116 SOCIAL SCIENTIST TABLE II CAUSES OF DEATH IN SHANGHAI AND IN NEW YORK CITY Shanghai* New York City** White Non-white Cancer 25 23 18 Stroke 19 7 - 8 Heart disease 12 45 28 All others 44 25 46 Total 100 100 100 NOTES: *Data for January through June 1972. **Datafor 1970. Health statistics from China's rural areas are more difficult to obtain but those which have been made available show remarkable improvement; for example, Jutung county of Kiangsu province has shown a fall in infant mortality rate from over 200 per thousand live births before 1949 to 33.9 per thousand in 1973. This figure compares favourably with those of rural areas in countries far wealtheir than China.2 The change in health status reflected by the observations of visitors and the limited statistics are all the more remarkable when one considers the size of China's population. Not only is it by far the world's largest (only that of India even approaches it) but the population is distributed very unevenly. The population is shifted very much toward the east, with very dense concentrations in the basins of the three great river systems of eastern China. Much of the mountain and desert regions of western China are almost uninhabited. The four least densely populated provinces (Inner Mongolia, Sinkiang, Tsinghai, and Tibet) include just over half of the area of the country but less than four per cent of the population. Both the resulting sparseness and denseness of the population lead to problems in health care delivery. Even more important from the point of view of health care, some 80 per cent of China's people live in the countryside; four out of every five are required to grow food, from a very limited amount of cultivable land, using labour-intensive methods. Finally, China remains a poor society. The concept of 'gross national product per capita' of course has limitations in the description of a country's wealth or even of the income of its people but is one of the few measures available. China^s GNP in 1975 has been estimated at about $350 per capita. An understanding of how this relatively poor country, with its enormous, unevenly distributed population, has organized its health care system and indeed its entire society in order to arrive at its current health picture may in our view provide some valuable insights into the whole of China's developmental experience over the last two decades, and may provide some lessons for other countries in comparable stages of development.