A Shanghai Expat Doctor on Health Risks in Shanghai

Shanghai Living

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As a doctor, I would strongly advise you to reconsider carefully before getting up in the morning.

The risks of daily life are greater than most of us realize. The Grim Reaper claims 1 in 800 forty-year-old men annually. Probably few of them were aware that simply minding their own business at the age of forty is nearly as dangerous as hang-gliding (1 in 500 hang-gliding enthusiasts disappear into the eternal void every year).

Yet people always seem to worry far more about the one in a million chance. Some things loom large in the imagination, and scare-stories about exotic diseases run rampant. For instance, people regularly ask me if they should be immunized against Japanese encephalitis. If you are living in Shanghai, the risk of acquiring this disease is so small that travelling to our clinic in a taxi is almost certainly more dangerous–especially when you remember that three return trips are needed for the three shots.

Another slightly over-hyped risk among expatriates in China is TB. Fortunately, this does not spread very easily from one person to another. I personally consider myself to enjoy an almost vanishingly small risk of acquiring the disease, even though I meet far more people with coughs than the average expat. By all means have a skin test for TB –especially if you have a local maid with a chronic cough and you have never been immunized. However, try to avoid “routine” chest x-rays.

Exotic infections kill very few tourists and expatriates. In one study of 2,500 deaths of American travellers of all ages while abroad, half were from heart attacks or strokes, and a quarter from injuries or accidents (especially road traffic accidents), of which a substantial number were alcohol-related. Only 1% of the deaths were from infections — of these, malaria eclispes all others in importance. So make sure you belt up in a taxi, even at the risk of hurting the driver’s feelings (local taxi drivers seem to take this as an insult to their driving skills).

The biggest long-term health risks come from inside ourselves, arising from what we inherit. Look in your family history for clues about your own personal risk profile. An interested doctor may be able to help you take evasive action. However, excessive preoccupation with risks to health has itself been shown to shorten life expectancy.

So, don’t worry and be happy…after checking with your doctor.

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