Where is the highest life expectancy in the world?

According to statistics from the World Bank (world      bank), since surpassing Japan in 2013, the population life expectancy of the Hong Kong Special Administrative Region of China ranked first in the world for seven consecutive years. In 2020, the life expectancy of men in Hong Kong reached 82.7 years and women reached 88.1 years.

What is the secret to longevity? After comparing it with 18 high-income countries, on November 10, 2021, the research team of the University of Hong Kong published a paper in "The Lancet - Public Health", analyzing the factors behind the longevity of Hong Kong residents and saying that this is of great significance to the population health of developing and developed regions.

Smoke, or smoke

Let’s first compare the life expectancy of some countries and regions in the world in 2019 before the COVID-19 pandemic:

Hong Kong, China: 84.9 years old; Japan: 84.3 years old; South Korea: 83.3 years old; France: 82.5 years old; United Kingdom: 81.4     year; United States: 78.4 years old; China's entire territory: 77.4 years old; South Africa: 65.3 years old;

The paper points out that taking the UK and the United States as examples, the growth trend of life expectancy had stagnated or decreased as early as before the outbreak of ****. Among them, obesity is one of the important factors, but it can only partially explain the difference in mortality, because about one-third of adults in Hong Kong are obese.

So what is the reason? The paper believes that it is cigarettes.

In 1990, Hong Kong achieved the lowest overall smoking rate among high-income regions. By 2018, relevant smoking rate data showed:

Hong Kong, China: 10.2%; Japan: 18.3%; South Korea: 20.6%; Britain: 16%; United States: 16.3%. According to data released by the Chinese Center for Disease Control and Prevention, the smoking rate of people over 15 in China in 2018 was 26.6%.

For every 100,000 people in high-income areas, male and female residents in Hong Kong have maintained the lowest level since 1979 and 2013 respectively. Among the causes of longevity of male and female residents in Hong Kong, tobacco control accounts for 50.5% and 34.8% respectively.

In contrast, the absolute risk level of smoking death is more than three times that of the Hong Kong Special Administrative Region. Therefore, the paper believes that if the tobacco control measures are further improved, the population life expectancy of these two countries will be significantly improved.

Data show that between 1979 and 2016, 18 high-income countries increased their life expectancy due to the decrease in men's smoking rates, the most obvious in the UK, reaching 3.7 years.

However, compared with Hong Kong, the improvement in the smoking rate of women in 18 countries is not optimistic, which directly led to a 0.4-year decrease in women's life expectancy in these countries in the past 40 years, the highest was the Netherlands, which was 1.26 years.

It is worth mentioning that although the smoking rate in high-income countries such as Norway, Canada and Australia has dropped significantly in recent years, reaching a level comparable to that of Hong Kong, deaths caused by smoking are still far higher than those of Hong Kong, because the current model is traced back to the smoking trend from 20 to 30 years ago.

Hong Kong is one of the earliest places to introduce tobacco control measures in the Western Pacific region. In 1982, the first ban on smoking law in Hong Kong was born, with the scope of bans including indoor places such as theaters and concert halls and public transportation. In 1998 and 2006, Hong Kong revised the law twice to further expand the scope of bans.

In 2007, Hong Kong promulgated a new smoking ban, expanding its scope to streets, karaoke places... and parks, swimming pools, beaches, etc. under the SAR government. Violators can be fined up to HK$5,000.

The paper emphasizes that the impact of smoking on life expectancy is still underestimated worldwide, and Hong Kong's gradual and comprehensive tobacco control measures are worth learning from around the world.

Extended lifespan is still not enough to define "happiness"

The paper shows that over the past 40 years, the growth of life expectancy in Hong Kong's population has shifted from infants and middle-aged people to the elderly, especially among older women.

In terms of diseases, since the 21st century, the increase in life expectancy has been due to the reduction of mortality rates including cerebrovascular diseases, ischemic heart disease, other heart diseases, lung cancer, etc., accounting for 59.5% and 59.2% of the absolute life expectancy growth factors in men and women.

Among them, the reduction in cardiovascular disease mortality among people over the age of 60 is the main factor, explaining the life span advantage of 1.22 years for men and 1.19 years for women. The reduction in cancer mortality rate for women, especially breast cancer, has made an indelible contribution and extended the life span of female residents in Hong Kong by 0.47 years. These are also partly due to the low smoking rate.

Hong Kong's control has also achieved remarkable results in neurological diseases, mental and behavioral disorders, digestive system diseases, diabetes and other endocrine nutritional metabolism diseases. The paper shows that Hong Kong's medical expenditure only accounts for about 5.9% of the local GDP, lower than that of Europe, the United States and other high-income regions in East Asia. In comparison, the United States is 17.1%, the United Kingdom is 9.6%, and Japan is 10.9%.

The decrease in traffic accident rates among male residents in Hong Kong also extends life span by 0.27 years. The paper analyzed that this may be attributed to Hong Kong's perfect public transportation system and the low private car ownership due to high population density.

However, the lifespan advantage of Hong Kong's population is partially offset by the relatively high mortality rates of pneumonia and liver cancer. The high mortality rate of liver cancer can be attributed to the prevalent hepatitis B infection in Hong Kong. The reason for the relatively high mortality rate of pneumonia is not clear, which may be air pollution or the reduction in deaths in other diseases is more obvious, resulting in a relatively high data on pneumonia.

In addition to the reasons for the above analysis, researchers believe that Hong Kong's life expectancy is higher than that of high-income countries, because Hong Kong is just a developed city, and some high-income countries also have rural populations.

In addition, the paper points out that although life expectancy is an important indicator of physical health, the World Health Organization defines health as a state of combination of physical, psychological and social health. Hong Kong has the longest working hours and the lowest housing affordability in the world, and is one of the most inequality in income distribution and the highest population density.

Studies have shown that the life significance of Hong Kong residents’ feedback reports ranks extremely low. The paper believes that maximizing life span is important, but it is obviously not enough to fully define "happiness". In order to comprehensively improve population health, public policies in various regions should also consider healthy life expectancy, mental health and life satisfaction at the same time.

On the evening of November 20, 2021, Pu Qibin, deputy director of the Department of Respiratory Therapy at the First Affiliated Hospital of Zhejiang University School of Medicine, died of ineffective treatment at the age of 47.

The official Weibo account of "Zhejiang University First Hospital" published a message today to commemorate: A shining star fell in the First Affiliated Hospital of Zhejiang University School of Medicine, and we have lost the best respiratory therapists, the most dedicated and responsible doctors, the most amiable teachers and the most sincere and humble colleagues.

The article "Zhejiang University First Hospital" reads: During the period when Pu Qibin was hospitalized for treatment, the hospital attached great importance to it, organized many consultations between domestic and foreign experts, and dispatched elite soldiers and generals of the hospital to organize rescue. However, the condition was critical and unable to make up for the situation.

The hospital did not disclose what disease Pu Qibin was suffering from.

One of the best respiratory therapists in China

Public information shows that Pu Qibin has been engaged in respiratory therapy for more than 20 years and is proficient in respiratory therapy-related technologies such as mechanical ventilation and airway management. He is a member of the respiratory therapy group of the 8th Committee of the Respiratory Disease Branch of the Chinese Medical Association, an editor and certified tutor of the textbook of the advanced mechanical ventilation training class, and a member of the respiratory therapy group of the Critical Disease Committee of the Chinese Pathophysiology Society.

Respiratory therapy is an emerging discipline developed in the field of critical care medicine. As the earliest hospital in China to independently set up a respiratory therapy system, Zhejiang University First Hospital established the respiratory therapy department in 2009. Pu Qibin is the founder of the team and one of the leading figures in respiratory therapy in Zhejiang Province.

When Pu Qibin started working in 1994, the profession of respiratory therapist had just entered China, and colleges and universities had not yet opened related majors. After being admitted to the hospital, he changed his professional development direction and became a respiratory therapist.

Respiratory therapists need to have a strong theoretical foundation and rich clinical experience, and be able to understand the patient's physical signs from clinical monitoring data as soon as possible. At the same time, based on pathological and physiological characteristics, they provide various clinical operation techniques such as respiratory support therapy and airway management for patients with respiratory insufficiency.

At the beginning, Pu Qibin and his team focused on the treatment of critically ill patients in the intensive care unit. With the development of the discipline, when each department encounters critically ill patients who need respiratory treatment, the respiratory treatment department will actively intervene.

According to relevant academic articles published by Pu Qibin, the disease fields he has studied over the past 20 years include acute respiratory failure, heart failure and various severe pneumonia. "We need to participate in the management of ventilator, artificial airway management, implementation and evaluation of oxygen therapy, tracheal intubation, tracheotomy, etc.," Pu Qibin once told a reporter from Zhejiang Daily.

At the same time, because it is directly involved in respiratory management, respiratory therapists are a high-risk occupation. For many sudden infectious diseases, the respiratory tract is the main transmission route. Pu Qibin has participated in the treatment of sars, severe influenza A, h7n9 avian influenza, and critically ill patients many times, and is recognized as one of the best respiratory therapists in China:

In 2003, Sars, Pu Qibin entered the Hangzhou isolation ward to participate in treatment and was awarded the title of "Advanced Worker in Fighting SARS" of Zhejiang University that year.

In 2009, as a member of the expert group, Pu Qibin rushed to Yiwu to participate in the treatment of the first critically ill patient in Zhejiang Province. In the same year, he was appointed by the hospital to the Beilun Branch and successfully treated critically ill women with influenza A.

During the 2013-2018 bird flu, Pu Qibin participated in the treatment of all critically ill patients with avian influenza in the First Hospital of Zhejiang University.

"The target organs of these diseases are lungs, and patients are prone to respiratory failure, and what they do is respiratory treatment." Pu Qibin once publicly stated that in 2003, he worked for less than 10 years and did not discuss with his family, so he took the initiative to go to the front line.

During the epidemic, he led 6 respiratory therapists to stay at his post. According to the official report of Zhejiang University First Hospital, since the first critically ill patient admitted to Zhijiang Hospital District ICU, Pu Qibin has participated in the daily multidisciplinary consultation for critically ill patients.

What impressed him most was a 39-year-old critically ill patient. At that time, the patient's oxygenation index was below 100mmhg when the worst was. This index was less than 150mmhg, which meant that respiratory function was seriously damaged.

"He may have to be intubated in many hospitals." However, intubation is traumatic. After multidisciplinary consultation, the treatment team believed that the patient's condition could be continued to be observed, and the respiratory support and treatment drugs were adjusted through transnasal high-flow oxygen therapy. After two days, the patient's condition improved significantly and he was eventually cured and discharged from the hospital.

With the clinical accumulation over the past decade and combined with the characteristics of **** patients, Pu Qibin and the treatment team proposed the "**** Patient Respiratory Support Strategy: Zhejiang University First Hospital Plan", which provides valuable experience for respiratory treatment of new coronavirus patients across the country.

Go back to the hospital to see the patient, otherwise you will be worried

Upon learning about Pu Qibin's death, many of his relatives, friends, patients and family members posted a message to express their condolences.

Ge Huiqing, director of the respiratory therapy department of Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine, told Qianjiang Evening News that whenever they had a party and asked Pu Qibin where he was going to go back, he would always say, "Go back to the hospital and go see the patient first." Otherwise, he would be worried, which has become a habit of him.

According to Zhejiang University First Hospital, colleagues familiar with Pu Qibin know that there is always a notebook in his work clothes, and the replacement frequency is very high. It records the changes in the patient's condition in real time, analyzes the causes, constantly explores and explores difficult problems, and proposes solutions.

Doctors who have listened to his lectures will also benefit greatly from the vividness and practicality of the case content and clinical combination of the clinical content mentioned by Pu Qibin.

In addition to caring about the changes in the patient's condition, Pu Qibin also attaches particular importance to the patient's psychological dynamics. During the treatment of "influenza A", he found that an extubated patient had difficulty falling asleep at night. He realized that this was not good for recovery and may have complications. He immediately patiently explained the patient's condition and family's condition, and stayed by the patient to soothe his emotions until he fell asleep peacefully.

Pu Qibin once publicly stated that he loves his job very much. "In medical work, we must be 'people-oriented'. Saving a life is saving a family, so I am willing to invest all my enthusiasm and intelligence in this job."

Nucleic acid testing in many places has reduced prices

Since November, many places across the country have successively issued notices of lowering the cost of nucleic acid testing. According to the Health Times, as of November 23, seven provinces (regions) have lowered the price of nucleic acid testing. Overall, the maximum price limit for nucleic acid single sample testing in many places has been reduced to 40 yuan; the price of mixed testing is mostly 8-10 yuan per time.

The community transmission of this round of epidemic in Dalian is basically blocked

On November 23, Dalian City, Liaoning Province held a press conference on epidemic prevention and control work. Zhao Zuowei, deputy secretary-general of the Dalian Municipal Government and director of the Health Commission, said that at present, the epidemic in Dalian has been controlled. Except for the close contacts and control personnel in the centralized medical observation site, no cases at the social level have been detected since the 19th, and community transmission has been basically blocked. It is reported that as of 24:00 on November 22, in this round of epidemic, Dalian has detected a total of 339 positive infections, including 301 confirmed cases and 38 asymptomatic infections.

A hospital in Jilin sets up free screening for early cancer

Recently, the Health Examination Center of Jilin Provincial Cancer Hospital launched a new measure for people-friendly services, and determined that every Wednesday is the "Free Early Cancer Screening Open Day", which is a permanent population aged 45 to 74 and a person without a history of tumors. It carries out questionnaire surveys on high-risk factors for tumors, biological testing, assessment of high-risk factors for early cancer, and popular science education and other services.
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