As the most populous nation in the world, China has now becoming an emerging ageing society. Shanghai is the first city facing the challenge of ageing demographics. Against this background, a study that employs self-rated health (SRH) assessment system was designed to explore the health status of Shanghai elders, and learn their attitudes toward health issues; as well as to investigate the determinants of SRH among Shanghai elders. Understanding SRH is crucial for finding appropriate solutions that could effectively tackle the increasing eldercare demand. This study adopted a quantitative research strategy. Using a multistage stratified cluster sampling method, we conducted a questionnaire survey in August 2011 in Shanghai, which collected 2001 valid survey responses. SRH assessments were categorized by five levels: very good, fairly good, average, fairly poor, or poor. The respondents’ functional status was evaluated using the Barthel index of activities for daily living. In the data analysis, we used chi-squared test to determine differences in socio-demographic characteristics among various groups. Along with statistics, several logistic regression models were designed to determine the associations between internal influence factors and SRH. Younger age (χ2 = 27.5, p < 0.05), male sex (χ2 = 11.5, p < 0.1), and living in the suburbs (χ2 = 55.1, p < 0.05) were associated with better SRH scores. Higher SRH scores were also linked with health behaviour of the respondents; namely, do not smoke (χ2 = 18.0, p < 0.1), do not drink (χ2 = 18.6, p < 0.1), or engage in regular outdoor activities (χ2 = 69.3, p < 0.05). The respondents with better social support report higher SRH scores than those without. Respondents’ ability to hear (χ2 = 38.7, p < 0.05), speak (χ2 = 16.1, p < 0.05) and see (χ2 = 78.3, p < 0.05) impacted their SRH scores as well. Meanwhile, chronic illness except asthma was a major influence factor in low SRH score. Applying multiple regression models, a series of determinants were analysed to establish the extent to which they contribute to SRH. The impact of these variables on SRH scores were 6.6% from socio-demographic and health risk behaviours, 2.4% from social support, 8.5% from mental health, 20% from physical conditions, and13% from chronic diseases. This is the first study that examines the determinants of SRH among Shanghai elders. Nearly 40% of our study’s respondents reported their health status as “good”. The main determinants of SRH among elders include living condition, health risk behaviour, social support, health status, and the economic status of the neighbourhood.

The increasing trend of Caesarean section (CS) in childbirth has become a global public health challenge. Previous studies have proposed financial intervention strategies for reducing CS rates by limiting caesarean delivery on maternal request (CDMR). This study synthesizes such strategies while evaluating their effectiveness. The sources of data for this study are Cochrane Library, PubMed, EMBASE, and CINAHL. The publication period included in this study is from January 1991 to November 2018. The financial intervention strategies are divide into two categories: healthcare provider interventions and patient interventions. Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) was employed to assess the risk of bias of included studies. The outcome of each study was evaluated with Grades of Recommendation, Assessment, Development and Evaluation (GRADE) through the GRADEpro Guideline Development Tool software. Nine studies were included in this systematic review: five with high certainty evidence (HCE), three with moderate certainty evidence (MCE), and one with low certainty evidence (LCE). Of the nine studies, seven are centered on the effect of provider-side interventions. Three of the HCE studies found that the diagnosis-related group payment system, risk-adjusted capitation, and equalizing fee for both facilities and physicians were effective intervention strategies. One HCE and one MCE study showed that only equalizing facility fees between vaginal and CS deliveries in healthcare service settings had no significant effect on reducing the CS rate. The MCE study showed that case payment had a negative effect on reducing the CS rates. One LCE study revealed that the effect of a global budget system was uncertain, and one HCE and one MCE study focused on combining both provider and patient-side interventions. However, equalizing fees for vaginal and CS deliveries and a co-payment policy for CDMRs failed to reduce the CS rate. The effectiveness of risk-adjusted payment methods appears promising and should be the subject of further research. Financial interventions should consider stakeholders’ characteristics, especially the personal interests of doctors. Finally, high-quality randomized control trials and comparative studies on different financial intervention methods are needed to confirm or refute previous studies’ outcomes.

Background Each nation’s government is searching for a cost-effective health care system. Some nations are developing their health care financing methods through gradual evolution of the existing ones, and others are trying to adopt other nations’ successful schemes as their own financing strategies. Results The Singaporean government seems able to finance its nation’s health care with a very low gross domestic product (GDP) input. Since the implementation of the medical savings accounts schemes (MSAs) in 1984, Singaporean government’s share of the nation’s total health care expenditure dropped from about 50% to 20%. Inspired by Singapore’s success, the Chinese government adopted the Singaporean MSAs model as its health care financing schemes for urban areas. Shanghai was the first large urban centre to implement the MSAs in China. Through the study of the Singapore and Shanghai experiences, this article examines whether it is rational to borrow another nation’s health care financing model, especially when the two societies have very different socioeconomic characteristics. Conclusion However, the MSAs’ success in Singapore did not guarantee its Shanghai success, because health care systems do not work alone. Through study of the MSAs’ experiences in Singapore and Shanghai, this paper examines whether it is rational to borrow another nation’s health care financing model, especially when the two societies have very different socioeconomic characteristics.

China has been a rapid growing economy in recent decades. Part of its economic development engine comes from internal rural-urban migration. The decades-long rural-urban migration is the result of China’s long-lasting uneven development between its urban and rural areas and its income and resource distribution inequality. Rural Anhui is one of the most affected outmigration regions of China. The absence of young and middle-aged villagers changed its natural villages’ demographics. It broke the self-sufficient rural family structure and their traditional lifestyle with no societal infrastructure to replace family support. Meanwhile, it created aging communities—particularly in relatively poorer villages. This study investigates rural elder villagers’ perception of their physical health in the context of rural-urban migration. It explores the reality of the left-behind rural aging population—their real life challenges and regional disparities reflected in their self-rated health status: those who are living in a relatively poorer region (county) tend to have significantly lower self-rated health (SRH) scores than their counterparts in wealthier areas. Women tend to have lower SRH scores than men, and living alone elders tend to perceive their own physical health to be poorer than others. These findings also show that regional economic condition affect individual lives, women are more vulnerable, and healthy personal interaction is an essential element for wellbeing.

The SARS outbreak in Toronto was a public health crisis. It was particularly frightening to the Chinese-Canadians, because of the origin of the deadly disease. The Chinese-Canadian community organizations launched various activities to help the Chinese-Canadians as well as other Asian-Canadian communities to fight against SARS and its social side-effects. From launching the SARS Supporting Line, distributing health promotional material, disseminating SARS related information, paying tribute to frontline health workers, and promoting local business, to fundraising for SARS related research; they played an active role in easing the public's anxiety, especially for the Chinese-Canadians in the great Toronto area. The culturally diverse population brought problems as well as solutions. Ethnic groups have expertise in almost all areas, including people with leadership skills. The Toronto Chinese community's experience in combating SARS is a good example. The Chinese-Canadian community organizations' activities during the SARS outbreak demonstrate that ethnic minority organizations can play an important role in public health, especially in a public health crisis, and beyond. (Promot Educ, 2008; 15 (4): pp. 53-55)

Canada is aging rapidly in recent years. Today, about 17 percent of the Canadian population is 65 or older. Although most seniors are aging at home (93 percent), an increasing number of elders are living in collective dwelling facilities or waiting for a vacant spot in such a community. Knowing the challenge in providing elders with satisfactory services in a multicultural society, we conducted a case study to explore elders’ quality of lives in an elders’ residence in Toronto. As the first such study in Canada, our goal is finding evidences for improving the quality of life of the elders. This project employed a qualitative case study method. Face-to-face interview and focus group discussion were the main data collection methods. The data analysis perspective is quality of life. The residence provides the elders an age appropriate lifestyle and socializing activities. Thus, most of its tenants feel at home and satisfied. However, some ethnic minority members experience communication barriers; and there are unmet service demands that require the support of societal resources. These findings are important for developing strategies to close the gaps. Collective dwelling has positive effects on elders’ general health. More resources are urgently needed for improving the seniors’ quality of lives and their subjective well-being. Elder residents’ communities require vital services such as social workers, basic health care, and a subsidized meal plan.