Food systems and life expectancy with rapid urbanisation in provincial China

Background and Objectives: Health outcomes such as survival, minimal disability and well-being are presumptively dependent on food and ecosystems. An integral measure of the critical urban food system linkages to health problems is needed. Much of the current health change in cities could be attributed to short-comings in food systems which can pose threats to food security and food safety. Health problems have needed a reconceptualisation of present medical and nutritional constructs. Methods and Study Design: The present study is based on a situational analysis of food and the related ecosystems presumptively affected by rapid urbanisation in China. With an ecological information matrix, an Urban Food System Index with ten indicators which could influence food system outcomes and promote health and well-being has been developed. It uses sixteen data sets from the National Bureau of Statistics for all 31 provinces in China. The indicators were Locality, Climate, Biodiversity, Infrastructure, Transport, Population structure, Livelihood, Recreation and Socialisation, Personal security and Communication. The indicators for each province, scored between 1 (severe) and 5 (best), were used to predict life expectancy for China as a whole by multivariable regression analysis. Results: The best model explained 70% of the variance and had significant beta coefficients for population structure (proportion of juveniles) (-0.52, p<0.0001) and livelihood (food expenditure) (0.31, p<0.05). Conclusions: Population characteristics and livelihoods related to food systems can account for much of life expectancy as a health outcome. An index which captured this information is provided and could evaluate concurrently as well as prospectively food system-related health with urbanisation.