improving the health literacy of the whole people is one of the most fundamental, economical and effective measures to improve the health level of the whole people. At present, the overall level of health literacy of Chinese residents is still relatively low. In 2017, the health literacy level of residents was only 14.18%. The knowledge and skills of urban and rural residents on health maintenance such as disease prevention, early detection, emergency rescue, timely medical treatment, rational drug use and emergency avoidance are relatively lacking, and unhealthy life behaviors are common. Popularizing health knowledge scientifically and improving health literacy will help improve residents’ self-health management ability and health level. "China citizen’s health literacy-basic knowledge and skills" defines the specific content of health literacy at this stage, which is the most important health knowledge and skills that citizens should master.
Action goal:
By 2022 and 2030, the national residents’ health literacy level will be no less than 22% and 30% respectively, among which, the basic knowledge and concept literacy level, healthy lifestyle and behavior literacy level and basic skills literacy level will be raised to 30%, 18%, 20% and above and 45%, 25%, 30% and above respectively, and residents’ basic medical literacy, chronic disease prevention literacy and infectious diseases literacy level will be improved. The blood donation rate of the population reached 15‰ and 25 ‰ respectively; Establish and improve the expert database and resource database of health science popularization, and build a mechanism for publishing and disseminating health science knowledge; The Central Radio, Film and Television General Station gives preferential protection to public welfare health programs and columns in terms of time and duration; Establish a performance appraisal mechanism for medical institutions and medical personnel to carry out health education and health promotion; Medical staff master the knowledge of health science suitable for their posts, and actively provide health guidance in the process of diagnosis and treatment; The proportion of preventive departments in Chinese medicine hospitals reached 90% and 100% respectively. Encourage major media websites and commercial websites to set up health science programs. Advocate individuals to regularly record their physical and mental health; Understand and master basic Chinese medicine health knowledge; Master basic first aid knowledge and skills.
-individuals and families:
1. Correct understanding of health. Health includes physical health, mental health and good social adaptability. Genetic factors, environmental factors, personal lifestyle and medical and health services are the main factors affecting health. Everyone is the first responsible person for their own health. They advocate actively learning health knowledge, developing a healthy lifestyle, consciously maintaining and promoting their own health, understanding the natural laws of birth, aging, illness and death, understanding the limitations of medical technology, respecting medicine and medical personnel, and coping with health problems together.
2. Develop a healthy and civilized lifestyle. Pay attention to diet, daily life, dynamic and static combination, and peace of mind. Pay attention to personal hygiene, environmental hygiene and food hygiene, wash your hands frequently, often take a bath, brush your teeth in the morning and evening, rinse your mouth after meals, do not share towels and toiletries, do not spit everywhere, and cover your mouth and nose with your arms or paper towels when coughing or sneezing. No bad habits, no smoking, smokers quit smoking as soon as possible, drink less, don’t drink too much, and refuse drugs. Actively participate in healthy and beneficial cultural and sports activities and social activities. Pay attention to and record your own health status, and have regular health checkups. Actively participate in voluntary blood donation. Healthy adults donate 400ml of blood each time, which will not affect their health, but also help others. The interval between two blood donations is not less than 6 months.
3. Pay attention to health information. Learn, understand, master and apply "China citizens’ health literacy-basic knowledge and skills" and TCM health care knowledge. When encountering health problems, actively obtain health-related information. Improve the ability to understand, identify and apply health information, and give priority to obtaining health knowledge from government departments such as health administrative departments and medical and health professional institutions.
4. Master the necessary health skills. Can measure body temperature and pulse; Be able to read the labels and instructions of food, medicine, cosmetics and health care products; Learn to identify common danger signs, such as high pressure, flammability, explosiveness, virulence, radioactivity, biological safety, etc., and stay away from dangerous objects. Actively participate in escape and first aid training and learn basic escape skills and first aid skills; Call 120 when you need emergency medical assistance; When there is a large amount of traumatic bleeding, stop bleeding and bandage it immediately; Don’t move the wounded who are suspected of fracture easily; Patients with respiratory or cardiac arrest will undergo cardiopulmonary resuscitation; When rescuing people who get an electric shock, first cut off the power supply and do not directly contact the people who get an electric shock; When there is a fire, you will call the fire alarm number 119, isolate the smoke, cover your nose and mouth with a wet towel, and escape in a low profile. Apply appropriate TCM health care techniques and methods to carry out self-help TCM health intervention.
5. Seek medical treatment scientifically. Usually take the initiative to contact general practitioners and family doctors. When encountering health problems, go to medical institutions in time for early diagnosis and treatment to avoid delaying the best treatment opportunity. According to the condition and the doctor’s advice, choose a suitable medical institution for medical treatment. Primary medical and health institutions are the first choice for minor illness diagnosis and treatment, and go to the hospital for serious illness. Follow the doctor’s advice, don’t believe in folk remedies, and don’t believe in "magic medicine."
6. Rational use of drugs. Use drugs on time and in quantity according to the doctor’s advice, and consult a doctor or pharmacist in time if there is any discomfort during the medication. Take the initiative to show the drug records and drug allergy history to the doctor or pharmacist every time you see a doctor, so as to avoid the occurrence of adverse events such as repeated medication or harmful interaction. Check the expiration date of drugs before taking them, do not use expired drugs, and clean up expired drugs in the family in time. Store medicines properly, and prevent children from touching and eating by mistake. Health food is not medicine, so choose health food correctly.
7. Create a healthy family environment. Family members actively learn health knowledge, establish a healthy concept, develop a good lifestyle, remind each other of regular physical examination, prenatal and postnatal care, love and respect for the elderly, family harmony, advocate public morality, help each other in the neighborhood, and support public welfare. Families with infants, the elderly and the disabled take the initiative to participate in nursing training and master relevant nursing knowledge and skills. Advocate the family of patients with diseases transmitted through the digestive tract to implement a separate meal system. Families with a family history should do preventive health care in a targeted manner. Equipped with household first aid kit (including first aid medicine, first aid equipment and first aid consumables, etc.).
-society and government:
1. Establish and improve the "two databases and one mechanism" for health science popularization. Establish and improve the national and provincial health science expert database, and carry out health science activities. Experts in health science popularization activities of central media should be produced from the national science popularization expert database, and provincial media should be produced from the science popularization expert database at or above the provincial level. Establish and improve the national health science database, publish, select and promote a number of health science books and materials. Organize the preparation of relevant knowledge and information guides for key populations and key health problems, and release them to the society by professional institutions. Establish a mechanism for the publication and dissemination of all-media health science knowledge, strengthen the guidance and supervision of health education content, rely on professional strength, strengthen the audit and supervision of health columns and health medical advertisements on TV, newspapers and periodicals, and monitor, evaluate and report health science information on new Internet media platforms. For health information platforms with more problems, they should be ordered to rectify according to laws and regulations until they are shut down. Promote health information with strong scientific nature and good communication effect. Organize experts to clarify and correct false information with wide spread and great harm to public health. (The Health and Wellness Committee takes the lead, and the Central Propaganda Department, the Central Network Information Office, the Ministry of Science and Technology, the General Administration of Market Supervision, the State Administration of Radio, Film and Television, the Bureau of Traditional Chinese Medicine, the Food and Drug Administration, and the China Association for Science and Technology are responsible according to the division of responsibilities)
2. The medical staff to master the knowledge of health science and adapt to the post, and take the initiative to provide health guidance in the process of diagnosis and treatment. The websites of medical institutions should set up health science columns according to their own characteristics, provide health lectures and consulting services for community residents, and tertiary hospitals should set up health science teams, formulate health science work plans, and build Weibo WeChat new media health science platform. Develop health science materials such as health education prescriptions, and hold targeted health knowledge lectures for patients regularly. Improve the training courses and teaching materials for general practitioners and specialists, and significantly improve the necessary knowledge and skills of family doctors’ health promotion and education. In-depth implementation of the health project of preventing diseases in traditional Chinese medicine, popularization of TCM health care knowledge and easy-to-master TCM health care technologies and methods. Encourage healthy citizens of school age to participate in voluntary blood donation regularly. (The Health and Wellness Committee takes the lead, and the Ministry of Education and the Bureau of Traditional Chinese Medicine are responsible according to the division of responsibilities)
3. Establish an incentive and restraint mechanism to encourage medical and health institutions and medical personnel to carry out health promotion and education, and mobilize the enthusiasm of medical personnel to participate in health promotion and education. Incorporate health promotion and education into the performance appraisal of various medical institutions at all levels, and into the professional title evaluation and performance appraisal of medical staff. Improve the medical insurance payment policy and encourage grassroots medical institutions and family contracted doctors to carry out health management services. Encourage and guide individuals to practice a healthy lifestyle and strengthen personal health management. (The Ministry of Human Resources and Social Security and the Health and Wellness Commission take the lead, and the Medical Insurance Bureau is responsible according to its duties)
4. Encourage and support the Central Radio and Television General Station and provincial radio and television stations to offer high-quality health science programs when conditions are ripe. The Central Radio and Television General Station will give preferential protection to public welfare health programs and columns in terms of time and duration, and continue to run the existing digital pay TV health channels well. Newspapers published a number of health columns. Use new media such as "two micro-tips" (referring to WeChat, Weibo and mobile client) and short videos to promote "internet plus Accurate Health Science Popularization". (The Central Propaganda Department, the Central Network Information Office, the Health and Wellness Commission, the State Administration of Radio, Film and Television, the Central Radio, Film and Television General Station, and the Bureau of Traditional Chinese Medicine are responsible for the division of responsibilities)
5. Mobilize more social forces to participate in the popularization of health knowledge. Encourage health industry associations and associations to organize experts to carry out various forms of public-oriented health science popularization activities and institution-oriented training. All communities and units should take the popularization of health knowledge for residents and workers as an important task, and organize health communication activities such as health lectures in combination with the main health problems of residents and workers. Strengthen the promotion of health literacy of the population in poverty-stricken areas. (The Health and Wellness Committee takes the lead, and the Bureau of Traditional Chinese Medicine, the All-China Federation of Trade Unions, the All-China Women’s Federation and the China Association for Science and Technology are responsible for the division of responsibilities)
6. Develop and popularize appropriate health technologies and support tools. Give play to the role of market mechanism, encourage the research and development of artificial intelligence and wearable devices for health management, make full use of Internet technology, monitor health status in real time and continuously under the premise of protecting personal privacy, realize online real-time management, early warning and behavioral intervention, and use health big data to improve the public’s self-health management ability. (The Health and Wellness Commission, the Ministry of Science and Technology and the Ministry of Industry and Information Technology are responsible for the division of responsibilities)
7. Carry out the construction of health promotion counties (districts) and strive to improve residents’ health literacy. Every year, the state chooses a health theme closely related to the masses to carry out the publicity and education activities of "Healthy China Tour". Carry out the activity of "Chinese medicine in China", promote the popularization of Chinese medicine health culture, and spread the knowledge of Chinese medicine health care. We will promote the action of healthy lifestyle of the whole people and strengthen the guidance and intervention of healthy lifestyle of families and high-risk individuals. (The Health and Wellness Committee and the Bureau of Traditional Chinese Medicine take the lead, and the China Association for Science and Technology is responsible according to its duties)
(2) Reasonable dietary action.
A reasonable diet is the basis of ensuring health. In recent years, the nutritional health status of Chinese residents has improved significantly, but they still face problems such as the coexistence of insufficient nutrition and excessive nutrition, and the frequent occurrence of nutrition-related diseases. According to the survey in 2012, the per capita daily salt intake of Chinese residents is 10.5g (recommended by the World Health Organization is 5g); The per capita daily edible oil intake of households is 42.1g (the recommended standard in Dietary Guidelines for China Residents (hereinafter referred to as Dietary Guidelines) is 25-30g per day); The proportion of dietary fat providing energy for residents reached 32.9% (the upper limit of recommended value in Dietary Guidelines was 30.0%). At present, the per capita daily intake of added sugar (mainly sucrose, such as "white sugar" and "brown sugar") in China is about 30g, among which the intake of children and adolescents deserves high attention. According to the survey in 2014, the energy provided by children and adolescents aged 3-17 who often drink beverages only exceeds 5% of the total energy, while that of urban children is much higher than that of rural children, and it is on the rise (the World Health Organization recommends that the daily intake of added sugar per capita is less than 10% of the total energy, and encourages it to be controlled to less than 5% or less than 25g). At the same time, from 2010 to 2012, the adult malnutrition rate in China was 6%; In 2013, the growth retardation rate of children under 5 years old was 8.1%, the anemia rate of pregnant women, children and the elderly was still high, micronutrients such as calcium, iron, vitamin A and vitamin D were still lacking, and dietary fiber intake was obviously insufficient.
Unhealthy diets such as high salt, high sugar and high fat are risk factors for obesity, cardiovascular and cerebrovascular diseases, diabetes and other metabolic diseases and tumors. The results of the global disease burden study in 2016 show that the disease burden caused by dietary factors accounts for 15.9%, which has become an important risk factor affecting people’s health. In 2012, the overweight rate of adults aged 18 and above was 30.1%, and the obesity rate was 11.9%, which increased by 32.0% and 67.6% respectively compared with 2002. The overweight rate of children and adolescents aged 6-17 years old is 9.6%, and the obesity rate is 6.4%, which is 1 and 2 times higher than that in 2002 respectively. Reasonable diet and reducing the daily intake of edible oil, salt and sugar are helpful to reduce the risk of obesity, diabetes, hypertension, stroke and coronary heart disease.
Action goal:
By 2022 and 2030, the growth rate of adult obesity will continue to slow down; The awareness rate of residents’ nutrition and health knowledge will increase by 10% on the basis of 2019 and 10% on the basis of 2022 respectively; The growth retardation rate of children under 5 years old is lower than 7% and 5%, the anemia rate is lower than 12% and 10% respectively, and the anemia rate of pregnant women is lower than 14% and 10% respectively. The coverage rate of qualified iodized salt has reached 90% and above; The energy supply ratio of adult fat decreased to 32% and 30%; 1 nutrition instructor for every 10,000 people; Implement the nutrition improvement plan for rural compulsory education students and the nutrition improvement project for children in poverty-stricken areas; Implement nutrition and health standards based on food safety and promote the construction of nutrition standard system.
Advocate that the daily intake of salt per capita is not higher than 5g, that of edible oil per capita of adults is not higher than 25 ~ 30g, that of added sugar per capita is not higher than 25g, that of vegetables and fruits is not lower than 500g, and that there are not less than 12 kinds of food per day and not less than 25 kinds of food per week; Adults maintain a healthy weight and control the body mass index (BMI) at 18.5 ~ 24 kg/㎡; Adult male waist circumference is less than 85cm and female waist circumference is less than 80cm.
-individuals and families:
1. For the general population. Learn China residents’ dietary science knowledge, use China residents’ balanced diet pagoda, balanced diet plate and other supporting tools, and reasonably match food according to personal characteristics. The daily diet includes cereals, vegetables and fruits, livestock, fish, eggs, milk, soybeans and nuts, etc., with an average intake of more than 12 kinds of food per day and more than 25 kinds per week. Ingredients that cannot be eaten raw should be cooked and eaten; Raw vegetables, fruits and other foods should be washed. Raw and cooked foods should be stored and processed separately. When eating daily, you should chew slowly, keep your mood calm, and don’t eat too much, but you should also pay attention to avoid affecting the intake of essential nutrients due to excessive dieting. Eat less fat meat, smoked and pickled meat products, eat less high-salt and fried foods, and control the intake of added sugar. Drink plenty of water, adults usually drink 7 ~ 8 cups (1500～1700ml) a day, advocate drinking boiled water or tea, and drink less sugary drinks; Children and adolescents, pregnant women and nursing mothers should not drink alcohol.
2. For overweight (24 kg/m2≤BMI<28 kg/m2) and obese (BMI≥28 kg/m2) adults. Reduce energy intake, increase the proportion of fresh vegetables and fruits in the diet, and appropriately select some foods rich in high-quality protein (such as lean meat, fish, protein and beans). Avoid greasy food and fried food, eat less snacks and sweets, and don’t drink or drink less sugary drinks. Eat regularly, don’t miss meals, don’t overeat, and be full in seven or eight minutes.
3. For malnourished people such as anemia and emaciation. It is suggested that on the basis of a reasonable diet, the intake of lean meat, dairy eggs, soybeans and bean products should be appropriately increased to maintain the diversity of diets and meet the body’s needs for nutrients such as protein, calcium, iron, vitamin A, vitamin D, vitamin B12 and folic acid. Increase the intake of iron-containing food or supplement iron under the guidance of a doctor to correct anemia.
4. For pregnant women and people with infants. It is suggested to learn about the diet of pregnant women, the diet of lactating women and infant feeding, and pay special attention to the nutrition in the first 1000 days of life (from the beginning of pregnancy to the second year after the baby is born). Pregnant women often eat foods rich in iron, increase animal foods and seafood rich in high-quality protein and vitamin A, and choose iodized salt to ensure adequate intake of iron, iodine and folic acid during pregnancy. Try to breastfeed exclusively for 6 months, and reasonably add complementary food for infants aged 6 ~ 24 months.
5. For the family. Advocate the purchase of food on demand and reasonable storage; Choose fresh, hygienic and seasonal food and adopt appropriate cooking methods; Prepare meals on demand, small portions of food; Learn to buy food and read labels; Ordering meals outside depends on the number of people, and taking separate meals, simple meals and individual meals when eating in groups; Advocate eating at home, sharing food with family members and enjoying family ties, and inherit and carry forward China’s excellent food culture.
-society:
1. Promote the normalization of nutrition and health science education activities, and encourage the whole society to participate in national nutrition week, "three reductions and three health" (reducing salt, oil and sugar, healthy mouth, healthy weight and healthy bones) and other education activities. Promote the use of "three small pieces" of health (limited salt spoons, limited oil pots and healthy waist measures), improve the family penetration rate, and encourage professional industry organizations to guide families to use them correctly. As soon as possible, we will study and formulate the limited guidance for children to add sucrose intake in China, and advocate the substitution of natural sweetening substances and sweetening drinks for drinking.
2. Strengthen the knowledge guidance of nutrition labels for food enterprises, guide consumers to confirm that they are reading nutrition labels, and improve the awareness rate of nutrition labels for residents. Encourage consumers to reduce their sucrose intake. Advocate food producers and operators to use natural sweet substances and sweeteners allowed by food safety standards to replace sucrose. Scientifically reduce the sucrose content in processed food. It is advocated that people with high sugar intake in cities should reduce the consumption of beverages and sweets containing sucrose, and choose natural sweet substances and sweeteners to replace beverages and foods produced by sucrose.
3. Encourage the production and sale of low sodium salt, and promote its use under the guidance of experts. Do a good job of warning people who use low-sodium salt with caution (high-temperature workers, workers with heavy physical labor intensity, people with renal dysfunction, hypertensive patients taking antihypertensive drugs and other people who are not suitable for high potassium intake). Guide enterprises in the production and sales of salt and edible oil supporting dosage control measures (such as giving 2g measuring spoons in salt bags, producing limited oil pots and graduated oil pots, etc.), and encourage qualified places to pilot first. Shops (supermarkets) are encouraged to set up food counters with low fat, low salt and low sugar.
4. Encourage canteens and restaurants to be equipped with full-time and part-time nutritionists, and regularly carry out skills training and assessment related to nutrition, balanced diet and food safety for management and employees; Publish the recipe in a prominent position in advance, mark the quantity and nutrient content and briefly describe the nutrient composition; Encourage people with different nutritional status to recommend corresponding recipes.
5. Formulate and implement the nutrition operation norms of collective feeding units, and carry out activities to create demonstration healthy canteens and healthy restaurants. Encourage the catering industry and collective canteens to provide nutrition labels to consumers. Encourage the publication of balanced dietary guidance and recipes suitable for people of different ages and regions. Encourage the development of traditional food and nutrition services, and promote the research and development of traditional food and nutrition products and industrial upgrading.
-government:
1. Comprehensively promote the implementation of the National Nutrition Plan (2017-2030), and carry out nutrition and dietary guidance according to local conditions. Implement nutrition intervention for key populations in poverty-stricken areas and incorporate nutrition intervention into health poverty alleviation work. Continue to promote the implementation of the nutrition improvement plan for rural compulsory education students and the nutrition improvement project for children in poverty-stricken areas. (The Health and Wellness Committee takes the lead, and the Ministry of Education and the State Council Poverty Alleviation Office are responsible according to the division of responsibilities)
2. Promote nutrition legislation and policy research. Study and formulate and implement the nutritionist system, with nutritionists in kindergartens, schools, pension institutions, hospitals and other collective feeding units, and nutrition instructors in communities. Strengthen clinical nutrition work and constantly standardize nutrition screening, evaluation and treatment. (The Health and Wellness Commission, the Ministry of Civil Affairs, the Ministry of Justice and the Ministry of Finance are responsible for the division of responsibilities)
3. Improve the food safety standard system, formulate nutrition and health standards based on food safety, and promote the construction of food nutrition standard system. Develop nutrition-oriented agriculture and food processing industry. The government should speed up research and formulate standards to limit the production and sale of high-sugar foods. Intensify publicity to promote the production and consumption of low-sugar or sugar-free foods. Implementation of food safety inspection and testing capacity standards project, strengthen food safety sampling and risk monitoring. (The Health and Wellness Commission, the Ministry of Agriculture and Rural Affairs and the General Administration of Market Supervision are responsible for the division of responsibilities)
4. To speed up the revision of the General Rules for Nutrition Labeling in prepackaged foods, increase the mandatory labeling of sugar such as sucrose, encourage enterprises to claim "low sugar" or "no sugar", actively promote the use of "FOP" information on food packaging, help consumers quickly choose healthy foods, and strengthen the supervision and management of nutrition labeling in prepackaged foods. Study and promote the formulation of nutrition operation norms for group meals of special people, and explore the pilot to increase the "sugar" logo in catering food. Study and improve the packaging standards of oil, salt and sugar, and indicate on the outer packaging the information that it is recommended that everyone eat a reasonable amount of oil, salt and sugar every day. (The Health and Wellness Committee takes the lead, and the General Administration of Market Supervision and the Ministry of Industry and Information Technology are responsible according to their duties.)
(3) National Fitness Campaign.
Life lies in sports, and sports need science. Scientific physical activity can prevent diseases, make people happy and promote health. According to the survey of national fitness activities conducted by the State Sports General Administration in 2014, the proportion of urban and rural residents who regularly participate in physical exercise in China is 33.9%, of which the regular exercise rate of residents aged 20-69 is only 14.7%, and the regular exercise rate of adults is at a low level. Lack of physical activity has become an important reason for the occurrence of various chronic diseases. At the same time, the changes of cardiopulmonary endurance, flexibility, muscle strength, muscle endurance, body composition and other indicators are not optimistic, and most residents are still very blind when participating in sports activities. Regular and moderate physical activity is helpful to prevent and improve overweight and obesity and chronic diseases such as hypertension, heart disease, stroke and diabetes, and can promote mental health, improve the quality of life and happiness, and promote social harmony.
Action goal:
By 2022 and 2030, the proportion of urban and rural residents who have reached the "National Physical Fitness Measurement Standard" is not less than 90.86% and 92.17% respectively; The proportion of people who regularly participate in physical exercise (the frequency of physical exercise is 3 times or more per week, the duration of each physical exercise is 30 minutes or more, and the exercise intensity of each physical exercise is medium or more) reaches 37% or more and 40% or more; The opening rate of school sports venues and facilities exceeds 70% and 90%; The per capita sports ground area is 1.9m2 and above and 2.3 m2 and above respectively; The per capita length of urban jogging footpath greenway continues to increase; There are not less than 1.9 and 2.3 social sports instructors per thousand people; The coverage rate of sports facilities in rural administrative villages has basically achieved full coverage and coverage rate of 100%.
Advocate organs, enterprises and institutions to carry out interval exercises; Encourage individuals to have at least one sport hobby or master one traditional sport, join at least one fitness organization, and exercise moderately for at least half an hour every day; Encourage medical institutions to provide guidance services for sports to promote health, and encourage and guide social sports instructors to provide scientific fitness guidance services for the masses in fitness places and other places to improve fitness effects and prevent sports injuries; Encourage public sports venues and facilities to provide free or low-cost open services more and better, and ensure that all qualified enterprises and institutions’ sports venues and facilities are open to the society.
-personal:
1. Understand the health benefits of exercise. It is suggested that individuals should improve their awareness of physical activity and cultivate their exercise habits. Understand and master the knowledge related to national fitness and physical activity, integrate physical activity into daily life, master sports skills, be quiet and move more, reduce sedentary, and maintain a healthy weight; Scientific sports avoid sports risks.
2. Exercise is beneficial, but persistence is important. Before exercise, it is necessary to know the history of illness and family history, evaluate physical condition, encourage the development of exercise programs under the guidance of family doctors or professionals, and choose the exercise mode, intensity and amount suitable for you to reduce exercise risks. Encourage moderate-intensity exercise for more than 30 minutes three times a week, or accumulate 150 minutes of moderate-intensity or 75 minutes of high-intensity physical activity. Try to move as much as possible in your daily life, and achieve 6000 ~ 10000 steps of physical activity every day. Eat dynamic balance, so that the intake of excess energy is consumed through exercise to achieve the balance of various functions of the body. A complete exercise includes warm-up activities, formal exercise and finishing activities. One-week exercise and fitness includes aerobic exercise, strength exercise, flexibility exercise and so on. Advocate the family to be equipped with small, portable and easy-to-operate fitness equipment suitable for family members.
3. Exercise for the elderly helps to maintain physical function and slow down the deterioration of cognitive function. Advocate the elderly to do what they can, and choose exercise methods that are suitable for their own physique and health. While paying attention to aerobic exercise, we should pay attention to muscle strength exercise and flexibility exercise, properly exercise balance ability, strengthen skeletal muscle system and prevent falls. Encourage the elderly to regularly measure blood pressure and blood sugar during exercise and adjust the amount of exercise.
4. Special people, such as pregnant women, patients with chronic diseases and disabled people, are advised to exercise under the guidance of doctors and sports professionals. Simple obese patients should at least reach the recommended amount of exercise for ordinary adults. Weight control requires more than 45 minutes of moderate and low-intensity exercise every day. In the process of losing weight, it is suggested to emphasize muscle strength exercise to avoid the weight loss of muscles and bones. Advocate the combination of exercise and diet control to lose weight.
People who mainly do manual labor should pay attention to the combination of work and rest, avoid "overwork" and promote the all-round development of the body through exercise. After working for a period of time, you can change to a relaxing exercise mode, reduce muscle soreness and stiffness, and eliminate local fatigue, but the amount and intensity of exercise should not be too large.
-society:
1. Establish and improve the fitness organizations around the masses. Sports federations will achieve full coverage in cities, counties and townships, and individual sports associations will extend to the masses, so that people who want to exercise can join the sports organizations.
2. Hold all kinds of national fitness events and implement the mass winter sports popularization plan. Develop fitness programs with China characteristics, and carry out ethnic, folk and folk sports activities. Popularize traditional sports such as Tai Ji Chuan and Qigong. Promote national fitness into the family. Popularize radio gymnastics and other interval exercises. Carry out national physical training standards and sports level grading standards.
3. Carry forward the fitness culture around the masses, make movies, cartoons and works with sports themes, encourage the national fitness volunteer service, popularize the knowledge of sports fitness culture, and enhance fitness awareness.
4. Encourage the inclusion of national physical fitness measurement in health examination items. Medical and health institutions at all levels carry out sports risk assessment and provide guidance services for fitness programs or sports to promote health.
-government:
1. Promote the construction of basic public sports service system, co-ordinate the construction of national fitness venues and facilities, build a number of sports parks, community fitness centers and other national fitness venues and facilities, promote the construction of urban jogging pedestrian greenways, and strive to create a "15-minute fitness circle" around the people, so that people who want to exercise have appropriate places. We will improve financial subsidies, service charges, social participation in management and operation, security and other measures, promote the opening of public sports facilities free of charge or at low fees, and ensure that all public sports facilities and sports facilities of enterprises and institutions that meet the opening conditions are open to the public. Encourage social forces to organize or participate in the management and operation of sports venues and facilities. (The General Administration of Sport takes the lead, and the Development and Reform Commission, the Ministry of Education, the Ministry of Finance and the Ministry of Housing and Urban-Rural Development are responsible according to the division of responsibilities)
2. Build a scientific fitness system. Establish guidance methods for sports to promote health for different people, different environments and different physical conditions, and promote the formation of a "combination of sports and medicine" disease management and health service model. Establish a system of prevention, treatment and first aid for sports injuries, and improve the ability of prevention and treatment of sports injuries. Encourage and guide social sports instructors to provide scientific fitness guidance services for the masses in fitness places and other places to improve fitness effects and prevent sports injuries. (The General Administration of Sport takes the lead, and the Health and Wellness Committee is responsible according to its duties)
3. Formulate and implement the physical health intervention plan for special population. Encourage and support new workplaces to build appropriate fitness venues. Strengthen the monitoring and evaluation intervention of college students’ physical health level, and include college students’ physical health level in the evaluation of colleges and universities. Ensure college students’ physical education classes and enrich the forms and contents of college students’ physical exercise. (The General Administration of Sports takes the lead, and the Ministry of Education and the All-China Federation of Trade Unions are responsible for the division of responsibilities.)
(4) Tobacco control actions.
Tobacco smoke contains a variety of known carcinogens, and there is sufficient evidence that smoking can cause a variety of malignant tumors, as well as respiratory system, cardiovascular and cerebrovascular systems and other systemic diseases. According to the report of the World Health Organization, one in every three smokers dies of smoking-related diseases, and the average life expectancy of smokers is 10 years shorter than that of non-smokers. The harm of tobacco to health has become one of the most serious public health problems in the world today. To this end, the World Health Organization has formulated the first international public health treaty-the Framework Convention on Tobacco Control (hereinafter referred to as the Convention). China signed the Convention in 2003, was approved by the National People’s Congress in 2005, and came into effect in January 2006. There are more than 300 million smokers in China, so it is urgent to prevent the harm of tobacco. Every year, the number of deaths caused by smoking-related diseases exceeds 1 million, and the number of deaths caused by secondhand smoke exposure exceeds 100,000.
Action goal:
By 2022 and 2030, the smoking rate of people over 15 years old will be lower than 24.5% and 20% respectively; The proportion of people protected by comprehensive smoke-free regulations reached 30% and above and 80% and above respectively; Build party and government organs at all levels into smoke-free organs and gradually ban smoking in indoor public places, indoor workplaces and public transport throughout the country; Businesses that sell tobacco to minors in violation of relevant laws and regulations, enterprises and businesses that publish tobacco advertisements will be included in the "blacklist" of the social credit system, and joint punishment will be implemented according to laws and regulations.
Advocate individuals to quit smoking as early as possible, and it is never too late; Create a smoke-free family to protect family members from the harm of second-hand smoke; Leading cadres, doctors and teachers play a leading role; Encourage enterprises and units to introduce a comprehensive indoor smoke-free policy, create a smoke-free working environment for employees, and provide necessary help for smokers to quit smoking.
-individuals and families:
1 fully understand the serious harm of smoking and second-hand smoke exposure. Non-smokers don’t try smoking. Smokers should quit smoking as soon as possible, the sooner the better, and it is never too late. Drug therapy and nicotine replacement therapy can improve the long-term smoking cessation rate. Do not smoke in places where smoking is prohibited.
2 leading cadres, medical personnel and teachers play a leading role. Leading cadres should play an exemplary role in accordance with the Notice of the General Office of the General Office of the Central Committee of the CPC and the State Council on Matters Related to Leading Cadres Taking the Lead in Smoking Ban in Public Places. Participants in official activities are not allowed to smoke, respect cigarettes or persuade them to smoke; Medical staff are not allowed to smoke during working hours, and advise and help patients to quit smoking; Teachers are not allowed to smoke in front of students.
3. Create a smoke-free family, persuade family members not to smoke or take the initiative to quit smoking, educate minors not to smoke, and protect their families from the harm of second-hand smoke.
4. discourage others from smoking in no-smoking places. Complain and report smoking behavior in no-smoking places according to law, and support the maintenance of smoke-free environment.
-society:
1. Promote smoke-free culture and improve the level of social civilization. Actively use World No Tobacco Day, World Heart Day, International Lung Cancer Day and other health theme days to carry out tobacco control publicity; Advocate smoke-free weddings and smoke-free families.
2. Pay attention to the problem of smoking among teenagers and create an environment away from tobacco for teenagers. Incorporate tobacco control-related knowledge such as tobacco hazards and second-hand smoke hazards into the health education curriculum of primary and secondary school students. Do not sell cigarettes to minors. Strengthen the construction of smoke-free schools.
3. Encourage enterprises and units to introduce comprehensive indoor smoke-free regulations to create a smoke-free working environment for employees and provide necessary support for employees to quit smoking.
4. Give full play to the role of neighborhood (village) committees and assist in the implementation of tobacco control policies within their respective jurisdictions.
5. Encourage voluntary service organizations, other social organizations and individuals to participate in or provide support for tobacco control through various forms.
-government:
1. Gradually increase the proportion of the population covered by comprehensive smoke-free laws and regulations, and achieve a comprehensive ban on smoking in indoor public places, indoor workplaces and public transport throughout the country. Actively promote the construction of smoke-free environment and strengthen the supervision and law enforcement of tobacco control in public places. Build party and government organs at all levels into smoke-free organs. (The Health and Wellness Committee takes the lead, and the Central Civilization Office and the Tobacco Bureau are responsible according to the division of responsibilities)
2. Research and promote the adoption of comprehensive measures such as taxation and price adjustment to improve the effectiveness of tobacco control. (Development and Reform Commission, Ministry of Finance, State Administration of Taxation and Tobacco Bureau are responsible for the division of responsibilities)
3. Strengthen tobacco control publicity and education, further strengthen cigarette packaging label management, improve the content and form of tobacco hazard warning, improve the warning effect of health hazards, and improve the public’s awareness of tobacco hazards. Formulate and improve relevant technical standards and supervise their implementation. Restrict smoking scenes in film and television works. (The Health and Wellness Committee takes the lead, and the Central Propaganda Department, the Ministry of Industry and Information Technology, the General Administration of Market Supervision, the State Administration of Radio, Film and Television, and the Tobacco Bureau are responsible according to the division of responsibilities)
4. Gradually establish and improve the smoking cessation service system, and incorporate the smoking history of patients into the daily outpatient consultation, and promote the brief smoking cessation intervention service and the diagnosis and treatment of tobacco dependence diseases. Strengthen the publicity and promotion of smoking cessation services, so that more smokers can understand the help they can get in the process of quitting smoking. Establish smoke-free hospitals and promote a comprehensive ban on smoking in hospitals. (Responsible by the Health and Wellness Committee)
5. Fully implement the Advertising Law of People’s Republic of China (PRC), strengthen the supervision and enforcement of tobacco advertisements, and severely investigate and deal with illegal acts of publishing tobacco advertisements in mass media, public places, public transport and outdoors. Standardize tobacco promotion and sponsorship according to law. (The General Administration of Market Supervision, the Ministry of Transport, the State Railway Administration and the Civil Aviation Administration are responsible for the division of responsibilities)
6. In accordance with the requirements of the implementation progress of the Framework Convention on Tobacco Control, accelerate the research and establishment of a sound system for the control and information disclosure of tobacco products. Strengthen the independence and authority of national tobacco products supervision and monitoring, improve the safety testing and evaluation system of tobacco products, ensure fairness and transparency, and protect the public’s right to know and supervise. (The Health and Wellness Commission, the General Administration of Market Supervision and the Tobacco Bureau are responsible according to the division of responsibilities)
7. It is forbidden to sell tobacco products to minors. Businesses that sell tobacco to minors in violation of relevant laws and regulations, enterprises and businesses that publish tobacco advertisements will be included in the "blacklist" of the social credit system, and joint punishment will be implemented according to laws and regulations. (The Health and Wellness Commission, the General Administration of Market Supervision, the Tobacco Bureau and the Ministry of Education are responsible for the division of responsibilities)
8. Strengthen the tobacco control work of professional institutions at all levels, determine the person who is responsible for the organization and implementation of relevant work, and ensure the investment of funds. Establish a monitoring and evaluation system, regularly carry out tobacco epidemic surveys, and understand the use of tobacco. (The Ministry of Finance and the Health and Wellness Commission are responsible according to the division of responsibilities)
(5) Mental health promotion actions.
Mental health is a good state of reasonable cognition, emotional stability, appropriate behavior, interpersonal harmony and adaptation to changes in the process of growth and development, and is an important part of health. At present, the number of common mental disorders and psychological and behavioral problems in China is increasing year by year, and malignant cases (incidents) caused by personal extreme emotions occur from time to time. The prevalence of depression in China is 2.1%, and the prevalence of anxiety disorder is 4.98%. By the end of 2017, there were 5.81 million registered patients with severe mental disorders in China. At the same time, the public’s awareness rate of common mental disorders and psychological and behavioral problems is still relatively low, and they lack knowledge of prevention and treatment and awareness of taking the initiative to seek medical treatment. Some patients and their families still feel sick and ashamed. Strengthening the promotion of mental health will help to promote social stability and interpersonal harmony, and enhance public happiness.
Action goal:
By 2022 and 2030, the level of residents’ mental health literacy will increase to 20% and 30%; The prevalence of insomnia, anxiety disorder and depression slowed down. There are 3.3 and 4.5 licensed (assistant) psychiatrists per 100,000 population; The treatment rate of depression is improved by 30% and 80% on the existing basis; The registered treatment rate of schizophrenia reached 80% and 85%; The standardized management rate of registered patients with severe mental disorders reached 80% and 85%; Establish a mental health medical institutions, community rehabilitation institutions, social organizations and families to connect with each other, and establish and improve the service model of psychological crisis intervention and psychological assistance with mental health education, psychological hotline service, psychological evaluation, psychological consultation, psychotherapy and psychiatric treatment.
Advocate that the average sleep time of adults is 7 ~ 8 hours per day; Encourage individuals to correctly understand the symptoms of depression and anxiety and master basic self-psychological adjustment methods such as emotional management and stress management; All kinds of clinical medical staff actively master mental health knowledge and skills and apply them to clinical diagnosis and treatment activities.
-individuals and families:
1. Improve mental health awareness, and pursue common physical and mental health. Everyone may encounter a variety of mental health problems in his life. Take the initiative to learn and understand mental health knowledge, scientifically understand the interaction between mental health and physical health, maintain positive and healthy emotions, and avoid the harm caused by persistent negative emotions to physical health. Advocate the concept of moral cultivation and health preservation, maintain the way of neutralization and improve psychological resilience. In the treatment of physical diseases, we should pay attention to the role of psychological factors. When self-adjustment can’t be alleviated, you can choose to seek psychological counseling and psychotherapy to ease your emotions in time and prevent psychological and behavioral problems and mental disorders.
2. Use scientific methods to relieve stress. Maintain an optimistic, cheerful and open-minded attitude towards life and set your own goals reasonably. Correctly understand the impact of major life and work accidents on people’s psychology, learn basic decompression knowledge, and learn scientific and beneficial psychological adjustment methods. Learn and use healthy decompression methods, and avoid unhealthy decompression methods such as smoking, drinking, indulging in the Internet or games. Learn to adjust your state, find out the negative thoughts behind bad emotions, adjust according to objective reality, and reduce irrational understanding. Establish good interpersonal relationships, actively seek interpersonal support, and properly talk and ask for help. Maintain a healthy lifestyle, actively participate in social activities, and cultivate healthy hobbies.
3. Pay attention to sleep health. Ensure adequate sleep time every day, work, study, entertainment and rest should be carried out according to the rules of work and rest, and pay attention to daily life. Understand the adverse psychological effects caused by lack of sleep and sleep problems, try to make up for lack of sleep in time, and seek medical advice in time for sleep problems. To improve sleep scientifically under professional guidance, you should follow the doctor’s advice when taking drugs.
4. Cultivate the habit of scientific movement. Choose and cultivate sports hobbies that suit you, and actively play the role of exercise in regulating emotions. When there is mild emotional distress, exercise can be combined to promote emotional relief.
5. Correct understanding of common emotional problems such as depression and anxiety. Depression, lack of pleasure, loss of interest, accompanied by decreased energy, loss of appetite, sleep disorders, decreased self-evaluation, pessimism and disappointment about the future, and even thoughts or behaviors of self-injury and suicide, which persist for more than 2 weeks, may suffer from depression; Sudden or often inexplicable feelings of nervousness, fear, fear, often accompanied by obvious physical symptoms such as palpitation, sweating, dizziness, dry mouth, shortness of breath, etc., in severe cases, there is a sense of dying and loss of control, and if it occurs frequently, it may suffer from anxiety disorder. Transient or short-term depression and anxiety can be relieved and eliminated through self-adjustment or psychological counseling, so don’t worry too much. Depression and anxiety disorders can be treated by drugs, psychological intervention or a combination of the two.
6. Ask for help in time if there are psychological and behavioral problems. You can seek professional help from relevant departments of the hospital, professional psychological counseling institutions and social work service institutions. It is necessary to realize that turning to professionals does not mean that you are sick, not to mention serious illness, but a responsible and capable performance.
7. Mental illness treatment should follow the doctor’s advice. To diagnose mental illness, you should go to a psychiatric hospital or a general hospital for specialized outpatient service. After the diagnosis, we should receive regular treatment in time, choose hospitalization or outpatient treatment according to the doctor’s advice, actively implement the treatment plan, take the medicine in full, uninterrupted and on time according to the doctor’s advice, and do not rush to reduce or stop the medicine after the illness is effectively controlled. Visit the clinic on time, feedback the treatment to the doctor in time and truthfully, and listen to the doctor’s guidance. Psychotropic drugs must be used under the guidance of a doctor and may not be taken at will.
8. Care for and understand patients with mental illness and reduce discrimination. Learn the basic knowledge of mental illness, know that mental illness can be prevented and treated, respect mental patients and not discriminate against them. It is necessary to realize that after effective treatment, mental illness can be alleviated and recovered, and it can undertake family functions and work functions. It is necessary to provide a supportive environment for patients with mental illness, their families and caregivers, improve their psychological and behavioral skills, and enable them to gain a sense of self-worth.
9. Pay attention to the psychological status of family members. Family members should communicate on an equal footing and respect the different psychological needs of family members. When there is a conflict with family members, do not use excessive words or hurtful behavior, do not avoid it coldly, but actively communicate to solve it. Timely channel bad emotions and create a family atmosphere of mutual understanding, mutual trust, mutual support and mutual care and harmonious family relations.
-society:
1. All kinds of medical institutions at all levels and professional mental health service institutions provide standardized diagnosis and treatment services for individuals with psychological and behavioral problems, so as to alleviate patients’ psychological pain and promote their rehabilitation. Medical staff should respond to physical diseases, especially cancer, cardiovascular and cerebrovascular diseases, diabetes, digestive system diseases and other patients and their families with appropriate psychological adjustment. Encourage medical institutions to carry out sleep-related diagnosis and treatment services, provide scientific sleep guidance, and reduce the occurrence of sleep problems in adults. Professionals can guide the use of exercise programs to assist in the treatment of common psychological and behavioral problems such as depression and anxiety. Encourage relevant social organizations, institutions of higher learning, scientific research institutes and medical institutions to carry out training in service skills and ethics for mental health practitioners, so as to enhance their service capabilities.
2. Give full play to the role of mental health medical institutions, carry out mental health knowledge and skills training for medical staff in various clinical departments, popularize the application of psychological counseling and treatment techniques in clinical diagnosis and treatment, and improve the screening, identification and disposal ability of psychological and behavioral problems such as depression, anxiety, cognitive impairment and autism and common mental disorders. Popularize the application of characteristic techniques and methods of TCM psychological adjustment in clinical diagnosis and treatment.
3. All organs, enterprises, institutions, universities and other employing units integrate mental health education into the ideological and political work of employees (students), encourage the establishment of mental health counseling rooms and mental health service teams relying on the party committees, trade unions, human resources departments and clinics of their own units, or provide employees (students) with health promotion, psychological evaluation, education and training, counseling and other services by purchasing services, and teach self-psychological adjustment such as emotional management and stress management. Provide timely psychological counseling and assistance to employees (students) who are in a specific period, in a specific position, or who have experienced special emergencies.
4. Encourage universities for the elderly, activity centers for the elderly, grassroots associations for the elderly, women’s homes, rehabilitation institutions for the disabled and qualified social organizations to publicize mental health knowledge. Train full-time and part-time social workers and psychologists, introduce social forces, and provide psychological health services such as psychological counseling, emotional relief, grief relief, and family relationship adjustment for empty nesters, widowed, disabled and demented elderly people, left-behind women and children, disabled people and special family members of family planning.
-government:
1. Make full use of radio, television, books and periodicals, animation and other forms, and widely use portal websites, WeChat, Weibo, mobile clients and other platforms to organize the creation and broadcast of mental health publicity and education products and public service advertisements, and spread self-esteem, self-confidence, optimistic modern civilization ideas and mental health knowledge. (The Central Propaganda Department, the Central Network Information Office, the Health and Wellness Commission and the State Administration of Radio, Film and Television are responsible for the division of responsibilities)
2. Relying on comprehensive service management institutions and facilities such as urban and rural community comprehensive management centers to establish psychological counseling (counseling) rooms or social studios (stations), equipped with full-time and part-time mental health counselors or social workers, and build a grassroots mental health service platform. Integrate social resources, set up mental health counseling centers for minors at city and county levels, and improve the mental health counseling network for minors. Cultivate socialized mental health service institutions and encourage psychological counseling professionals to establish social psychological service institutions. Gradually expand the service coverage by purchasing services from social psychological service institutions. (The Central Political and Legal Committee, the Central Civilization Office, the Ministry of Education, the Ministry of Civil Affairs, and the Health and Wellness Committee are responsible for the division of responsibilities)
3. Strengthen the training of applied mental health workers and promote the establishment of related majors in colleges and universities. Further strengthen the system construction of training and using mental health workers, and actively set up mental health service posts. Support the capacity building of mental health medical institutions, improve the personnel salary distribution system, and reflect the labor value of psychotherapy services. Gradually bring mental health workers into the professional and technical post setting and management system, and smooth the career development channels. (The Ministry of Education, the Ministry of Finance, the Ministry of Human Resources and Social Security, the Health and Wellness Commission and the Medical Insurance Bureau are responsible for the division of responsibilities)
4. Political and legal departments at all levels, health and health departments shall, jointly with public security, civil affairs, judicial administration, disabled persons’ federations and other units, establish a comprehensive mental health management mechanism, carry out daily discovery, registration, follow-up, risk assessment, medication guidance and other services for patients with severe mental disorders through multiple channels, and mobilize community organizations and patients’ families to participate in home patient management services. Establish mental health medical institutions, community rehabilitation institutions, social organizations and families to connect with each other, and strengthen the technical guidance of mental health medical institutions to community rehabilitation institutions. By the end of 2030, more than 80% of counties (cities, districts) will carry out community rehabilitation services, and in counties (cities, districts) that carry out community rehabilitation for mental disorders, more than 60% of patients at home will receive community rehabilitation services. Encourage and guide social organizations to provide mental health community rehabilitation services by organizing community rehabilitation institutions for mental disorders or by government purchasing services. (The Central Political and Legal Committee, the Ministry of Public Security, the Ministry of Civil Affairs, the Ministry of Justice, the Health and Wellness Commission and the China Disabled Persons’ Federation are responsible for the division of responsibilities)
5. Pay attention to and carry out psychological crisis intervention and psychological assistance. Health, politics, law, civil affairs and other units have established and improved the service mode of psychological crisis intervention and psychological assistance, which includes mental health education, psychological hotline service, psychological evaluation, psychological consultation, psychotherapy and psychiatric treatment. Incorporate psychological crisis intervention and psychological assistance into all kinds of emergency plans and technical programs, and strengthen the professional and systematic construction of psychological crisis intervention and psychological assistance teams. Relevant departments promote the establishment of a psychological assistance hotline to provide public welfare services, which will be answered by professionals, and provide mental health education, psychological counseling and psychological crisis intervention to callers, so as to reduce the risk of suicide or self-injury of callers. (The Health and Wellness Committee takes the lead, and the Central Political and Legal Committee, the Ministry of Public Security and the Ministry of Civil Affairs are responsible according to the division of responsibilities)
(6) Health environment promotion actions.
A healthy environment is an important guarantee for people’s health. Environmental factors affecting health include not only physical, chemical and biological factors, but also social environmental factors. Environmental pollution has become a health risk factor that can not be ignored, and problems related to environmental pollution, such as cardiovascular diseases, respiratory diseases and malignant tumors, have become increasingly prominent. There are about 680,000 deaths due to injuries in China every year, accounting for about 7% of the total number of deaths. At present, the most common injuries are mainly road traffic accidents, falls, suicides, drowning, poisoning, etc., and the deaths caused by them account for about 84% of all injuries and deaths. It is necessary to continue to give full play to the organizational advantages of the patriotic health campaign, mobilize the whole society, integrate health into the whole process of urban and rural planning, construction and governance, establish a national environmental and health risk assessment system, promote the construction of healthy cities and healthy villages and towns, and create a healthy environment.
Action goal:
By 2022 and 2030, the standard of drinking water quality of residents will be significantly improved and will continue to improve; Residents’ environmental and health literacy levels reached 15% and above and 25% and above respectively; Vigorously promote the classified treatment of urban and rural domestic waste, and basically build a classified treatment system for domestic waste in key cities.
Advocate the active implementation of garbage sorting and timely cleaning, and actively put solid waste into the corresponding recycling sites and facilities; Prevent and control indoor air pollution, advocate simple green decoration, do a good job in indoor oil smoke exhaust, and improve the level of home environment; Schools, hospitals, stations, large shopping malls, cinemas and other crowded places should regularly carry out emergency drills for natural disasters and emergencies such as fires and earthquakes; Improve their awareness and ability of health protection, and learn to identify common danger signs, chemical safety labels and environmental protection graphic signs.
-individuals and families:
1. Improve environmental and health literacy. Take the initiative to learn and master the basic concepts, knowledge and skills of environmental and health literacy, abide by the ecological environment code of conduct, and enhance the awareness and ability of ecological environmental protection.
2. Consciously maintain environmental sanitation and resist environmental pollution. Family members should develop good habits of environmental sanitation, carry out timely and active cleaning of family environmental sanitation, and ensure that the family is clean and tidy, with sufficient light, good ventilation and sanitary toilets. Maintain environmental sanitation in communities and units, and improve the living and production environment. Actively implement garbage sorting and timely cleaning, and actively put solid wastes (waste batteries, waste fluorescent tubes, waste water silver thermometers, expired drugs, etc.) into corresponding recycling sites and facilities to reduce the spread of pollutants and the impact on the environment. Reduce smoke and dust emissions, try to avoid burning garbage stalks, put less or no fireworks, and prohibit open-air barbecues when the weather is heavily polluted; Found that the behavior of polluting the ecological environment, timely discourage or report.
3. Advocate a simple, moderate, green, low-carbon and healthy lifestyle. Give priority to green products, buy durable goods as much as possible, buy less products that are easy to cause pollution, such as plastic bags, disposable foamed plastic lunch boxes and plastic pipes, buy less products that are over-packaged, don’t follow the trend to buy electronic products that are updated quickly, and bring your own shopping bags and cups when you go out. Moderate use of air conditioning, winter setting temperature is not higher than 20 degrees Celsius, summer setting temperature is not lower than 26 degrees Celsius. Turn off the electrical power supply in time to reduce standby power consumption. Adhere to low-carbon travel, give priority to walking, cycling or public transportation, and use shared transportation more.
4. Pay attention to the air pollution in the room (car). Try to buy decoration materials, furniture and home appliances with green signs. Newly renovated rooms are ventilated regularly to reduce indoor air pollution caused by decoration materials. Cooking and heating advocate the use of clean energy (such as gas fuel and electricity). Advocate the use of exhaust fans, range hoods and other equipment during cooking. Purchase and use household chemicals that meet the limits of harmful substances. Regularly clean pets and pet supplies kept at home, and dump indoor garbage in time to avoid the breeding of microorganisms. According to the weather change and air quality, ventilate in time. When the weather is heavily polluted, doors and windows should be closed to reduce the outdoor air pollutants from entering the room. It is suggested to open the air purification device or fresh air system if possible. Encourage the purchase of cars with suitable displacement according to actual needs, do not carry out unnecessary interior decoration, pay attention to ventilation and clean the air conditioning system for vehicles in time.
5. Do a good job in outdoor health protection. When the weather is heavily polluted, it is suggested to reduce the outdoor stay time as much as possible, and the susceptible people should stop outdoor activities. If you go out, you need to do health protection.
6. Pay attention to road traffic safety. Strictly abide by traffic laws and regulations, enhance the awareness of traffic rules, safety and civilization, do not drive fatigue, overspeed and drink, and have certain emergency handling ability. Correct use of seat belts and reasonable use of safety seats according to children’s age, height and weight can reduce the occurrence of traffic accidents.
7. Prevent drowning. It is suggested to choose a swimming place with standardized management, not to promote swimming in natural waters, and not to swim outdoors when it rains. It is suggested to prepare carefully before entering the water to avoid muscle spasm and other problems after entering the water. When doing activities in the water, you should avoid dangerous behaviors such as slapstick and diving. Avoid children from approaching dangerous waters. When children swim, they should be led by adults or organized. Strengthen nursing, and children should not be left alone in bathrooms, bathrooms and open water sources.
-society:
1. Formulate community health conventions and health codes and other codes of conduct, and vigorously carry out activities of stressing hygiene, fostering new practices and eliminating bad habits. Strengthen the construction of community infrastructure and ecological environment, and create a healthy community environment with complete facilities, neat and orderly, beautiful and livable, safe and harmonious. Establish fixed health education windows such as health bulletin boards and window displays, set up community health self-help detection points, and equip them with sphygmomanometer, blood glucose meter, waist circumference ruler, weight meter, body mass index (BMI) ruler, healthy diet chart, etc., encourage and guide volunteers to participate, and guide community residents to form a healthy lifestyle. Employers give full consideration to the health needs of workers and provide them with a healthy and supportive environment. We will improve the standard of healthy families, include civilized and healthy lifestyles and the control of weight, oil, salt, sugar, blood pressure and myopia in the selection criteria of "Five Good Civilized Families", and guide family members to actively learn and master the necessary health knowledge and skills, keep their homes clean and harmonious, and improve their self-health management ability.
2. Enterprises actively enhance environmental awareness, reasonably determine environmental protection targets, establish environmental monitoring systems, and manage and maintain pollution control devices. Pollutant discharge must meet environmental protection standards. Involving the production, transportation, storage, sale, use and waste disposal of hazardous chemicals, enterprises should implement the main responsibility of safety production and strengthen the whole process management of hazardous chemicals. Encourage the development of safe, energy-saving and environmentally-friendly automobile products.
3. Encourage enterprises to establish a system of limited disclosure of harmful substances in consumer goods and monitoring and reporting of quality and safety accidents, improve the safety standards of consumer goods such as decoration materials, daily chemicals, children’s toys and supplies, and reduce the harm caused by consumer goods.
4. Central air conditioning and fresh air system should be cleaned regularly in public places. It is recommended to install fresh air system or air purification device in fitness and entertainment places. When the weather is heavily polluted, the purification device should be turned on in time to supplement fresh air according to the situation of personnel. Public swimming places should be disinfected and water changed regularly to ensure that people can move in a clean environment. According to the climate and environment, post warning signs in public places to prevent falls, electric shock, drowning, etc., reduce accidental injuries and falls, and prevent poisoning caused by accidents such as carbon monoxide, ammonia gas, chlorine gas and disinfectant pesticides.
5. According to different groups of people, prepare environment and health manuals, publicize and popularize the basic concepts, knowledge and skills of environment and health, and formulate and issue environmental pollution protection guidelines and public and indoor health environment guidelines.
6. Regularly disseminate and train the knowledge and skills of disaster prevention and mitigation and emergency response to the public, so as to improve self-help and mutual rescue capabilities. Schools, hospitals and other crowded places should regularly carry out emergency drills for natural disasters and emergencies such as fires and earthquakes.
-government:
1. Formulate norms and evaluation indicators for the construction of healthy cell engineering such as healthy communities, healthy units (enterprises) and healthy schools. Establish and improve the monitoring and evaluation system of healthy urban and rural areas, regularly organize third-party evaluation, and create an upgraded version of healthy towns. (The Health and Wellness Committee takes the lead, and the Ministry of Education and the Ministry of Civil Affairs are responsible according to the division of responsibilities)
2. Gradually establish an environment and health investigation, monitoring and risk assessment system. Strengthen the monitoring and evaluation of environmental health impacts such as drinking water, air and soil, which are closely related to people’s health, carry out research on the relationship between environmental pollution and diseases, health risk early warning and protective intervention, strengthen the construction of injury monitoring network, and take effective measures to prevent and control diseases related to environmental pollution. Promote the concept of "harmonious coexistence between man and nature" and "everyone enjoys a healthy environment", popularize environmental health knowledge, and create a good atmosphere for the whole society to care about and participate in environmental health. (The Health and Wellness Committee takes the lead, and the Ministry of Natural Resources, the Ministry of Ecology and Environment, the Ministry of Housing and Urban-Rural Development, the Ministry of Water Resources, the Ministry of Agriculture and Rural Affairs, the General Administration of Market Supervision, the Grain and Reserve Bureau, and the Forestry and Grass Bureau are responsible according to their division of responsibilities.)
3. In-depth prevention and control of air, water and soil pollution. Revise the "Environmental and Health Literacy of China Citizens (Trial)" and carry out the promotion of environmental and health literacy of citizens and the popularization of science. (The Ministry of Ecology and Environment takes the lead, and the Development and Reform Commission, the Ministry of Science and Technology, the Ministry of Industry and Information Technology, the Ministry of Natural Resources, the Ministry of Housing and Urban-Rural Development, the Ministry of Transport, the Ministry of Water Resources, the Ministry of Agriculture and Rural Affairs, and the Health and Wellness Commission are responsible according to the division of responsibilities.)
4. Increase the investment, management and maintenance of drinking water engineering facilities to ensure the safety of drinking water. Strengthen the construction of urban public safety infrastructure, increase investment in solid waste recycling facilities, and strengthen the management of waste classification and disposal. Strengthen the construction and maintenance management of urban and rural public fire control facilities, rationally plan and build emergency shelters, and strengthen the construction of emergency material reserve system. Improve the ability of enterprises, hospitals, schools, large shopping malls, cultural and sports entertainment places and other densely populated areas to prevent disasters and respond to emergencies. Improve the barrier-free facilities of medical institutions. (The Development and Reform Commission, the Ministry of Ecology and Environment, the Ministry of Housing and Urban-Rural Development, the Ministry of Water Resources, the Ministry of Culture and Tourism, the Health and Wellness Commission, the Emergency Department, the General Administration of Sports, etc. are responsible according to the division of responsibilities)
5. Organize the implementation of traffic safety life protection projects, improve traffic safety technical standards, strengthen the management of traffic safety hazards, and reduce the occurrence of traffic injuries. (The Ministry of Transport takes the lead, and the Ministry of Industry and Information Technology, the Ministry of Public Security, the State Railway Administration and the Civil Aviation Administration are responsible for the division of responsibilities.)
6. Strengthen the safety evaluation of consumer goods such as decoration materials, daily chemicals, children’s toys and supplies, improve the product injury monitoring system, raise relevant standards, strengthen the green safety certification of consumer goods, establish a mandatory reporting system for quality and safety accidents of consumer goods, strengthen recall management, and strengthen quality and safety supervision in key areas. (The General Administration of Market Supervision takes the lead, and the Ministry of Industry and Information Technology and the Ministry of Housing and Urban-Rural Development are responsible according to the division of responsibilities.)
7. Focus on the impact of combined pollution on health and pollution health protection, and focus on developing a number of key core technologies to guide the public to do a good job in health protection. (The Health and Wellness Committee takes the lead, and the Ministry of Science and Technology, the Ministry of Ecology and Environment, and the Meteorological Bureau are responsible according to the division of responsibilities)
(seven) maternal and child health promotion action.
Maternal and child health is the foundation of national health. Maternal and child health is facing new challenges in the new era. Birth defects not only seriously affect children’s health and quality of life, but also affect the health quality of the population. With the adjustment and improvement of the birth policy, the demand for birth is gradually released, the proportion of high-risk pregnant women has increased, and the pressure to ensure the safety of mothers and babies has increased. The whole-course service coverage is not extensive, the high incidence of cervical cancer and breast cancer has not been reversed, the early development of children needs to be strengthened, the health status of women and children still differs between urban and rural areas and between regions, and the supply capacity of maternal and child health services needs to be improved. The implementation of maternal and child health promotion action is an important measure to protect the health rights and interests of women and children, promote their all-round development and maintain reproductive health, and help to improve the national health level from the source and foundation.
Action goal:
By 2022 and 2030, the infant mortality rate will be controlled at 7.5‰ and below and 5‰ and below respectively; The mortality rate of children under 5 years old is controlled at 9.5‰ and below and 6‰ and below respectively; The maternal mortality rate dropped to 18/100,000 and below and 12/100,000 and below respectively; Prenatal screening rates reached 70% and above and 80% and above respectively; The screening rate of neonatal hereditary metabolic diseases reached 98% and above; Neonatal hearing screening rate reached 90% and above; Serious birth defects such as congenital heart disease, Down syndrome, deafness, neural tube defects and thalassemia have been effectively controlled; The health management rate of children under 7 years old is above 85% and above 90% respectively; The screening coverage rate of cervical cancer and breast cancer (hereinafter referred to as "two cancers") of rural school-age women reached 80% and above and 90% and above respectively.
Advocate school-age people to actively learn and master the knowledge of birth defect prevention and early childhood development; Take the initiative to accept pre-marital medical examination and pre-pregnancy eugenics health examination; Advocate exclusive breastfeeding for infants aged 0-6 months, and add complementary food to infants aged 6 months or more in a timely and reasonable manner.
-individuals and families:
1. Actively prepare for a healthy new life. Take the initiative to understand the knowledge of maternal and child health care and birth defects prevention, fully understand that pregnancy and childbirth are normal physiological processes of human reproduction, and suggest planning and preparation. Actively participate in pre-marital and pre-pregnancy health checks, choose the best reproductive age, and supplement folic acid from 3 months before pregnancy to 3 months after pregnancy. Prevent infection, quit smoking and drinking, and avoid contact with toxic and harmful substances and radiation.
2. Regular check-ups to ensure the safety of mother and baby. If you find pregnancy, you should go to the medical and health institutions as soon as possible to build a file, conduct pregnancy risk screening and evaluation, take the initiative to receive maternal health care services on time according to different risk management requirements, and master the knowledge and skills of maternal self-care. At least five prenatal examinations were conducted during pregnancy (once in the first trimester, twice in the second trimester and twice in the third trimester). Those with abnormal conditions are advised to increase the number of examinations according to the doctor’s advice. For the first prenatal examination, it is recommended to have AIDS, syphilis and hepatitis B examinations and receive regular prenatal screening. Pregnant women over the age of 35 are elderly pregnant women, and it is recommended that elderly and high-risk pregnant women receive prenatal diagnosis services in a qualified medical institution in time. During pregnancy, if you feel unwell, it is recommended to go to a medical and health institution immediately. Pregnant women should be hospitalized in time for delivery, advocate natural delivery and reduce cesarean section for non-medical needs. Pregnant women should ensure a reasonable diet, balanced nutrition and maintain a reasonable weight. Keeping a positive attitude and relaxing mood is helpful to prevent depression during pregnancy and postpartum. 3 ~ 7 days and 42 days after delivery, take the initiative to accept community doctors’ visits, and choose appropriate contraceptive measures according to their own situation.
3. Scientific parenting to promote the healthy growth of children. Strengthen the concept that children’s parents are the first responsible person for children’s health and improve their health literacy. Breast milk is an ideal natural food for babies. Start breastfeeding as soon as possible after birth, and try to breastfeed exclusively for 6 months. After 6 months, gradually supplement the baby with iron-rich muddy food. Infants under 1 year old should not eat fresh milk. Understand the characteristics of children’s development, treat the differences between children rationally, respect each child’s own development rhythm and characteristics, understand and respect children’s emotions and needs, and provide children with a safe, beneficial and interesting growth environment. Avoid children’s brain development and psychological growth due to factors such as excessive pressure, lack of exercise and lack of social interaction. If you find children’s psychological and behavioral problems, don’t be too nervous or ignore them too much. It is recommended to consult and ask for help from professionals in time. Avoid accidental injuries such as falls, burns, suffocation, poisoning, electric shock, drowning, and animal bites.
4. Strengthen health care and prevent childhood diseases. Do a good job in children’s health management and carry out vaccination according to immunization planning procedures. Screening for neonatal diseases such as phenylketonuria, congenital hypothyroidism and hearing impairment, and screening for disability of children aged 0-6 years such as vision, hearing, intelligence, physical disability and autism, etc. Those with positive screening should take the initiative to receive follow-up, diagnosis, treatment and intervention. Children under the age of 3 should go to township hospitals or community health service centers to receive 8 health checks, and children aged 4-6 should receive a health check every year.
5. Care for women and promote reproductive health. It is suggested that women should improve their awareness and ability of reproductive health, take the initiative to acquire health care-related knowledge of adolescence, reproductive period, menopause and old age, pay attention to menstrual hygiene, and be familiar with symptoms and prevention knowledge of common diseases of women such as reproductive tract infection, breast disease and cervical cancer. It is suggested that family members should strengthen their psychological care for women in special periods. Master the informed choice of contraceptive methods, know all kinds of contraceptive methods, and know the precautions of contraceptive methods you use. Recognize the impact of promoting reproductive health on individuals, families and society, enhance the awareness of sexual morality, health and safety, reject unsafe sex, and avoid unintended pregnancy, premature birth and the spread of sex-related diseases.
-society and government:
1. Improve the maternal and child health service system, implement the maternal and child health and family planning service guarantee project, focus on the central and western regions and poverty-stricken areas, strengthen the infrastructure construction of maternal and child health care institutions, and ensure that there is a standardized maternal and child health care institution at the provincial, municipal and county levels. Strengthen the training of urgently needed talents in pediatrics, obstetrics, midwifery, etc., and enhance the attractiveness of posts. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission, the Ministry of Education, the Ministry of Finance and the Ministry of Human Resources and Social Security are responsible according to the division of responsibilities)
2. Strengthen pre-marriage, pre-pregnancy, pregnancy, neonatal period and childhood health care, promote the use of the Mother and Child Health Manual, and provide systematic and standardized services for women and children. Improve the prevention and control network of birth defects and improve the accessibility of comprehensive prevention and control services for birth defects. (Responsible by the Health and Wellness Committee)
3 vigorously popularize the scientific knowledge of maternal and child health, and promote the "one-stop" service model of marriage registration, pre-marital medical examination and birth guidance. Do a good job in contraceptive services after induced abortion, standardize postpartum contraceptive services, and improve the accessibility of free contraceptive distribution services. Strengthen the labor protection of female workers, and avoid contact with toxic and harmful substances and radiation during pregnancy and lactation. Promote the construction of facilities such as pregnant women’s lounge and maternal and child room. (The Health and Wellness Committee takes the lead, and the Ministry of Civil Affairs, the All-China Federation of Trade Unions and the All-China Women’s Federation are responsible according to the division of responsibilities)
4. To provide scientific pregnancy preparation and fertility evaluation guidance for families planning to have children, prenatal eugenics services, infertility diagnosis and treatment for couples with fertility difficulties, and guide scientific pregnancy preparation. Implement the national free pre-pregnancy eugenics health check-up and promote the full coverage of urban and rural residents. Widely carry out prenatal screening, popularize appropriate technologies for prenatal screening, standardize the application of Qualcomm gene sequencing and other technologies, and gradually realize that pregnant women receive prenatal screening at least once voluntarily before 28 weeks of pregnancy. In-depth development of thalassemia prevention and control projects in high-incidence provinces, and gradually expand the coverage. Give timely medical guidance and advice to cases of serious birth defects such as congenital heart disease, Down syndrome, neural tube defect and thalassemia. (The Health and Wellness Committee takes the lead, and the Ministry of Finance is responsible according to its duties)
5. Implement the five systems of pregnancy risk screening and assessment, high-risk project management, critical and severe treatment, maternal death case report and interview notification, strengthen the construction of critical pregnant women and newborn care support capacity, and improve the mechanisms of treatment consultation and referral. Pregnant women and newborns participate in basic medical insurance and serious illness insurance according to regulations, and enjoy relevant treatment according to regulations. Those who meet the conditions can enjoy the medical assistance subsidy policy. Project management for premature infants, and newborn safety projects in poor areas. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission, the Ministry of Finance and the Medical Insurance Bureau are responsible according to the division of responsibilities)
6. Carry out neonatal disease screening in an all-round way, strengthen the follow-up, diagnosis, treatment and intervention of screening positive cases, improve the treatment rate of confirmed cases, and gradually expand the scope of diseases for neonatal disease screening. We will continue to carry out rescue projects for congenital structural malformations and genetic and metabolic diseases, focusing on key diseases of birth defects that are serious and frequent, can be screened and cured, mature in technology, good in prognosis and controllable in cost, and carry out pilot services for screening, diagnosis, treatment and poverty relief. Establish an integrated working mechanism for screening, diagnosis and intervention of disabling diseases and birth defects in newborns and children. (The Health and Wellness Committee takes the lead, and the Ministry of Finance and the China Disabled Persons’ Federation are responsible according to the division of responsibilities)
7. Implement the health management of children aged 0-6, standardize the visit of newborns, and guide parents to do a good job in neonatal feeding, nursing and disease prevention. We will implement infant feeding strategies, innovate the management of baby-friendly hospitals, and cover all poverty-stricken counties with child nutrition improvement projects in poverty-stricken areas. Guide children to eat a scientific and balanced diet, strengthen physical exercise, and realize comprehensive prevention and intervention of childhood obesity. Strengthen the guidance and supervision of health care business in kindergartens. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission and the Ministry of Education are responsible according to the division of responsibilities)
8. Strengthen early childhood development services, combine the implementation of basic public health service projects, promote the equalization of early childhood development, promote early childhood development services into rural areas, communities and families, and explore service contents and models suitable for early childhood development in rural areas. Improve the accessibility of infant care. Improve the rehabilitation and assistance system for disabled children. Strengthen the construction of professional rehabilitation institutions, rehabilitation medical institutions, primary medical rehabilitation facilities and talent teams for the disabled, improve the linkage and cooperation mechanism, and continuously improve the level of rehabilitation security. (The Health and Wellness Committee takes the lead, and the Development and Reform Commission, the Ministry of Education, the Ministry of Finance, the All-China Women’s Federation and the China Disabled Persons’ Federation are responsible according to the division of responsibilities)
9. Focus on poverty-stricken areas, gradually expand the coverage of the "two cancers" screening project for rural women, continue to implement the prevention of mother-to-child transmission of AIDS, syphilis and hepatitis B, and achieve the goal of eliminating mother-to-child transmission of AIDS as soon as possible. Focus on pneumonia, diarrhea, anemia, asthma, dental caries, poor eyesight, psychological and behavioral problems, etc., and promote appropriate technologies for comprehensive management of children’s diseases. (The Health and Wellness Committee takes the lead, and the Ministry of Finance and the All-China Women’s Federation are responsible according to the division of responsibilities)
10. Actively promote the application of appropriate technologies and methods of Chinese medicine in medical institutions providing maternal and child health care services, and carry out rational use and training of Chinese patent medicines. Expand the application of traditional Chinese medicine in pregnancy, nursed back to health and postpartum rehabilitation. Give full play to the role of traditional Chinese medicine in children’s medical and health care services. Strengthen the clinical cooperation between Chinese and western medicine in the diagnosis and treatment of women and children’s diseases, and improve the level of diagnosis and treatment of difficult and critical diseases. (The Chinese Medicine Bureau takes the lead, and the Health and Wellness Committee is responsible according to its duties)
(8) Health promotion actions in primary and secondary schools.
Primary and secondary school students are at a critical stage of growth and development. Strengthening the health promotion of primary and secondary schools and strengthening the physique of teenagers is the need to promote the healthy growth and all-round development of primary and secondary school students. According to the results of the survey on students’ physique and health in China in 2014, the obesity detection rates of urban boys and girls aged 7-18 in China were 11.1% and 5.8% respectively, while those of rural boys and girls were 7.7% and 4.5% respectively. In 2018, the overall myopia rate of children and adolescents nationwide was 53.6%. Among them, 14.5% are 6-year-old children, 36.0% are primary school students, 71.6% are junior high school students and 81.0% are senior high school students. Health problems such as obesity and myopia among primary and secondary school students are prominent.
In addition, with the growth and development, the self-awareness of primary and secondary school students is gradually enhanced, the development of cognition, emotion, will and personality is gradually mature, and the outlook on life, world outlook and values are gradually formed. Therefore, it is of great significance to effectively protect and actively promote their healthy physical and mental growth during this period.
Action goal:
By 2022 and 2030, the excellent rate of reaching the national students’ physical health standards will reach 50% and above and 60% and above respectively; The overall myopia rate of children and adolescents in China will strive to reduce by more than 0.5 percentage points every year and the rate of new myopia will drop significantly; The myopia rate of primary school students dropped below 38%; The starting rate of physical education and health courses in primary and secondary schools that meet the requirements reaches 100%; Primary and secondary school students spend no less than 1 hour in school sports activities every day; The popularization rate of eye exercises in schools has reached 100%; Boarding primary and secondary schools or non-boarding primary and secondary schools with more than 600 students are equipped with full-time health professional technicians, and non-boarding primary and secondary schools with less than 600 students are equipped with full-time and part-time health teachers or health professional technicians, reaching 70% and above and 90% and above respectively; Schools that are not equipped with health professional and technical personnel should be unified by the local government to establish a package system for primary medical and health institutions to achieve full coverage of primary and secondary schools; The proportion of primary and secondary schools equipped with full-time and part-time mental health workers reached above 80% and above 90% respectively; Incorporate students’ physical health into the school performance evaluation, link it with the rewards and punishments of the school leaders, and incorporate high school physical education subjects into the comprehensive evaluation system of high school academic level test or college entrance examination; Encourage colleges and universities to explore the addition of physical education subject tests in special types of enrollment.
Advocate primary and secondary school students to contact natural light for more than 1 hour outside school every day; Pupils, junior high school students and senior high school students sleep for no less than 10, 9 and 8 hours each day; Primary and secondary school students should not use electronic screen products for more than 15 minutes at a time for non-learning purposes, and should not use them for more than 1 hour every day; The school encourages and guides students to reach the "National Students’ Physical Health Standards" and above.
-personal:
1. The scientific movement. Ensure adequate physical activity and reduce sedentary and screen watching (watching TV, using computers, mobile phones, etc.). During the break, you should leave your seat and exercise moderately. Accumulate at least one hour of moderate-intensity and above exercise every day to cultivate the habit of lifelong exercise.
2. Pay attention to eye hygiene. Actively learn and master health knowledge such as scientific eye protection, and develop healthy eye habits. Maintain correct reading and writing posture. Hold the fingertips of the pen one inch away from the tip of the pen, punch the chest from the table, and keep the books one foot away from the eyes, and keep the reading and writing posture correct. Reading and writing should be carried out in an environment with good lighting and sufficient lighting. When studying during the day, make full use of natural light to avoid direct light on the desktop. When studying at night, turn on the desk lamp and room headlights at the same time. Continuous eye use for reading and writing should not exceed 40 minutes. Consciously reduce the use of electronic screen products. Avoid bad eye behavior, do not read books or use electronic screen products when walking, eating, lying down, in a swaying carriage, in dim light or in direct sunlight. When you feel that your vision has changed significantly, you should inform your parents and teachers in time and go to an eye medical institution for examination and treatment as soon as possible.
3. Maintain a healthy weight. Learn the life skills of choosing food and matching food reasonably. Eat breakfast every day, choose snacks reasonably, and choose a proper amount of fruits, nuts or yogurt as snacks between meals. Drink plenty of water, preferably boiled water, and drink little or no sugary drinks. Self-monitoring growth and development indicators such as height and weight, early detection, scientific judgment whether there are overweight, obesity and other health problems.
4. Understand the knowledge of infectious disease prevention and control, enhance physical fitness, and prevent infectious diseases, especially common respiratory infectious diseases.
5. Master scientific coping methods to promote mental health. Maintain a positive and healthy mental state, and actively participate in cultural and sports activities and social practice. Understand the influence of bad emotions on health and master the basic methods of regulating emotions. Correctly understand psychological problems, learn to actively hint and vent appropriately. You can vent your pent-up negative emotions such as pain, grievance and anger by taking a deep breath or talking to friends, writing diaries, drawing pictures and playing football. You can seek help from parents, teachers and friends, and you can also take the initiative to receive psychological counseling (psychological counseling and treatment).
6. Use the Internet reasonably and safely, enhance the discrimination of Internet information, actively control the online time, and resist Internet addiction.
7. Ensure adequate sleep and don’t stay up late. Use your ears scientifically and pay attention to protecting your hearing. Brush your teeth in the morning and evening, rinse your mouth after meals, and use the correct method of brushing your teeth for at least 2 minutes each time. Remind parents to accompany them to see a doctor in time when dental caries occur. Do not smoke, refuse to smoke secondhand smoke, and help parents quit smoking. Enhance their own awareness of safety precautions, master the knowledge and skills of injury prevention, and prevent traffic injuries, campus violence injuries, drowning, sexual harassment, etc. Stay away from unsafe sex. Do not try drugs for any reason.
-family:
1. Give children health knowledge through parent-child reading, participating in lectures and other ways, set an example, drive and help children to form good health behaviors, eat reasonably, work and rest regularly, and exercise every day.
2. Pay attention to parenting methods, neither doting on children nor treating them rudely. Be a child’s listener, help children face and deal with problems correctly, and pay attention to their mental health.
3. Guarantee children’s sleep time, ensure that primary school students sleep for 10 hours, junior high school students for 9 hours and senior high school students for 8 hours every day, and reduce the time for children to use their eyes and watch electronic screens at close range.
4. Create a good family sports atmosphere, actively guide children to engage in outdoor activities or physical exercise, and ensure that children spend more than one hour in contact with natural light outside school every day. Encourage and support children to participate in various forms of off-campus sports activities, urge children to conscientiously complete sports homework in winter and summer vacations, enable them to master one or two sports skills, and guide children to develop lifelong exercise habits.
5. Parents are advised to minimize the use of electronic screen products when accompanying their children. Consciously control the use of electronic screen products by children, especially preschool children. The use of electronic screen products for non-learning purposes should not exceed 15 minutes at a time, and the cumulative time should not exceed 1 hour every day. After studying with electronic screen products for 30-40 minutes, it is recommended to take a rest and relax for 10 minutes. The younger you are, the shorter the continuous use of electronic screen products should be.
6. Effectively reduce the burden of children’s families and off-campus studies. Don’t blindly participate in extracurricular training and follow the trend. It is recommended to choose according to children’s hobbies.
7. Ensure the quality of nutrition. Encourage children not to be picky about food and partial eclipse, balance their diet according to their physical development, and avoid the intake of foods high in sugar, salt and oil.
8. Pay close attention to the child’s health status at any time, and consult a professional or take him to a medical institution for examination when he finds the early signs of the disease.
-school:
1. Organize and arrange teaching activities in strict accordance with the national curriculum plan and curriculum standards. No written homework is arranged for the first and second grades of primary school, and the completion time of written homework for the third to sixth grades shall not exceed 60 minutes, and it shall not exceed 90 minutes for junior high school. The homework time shall also be reasonably arranged for senior high school.
2. Comprehensively promote the full coverage of compulsory education schools. Resolutely control the number of unified examinations in the compulsory education stage, and the number of examinations in the first and second grades of primary school shall not exceed 1 per semester, and the number of examinations in other grades shall not exceed 2 per semester.
3. Improve teaching facilities and conditions to provide students with a healthy learning environment. Accelerate the elimination of the phenomenon of "large classes". Adjust students’ seats every month, and adjust the height of students’ desks and chairs individually every semester to adapt to students’ growth and development.
Primary and secondary schools should strictly organize all students to do eye exercises once every morning and afternoon. Teachers should teach students to master the correct writing posture, urge students to sit correctly when reading and writing, and supervise and correct students’ bad reading and writing posture at any time. Teachers should know about students’ eyesight when they find that they can’t see the blackboard clearly and often rub their eyes.
5. Strengthen physical education class and extracurricular exercise to ensure that primary and secondary school students spend more than one hour of physical activity every day at school. Strictly implement the national physical education and health curriculum standards, and ensure that the first and second grades of primary school have 4 class hours per week, the third to sixth grades and junior high school have 3 class hours per week, and the senior high school has 2 class hours per week. Primary and secondary schools arrange 30 minutes of big recess sports activities every day. Organize and urge students to go outdoors or overlook during recess in order to prevent students from continuing fatigue and using their eyes.
6. According to the different stages of school education, set up corresponding physical education and health education courses, teach students knowledge of healthy behavior and lifestyle, disease prevention and control, mental health, growth and adolescence health care, safety emergency and avoidance, improve students’ health literacy, and actively use various forms to carry out health education for students and parents. Train health education teachers and develop and expand health education curriculum resources.
7. Guide students to use electronic screen products scientifically and standardize, and develop good habits of study and eye hygiene under the information environment. Students are strictly forbidden to bring personal mobile phones, tablets and other electronic screen products into the classroom, and those brought into the school should be kept in a unified way. In principle, the teaching time using electronic screen products should not exceed 30% of the total teaching time, and paper homework should be used in principle.
8 strengthen the strength of the infirmary (health room, school hospital, health room, etc.), and equip the school doctor and necessary equipment according to the standard. Strengthen the publicity and prevention and control of key infectious diseases in primary and secondary schools, strictly implement the system of tracing and registering the causes of school entrance examination and absence due to illness, and reduce the occurrence of infectious diseases such as influenza and tuberculosis in schools. Strictly implement the student health examination system, and remind students with health problems to check in medical institutions. Strengthen nutrition management and guidance for students, carry out nutrition and health education for students, prohibit the provision of high-sugar foods in primary and secondary school canteens, restrict the sale of sugary drinks on campus and avoid selling high-salt, high-sugar and high-fat foods, and cultivate healthy eating habits.
9. Primary and secondary schools are equipped with full-time and part-time mental health workers. Care about the mental health of left-behind children and floating children, and provide timely psychological intervention for students.
-government:
1. To study and revise the Regulations on School Health Work and the Guidelines for Health Education in Primary and Secondary Schools, and formulate the Regulations on the Management of Food Safety and Nutrition Health in Schools, so as to further improve the system and system for the development of school sports health. Formulate healthy school standards and carry out healthy school construction. Deepen the teaching reform of physical education and health education in schools, and generally offer physical education and health education courses in primary and secondary schools across the country. According to the growth law and characteristics of students, the content of health education is determined in stages and included in the evaluation scope, so that the teaching plan, teaching materials, class hours and teachers are "in place" and all students are gradually covered. (The Ministry of Education takes the lead, and the Health and Wellness Committee is responsible according to the division of responsibilities)
2. Strengthen the construction of existing primary and secondary health care institutions, and strengthen personnel and equipment in accordance with standards and requirements. Ensure the food safety and nutritional health of teachers and students in school, and strengthen the construction of canteens in compulsory education schools. Resolutely manage and standardize off-campus training institutions, and carry out full coverage special inspections on classroom lighting, desks and chairs, and electronic screen products of off-campus training institutions every year. (The Ministry of Education takes the lead, and the Health and Wellness Committee is responsible according to its duties)
3. Comprehensively strengthen the national monitoring network, data collection and information construction of children’s and adolescents’ visual health and related risk factors. Establish a national team of children and adolescents’ myopia prevention and vision health experts to scientifically guide children and adolescents’ myopia prevention and vision health management. In accordance with the requirements of the relevant national standards for lighting and lighting, the classrooms (teaching places) of schools, kindergartens and off-campus training institutions are randomly sampled, recorded and published. Establish a system of primary and secondary schools in primary health care institutions. (The Health and Wellness Committee takes the lead, and the Ministry of Education is responsible according to its responsibilities)
4. Actively guide and support social forces to carry out various sports activities for children and adolescents, and carry out various winter (summer) camps, training camps and sports events in a targeted manner to attract children and adolescents to participate in sports extensively. (The Development and Reform Commission, the Ministry of Education, the General Administration of Sport and the Central Committee of the Communist Youth League are responsible for the division of responsibilities)
5. Implement the regulation of the total amount of online games, control the number of online operations of new online games, encourage the research and development and dissemination of excellent online game works that are knowledgeable, educational, original, skilled and interesting, explore the age-appropriate prompt system in line with national conditions, and take measures to limit the use time of minors. (The Central Network Information Office, the Ministry of Industry and Information Technology and the State Press and Publication Administration are responsible for the division of responsibilities)
6. Improve the students’ physical examination system and the students’ physical health monitoring system. The school sports work and students’ physical health status should be included in the evaluation system of local governments, education administrative departments and schools, and linked to the rewards and punishments of school leaders. Students’ health knowledge, first aid knowledge, especially cardiopulmonary resuscitation, should be included in the examination content, and the mastery of health knowledge, first aid knowledge and physical fitness test should be taken as important indicators for students’ evaluation, graduation assessment and further study. High school physical education subjects should be included in the comprehensive evaluation system of high school academic level test or college entrance examination, and colleges and universities should be encouraged to explore adding physical education subject tests to special types of enrollment. (The Ministry of Education takes the lead, and the Health and Wellness Committee is responsible according to its duties)
(9) Occupational health protection actions.
China is the country with the largest working population in the world. In 2017, China’s employed population was 776 million, accounting for 55.8% of the total population. Most workers’ careers exceeded half of their life cycle. Occupational health problems caused by workplace exposure to various hazardous factors are still serious, the situation of occupational disease prevention and control is severe and complicated, and new occupational health hazards are constantly emerging. Physical and psychological problems caused by diseases and work stress have become new occupational health challenges to be urgently addressed. Implementing occupational health protection actions, strengthening government supervision responsibilities, urging employers to implement the main responsibilities, improving the level of occupational health work, effectively preventing and controlling occupational hazards, and effectively protecting workers’ occupational health rights and interests are essential to maintaining the health of all workers and promoting sustained and healthy economic and social development.
Action goal:
By 2022 and 2030, the working hours system will be fully implemented; The number of people participating in industrial injury insurance has steadily increased, and in 2030, the full coverage of the statutory population of industrial injury insurance will be realized; The proportion of reported cases of new pneumoconiosis among workers who have been exposed to dust for less than 5 years to the total number of cases reported in the annual report has decreased obviously and continuously; The coverage rate of occupational health examination and occupational disease diagnosis services in the jurisdiction reached 80% and above and 90% and above respectively; The reporting rate of occupational hazard projects of employers in key industries reaches 90% or above; The detection rate of occupational hazards in the workplace is 85% or above, and the occupational health examination rate of workers exposed to occupational hazards is 90% or above; The reporting rate of occupational disease diagnosis institutions reached 95% and above.
Advocate the awareness rate of workers in key industries on the main hazards and protection knowledge of their posts to reach 90% or above and maintain it continuously; Encourage all employers to do a good job in employee health management and select "health experts", among which state organs, schools, medical and health institutions, state-owned enterprises and other employers should support employees to take the lead in establishing a healthy image and reward them; For those who are engaged in long-term, high-intensity repetitive exertion, rapid movement and video operation, measures such as popularizing advanced technology and adjusting work and rest hours should be taken to prevent and control the occurrence of excessive fatigue and work-related musculoskeletal diseases; Take comprehensive measures to reduce or eliminate work pressure.
-individual workers:
1. Advocate healthy working methods. Actively spread advanced concepts and culture of occupational health. Employees of state organs, schools, medical and health institutions, state-owned enterprises and other units take the lead in establishing a healthy image and strive to be "healthy people".
2. Establish health awareness. Actively participate in occupational health training, learn and master various systems and standards related to occupational health, understand the harmful factors existing in the workplace, master the knowledge of occupational hazard protection, post operation procedures, and the correct wearing and using methods of personal protective equipment.
3. Strengthen legal awareness, know and understand the law. Abide by the laws, regulations and rules on the prevention and control of occupational diseases. Workers exposed to occupational hazards shall regularly participate in occupational health examinations; Workers suffering from occupational diseases are advised to be diagnosed and treated in time to protect their legitimate rights and interests.
4. Strengthen labor process protection. Workers’ long-term exposure to dust, chemical hazards, radioactive hazards, physical hazards and biological hazards in the production environment may cause related occupational diseases. It is suggested that workers exposed to occupational hazards should pay attention to the protection of all kinds of hazards, operate in strict accordance with the operating procedures, and wear personal occupational protection articles consciously and correctly.
5. Improve emergency response capability. Learning and mastering the on-site first aid knowledge and the emergency treatment methods of acute hazards can achieve correct self-help and mutual rescue.
6. Strengthen heatstroke prevention and cooling measures. It is suggested that workers working in high temperature and high temperature weather should pay attention to prevent heatstroke. You can wear a heat-insulating mask and a heat-proof suit with good heat insulation and ventilation performance, and pay attention to using heatstroke prevention and cooling facilities such as air conditioners to cool down. It is suggested to supplement water, salt and water-soluble vitamins to prevent heatstroke and cool down.
7. Health protection of the occupational population who bend their heads at their desks for a long time or sit forward for a long time. Attention should be paid to relieving muscle tension through stretching activities to avoid cervical spondylosis, scapulohumeral periarthritis and low back pain. When working at the desk, you should pay attention to maintaining a correct sitting posture and keeping your upper body straight; Adjust the height of the chair so that your feet are just right on the ground. If you use the computer for a long time, the elevation angle of the computer should be opposite to the user’s line of sight when working, and it is not advisable to bow your head or raise your head too much. It is recommended to take a break every 1-2 hours, look into the distance, exercise your waist and neck, and do eye exercises and workouts.
8. Health protection of teachers, traffic policemen, doctors, nurses and other occupational groups mainly engaged in standing work. When standing, it is recommended to use the center of gravity of both legs alternately to prevent varicose veins. It is recommended to keep the waist and knees relaxed and promote blood circulation by walking properly. If you use your voice for a long time, pay attention to replenish water and keep throat lozenges to prevent pharyngitis.
9. Health protection of occupational groups who work in a fixed position for a long time. It is suggested that the operation time should be arranged reasonably, so as to eat regularly and quantitatively; Maintain a correct working posture, adjust the seat to an appropriate position, ensure that the lumbar spine is moderately stressed, and pay attention to reducing vibration to avoid cervical spondylosis, scapulohumeral periarthritis, hyperosteogeny, sciatica and other diseases; Pay attention to intermittent rest during operation, reduce urination, and fatigue operation is strictly prohibited.
-Employer:
1. Encourage employers to provide workers with a clean, hygienic, green, comfortable, beautiful and humanized working environment, and take comprehensive preventive measures to minimize the impact of various hazardous factors on workers’ health and effectively protect workers’ health rights and interests. Advocate employers to select "healthy people" and give them rewards.
2. Encourage employers to set up health tips in suitable places, and provide places and facilities for employees to measure health indicators such as blood pressure, weight and waist circumference free of charge. Under normal circumstances, the meeting time exceeds 2 hours and the rest is arranged for 10 to 15 minutes. Encourage the establishment of relevant systems to protect workers’ health, such as: interval exercise system, fitness system, smoke-free unit system, etc. According to the number of employees and the degree of occupational health risks of the employer, the infirmary, emergency rescue station and toxic gas protection station are set up according to relevant standards, equipped with first-aid kits and other equipment.
3. If the newly-built, expanded and rebuilt construction projects, technological transformation and technology introduction projects may cause occupational hazards, the construction unit shall perform the "three simultaneities" system of occupational disease protection measures for construction projects according to laws and regulations (that is, the occupational disease protection facilities of construction projects are designed, constructed and put into production and use at the same time). Employers are encouraged to give priority to the adoption of new technologies, new processes, new equipment and new materials that are conducive to the prevention and treatment of occupational diseases and the protection of employees’ health, and are not allowed to produce, operate, import or use equipment or materials that may cause occupational hazards that are explicitly prohibited by the state. For long-term, high-intensity, repeated exertion, rapid movement and other working methods, measures such as advanced technology and adjustment of work and rest time are adopted to prevent and control excessive fatigue and related diseases. Take comprehensive measures to reduce or eliminate work stress and prevent and control its possible adverse health effects.
4. The employing unit that produces occupational hazards should strengthen the project declaration, daily monitoring, regular detection and evaluation of occupational hazards, set up bulletin boards in eye-catching positions, announce the detection results of occupational hazards in workplaces and emergency rescue measures for occupational hazards accidents, and set warning signs and Chinese warning instructions in eye-catching positions for jobs that produce serious occupational hazards.
5. The employing unit that produces occupational hazards shall establish the occupational disease prevention and control management responsibility system, improve the post responsibility system, and ensure that the responsibilities, inputs, supervision, protection and emergency rescue are in place. The employing unit shall, according to the existing hazard factors, set up or designate an occupational health management institution, and be equipped with full-time and part-time occupational health management personnel to carry out occupational disease prevention, occupational health guidance and management.
6. The employer shall establish a sound occupational health monitoring system, organize workers to carry out occupational health examination according to law, and cooperate with the work of occupational disease diagnosis and identification. Check and treat gynecological diseases and breast diseases on a regular basis for female employees.
7. The employing unit shall standardize the management of labor and employment, and sign labor contracts with workers according to law. The contracts shall specify labor protection, labor conditions and occupational hazards protection, labor protection for female employees and taboo jobs for female employees, etc. The employing unit shall ensure the rest time of the workers, arrange the workers’ vacation according to law, implement the maternity leave, prenatal examination and breastfeeding time of female employees, and put an end to illegal overtime; It is necessary to pay work-related injury insurance premiums in full and on time according to law. Encourage employers to form a team of health instructors to carry out health guidance and management for employees.
-government:
1. To study and revise the Law of People’s Republic of China (PRC) on the Prevention and Control of Occupational Diseases and other laws and regulations, and formulate and revise the regulations of the occupational disease prevention department. Sorting out, analyzing and evaluating the existing occupational health standards, focusing on dust prevention, virus prevention, noise prevention and radiation protection, and taking mandatory standards as the core, researching, formulating, revising and introducing stricter and more effective national occupational health standards and measures, and improving the system of occupational disease prevention and control laws and standards. Strengthen the research, identification, evaluation and control of new occupational hazards, organize relevant investigations, study and formulate norms and standards, put forward preventive measures, and incorporate them into legal management in time to cope with new occupational health problems that may arise from industrial transformation and technological progress. (The Health and Wellness Committee takes the lead, and the Ministry of Science and Technology, the Ministry of Justice and the General Administration of Market Supervision are responsible according to the division of responsibilities)
2 research and development, promotion of new technologies, new processes, new equipment and new materials conducive to the protection of workers’ health. Focus on occupational pneumoconiosis, noise deafness and chemical poisoning, and carry out special treatment in mining, building materials, metal smelting, chemical industry and other industries. Strictly control the source and guide the employers with serious occupational hazards to carry out technical transformation and transformation and upgrading. Promote all trade associations to formulate and implement occupational health codes. (The Health and Wellness Committee takes the lead, and the Development and Reform Commission, the Ministry of Science and Technology, the Ministry of Industry and Information Technology, and the State-owned Assets Supervision and Administration Commission of the State Council are responsible according to the division of responsibilities)
3. Improve the technical support system for occupational disease prevention and control, and strengthen the construction of occupational disease prevention and control institutions in accordance with the principle of regional coverage and rational allocation, so as to achieve reasonable layout and sound functions. At least one medical and health institution in a city divided into districts undertakes the diagnosis of occupational diseases within its jurisdiction, and in principle, at least one medical and health institution in a county-level administrative region undertakes the occupational health examination within its jurisdiction. Give full play to the role of various occupational disease prevention and control institutions in occupational health examination, occupational disease diagnosis, treatment and rehabilitation, occupational disease hazard monitoring and evaluation, occupational health risk assessment, etc., and improve the working mechanism of division of labor and cooperation. Strengthen the construction of professional talents and encourage colleges and universities to expand the enrollment scale of occupational health and related majors. Promote the construction of occupational health management team in enterprises and enhance the occupational health management ability of enterprises. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission, the Ministry of Education, the Ministry of Finance and the Ministry of Human Resources and Social Security are responsible according to the division of responsibilities)
4. Strengthen the construction of occupational health supervision system, improve the occupational health supervision and law enforcement team, focus on strengthening grassroots law enforcement forces such as counties (districts) and towns (streets), and strengthen the construction of law enforcement equipment. Strengthen the supervision of employers, and urge employers to effectively implement the main responsibility of occupational disease prevention and control. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission and the Ministry of Finance are responsible according to the division of responsibilities)
5. Take migrant workers’ pneumoconiosis as the breakthrough point, further strengthen the supervision and inspection of occupational disease prevention and control in labor dispatch units, optimize occupational disease diagnosis procedures and service processes, and improve service quality. Strengthen the protection of pneumoconiosis patients who have joined the industrial injury insurance; For those who have not participated in work-related injury insurance, the legitimate rights and interests of medical security shall be guaranteed through medical insurance and medical assistance according to regulations. Strengthen the sharing and utilization of information among departments, and timely exchange information and data on occupational hazards, workers’ occupational health and work-related injury insurance of employers. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission, the Ministry of Civil Affairs, the Ministry of Human Resources and Social Security, and the Medical Insurance Bureau are responsible according to the division of responsibilities)
6. Improve the declaration of occupational disease hazard projects and establish a unified and efficient information management mechanism for supervision and law enforcement. Establish and improve the detection, monitoring and occupational disease reporting network of occupational hazard factors in the workplace. Timely carry out monitoring of occupational disease hazard factors in the workplace and special investigation of occupational diseases, and systematically collect relevant information. Carry out the informatization construction of "Occupational Health in internet plus", establish a big data platform for occupational health and radiation health, and use informatization to improve supervision efficiency. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission and the Ministry of Finance are responsible according to the division of responsibilities)
7. Take the construction of "healthy enterprises" as an important part of the construction of healthy cities, gradually broaden and enrich the scope of occupational health, and actively study the inclusion of new occupational hazards such as work stress and musculoskeletal diseases in the scope of protection. Promote enterprises to fulfill their legal responsibilities and obligations related to occupational disease prevention and control according to law, create a healthy corporate culture, fulfill corporate social responsibilities, and effectively protect the health and well-being of workers. (The Health and Wellness Committee takes the lead, and the Ministry of Human Resources and Social Security, the State-owned Assets Supervision and Administration Commission of the State Council, the All-China Federation of Trade Unions and the All-China Women’s Federation are responsible according to the division of responsibilities)
(10) Health promotion actions for the elderly.
China has the largest elderly population in the world. By the end of 2018, China’s elderly population aged 60 and over was about 249 million, accounting for 17.9% of the total population; The population aged 65 and over is about 167 million, accounting for 11.9% of the total population. The overall health status of the elderly in China is not optimistic. Nearly 180 million elderly people suffer from chronic diseases, and the proportion of people suffering from one or more chronic diseases is as high as 75%. There are about 40 million disabled and partially disabled elderly people. It is of great significance to carry out health promotion actions for the elderly to improve their health level, improve their quality of life and achieve healthy aging.
Action goal:
By 2022 and 2030, the incidence of disability among the elderly aged 65-74 will decrease; The growth rate of senile dementia in people aged 65 and above decreased; The proportion of geriatrics departments in general hospitals above the second level reached 50% and above and 90% and above respectively; The proportion of rehabilitation departments in tertiary Chinese medicine hospitals reached 75% and 90% respectively; The proportion of old-age care institutions providing medical and health services for the elderly in different forms, and the proportion of green channels for medical institutions providing convenient services such as registered medical treatment for the elderly reached 100% respectively; Strengthen the construction of community pension institutions such as community day care centers to provide support for home-based pension; Gradually establish a policy system to support family pension, support adult children and elderly parents to live together, and promote the solid foundation of home community pension services.
Advocate the elderly to know the core information of health; The elderly take part in regular physical examination, often monitor their breathing, pulse, blood pressure and defecation, and receive health guidance from the family doctor team; Encourage and support universities for the elderly, activity centers for the elderly, grassroots associations for the elderly, and qualified social organizations to organize health activities for the elderly; Encourage and support social forces to participate in and set up home care service institutions.
-individuals and families:
1. Improve the nutritional status. Take the initiative to learn the dietary knowledge of the elderly, carefully design meals, choose nutritious foods, ensure adequate food intake, eat enough fish, shrimp, lean meat, eggs, milk, soybeans and bean products, get more sunshine, exercise moderately, consciously prevent nutritional deficiency, and delay muscle attenuation and osteoporosis. The body mass index (BMI) of the elderly should be on the high side of the normal value of the whole population. The emaciated elderly can use various methods to increase their appetite and food intake, eat three meals well and add meals reasonably. Older people with significantly reduced digestive ability should make soft food, with a small amount of meals.
2. Strengthen physical exercise. Choose the exercise mode suitable for your own physique and health, and do physical exercise according to your ability. While paying attention to aerobic exercise, we should pay attention to muscle strength exercise and flexibility exercise, properly exercise balance ability, strengthen skeletal muscle system and prevent falls. During the exercise, it is suggested to adjust the amount of exercise in time according to the physical health.
3. Participate in regular physical examination. Regularly monitor the breathing, pulse, blood pressure, urine and stool, record the abnormal situation in time and see a doctor if necessary. Actively cooperate with the family doctor team to complete the health assessment, physical examination and auxiliary examination, understand the functions of their main organs such as brain, heart, lung, stomach, liver and kidney, and accept the health guidance of the family doctor team.
4. Do a good job in chronic disease management. Elderly people with chronic diseases should establish confidence in overcoming the disease, cooperate with doctors to actively treat them, actively consult doctors about the knowledge and skills of self-management of chronic diseases, and under the guidance of doctors, do a good job in self-management, delay the progress of the disease, reduce complications, learn and use traditional Chinese medicine diet for the elderly, and improve the quality of life.
5. Promote mental health. Understand that old age is a process of life, and calmly face the changes in the body and environment of old age. Exercise more, use more brains, participate in social communication more, delay aging and prevent mental disorders and psychological and behavioral problems through a healthy lifestyle. The elderly and their families should know about diseases such as senile dementia, find suspicious symptoms and check them in professional institutions in time, so as to achieve early detection, early diagnosis and early treatment. Once the elderly are diagnosed with mental illness, their families should pay attention to the care and care of the patients and help them actively follow the treatment and training program. For the elderly with serious cognitive degradation, we should take good care of their diet and daily life to prevent them from getting lost.
6. Pay attention to safe medication. The incidence of comorbidity in the elderly is high, and the ability of drug metabolism, transformation and excretion is reduced, which is prone to adverse drug reactions. If you are sick, seek medical attention in time and take medicine under the guidance of a doctor. Actively monitor drug use, record subjective feelings and adverse reactions after drug use, and give timely feedback to the doctor when returning to the clinic.
7. Pay attention to family support. Advocate family members to learn about the knowledge and skills related to health maintenance of the elderly, take good care of their diet and daily life, care about the psychological, physical and behavioral changes of the elderly, find abnormal situations as early as possible, arrange medical treatment in time, ensure sufficient lighting brightness in the home environment, take anti-skid measures on the ground and keep it dry, and install handrails beside the pool, toilet and bathroom to prevent the elderly from falling.
-society:
1. The whole society pays more attention to and cares for the elderly, builds a community environment of respecting and filial piety for the elderly, encourages universities for the elderly, activity centers for the elderly, grassroots associations for the elderly, qualified social organizations, etc. to publicize mental health knowledge and organize activities beneficial to the body and mind; Training full-time and part-time social workers and psychologists. Introduce social forces to provide psychological counseling, emotional relief, grief comfort and other mental health services for the elderly in need.
2. Support social organizations to provide care and spiritual comfort services for disabled and partially disabled elderly people at home, communities and institutions. Encourage and support social forces to participate in and set up home care services.
3. Encourage and support deep cooperation between scientific research institutions and high-tech enterprises, make full use of information technology means such as Internet, Internet of Things and big data, carry out large-scale cohort studies, study indicators, standards and methods for judging and predicting the health of the elderly, and develop wearable health support technologies and equipment for the elderly.
4. Encourage health service-related enterprises to combine the physical and mental characteristics of the elderly and vigorously carry out diversified services such as health preservation, physical examination, consulting management, physical fitness measurement, physical fitness, sports rehabilitation and health tourism.
-government:
1. To carry out educational activities on fitness, health care, disease prevention and rehabilitation for the elderly. Actively promote traditional Chinese medicine health care methods suitable for the elderly. Strengthen the health emergency skills training of self-help and mutual aid for the elderly. Popularize appropriate technologies for the prevention and treatment of common diseases in the elderly, and carry out intervention and health guidance to prevent falls in the elderly. (The Health and Wellness Committee takes the lead, and the Ministry of Civil Affairs, the Ministry of Culture and Tourism, the General Administration of Sports, and the Bureau of Traditional Chinese Medicine are responsible according to the division of responsibilities)
2. Implement the mental health prevention and intervention plan for the elderly, and provide daily care and psychological support services for poor, empty nest, disabled, demented, family planning special families and elderly people living alone. Strengthen community management and rehabilitation treatment for elderly patients with severe mental disorders, encourage the elderly to actively participate in social activities, and promote their mental health. (The Health and Wellness Committee takes the lead, and the Chinese Medicine Bureau is responsible according to its duties)
3. Establish and improve the health service system for the elderly. Optimize the allocation of medical and health resources for the elderly, encourage the transformation and construction of secondary hospitals in cities, rationally distribute them, and actively develop medical institutions such as hospitals for the elderly, rehabilitation hospitals and nursing homes. Promote the establishment of geriatrics departments in general hospitals above the second level, increase the number of beds for geriatrics, and improve the accessibility of medical and health services for the elderly. (The Development and Reform Commission and the Health and Wellness Commission are responsible according to the division of responsibilities)
4. Strengthen the network function of primary medical and health services, give play to the role of family doctors (teams), and provide comprehensive, continuous, coordinated and standardized basic medical and public health services for the elderly. Establish free health records for the elderly aged 65 and above, and provide free health checkups every year. Provide family doctor contract service for the elderly. To study and formulate the service standards and operational norms for home visits and family beds. (The Ministry of Civil Affairs, the Health and Wellness Commission, the Medical Insurance Bureau and the Chinese Medicine Bureau are responsible for the division of responsibilities)
5. Expand the coverage and service depth of TCM health management services, and provide more TCM health care, disease prevention and other health guidance according to the different physique and health status of the elderly. Promote the cooperation between Chinese medicine hospitals and nursing homes for the aged and rehabilitation institutions, promote the establishment of geriatrics departments in Chinese medicine hospitals above the second level, increase the resources for elderly services and provide health services for the elderly. (The Chinese Medicine Bureau takes the lead, and the Health and Wellness Committee is responsible according to its duties)
6. Improve the policy of combining medical care with nursing care, promote the integrated development of medical and health care and old-age care services, and promote the development of medical and nursing care services with Chinese medicine characteristics. Encourage old-age care institutions to carry out various forms of cooperation with neighboring medical and health institutions, and promote the extension of medical and health services to communities and families. Support social forces to set up non-profit medical and nursing service institutions. (The Health and Wellness Committee takes the lead, and the Ministry of Civil Affairs and the Bureau of Traditional Chinese Medicine are responsible according to the division of responsibilities)
7. Comprehensively promote the basic research of geriatrics and improve the scientific research level of geriatrics in China. Carry out multidisciplinary collaborative diagnosis and treatment, and attach importance to senile syndrome and comprehensive evaluation of the elderly. Vigorously promote the construction of geriatric research centers and innovation bases, promote medical research enterprises to jointly carry out innovative and integrated research, and build a high-level technological innovation and achievement transformation base. (The Ministry of Science and Technology and the Health and Wellness Commission are responsible according to the division of responsibilities)
8. Support institutions of higher learning and vocational colleges to set up geriatrics-related majors or courses, focusing on geriatrics, rehabilitation, nursing, nutrition, psychology and social work, and accelerate the cultivation of compound multi-level talents adapted to modern geriatrics concepts. Geriatrics, rehabilitation and nursing talents will be included in the training plan of health personnel as talents in urgent need and shortage, and professional skills training will be strengthened. (The Ministry of Education and the Health and Wellness Commission are responsible according to the division of responsibilities)
9. Accelerate the guidance on pushing forward the pilot of long-term care insurance system. We will promptly study and improve the standard system of care services, and establish and improve industry norms and institutional mechanisms such as long-term care level identification standards, project connotations, service standards and quality evaluation. (The Medical Insurance Bureau takes the lead, and the Health and Wellness Committee is responsible according to its duties)
10 gradually establish and improve the policy system to support family pension, and support adult children to live with elderly parents. Starting from the actual needs of the elderly, we should strengthen the family pension function, integrate resources from the community level, strengthen the construction of home care service institutions, places and related service teams such as community day care centers, encourage the provision of on-site services for the elderly, and provide support for home care. Carry forward the social fashion of respecting, supporting and helping the elderly. (The Ministry of Civil Affairs takes the lead, and the Ministry of Culture and Tourism and the Health and Wellness Commission are responsible according to the division of responsibilities.)
11. Optimize the living, transportation, medical care and support environment for the elderly, and create a safe, convenient, comfortable and barrier-free livable environment for the elderly. Promote the aging transformation of the elderly community and home, and support the construction of housing suitable for the elderly. (The Ministry of Civil Affairs, the Ministry of Housing and Urban-Rural Development, the Ministry of Transport and the Health and Wellness Commission are responsible for the division of responsibilities)
12. Encourage professionals in professional and technical fields to extend their working life, and formulate special plans for the development and utilization of human resources for the elderly throughout the country to encourage and guide the elderly to make more contributions to society. Give play to the role of mentoring the good conduct of the elderly, and support old party member, old experts, old soldiers, old model workers and veteran cadres to carry out activities of caring for and educating the next generation. Encourage the elderly to participate in voluntary service, prosper the culture of the elderly, and achieve "a sense of worthiness". (The Central Organization Department, the Ministry of Civil Affairs, the Ministry of Human Resources and Social Security, and the Ministry of Veterans are responsible for the division of responsibilities)
(eleven) the prevention and treatment of cardiovascular and cerebrovascular diseases.
Cardiovascular and cerebrovascular diseases are characterized by high morbidity, disability, recurrence and mortality, which bring heavy social and economic burdens. At present, there are 270 million patients with hypertension, 13 million patients with stroke and 11 million patients with coronary heart disease in China. Hypertension, dyslipidemia, diabetes, obesity, smoking, lack of physical activity and unhealthy eating habits are the main risk factors of cardiovascular and cerebrovascular diseases that can be changed. The prevalence rate of hypertension and dyslipidemia in China residents aged 18 and above was 25.2% and 40.4%, both of which showed an upward trend. Interventions on these risk factors can not only prevent or delay the occurrence of cardiovascular and cerebrovascular diseases, but also cooperate with drug treatment to prevent the recurrence of cardiovascular and cerebrovascular diseases.
Action goal:
By 2022 and 2030, the mortality rate of cardiovascular and cerebrovascular diseases will be reduced to 209.7/100,000 and below and 190.7/100,000 and below respectively; The awareness rate of hypertension among residents aged 30 and above is not less than 55% and 65% respectively; The standardized management rate of hypertension patients is not less than 60% and 70% respectively; The treatment rate and control rate of hypertension have been continuously improved; Intravenous thrombolysis technology is carried out in stroke centers of all secondary and above hospitals; The annual blood lipid detection rate of residents aged 35 and above is not less than 27% and 35%; The proportion of township hospitals and community health service centers providing more than 6 kinds of Chinese medicine non-drug therapy reached 100%, and the proportion of village clinics providing more than 4 kinds of Chinese medicine non-drug therapy reached 70% and 80% respectively; Encourage the development of mass emergency rescue training, and increase the proportion of personnel who have obtained training certificates to 1% and above and 3% and above respectively.
Advocate residents to have regular health checkups; Adults aged 18 and above regularly monitor their blood pressure, and people with normal high blood pressure and other high-risk groups often measure their blood pressure; People under 40 years old with normal blood lipids should be tested once every 2 to 5 years, people over 40 years old should be tested at least once a year, and people at high risk of cardiovascular and cerebrovascular diseases should be tested once every 6 months.
-personal:
1. Know your blood pressure. Adults aged 18 and above regularly monitor their blood pressure, pay attention to the changes of blood pressure and control the risk factors of hypertension. Overweight or obesity, high-salt diet, smoking, long-term drinking, long-term mental stress and insufficient physical activity are the high-risk groups of hypertension. It is suggested that people with normal high blood pressure (120 ~ 139 mmHg/80 ~ 89 mmHg) should pay attention to controlling the above risk factors as soon as possible. It is suggested that people with normal blood pressure should measure their blood pressure at least once a year, and high-risk groups should measure their blood pressure frequently and receive health guidance from medical staff.
2. Self-blood pressure management. Hypertension can be diagnosed by measuring systolic blood pressure ≥140mmHg and/or diastolic blood pressure ≥90mmHg three times on the same day without using antihypertensive drugs. Patients with hypertension should learn self-health management, take medicine seriously according to the doctor’s advice, and often measure their blood pressure and make follow-up visits.
3. Pay attention to a reasonable diet. It is suggested that people at high risk of hypertension and patients should pay attention to the intake of dietary salt, the daily intake of salt should not exceed 5g, and abstain from drinking, reduce the intake of foods rich in oil and sugar, and limit the consumption of cooking oil.
4. Exercise according to your ability. It is suggested that the high-risk population of cardiovascular and cerebrovascular diseases (with a past history of cardiovascular and cerebrovascular diseases or abnormal blood pressure and dyslipidemia, or the risk of cardiovascular and cerebrovascular diseases is ≥20% according to the Guidelines for Cardiovascular Risk Assessment and Management issued by the World Health Organization in 10 years) and the exercise form of patients should be determined according to their personal health and physique. Cardiovascular and cerebrovascular risk assessment should be considered, and the exercise limit should be considered in an all-round way, with aerobic endurance exercise involving large muscle groups as the main exercise, such as walking, jogging, swimming, Tai Ji Chuan and so on.
5. Pay attention to and regularly carry out blood lipid testing. People under the age of 40 with normal blood lipids should have their blood lipids tested once every 2 to 5 years. People aged 40 and above should be tested for blood lipids at least once a year. Blood lipids of high-risk groups of cardiovascular and cerebrovascular diseases are tested once every 6 months.
6. Prevent the occurrence of stroke. The increase of stroke incidence and mortality is closely related to the increase of blood pressure. The higher the blood pressure, the higher the risk of stroke. There is a significant correlation between dyslipidemia and the incidence of ischemic stroke. Atrial fibrillation is an important cause of ischemic stroke. Lowering blood pressure, controlling blood lipids and maintaining a healthy weight can reduce the risk of stroke. It is suggested that patients with atrial fibrillation should be treated with anticoagulation according to the doctor’s advice.
7. Learn to master the correct self-help measures and emergency medical guidance in the early stage of cardiovascular and cerebrovascular diseases. The pain parts of acute myocardial infarction (precordial area, posterior sternum, subxiphoid process, left shoulder, etc.) are the same as angina pectoris, but they last for a long time and are severe, and may be accompanied by symptoms such as nausea, vomiting, sweating, etc. Patients should be allowed to stay in bed absolutely, loosen the neckline, and keep quiet and air circulation indoors. Those who have the conditions can take oxygen immediately, take 1 piece of nitroglycerin under the tongue, and call the emergency center immediately. Do not take the bus or help the patient walk to the hospital. Early stroke is characterized by sudden weakness or numbness of one limb, sudden inability to speak clearly or understand others’ speech, sudden rotation and inability to stand, transient visual impairment, black eyes, blurred vision, unbearable headache, gradual aggravation or persistence of symptoms, accompanied by nausea and vomiting. When this happens, the patient should be laid flat, supine, not with a pillow, and his head tilted to one side, so as to keep the patient warm. At the same time, call the emergency number immediately and get to the hospital as quickly as possible. Grasping the golden rescue time window of 4 hours and receiving intravenous thrombolytic therapy can greatly reduce the mortality and disability rate.
-society and government:
1. Encourage and support social organizations such as the Red Cross and medical institutions such as emergency centers to carry out mass emergency rescue training, popularize the knowledge of emergency rescue for the whole people, and enable the public to master the basic knowledge and skills of emergency self-help and mutual rescue such as cardiopulmonary resuscitation. By 2022 and 2030, the number of people who have obtained the first aid training certificate will reach 1% and 3% respectively, and the public welfare training for first aid personnel will be conducted for primary and secondary school teachers and students according to the ratio of 1: 50. Improve the standard of first-aid facilities and equipment in public places, equip schools, institutions, enterprises and institutions, airports, stations, port passenger stations, large shopping malls, cinemas and other crowded places with first-aid medicines, equipment and facilities, and equip them with automated external defibrillator (AED). Every 50,000 people are equipped with an ambulance, which shortens the emergency response time, and the 10-second answering rate of pre-hospital medical emergency institutions is 100%, which improves the departure rate of ambulances within 5 minutes after receiving the report. (The Health and Wellness Committee takes the lead, and the Ministry of Education, the Ministry of Finance, and the China Red Cross Society are responsible for the division of responsibilities.)
2. Fully implement the system of blood pressure measurement at the first diagnosis for people over 35 years old. Primary medical and health institutions provide standardized health management services for patients with essential hypertension among permanent residents aged 35 and above in their jurisdiction. Township hospitals and community health service centers should be equipped with blood lipid testing instruments, expand the coverage of screening intervention for high-risk groups of cardiovascular and cerebrovascular diseases, and carry out opportunistic screening for cardiovascular and cerebrovascular diseases among hospital patients. Increase the equipment and places for detecting hypertension. (The Health and Wellness Committee takes the lead, and the Ministry of Finance is responsible according to the division of responsibilities)
3. Promote the "three highs" (hypertension, hyperglycemia and hyperlipidemia) condominium, carry out risk assessment and intervention guidance for high-risk groups such as overweight and obesity, elevated blood pressure and blood glucose, and dyslipidemia, and do a good job in standardized management of hypertension, diabetes and dyslipidemia. (The Health and Wellness Committee and the Bureau of Traditional Chinese Medicine are responsible for the division of responsibilities)
4. All cities (prefectures) and counties rely on existing resources to build chest pain centers and form a collaborative treatment network for acute chest pain. Continue to promote the construction of hospital stroke centers. Strengthen training, quality control, supervision and assessment, and popularize appropriate technologies. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission is responsible according to the division of responsibilities.)
5. Strengthen the pre-hospital emergency equipment and facilities related to the diagnosis and treatment of stroke and chest pain, and promote the improvement and release of the "first aid map" for stroke and chest pain. We will build a green channel for stroke and chest pain in hospital emergency, realize the interconnection and effective connection between pre-hospital emergency and in-hospital emergency, and improve the efficiency of treatment. Stroke centers in secondary and above hospitals have the ability to carry out intravenous thrombolysis, and stroke screening and prevention base hospitals and stroke centers in tertiary hospitals have the ability to carry out arterial embolectomy. Strengthen the cooperation between stroke center and primary medical and health institutions, and improve the awareness rate and coping ability of thrombolysis knowledge in primary medical and health institutions. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission and the Ministry of Finance are responsible according to the division of responsibilities)
(12) cancer prevention and control actions.
Cancer seriously endangers people’s health. According to the Annual Report of Cancer Registration in China in 2017, there are about 3.8 million new cancer cases and 2.29 million deaths in China every year, and the incidence rate and mortality rate are increasing year by year. With China’s aging population, accelerating industrialization and urbanization, and the widespread prevalence of chronic infection, unhealthy lifestyles, environmental pollution and occupational exposure, the situation of cancer prevention and control in China will remain very severe. International experience shows that taking active prevention, early screening, standardized treatment and other measures has a significant effect on reducing the incidence and mortality of cancer.
Action goal:
By 2022 and 2030, the overall 5-year survival rate of cancer will be no less than 43.3% and 46.6% respectively; The awareness rate of core knowledge of cancer prevention and treatment is not less than 70% and 80% respectively; The early diagnosis rate of key cancer species in high-incidence areas reached 55% and above, and continued to increase; Basically, people at high risk of cancer will regularly participate in anti-cancer physical examination.
-personal:
1. Pay attention to cancer prevention as soon as possible. The occurrence of cancer is a multi-factor, multi-stage, complex and gradual process. It is suggested that everyone learn and master the Core Information and Knowledge Points of Cancer Prevention and Control as soon as possible to actively prevent cancer.
2. Practicing a healthy lifestyle, quitting smoking and limiting alcohol, balancing diet, scientific exercise and feeling comfortable can effectively reduce the occurrence of cancer. For example, quitting smoking can reduce the risk of lung cancer, and a reasonable diet can reduce the occurrence of colon cancer, breast cancer, esophageal cancer, liver cancer and gastric cancer.
3. Reduce cancer-related infections. Cancer is not contagious, but some bacteria (such as Helicobacter pylori) and viruses (such as human papillomavirus, hepatitis virus, EB virus, etc.) closely related to cancer are contagious. By maintaining personal hygiene and healthy lifestyle, vaccination (such as hepatitis virus vaccine and human papillomavirus vaccine) can avoid infection with related bacteria and viruses, thus preventing the occurrence of cancer.
4. Regular anti-cancer physical examination. Standardized anti-cancer physical examination is an important way to find cancer and precancerous lesions. At present, most common cancers can be found early by technical means, for example, gastrointestinal cancer can be found by gastrointestinal endoscopy, cervical cancer can be found by visual observation with acetic acid staining/visual observation with iodine staining (VIA/VILI), cervical exfoliative cytology or high-risk human papillomavirus (HPV)DNA detection, lung cancer can be found by low-dose spiral CT in the chest, and breast cancer can be found by ultrasound combined with molybdenum target. It is suggested that high-risk groups should choose professional physical examination institutions for regular anti-cancer physical examination, and choose appropriate physical examination intervals according to individual age and previous examination results.
5. Pay close attention to cancer danger signals. Such as: abnormal masses in superficial parts of the body; The color of moles and warts on the body surface deepens or increases rapidly in a short period of time; Abnormal feelings such as choking and pain appear in the body; The skin or mucous membrane has a long-lasting ulcer; Persistent dyspepsia and loss of appetite; Changes in stool habits and traits or blood; Persistent hoarseness, dry cough and blood in sputum; Abnormal hearing, nosebleed, headache; Abnormal vaginal bleeding, especially contact bleeding; Painless hematuria, dysuria; Unexplained fever, fatigue and progressive weight loss. It is recommended to seek medical advice in time when the above symptoms appear.
6. receive standardized treatment. Cancer patients should go to regular hospitals for standardized treatment, and don’t believe in folk remedies or false advertisements, so as not to delay the treatment opportunity.
7. Pay attention to rehabilitation. It is necessary to face up to cancer, actively adjust physical immunity, maintain a good psychological state, and achieve long-term stability of the disease. Pain is the most common and main symptom of cancer patients. With the help of doctors, we can actively deal with pain through scientific analgesic methods.
8. Reasonable dietary nutrition. For food intake of cancer patients, please refer to Dietary Guidance for Patients with Malignant Tumors. Maintain a proper daily intake of cereals, bean products, vegetables and fruits. In the case of normal gastrointestinal function, pay attention to the matching of thickness, eat more fish, poultry and eggs appropriately, and reduce the intake of red meat. For patients with gastrointestinal injury, it is recommended to make soft, rotten and fine animal food. When the dietary intake is insufficient during the anti-tumor treatment and rehabilitation period, and the target requirement can not be met after dietary guidance, enteral and parenteral nutrition support therapy can be actively accepted. Do not eat moldy food, and limit the intake of barbecue (fire, charcoal), pickled and fried animal food.
-society and government:
1. For key cancers such as gastric cancer, esophageal cancer, colorectal cancer, lung cancer, cervical cancer and breast cancer with high incidence and mature screening methods and technical schemes, guidelines for screening, early diagnosis and early treatment are formulated. According to the epidemic situation of cancer in this region, all localities have created conditions to generally carry out opportunistic screening of cancer. (The Health and Wellness Committee takes the lead, and the Ministry of Finance is responsible according to its duties)
2. Formulate guidelines for cancer prevention and treatment in the workplace, and carry out regular detection, evaluation and individual protection management of hazardous factors of carcinogenic occupational diseases in the workplace. (The Health and Wellness Committee takes the lead, and the All-China Federation of Trade Unions is responsible according to its responsibilities)
3. Formulate and promote the application of common cancer diagnosis and treatment norms and clinical pathways, innovate the traditional Chinese medicine cancer diagnosis and treatment model combining traditional Chinese medicine with modern technology, and improve the clinical efficacy. Do a good job in patient rehabilitation guidance, pain management, long-term care, nutrition and psychological support to improve the quality of life of cancer patients. Attach importance to the management of patients with advanced cancer and promote the pilot work of hospice care. (The Health and Wellness Committee and the Bureau of Traditional Chinese Medicine take the lead, and the Ministry of Science and Technology and the Ministry of Civil Affairs are responsible for the division of responsibilities)
4 to carry out cancer screening, diagnosis, surgery, chemotherapy, radiotherapy, intervention and other medical and technical personnel training. Promote the application and management of new diagnosis and treatment technologies. Through the project of improving the ability of diagnosis and treatment of difficult diseases, we will strengthen the ability of the central and western regions and grassroots units and improve the homogenization level of cancer prevention and treatment. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission and the Ministry of Finance are responsible according to the division of responsibilities)
5. Promote the complementary linkage and effective connection between the basic medical insurance, serious illness insurance, medical assistance, emergency assistance, commercial health insurance and charity assistance, form a joint force of protection, and effectively reduce the medical burden of cancer patients. (The Ministry of Civil Affairs, the Health and Wellness Commission, the Medical Insurance Bureau and China Banking and Insurance Regulatory Commission are responsible for the division of responsibilities)
6. Establish and improve the clinical comprehensive evaluation system of anticancer drugs, and speed up the review and approval process for anticancer drugs that are urgently needed in clinic. Improve the dynamic adjustment mechanism of medical insurance catalogue, and include eligible anticancer drugs into the medical insurance catalogue according to regulations. (The Ministry of Finance, the Health and Wellness Commission, the Medical Insurance Bureau and the Food and Drug Administration are responsible for the division of responsibilities)
7. Strengthen cancer screening for rural poor people, continue to carry out special treatment for serious diseases of rural poor people, and carry out centralized treatment for key cancers such as esophageal cancer, gastric cancer, colon cancer, rectal cancer, cervical cancer, breast cancer and lung cancer for rural poor people and low-income people. (The Health and Wellness Committee takes the lead, and the Ministry of Civil Affairs, the Medical Insurance Bureau and the the State Council Poverty Alleviation Office are responsible according to the division of responsibilities)
8. Improve the system of death cause monitoring and tumor registration report, carry out death cause monitoring and tumor registration in all counties and districts, and regularly publish national and provincial tumor registration reports. Establish a national cancer big data platform, build a nationwide cancer case registration system, conduct cancer clinical data analysis and research, and provide decision support for cancer diagnosis and treatment. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission is responsible according to its responsibilities)
9 in the national science and technology plan to further strengthen the deployment of scientific and technological innovation for the weak links that need to be solved urgently in the current cancer prevention and treatment. In the major project of scientific and technological innovation 2030, the whole chain deployment of basic frontier research, diagnosis and treatment technology and application demonstration for cancer prevention and treatment will be strengthened. Give full play to the leading role of the National Clinical Medical Research Center and its collaborative network in clinical research, achievement transformation, popularization and application, and continuously improve the overall scientific and technological level of cancer prevention and treatment in China. (The Ministry of Science and Technology, the Health and Wellness Committee, etc. are responsible according to the division of responsibilities)
(thirteen) the prevention and treatment of chronic respiratory diseases.
Chronic respiratory diseases are a series of diseases represented by chronic obstructive pulmonary disease (COPD) and asthma. The prevalence rate of chronic obstructive pulmonary disease (COPD) in people aged 40 and above in China is 13.6%, and the total number of patients is nearly 100 million. Chronic obstructive pulmonary disease (COPD) has the characteristics of high prevalence rate, high disability rate, high mortality rate and high disease burden, with long illness cycle, repeated acute exacerbation and various complications, which seriously affects the prognosis and quality of life of middle-aged and elderly patients. There are more than 30 million asthma patients in China. Because of the long course and recurrent attacks, they miss work and school, which affects the growth and development of children and the quality of life of patients. The most important risk factors of COPD are smoking, indoor and outdoor air pollutants and inhalation of occupational dust and chemicals. The main risk factors of asthma include hereditary susceptibility, exposure to environmental allergens, air pollution and virus infection. By actively controlling related risk factors, the occurrence and development of chronic respiratory diseases can be effectively prevented, and the prognosis and quality of life of patients can be significantly improved.
Action goal:
By 2022 and 2030, the mortality rate of chronic respiratory diseases among people aged 70 and below will be reduced to 9/100,000 or below and 8.1/100,000 or below; The awareness rate of COPD among residents aged 40 and above reached 15% and above and 30% and above respectively. People aged 40 and above or people at high risk of chronic respiratory diseases should have their lung function checked once a year.
-personal:
1. Pay attention to early detection of diseases. Dyspnea, chronic cough and/or expectoration are the most common symptoms of chronic obstructive pulmonary disease (COPD). People over 40 years old, people who have been exposed to risk factors such as long-term smoking, occupational dust or chemical substances, and those who have symptoms such as shortness of breath or dyspnea after exercise, chronic cough and expectoration, and repeated lower respiratory tract infections, it is recommended to have a lung function test once a year to confirm whether they have COPD. Asthma is mainly manifested as recurrent wheezing, shortness of breath, chest tightness or cough, which often occurs or worsens at night and in the early hours of the morning. It is recommended to go to the hospital for diagnosis as soon as possible.
2. Pay attention to the protection of risk factors. Reduce tobacco exposure and smokers should quit smoking as much as possible. Strengthen occupational protection, avoid contact with toxic and harmful gases and chemicals, reduce indoor air pollution caused by the burning of biofuels (wood, animal manure, crop residues, coal, etc.), avoid a lot of oil smoke stimulation, and take protective measures such as going out or wearing masks in severe outdoor air pollution weather. Advocate wet cleaning in the home.
3. Pay attention to prevent colds. Cold is the main cause of acute attack of chronic respiratory diseases such as COPD and asthma. It is suggested that patients with chronic respiratory diseases and high-risk groups such as the elderly should take the initiative to vaccinate influenza vaccine and pneumococcal vaccine.
4. Strengthen lifestyle intervention. It is suggested that patients with asthma and chronic obstructive pulmonary disease should pay attention to dietary nutrition, eat more vegetables and fruits, do moderate physical activities, such as Tai Ji Chuan, Baduanjin, walking, etc., and also do abdominal breathing and breathing exercises, and actively participate in rehabilitation treatment under the guidance of professionals. It is suggested to actively understand the special services of traditional Chinese medicine such as "three-volt stickers" provided by medical institutions.
5. Asthma patients should avoid contact with allergens and various inducing factors. Pet hair and dander are risk factors for the onset and aggravation of asthma. It is suggested that families with asthma patients should avoid keeping pets as much as possible. Breastfeeding can reduce the risk of asthma in infants.
-society and government:
1. Incorporate lung function examination into the routine physical examination of people aged 40 and above. Carry out the first diagnosis and measurement of lung function in high-risk groups, and provide timely referral services for patients with suspected chronic obstructive pulmonary disease. Promote all localities to equip community health service centers and township hospitals with equipment such as lung function testers, and do a good job in training grassroots professionals. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission and the Ministry of Finance are responsible according to the division of responsibilities)
2. Study the health management of patients with chronic obstructive pulmonary disease into the national basic public health service project, implement the grading diagnosis and treatment system, provide screening intervention, diagnosis, treatment, follow-up management, functional rehabilitation and other full-course prevention and management services for high-risk groups and patients with chronic obstructive pulmonary disease, and improve the early diagnosis and treatment rate and standardized management rate of primary chronic obstructive pulmonary disease. (The Health and Wellness Committee takes the lead, and the Ministry of Finance is responsible according to its duties)
3. Efforts should be made to improve the ability and level of prevention and treatment of chronic respiratory diseases at the grass-roots level, and strengthen the provision of relevant diagnosis and treatment equipment (atomizing inhalation facilities, oxygen therapy equipment, non-invasive ventilators, etc.) and long-term treatment management drugs in grass-roots medical institutions. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission and the Ministry of Finance are responsible according to the division of responsibilities)
4. Strengthen scientific and technological research and transformation of achievements, use clinical comprehensive evaluation, encourage relevant enterprise departments to develop and other measures, improve the accessibility of new vaccines, diagnostic techniques and therapeutic drugs, and reduce the economic burden of patients. (The Ministry of Science and Technology, the Health and Wellness Commission and the Medical Insurance Bureau are responsible for the division of responsibilities)
(fourteen) diabetes prevention and control actions.
Diabetes is a common endocrine and metabolic disease. The prevalence of diabetes among people over the age of 18 in China rose rapidly from 4.2% in 2002 to 9.7% in 2012. It is estimated that there are more than 97 million diabetic patients and about 150 million pre-diabetic people in China. Complications of diabetes involve blood vessels, eyes, kidneys, feet and other organs, resulting in high disability and mortality, which seriously affects the health of patients and brings heavy burdens to individuals, families and society. Type 2 diabetes is the most common type of diabetes in China. Obesity is an important risk factor for type 2 diabetes, and appropriate lifestyle intervention can delay or prevent the occurrence of diabetes.
Action goal:
By 2022 and 2030, the awareness rate of diabetes among residents aged 18 and above will reach 50% and above and 60% and above respectively; The standardized management rate of diabetic patients reached 60% and above and 70% and above respectively; Diabetes treatment rate, diabetes control rate and diabetes complications screening rate have been continuously improved.
It is recommended that people aged 40 and above should be tested for fasting blood glucose at least once a year, and people with pre-diabetes should be tested for fasting blood glucose once every 6 months or 2 hours after meals.
-personal:
1. Fully understand the knowledge of diabetes and pay attention to personal blood sugar level. Healthy people began to test fasting blood glucose once a year at the age of 40. Have one of the following factors, that is, the high-risk group of diabetes: overweight and obesity, hypertension, dyslipidemia, family history of diabetes, history of gestational diabetes, and birth history of macrosomia (birth weight ≥4kg). 6.1mmol/L≤ fasting blood glucose (FBG) < 7.0 mmol/L, or 7.8mmol/L≤ 2-hour glucose load (2 hpg) < 11.1 mmol/L, which is also called pre-diabetes, is an extremely high-risk group of diabetes.
2. Pre-diabetic people can reduce the risk of disease through diet control and scientific exercise. It is recommended to test fasting blood glucose or 2 hours after meals once every six months. At the same time, pay close attention to other cardiovascular and cerebrovascular risk factors and give appropriate intervention measures. It is suggested that overweight or obese people should make their body mass index (BMI) reach or approach 24kg/㎡, or lose at least 7% of their weight, reduce the total daily calories by at least 400～500kcal, take less than 30% of the total fatty acid intake, and keep moderate-intensity physical activity at least 150 minutes/week.
3. Diabetic patients should strengthen health management. If there are typical symptoms of diabetes (polydipsia, polyphagia, polyuria and weight loss) and the random blood sugar is ≥11.1mmol/L, or the fasting blood sugar is ≥7.0mmol/L, or the blood sugar is ≥11.1mmol/L after 2 hours of sugar loading, it can be diagnosed as diabetes. It is suggested that diabetic patients should regularly monitor blood sugar and blood lipid, control diet, exercise scientifically, quit smoking and limit alcohol, take drugs according to doctor’s advice and check complications regularly.
4. Pay attention to dietary nutrition. The diet of diabetic patients can refer to "Dietary Guidelines for Diabetes in China", so as to achieve: reasonable diet, quantitative staple food (intake varies from person to person), it is recommended to choose foods with low glycemic index (GI), and whole grains and miscellaneous beans account for one third of the staple food intake; It is suggested that there are vegetables in meals, and low GI fruits should be selected between meals. No more than 4 eggs a week or 1 egg every two days, and the yolk is not discarded; Milk beans are available every day, and a few nuts can be selected for snacks and meals; Pay attention to less oil and salt in cooking; It is recommended to drink boiled water instead of alcohol; Eat regularly and quantitatively, control the eating speed, chew slowly. The proper meal order is to eat vegetables first, then meat, and finally staple food.
5. The scientific movement. Diabetic patients should abide by the appropriate guidance methods of sports to promote health and make necessary adjustments in time. At least five days a week, more than half an hour of moderate exercise every day. The exercises suitable for diabetic patients include walking, swimming, Tai Ji Chuan, square dance and so on. When exercising, it is necessary to prevent hypoglycemia and falls. It is not recommended for elderly patients to take part in strenuous exercise. When blood sugar control is extremely poor and accompanied by acute complications or serious chronic complications, exercise therapy is not suitable.
-society and government:
1. Grassroots medical and health institutions undertaking national public health service projects should provide standardized health management services for patients with type 2 diabetes among permanent residents aged 35 and above within their jurisdiction, and conduct targeted health education for high-risk groups of type 2 diabetes. (The Health and Wellness Committee takes the lead, and the Ministry of Finance is responsible according to its duties)
2. Implement the technical specifications of graded diagnosis and treatment services for diabetes, encourage medical institutions to carry out diet control guidance and exercise to promote health guidance for diabetic patients, and guide patients to carry out self-blood sugar monitoring and health management. (The Health and Wellness Committee takes the lead, and the General Administration of Sport and the Bureau of Traditional Chinese Medicine are responsible according to the division of responsibilities)
3. Promote the standardization of screening for diabetes and its complications at the grass-roots level, and improve the medical staff’s ability of early detection, standardized diagnosis and treatment of diabetes and its complications. Early intervention and treatment of diabetic retinopathy, diabetes with renal damage, diabetic foot and other complications, delay the progress of complications, reduce disability and mortality. (The Health and Wellness Committee takes the lead, and the Ministry of Finance is responsible according to its duties)
4. Relying on the regional national health information platform, promote the "internet plus Public Health" service, make full use of information technology to enrich diabetes health management means, innovate health service mode, and improve management effect. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission and the Ministry of Finance are responsible according to the division of responsibilities)
(fifteen) the prevention and control of infectious diseases and endemic diseases.
In recent years, the overall situation of infectious diseases in China has declined steadily, but the situation of prevention and control is still grim. Sexual transmission has become the main route of transmission of AIDS, and the epidemic situation has gradually spread from people who are susceptible to AIDS risk behaviors to the general population, with a wide range, complex influencing factors and difficult intervention; There are about 28 million patients with chronic hepatitis B, 4.5 million patients with chronic hepatitis C, and about 900,000 new cases of tuberculosis every year. Key parasitic diseases such as echinococcosis still seriously threaten the health of residents in endemic areas. Endemic diseases have a wide epidemic area and a large number of threatened people. 40% of counties have one endemic disease and 22% have more than three endemic diseases. The key areas of endemic diseases are highly coincident with poverty-stricken areas. Among the 832 national poverty-stricken counties in China, 831 counties have iodine deficiency disease, and 584 counties have drinking water-type fluorosis, tea-drinking endemic fluorosis, Kaschin-Beck disease, Keshan disease, etc., resulting in poverty and returning to poverty due to illness. Strengthening the prevention and control of infectious diseases and endemic diseases is an urgent need to safeguard people’s health and an important measure to help the poor.
Action goal:
By 2022 and 2030, the infection rate of AIDS in the whole population will be controlled below 0.15% and below 0.2% respectively; The prevalence rate of hepatitis B virus surface antigen in children under 5 years old was controlled below 1% and 0.5% respectively. The incidence of pulmonary tuberculosis has dropped to below 55/100,000, and it has a continuous downward trend. In the township (town, street) as a unit, the vaccination rate of school-age children’s immunization program remains above 90%; The reporting rate of legal infectious diseases remains above 95%; Eliminate malaria by 2020 and maintain it; Effectively control and eliminate the harm of schistosomiasis by 2022 and eliminate schistosomiasis by 2030; By 2022, the prevalence rate of echinococcosis in more than 70% of the endemic counties will be below 1%, and by 2030, the prevalence rate of echinococcosis in all endemic counties will be below 1%; Continuously eliminate the harm of iodine deficiency by 2020; By 2022, the hazards of coal-burning fluorosis, Kaschin-Beck disease and Keshan disease will be basically eliminated, and the hazards of drinking water-drinking fluorosis, tea-drinking endemic fluorosis and water-borne high iodine will be effectively controlled; By 2030, key endemic diseases will be controlled and eliminated, and endemic diseases will no longer be the key problems endangering people’s health.
Promote responsible and safe sex and encourage the use of condoms; Cover your mouth and nose with your arms or paper towels when coughing or sneezing, and spit correctly and civilly; Fully understand the important role of vaccines in preventing diseases and actively vaccinate them.
-personal:
1. Raise awareness of self-prevention. Take the initiative to understand the harm, prevention knowledge and relevant policies of AIDS, hepatitis B and hepatitis C, resist illegal and criminal acts such as prostitution, gathering people for fornication, taking drugs, avoid and reduce dangerous behaviors that are susceptible to AIDS, hepatitis B and hepatitis C, do not share needles and needles, razors and toothbrushes, be loyal to sexual partners, advocate responsible and safe sexual behavior, and encourage the use of condoms. Actively participate in prevention and control publicity activities, take the initiative to detect after the occurrence of risk behaviors, and do not discriminate against infected people and patients.
2. Fully understand the important role of vaccines in preventing diseases. Vaccination of hepatitis B vaccine is the safest and most effective measure to prevent hepatitis B. Medical staff, people who have frequent contact with blood, staff of nurseries and kindergartens, family members of hepatitis B virus surface antigen carriers, gay men or people who have multiple sexual partners and intravenous drug users are advised to vaccinate hepatitis B vaccine. Babies born to mothers of hepatitis B virus surface antigen carriers are advised to receive combined immunization with hepatitis B immunoglobulin and hepatitis B vaccine within 24 hours of birth (as early as possible) to prevent mother-to-child transmission. Paying attention to the hygiene of diet and drinking water can prevent hepatitis A and hepatitis E virus infection.
3. Develop good hygiene habits. Cover your mouth and nose with your arms or paper towels when coughing or sneezing, and spit correctly and civilly. Cough, expectoration for more than 2 weeks, or suspicious symptoms such as blood in sputum should be treated at designated medical institutions for tuberculosis in time. Tuberculosis patients should follow the doctor’s advice, adhere to the law, the whole process, and take medicine on time, and most of them can be cured after standardized treatment. Appropriate isolation measures should be taken when there are patients with infectious tuberculosis at home. Patients with infectious tuberculosis should try to avoid going to public places, wear masks when going out, and avoid taking closed transportation. It is recommended to wear a medical protective mask when coming into contact with patients with infectious tuberculosis, or when entering or leaving places with high infection risk (such as hospitals and tuberculosis clinics).
4. Children, the elderly and patients with chronic diseases have low immunity and weak resistance, and they are high-risk groups of influenza. It is suggested to vaccinate against influenza under the guidance of doctors before the influenza epidemic season.
5. Breeders should vaccinate dogs and cats with rabies vaccine for animals. When taking dogs out, they should use a dog chain or put a cage mouth on them to prevent them from biting others. After being scratched or bitten by a dog or cat, the wound should be washed immediately, and anti-rabies immunoglobulin (or serum) and rabies vaccine for human use should be injected as soon as possible under the guidance of a doctor.
6. Wash your hands after touching livestock. Do not contact with sick animals and sick birds. Do not process or eat dead livestock or poultry meat that has not passed the health and quarantine inspection. Animal-borne infectious disease areas do not eat raw or undercooked poultry meat, and do not eat wild animals. Found dead livestock should be reported to the animal husbandry department in a timely manner, and properly handled in accordance with the requirements.
7. Pay attention to personal hygiene and do a good job of protection. Residents in hydatid disease epidemic areas should wash their hands before meals, domestic dogs should be regularly deworming, dog feces should be buried or burned for harmless treatment, and the viscera of infected livestock should be buried deeply and not discarded at will to prevent other animals from eating; Slaughterers don’t discard the internal organs of livestock at will, and don’t feed the dogs with fresh internal organs. Residents in schistosomiasis endemic areas should avoid contact with infected water, and fishermen should take protective measures before launching; Residents in endemic areas of liver fluke disease do not eat fish, snails and meat raw or half-eaten, and do not need to feed fish and fertilize with non-harmless feces. Residents in hookworm endemic areas should avoid going barefoot in underwater fields and strengthen protection. Residents in endemic areas of Kala-azar use medicated or long-lasting mosquito nets and install screen doors and screens to reduce the contact between people and birds and prevent them from being bitten.
8. Stay away from disease. It is suggested that residents in Kaschin-Beck disease areas should try to buy commercial grain instead of self-produced grain. It is suggested that residents in Keshan disease area should develop a balanced diet habit, residents in iodine deficiency areas should eat iodized salt, and residents in pastoral areas should drink low-fluorine brick tea. It is suggested that residents in drinking water fluorosis areas should drink qualified water after water improvement and do a good job in maintaining their own pipelines; Residents in coal-burning fluorosis areas should try their best to use clean energy or improve stoves.
-society and government:
1. Mobilize all sectors of society to participate in AIDS prevention and control work, support social groups, enterprises, foundations, relevant organizations and volunteers to carry out AIDS prevention and control propaganda, poverty alleviation and other public welfare activities for infected people, and encourage and support mobilization testing and comprehensive intervention for people who are susceptible to AIDS risk behaviors, and care and assistance for infected people. (The Health and Wellness Committee takes the lead, and the Central Propaganda Department, the Ministry of Civil Affairs, the Ministry of Finance, the Bureau of Traditional Chinese Medicine, the All-China Federation of Trade Unions, the Central Committee of the Communist Youth League, the All-China Women’s Federation, the China Red Cross Society, and the All-China Federation of Industry and Commerce are responsible according to the division of responsibilities.)
2. Implement the full coverage of HIV, HBV and HCV nucleic acid detection in blood stations, implement the full coverage of measures to prevent mother-to-child transmission of AIDS, syphilis and hepatitis B, and implement the rescue policy for infected people. Comprehensively improve the pertinence of AIDS prevention publicity and education, improve the effectiveness of comprehensive intervention, improve the accessibility of testing and consultation and the standardization of follow-up services. (The Health and Wellness Committee takes the lead, and the Central Propaganda Department, the Central Political and Legal Committee, the Central Network Information Office, the Development and Reform Commission, the Ministry of Education, the Ministry of Industry and Information Technology, the Ministry of Public Security, the Ministry of Civil Affairs, the Ministry of Justice, the Ministry of Finance, the Ministry of Transport, the Ministry of Agriculture and Rural Affairs, the Ministry of Culture and Tourism, the General Administration of Customs, the State Administration of Radio, Film and Television, and the Food and Drug Administration are responsible according to the division of responsibilities.)
3. Fully implement various prevention and treatment measures for viral hepatitis, and control the rising trend of death of viral hepatitis and related liver cancer and cirrhosis. Encourage qualified areas to carry out hepatitis B vaccination for high-risk groups, such as medical personnel, personnel who have frequent contact with blood, staff of nurseries and kindergartens, and family members of hepatitis B virus surface antigen carriers, and vaccinate key people who are easy to spread hepatitis A virus, such as food production and operation employees, staff of nurseries and kindergartens, and collective life personnel. (The Health and Wellness Committee takes the lead, and the General Administration of Market Supervision and the Food and Drug Administration are responsible according to their duties)
4. Strengthen the screening of key areas and key groups such as students, the elderly and the poor, strengthen the screening of drug resistance, and find tuberculosis patients in time. Implement standardized treatment of tuberculosis and improve the level of diagnosis and treatment. Strengthen the whole course health management service of tuberculosis patients in primary medical and health institutions. Implement the policy of TB treatment and protection. (The Health and Wellness Committee takes the lead, and the Ministry of Education, the Medical Insurance Bureau and the the State Council Poverty Alleviation Office are responsible according to the division of responsibilities)
5. Continue to carry out influenza surveillance and epidemic judgment, grasp the activity level and epidemic dynamics of influenza virus, and timely release early warning information. Encourage qualified areas to vaccinate the elderly aged 60 and above, children in kindergartens, primary and secondary school students and students in secondary specialized schools for free. Ensure the supply of influenza vaccine. (The Health and Wellness Committee takes the lead, and the Ministry of Education, the Ministry of Industry and Information Technology and the Food and Drug Administration are responsible according to the division of responsibilities)
6 to carry out comprehensive prevention and control of parasitic diseases, strengthen environmental sanitation management, and reduce the infection rate of people in rural parasitic diseases endemic areas. In schistosomiasis endemic areas, we should adhere to the prevention and control strategy of controlling the source of infection, strengthen the key measures of controlling the source of infection, implement the prohibition of grazing in snail environment, promote and build harmless toilets and ship feces containers in schistosomiasis endemic areas, coordinate comprehensive control blocking measures, reduce the area of snails, and strictly control the pollution of livestock and poultry breeding in rivers and lakes in combination with the work of making rivers and lakes long. (The Health and Wellness Committee takes the lead, and the Ministry of Natural Resources, the Ministry of Water Resources, the Ministry of Agriculture and Rural Affairs, and the Forestry and Grass Bureau are responsible according to the division of responsibilities)
7. Improve the dog registration management, strengthen the responsibility constraint on pet owners, and improve the coverage of rabies vaccine injection for animals. In areas where echinococcosis is prevalent, domestic dogs should be kept captive in an all-round way, dogs should be regularly dewormed, and dog feces should be buried deeply and burned harmlessly. To carry out screening of hydatid disease population and give patients medication or surgical treatment. Gradually implement fixed-point slaughter of livestock, strengthen the inspection and quarantine of livestock slaughtered in slaughterhouses (points), and do a good job in the harmless treatment of diseased organs. (The Ministry of Public Security, the Ministry of Housing and Urban-Rural Development, the Ministry of Agriculture and Rural Affairs, and the Health and Wellness Committee are responsible for the division of responsibilities)
8. Complete the construction of water improvement project in areas with high incidence of drinking water fluoride and arsenic poisoning; Those who live in scattered places and have high water improvement costs can be relocated in combination with poverty alleviation. In areas with high incidence of tea-drinking endemic fluorosis, support local governments to take measures such as fixed-point production and financial subsidies to reduce the price of low-fluorine brick tea and promote low-fluorine brick tea. In areas with high incidence of coal-burning fluorosis and arsenic poisoning, clean energy should be promoted where conditions permit, and high-fluorine (arsenic) coal should not be burned, and the masses should be guided to change stoves and stoves and use improved stoves. (The State Ethnic Affairs Commission, the Ministry of Ecology and Environment, the Ministry of Water Resources, the Health and Wellness Commission, the General Administration of Market Supervision, etc. are responsible according to the division of responsibilities)
9. In areas with high incidence of Kaschin-Beck disease, formulate special nutrition and food exchange policies for children aged 2-6 in endemic areas to ensure that children eat food from non-endemic areas. On the basis of respecting the wishes of the masses, the affected villages with new cases will be relocated as a whole. (The Development and Reform Commission, the Ministry of Agriculture and Rural Affairs, the Food and Reserve Bureau and the the State Council Poverty Alleviation Office are responsible for the division of responsibilities)
10. Do a good job in the treatment and assistance of severe patients such as Kaschin-Beck disease and skeletal fluorosis. For patients who meet the conditions of rural poor population, strengthen comprehensive prevention and classified treatment in accordance with the requirements of relevant policies for health poverty alleviation. Assess the disability of patients with Kaschin-Beck disease and skeletal fluorosis, and include those who meet the requirements in the scope of disability protection and minimum living security. (The Health and Wellness Committee takes the lead, and the Ministry of Civil Affairs, the Medical Insurance Bureau, and the the State Council Poverty Alleviation Office are responsible according to the division of responsibilities)
Fourth, safeguard measures
(1) Strengthen organizational leadership. The Healthy China Action Promotion Committee (hereinafter referred to as the Promotion Committee) is responsible for the organization and implementation of the Healthy China Action, coordinating the participation of the government, society and individuals in the Healthy China Action, coordinating the overall work, guiding all localities to study and formulate specific action plans according to local actual conditions, studying and determining the annual work priorities and coordinating their implementation, organizing the monitoring and evaluation of actions, and setting up a special action working group to promote the implementation of relevant tasks. All relevant departments work together and take their respective responsibilities. All provinces (autonomous regions and municipalities) should put the implementation of this action into the important agenda, improve the leadership system and working mechanism, study and formulate specific action plans for major health problems that threaten the health of residents in the region, and organize their implementation in stages and steps to ensure that all work objectives are achieved as scheduled. Promote the integration of health into all policies, consolidate and promote the creation of health towns, promote the construction of healthy cities and villages, and build a number of demonstration cities (villages), carry out the selection of national sports fitness model cities (counties), effectively integrate resources, form a joint effort, and ensure the effectiveness of actions. (The Health and Wellness Committee takes the lead, the Ministry of Education and the General Administration of Sport are responsible according to the division of responsibilities, and the provincial people’s governments are responsible respectively)
(two) to carry out monitoring and evaluation. The monitoring and evaluation work is led by the Promotion Committee as a whole, and each special action working group is responsible for the specific organization and implementation. Under the leadership of the Promotion Committee, the special action working groups have improved the index system and formulated the monitoring and evaluation work plan around the target indicators and action measures put forward by the action. Based on the existing statistical data, improve the monitoring and evaluation system, rely on the Internet and big data, play the role of third-party organizations, and conduct annual monitoring and evaluation on the implementation progress and effects of major advocacy indicators and expected indicators and key tasks. Each special action working group will form a special report on the implementation progress of each special action every year according to the monitoring situation, and the office of the Promotion Committee will play the role of a third-party organization to form an overall monitoring and evaluation report, which will be reported to the State Council and notified to all relevant departments and provincial (autonomous regions and municipalities) party committees and governments with the consent of the Promotion Committee. On the basis of monitoring and evaluation, timely release the monitoring and evaluation report. All provinces (autonomous regions and municipalities) carry out monitoring and evaluation in the region as required. (The Health and Wellness Committee takes the lead, and the Ministry of Finance and the Statistics Bureau are responsible according to the division of responsibilities, and the provincial people’s governments are responsible respectively)
(3) Establish a performance appraisal and evaluation mechanism. Take the implementation of "Healthy China Action" as an important part of the overall assessment and evaluation of building a healthy China, and strengthen the implementation responsibilities of local party committees, governments and relevant departments. Establish a supervision system and carry out special supervision once a year. According to the main indicators and important tasks, formulate assessment methods and strengthen the annual assessment of binding indicators. Establish an assessment accountability mechanism to assess the implementation of all regions, departments and units, and take the assessment results as an important basis for the performance assessment of all regions and relevant departments. The regions and departments with good evaluation results shall be informed of praise and given appropriate rewards in accordance with relevant regulations; For areas and departments that are lagging behind in progress and ineffective in work, timely interview and urge rectification. All relevant responsible departments shall report the work progress to the Promotion Committee every six months. Fully mobilize the enthusiasm of social organizations and enterprises, give play to the role of industry associations, do special investigations, and explore the establishment of a third-party assessment and evaluation mechanism. (The Central Organization Department, the Ministry of Finance, the Health and Wellness Commission, etc. are responsible according to the division of responsibilities, and the provincial people’s governments are responsible respectively)
(4) Improve the support system. Under the leadership of the Promotion Committee, select experts from relevant fields, set up national expert advisory committees, and set up provincial expert advisory committees in all provinces (autonomous regions and municipalities) to provide technical support for the implementation of actions, timely put forward suggestions for action adjustment, and improve relevant guidelines and technical specifications. The medical security system should adhere to the basic principle of insurance, reasonably determine the basic medical insurance treatment standard, and make the level of insurance adapt to the level of economic and social development. Starting with the chronic diseases with clear treatment plan standards and evaluation indicators, we will carry out the per capita payment for special chronic diseases and encourage medical institutions to do a good job in health management. Promote the development of "Internet+medical health" and innovate the service model. Increase government investment, strengthen support and guidance, and ensure that actions are put in place. Relying on social forces, the Healthy China Action Foundation was established according to law to provide support for the implementation of key actions. Encourage financial institutions to innovate products and services, and promote the formation of a diversified guarantee mechanism for funding sources. In view of the key technologies in the implementation of the action, combined with the national major science and technology projects and key research and development plans, we will strengthen scientific and technological research and support various actions; Simultaneously carry out health technology assessment, and constantly enhance the scientific, effective and economic nature of the action. Improve the relevant laws and regulations system, and ensure the implementation of the task and goal of building a healthy China by the rule of law. (The Health and Wellness Commission takes the lead, and the Development and Reform Commission, the Ministry of Science and Technology, the Ministry of Civil Affairs, the Ministry of Finance, the People’s Bank of China, the Medical Insurance Bureau, the China Banking and Insurance Regulatory Commission, and the CSRC are responsible according to the division of responsibilities, and the provincial people’s governments are responsible respectively).
(5) Strengthen publicity and guidance. Set up a special website for Healthy China Action, and vigorously publicize the significance, objectives, tasks and major initiatives of implementing the action and promoting the health of the whole people. All relevant responsible departments should, according to the requirements of this action, compile interpretation materials and literary works that the masses like, and guide the masses to understand and master them in an effective way, so as to promote individuals to practice a healthy lifestyle. Set up health image ambassadors, select a group of "health experts", and play the leading role of image ambassadors and "health experts". Strengthen positive publicity, scientific guidance and typical reports, enhance the general cognition of society and create a good social atmosphere. Attach great importance to the important role of medical and health institutions and medical personnel in the implementation of the action, improve the training, service standards, performance appraisal and other systems, encourage and guide the majority of medical personnel to practice the concept of "great health, great health", and do a good job in health promotion and education. (The Health and Wellness Committee takes the lead, and the Central Propaganda Department, the Central Network Information Office, the State Administration of Radio, Film and Television, the All-China Federation of Trade Unions, the Central Committee of the Communist Youth League, and the All-China Women’s Federation are responsible according to the division of responsibilities)
