The call for “W orking Together to Build a Community of Shared Future for Mankind” requires us to improve people’s health across the globe, while global health development entails a satisfactory answer to a fundamental question: “What is global health?” To promote research, teaching, policymaking, and practice in global health, we summarize the main points on the definition of global health from the Editorial Board Meeting of Global Health Research and Policy, convened in July 2019 in Wuhan, China. The meeting functioned as a platform for free brainstorming, in-depth discussion, and post-meeting synthesizing. Through the meeting, we have reached a consensus that global health can be considered as a general guiding principle, an organizing framework for thinking and action, a new branch of sciences and specialized discipline in the large family of public health and medicine. The word “global” in global health can be subjective or objective, depending on the context and setting. In addition to dual-, multi-country and global, a project or a study conducted at a local area can be global if it (1) is framed with a global perspective, (2) intends to address an issue with global impact, and/or (3) seeks global solutions to an issue, such as frameworks, strategies, policies, laws, and regulations. In this regard, global health is eventually an extension of “international health” by borrowing related knowledge, theories, technologies and methodologies from public health and medicine. Although global health is a concept that will continue to evolve, our conceptualization through group effort provides, to date, a comprehensive understanding. This report helps to inform individuals in the global health community to advance global health science and practice, and recommend to take advantage of the Belt and Road Initiative proposed by China.

Reform of the health care system in urban areas of China has prompted concerns about the utilization of Community Health Centers (CHC). This study examined which of the dominant primary care delivery models, i.e., the public CHC model, the ‘gate-keeper’ CHC model, or the hospital-owned CHC models, was most effective in enhancing access to and quality of care for patients with chronic illness. The case-comparison design was used to study nine health care organizations in Guangzhou, Dongguan, and Shenzhen cities within Guangdong province, China. 560 patients aged 50 or over with hypertension or diabetes who visited either CHCs or hospitals in these three cities were surveyed by using face-to-face interviews. Bivariate analyses were performed to compare quality and value of care indicators among subjects from the three cities. Multivariate analyses were used to assess the association between type of primary care delivery and quality as well as value of chronic care after controlling for patients’ demographic and health status characteristics. Patients from all three cities chose their current health care providers primarily out of concern for quality of care (both provider expertise and adequate medical equipment), patient-centered care, and insurance plan requirement. Compared with patients from Guangzhou, those from Dongguan performed significantly better on most quality and value of care indicators. Most of these indicators remained significantly better even after controlling for patients' demographic and health status characteristics. The Shenzhen model (hospital-owned and -managed CHC) was generally effective in enhancing accessibility and continuity. However, coordination suffered due to seemingly duplicating primary care outpatients at the hospital setting. Significant associations between types of health care facilities and quality of care were also observed such that patients from CHCs were more likely to be satisfied with traveling time and follow-up care by their providers. The study suggested that the Dongguan model (based on insurance mandate and using family practice physicians as ‘gate-keepers’) seemed to work best in terms of improving access and quality for patients with chronic conditions. The study suggested adequately funded and well-organized primary care system can play a gatekeeping role and has the potential to provide a reasonable level of care to patients.

Objectives: The purpose of this paper is to describe the prevalence of depressive symptoms in the Chinese labor force; to explore the relationship between depressive symptoms and socioeconomic status among the Chinese labor force, including both the structural determinants and the intermediary determinants of health inequities; and to identify vulnerable populations who would benefit from intervention measures. Methods: Data were from the China Labor-Force Dynamics Survey (CLDS) 2016. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depressive symptoms. The World Health Organization’s theoretical framework of the social determinants of health was adopted to analyze the relationship between social determinants and depressive symptoms. Results: Of the participants in the research from the Chinese labor force, 17.34% were identified as having depressive symptoms. Depression was significantly related to socioeconomic factors such as hukou status (p < 0.05 in the age < 45 model), education (p < 0.01 in all five models), employment (p < 0.05 in the male model), income (p < 0.05 in all five models), and self-assessed social class position (p < 0.01 in all five models). Intermediary factors were also related to depressive symptoms, such as gender (p < 0.001 in the overall model), age (p < 0.05 in the overall model), marriage (p < 0.05 in the female model), occupational exposure (p < 0.01 in the overall model), exercise (p < 0.05 in all five models), and health insurance (p < 0.05 in the overall model). The results showed that low socioeconomic status was associated with an increased risk of depression and there were some gradient changes in the distribution of depressive symptoms in socioeconomic status. Conclusions: The findings showed that depression symptoms are significantly related to structural determinants and intermediary determinants in China’s labor force. There are some gradient changes in the distribution of depressive symptoms among people of different socioeconomic status. Low socioeconomic status is associated with increased risk of depression. Women, older people, and single and divorced people are the relative vulnerable groups in China’s labor force.

This article shows how the Internet and mobile technologies are being adopted by Chinese hospitals to reduce the difficulties that patients face in obtaining hospital services. It presents the ways in which new technologies reduces the number of queuing patients at the hospital and the overall service time associated with accessing hospital services, while increasing the service volume and number of service providers in China’s health sector. Although the online platform reduces patients’ difficulties in obtaining hospital services, reform efforts should still be made offline to solve the issues that trouble the Chinese health care sector in the long run.