NUR3101: Depression in China and Primary Healthcare Strategies
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This report delves into the critical issue of depression in China, examining the role of primary healthcare in addressing this growing concern. It analyzes the social determinants of health, such as unemployment, low income, and lack of education, which significantly contribute to depression among the Chinese population. The report highlights the importance of nurses and primary healthcare facilities in raising awareness, providing support, and implementing strategies to combat depression. It also explores the epidemiological factors associated with depression management and emphasizes the need for cultural competence in healthcare to ensure effective and equitable treatment. The report concludes by stressing the need for strengthened primary healthcare systems, improved employment opportunities, and poverty reduction to enhance the mental well-being of the Chinese population.
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Running Head: Depression in Chinese People
Depression in Chinese People
Report
System04104
10/5/2019
Depression in Chinese People
Report
System04104
10/5/2019
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Depression in Chinese People
1
Introduction
China is the fastest growing economy in the world and one of the biggest economies
in the Asian countries. With the growing population and strengthen the economy of the
country, China has also strengthened its primary healthcare system. Apart from this, China is
facing some key challenges in the structural characteristics in the healthcare system because
of its inappropriate policies, lack of preparedness to provide quality care, and poor quality of
healthcare services. Depression is one of the major issues in Chinese people and the role of
primary healthcare and nurses is so important to provide preventive care to the people and
make them aware of the symptoms of depression. This report analyses the role of primary
healthcare in China and describes the role of social determinants of health in depression. The
report also helps to analyse the role of primary healthcare nurses to avoid depression in
people and their role to reduce the number of cases of depressive disorders in the country.
The culture and environment have also some significant role in the health and wellbeing of
people, which is described in this report.
Primary Health Care and Its Role in Controlling the Depressive Disorder in China
The role of WHO and UNICEF is also noticeable here because these organisations
provide guidance and road map to every country to control depression in the country and
China is one of these countries. According to WHO, more than 300 million people are
suffering from depression and more than 800,000 people died every year because of suicide
that is caused because of depression and mental illness. It is also noticeable that according to
WHO, suicide is the second leading cause of death in the world and most of the suicide cases
are the result of depression (Paine & Sandage, 2017). To avoid depression and suicide
attempts WHO forces the countries and assist them to make strategies to strengthen the
service care facilities at the primary healthcare centres and focus on accessibility, availability,
and affordability of services for people who need it. However, the participation of nurses and
community in promoting healthcare awareness is also crucial and the role of technology in it
has a great impact. The country can also make collaboration with the private organisations to
conduct awareness program to avoid depression in people. However, the intention of WHO
that people will get prompt response from the healthcare facilities and access quality
healthcare all over the world at very affordable cost and convenience.
1
Introduction
China is the fastest growing economy in the world and one of the biggest economies
in the Asian countries. With the growing population and strengthen the economy of the
country, China has also strengthened its primary healthcare system. Apart from this, China is
facing some key challenges in the structural characteristics in the healthcare system because
of its inappropriate policies, lack of preparedness to provide quality care, and poor quality of
healthcare services. Depression is one of the major issues in Chinese people and the role of
primary healthcare and nurses is so important to provide preventive care to the people and
make them aware of the symptoms of depression. This report analyses the role of primary
healthcare in China and describes the role of social determinants of health in depression. The
report also helps to analyse the role of primary healthcare nurses to avoid depression in
people and their role to reduce the number of cases of depressive disorders in the country.
The culture and environment have also some significant role in the health and wellbeing of
people, which is described in this report.
Primary Health Care and Its Role in Controlling the Depressive Disorder in China
The role of WHO and UNICEF is also noticeable here because these organisations
provide guidance and road map to every country to control depression in the country and
China is one of these countries. According to WHO, more than 300 million people are
suffering from depression and more than 800,000 people died every year because of suicide
that is caused because of depression and mental illness. It is also noticeable that according to
WHO, suicide is the second leading cause of death in the world and most of the suicide cases
are the result of depression (Paine & Sandage, 2017). To avoid depression and suicide
attempts WHO forces the countries and assist them to make strategies to strengthen the
service care facilities at the primary healthcare centres and focus on accessibility, availability,
and affordability of services for people who need it. However, the participation of nurses and
community in promoting healthcare awareness is also crucial and the role of technology in it
has a great impact. The country can also make collaboration with the private organisations to
conduct awareness program to avoid depression in people. However, the intention of WHO
that people will get prompt response from the healthcare facilities and access quality
healthcare all over the world at very affordable cost and convenience.

Depression in Chinese People
2
Social Determinants of Health
Social determinants are those factors, which are directly related to the health issues of people.
There are various types of factor, which are responsible for depression among people while
some of them are crucial for preventing depression. There are large numbers of people in
China are suffering from depression and some of the major causes are unemployment,
poverty, low income of people, and lack of education. These factors are generally considered
as the social determinants of health and plays a crucial role in analyse and understand the
health issue in the population.
Unemployment is the major causes of depression in China. According to a report, more than
30% of people in China are facing issues related to unemployment or low income. In such a
scenario, the mental stress in unemployed people is very high (Meng, Xu, He, Zhang, & Lin,
2017). More than 60% of people who are facing unemployment are suffering from any
mental health issues such as stress, anxiety, depression, and other mental health issues.
However, the awareness of people about a mental health issue, such as depression is so
crucial but there is no significant step taken by the government to educate people about its
symptoms. The mental stress of earning money and very cheap labour cost in China are some
of the major causes of unemployment that further leads to depression among people (Wang,
Liu, Xue, Yao, Liu, & Helbich, 2019).
The second major issue is related to the low income of people. Generally, people who live in
provincials of China are struggling to earn sufficient amount of money for running their lives.
The low-income people cannot afford the cost of primary health care in China and even the
medicines and drugs are not available at low cost in the country. As per research, it has been
found that the impact of chronicle disease in low-income group of people was highest in last
two decades. Therefore, it is not easy for people to afford the cost of mental health illness
such as depression. However, the large population of the country is also a burden to handle
the pressure of depression on the large numbers of unemployed and low-income people
(Alduraidi & Waters, 2018).
According to a survey conducted by a non-government survey, more than 6% of
Chinese adults are suffering from major depressive disorder while among them 30% consume
alcohol products to overcome their stress or depression. However, education is another factor
in depression in China because it has been seen that most of the cases related to depression
have been found in the rural areas where people do not have better facilities to get education,
2
Social Determinants of Health
Social determinants are those factors, which are directly related to the health issues of people.
There are various types of factor, which are responsible for depression among people while
some of them are crucial for preventing depression. There are large numbers of people in
China are suffering from depression and some of the major causes are unemployment,
poverty, low income of people, and lack of education. These factors are generally considered
as the social determinants of health and plays a crucial role in analyse and understand the
health issue in the population.
Unemployment is the major causes of depression in China. According to a report, more than
30% of people in China are facing issues related to unemployment or low income. In such a
scenario, the mental stress in unemployed people is very high (Meng, Xu, He, Zhang, & Lin,
2017). More than 60% of people who are facing unemployment are suffering from any
mental health issues such as stress, anxiety, depression, and other mental health issues.
However, the awareness of people about a mental health issue, such as depression is so
crucial but there is no significant step taken by the government to educate people about its
symptoms. The mental stress of earning money and very cheap labour cost in China are some
of the major causes of unemployment that further leads to depression among people (Wang,
Liu, Xue, Yao, Liu, & Helbich, 2019).
The second major issue is related to the low income of people. Generally, people who live in
provincials of China are struggling to earn sufficient amount of money for running their lives.
The low-income people cannot afford the cost of primary health care in China and even the
medicines and drugs are not available at low cost in the country. As per research, it has been
found that the impact of chronicle disease in low-income group of people was highest in last
two decades. Therefore, it is not easy for people to afford the cost of mental health illness
such as depression. However, the large population of the country is also a burden to handle
the pressure of depression on the large numbers of unemployed and low-income people
(Alduraidi & Waters, 2018).
According to a survey conducted by a non-government survey, more than 6% of
Chinese adults are suffering from major depressive disorder while among them 30% consume
alcohol products to overcome their stress or depression. However, education is another factor
in depression in China because it has been seen that most of the cases related to depression
have been found in the rural areas where people do not have better facilities to get education,

Depression in Chinese People
3
which is directly related with the employment and job opportunities (Bahia, Kupfer,
Momesso, Cabral, Tschiedel, Puñales, & Tura, 2017). Education can also play a significant
role in providing better healthcare facilities for mental health patients. It has been researched
that only 17000 certified psychiatrists are available in the country. It means China has one
psychiatrist for every 83,000 people. However, education can improve these numbers and
that will further help the country to prevent cases of depression. Education definitely helps
the country to improve the situation and prevent depression to increase with the current
growing speed (Assari, 2017).
The modern world looks the mental health issues as social justice or human right
issue. That is why the entire world relates the mental health issues with the social
environment and other cultural factors that are related to the mental health issues (Kleyman,
& Hazel, 2019). It has been found that without caring about the economic, social, and cultural
factors one cannot prevent the depression in the country. It is really necessary for the country
to care about social justice and equality while providing healthcare facilities to the people
who are suffering from mental health illness. It has been found that there are certain
restrictions on the people in China while accessing the resources or living their life. It is
directly related to the mental health conditions of people. China needs to provide a wide
range of freedom to its people to live a good life without any restrictions on religious or
social aspects. For example, there are very few Muslim people are living in the country but
they are facing strict restrictions from the Chinese government. This will lead to poor mental
health conditions of people and causes depression (Tyler, Boeckmann, Smith, & Huo, 2019).
Epidemiological factors associated with management of Depression
The proper management and prevention of depression in the country depend on
various factors such as increasing awareness about the disease, improving the economic and
physical wellbeing of people, identification of risk factors that are involved to raise the issue
related to depression in people and detection of early-stage of depression in people. The role
of nurses is so crucial in epidemiological factors in managing depression in people. The
government ask the nurses and healthcare practitioners to spread awareness among people
and provide counselling to those people who are suffering from mental health illness (Ding,
Yu, Vinturache, Gu, & Lu, 2018). The healthcare facilities can be provided to people who
3
which is directly related with the employment and job opportunities (Bahia, Kupfer,
Momesso, Cabral, Tschiedel, Puñales, & Tura, 2017). Education can also play a significant
role in providing better healthcare facilities for mental health patients. It has been researched
that only 17000 certified psychiatrists are available in the country. It means China has one
psychiatrist for every 83,000 people. However, education can improve these numbers and
that will further help the country to prevent cases of depression. Education definitely helps
the country to improve the situation and prevent depression to increase with the current
growing speed (Assari, 2017).
The modern world looks the mental health issues as social justice or human right
issue. That is why the entire world relates the mental health issues with the social
environment and other cultural factors that are related to the mental health issues (Kleyman,
& Hazel, 2019). It has been found that without caring about the economic, social, and cultural
factors one cannot prevent the depression in the country. It is really necessary for the country
to care about social justice and equality while providing healthcare facilities to the people
who are suffering from mental health illness. It has been found that there are certain
restrictions on the people in China while accessing the resources or living their life. It is
directly related to the mental health conditions of people. China needs to provide a wide
range of freedom to its people to live a good life without any restrictions on religious or
social aspects. For example, there are very few Muslim people are living in the country but
they are facing strict restrictions from the Chinese government. This will lead to poor mental
health conditions of people and causes depression (Tyler, Boeckmann, Smith, & Huo, 2019).
Epidemiological factors associated with management of Depression
The proper management and prevention of depression in the country depend on
various factors such as increasing awareness about the disease, improving the economic and
physical wellbeing of people, identification of risk factors that are involved to raise the issue
related to depression in people and detection of early-stage of depression in people. The role
of nurses is so crucial in epidemiological factors in managing depression in people. The
government ask the nurses and healthcare practitioners to spread awareness among people
and provide counselling to those people who are suffering from mental health illness (Ding,
Yu, Vinturache, Gu, & Lu, 2018). The healthcare facilities can be provided to people who
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Depression in Chinese People
4
need it without any cultural, social, economic, or religious biases. Apart from this, the
Chinese government wants to educate and aware people, so they can contribute in the
healthcare policies; programs of the government and ensure that depression can be prevented
in the country to spread further. The government also focuses on to control the unnecessary
activities of a depression patient such as alcoholism, smoking, drugs, or consumption of
tobacco products, so they can avoid depression in the country (Wang, Pang, Jiang, Guo,
Chen, Wang, & Jiao, 2016).
Role of Primary Health Care Nurses in Preventing Depression in Chinese People
The major focus of the Chinese government is on those provinces, which are attached
to the rural population where people are facing extreme challenges of depression and other
mental health issues. The government is also trying to employ a large number of healthcare
practitioners, psychiatrists, and nurses in those areas where a large population is suffering
from depression. Apart from this, the government set the roles and responsibilities of nurses
that how they can meet every people in the country to ensure the prevention and care of
people who may victim of the depression in future (Ruiz, Hu, Martikainen, & Bobak, 2019).
Nurses can play a crucial role in the prevention of depression among people as they can
provide assistance and support to the people and suggest them how they can avoid
depression. Nurses in the primary sector have really a great role in the prevention of
depression because it has been seen that most of the people do not have any idea about the
symptoms of depression. In such a scenario, the nurses can provide assistance to the people
and provide all the necessary care and treatment to the people through primary healthcare
services in the country (Everingham, 2018).
Conclusion
In conclusion, depression is a serious concern in China and it is growing with rapid
speed. To ensure the healthy wellbeing and good mental conditions of people, it is necessary
for the Chinese government to strengthen the capacity of primary healthcare and give
responsibility to the nurses to interact with the people who have the potential threat of
depression or suffering from it. The availability, accessibility, and affordability of healthcare
4
need it without any cultural, social, economic, or religious biases. Apart from this, the
Chinese government wants to educate and aware people, so they can contribute in the
healthcare policies; programs of the government and ensure that depression can be prevented
in the country to spread further. The government also focuses on to control the unnecessary
activities of a depression patient such as alcoholism, smoking, drugs, or consumption of
tobacco products, so they can avoid depression in the country (Wang, Pang, Jiang, Guo,
Chen, Wang, & Jiao, 2016).
Role of Primary Health Care Nurses in Preventing Depression in Chinese People
The major focus of the Chinese government is on those provinces, which are attached
to the rural population where people are facing extreme challenges of depression and other
mental health issues. The government is also trying to employ a large number of healthcare
practitioners, psychiatrists, and nurses in those areas where a large population is suffering
from depression. Apart from this, the government set the roles and responsibilities of nurses
that how they can meet every people in the country to ensure the prevention and care of
people who may victim of the depression in future (Ruiz, Hu, Martikainen, & Bobak, 2019).
Nurses can play a crucial role in the prevention of depression among people as they can
provide assistance and support to the people and suggest them how they can avoid
depression. Nurses in the primary sector have really a great role in the prevention of
depression because it has been seen that most of the people do not have any idea about the
symptoms of depression. In such a scenario, the nurses can provide assistance to the people
and provide all the necessary care and treatment to the people through primary healthcare
services in the country (Everingham, 2018).
Conclusion
In conclusion, depression is a serious concern in China and it is growing with rapid
speed. To ensure the healthy wellbeing and good mental conditions of people, it is necessary
for the Chinese government to strengthen the capacity of primary healthcare and give
responsibility to the nurses to interact with the people who have the potential threat of
depression or suffering from it. The availability, accessibility, and affordability of healthcare

Depression in Chinese People
5
facilities are also crucial for preventing depression among people. Although, if government
provide better employment opportunities and remove the poverty from the society, it will
almost reduce the depression by 50% in the country and people can live a healthy and happy
life without any mental stress, anxiety, or depression type of diseases.
5
facilities are also crucial for preventing depression among people. Although, if government
provide better employment opportunities and remove the poverty from the society, it will
almost reduce the depression by 50% in the country and people can live a healthy and happy
life without any mental stress, anxiety, or depression type of diseases.

Depression in Chinese People
6
References
Alduraidi, H., & Waters, C. M. (2018). Depression, Perceived Health, and Right‐of‐Return
Hopefulness of Palestinian Refugees. Journal of Nursing Scholarship, 50(2), 163-171.
Assari, S. (2017). Social Determinants of depression: The intersections of race, gender, and
socioeconomic status. Brain sciences, 7(12), 156.
Bahia, L., Kupfer, R., Momesso, D., Cabral, D. A., Tschiedel, B., Puñales, M., & Tura, B. R.
(2017). Health-related quality of life and utility values associated to hypoglycemia in
patients with type 1 diabetes mellitus treated in the Brazilian Public Health System: a
multicenter study. Diabetology & Metabolic Syndrome, 9(1), 9.
Cao, W., Li, L., Zhou, X., & Zhou, C. (2015). Social capital and depression: evidence from
urban elderly in China. Aging & mental health, 19(5), 418-429.
Ding, G., Yu, J., Vinturache, A., Gu, H., & Lu, M. (2018). Therapeutic Effects of the
Traditional “Doing the Month” Practices on Postpartum Depression in
China. American Journal of Psychiatry, 175(11), 1071-1072.
Everingham, C. (2018). Social justice and the politics of community. UK: Routledge.
Kleyman, K. S., & Hazel, K. L. (2019). Introduction to the JPIC Issue: Social Inequality:
Impact on School, Youth, and Families: Social inequalities matter: from the great
depression to the rise of Trumpism. Journal of prevention & intervention in the
community, 47(4), 275-278.
Meng, D., Xu, G., He, L., Zhang, M., & Lin, D. (2017). What determines the preference for
future living arrangements of middle-aged and older people in urban China?. PloS
one, 12(7), e0180764.
Overstreet, C., Berenz, E. C., Sheerin, C., Amstadter, A. B., Canino, G., & Silberg, J. (2016).
Potentially traumatic events, posttraumatic stress disorder, and depression among
adults in Puerto Rico. Frontiers in psychology, 7, 469.
Paine, D. R., & Sandage, S. J. (2017). Religious involvement and depression: The mediating
effect of relational spirituality. Journal of religion and health, 56(1), 269-283.
6
References
Alduraidi, H., & Waters, C. M. (2018). Depression, Perceived Health, and Right‐of‐Return
Hopefulness of Palestinian Refugees. Journal of Nursing Scholarship, 50(2), 163-171.
Assari, S. (2017). Social Determinants of depression: The intersections of race, gender, and
socioeconomic status. Brain sciences, 7(12), 156.
Bahia, L., Kupfer, R., Momesso, D., Cabral, D. A., Tschiedel, B., Puñales, M., & Tura, B. R.
(2017). Health-related quality of life and utility values associated to hypoglycemia in
patients with type 1 diabetes mellitus treated in the Brazilian Public Health System: a
multicenter study. Diabetology & Metabolic Syndrome, 9(1), 9.
Cao, W., Li, L., Zhou, X., & Zhou, C. (2015). Social capital and depression: evidence from
urban elderly in China. Aging & mental health, 19(5), 418-429.
Ding, G., Yu, J., Vinturache, A., Gu, H., & Lu, M. (2018). Therapeutic Effects of the
Traditional “Doing the Month” Practices on Postpartum Depression in
China. American Journal of Psychiatry, 175(11), 1071-1072.
Everingham, C. (2018). Social justice and the politics of community. UK: Routledge.
Kleyman, K. S., & Hazel, K. L. (2019). Introduction to the JPIC Issue: Social Inequality:
Impact on School, Youth, and Families: Social inequalities matter: from the great
depression to the rise of Trumpism. Journal of prevention & intervention in the
community, 47(4), 275-278.
Meng, D., Xu, G., He, L., Zhang, M., & Lin, D. (2017). What determines the preference for
future living arrangements of middle-aged and older people in urban China?. PloS
one, 12(7), e0180764.
Overstreet, C., Berenz, E. C., Sheerin, C., Amstadter, A. B., Canino, G., & Silberg, J. (2016).
Potentially traumatic events, posttraumatic stress disorder, and depression among
adults in Puerto Rico. Frontiers in psychology, 7, 469.
Paine, D. R., & Sandage, S. J. (2017). Religious involvement and depression: The mediating
effect of relational spirituality. Journal of religion and health, 56(1), 269-283.
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Depression in Chinese People
7
Qin, X., Wang, S., & Hsieh, C. R. (2018). The prevalence of depression and depressive
symptoms among adults in China: Estimation based on a National Household
Survey. China Economic Review, 51, 271-282.
Ruiz, M., Hu, Y., Martikainen, P., & Bobak, M. (2019). Life course socioeconomic position
and incidence of mid–late life depression in China and England: a comparative
analysis of CHARLS and ELSA. J Epidemiol Community Health, 73(9), 817-824.
Tyler, T., Boeckmann, R. J., Smith, H. J., & Huo, Y. J. (2019). Social justice in a diverse
society. UK: Routledge.
Wang, P. W., Pang, X. Q., Jiang, Z. X., Guo, Y. C., Chen, X., Wang, Y. W., & Jiao, J.
(2016). Origin and evolution of overpressure in the Lower Jurassic succession in the
Kuqa Depression, western China. Journal of Natural Gas Science and
Engineering, 28, 700-710.
Wang, R., Liu, Y., Xue, D., Yao, Y., Liu, P., & Helbich, M. (2019). Cross-sectional
associations between long-term exposure to particulate matter and depression in
China: The mediating effects of sunlight, physical activity, and neighborly
reciprocity. Journal of affective disorders, 249, 8-14.
Zhang, R., Eschler, J., & Reddy, M. (2018). Online support groups for depression in China:
Culturally shaped interactions and motivations. Computer Supported Cooperative
Work (CSCW), 27(3-6), 327-354.
7
Qin, X., Wang, S., & Hsieh, C. R. (2018). The prevalence of depression and depressive
symptoms among adults in China: Estimation based on a National Household
Survey. China Economic Review, 51, 271-282.
Ruiz, M., Hu, Y., Martikainen, P., & Bobak, M. (2019). Life course socioeconomic position
and incidence of mid–late life depression in China and England: a comparative
analysis of CHARLS and ELSA. J Epidemiol Community Health, 73(9), 817-824.
Tyler, T., Boeckmann, R. J., Smith, H. J., & Huo, Y. J. (2019). Social justice in a diverse
society. UK: Routledge.
Wang, P. W., Pang, X. Q., Jiang, Z. X., Guo, Y. C., Chen, X., Wang, Y. W., & Jiao, J.
(2016). Origin and evolution of overpressure in the Lower Jurassic succession in the
Kuqa Depression, western China. Journal of Natural Gas Science and
Engineering, 28, 700-710.
Wang, R., Liu, Y., Xue, D., Yao, Y., Liu, P., & Helbich, M. (2019). Cross-sectional
associations between long-term exposure to particulate matter and depression in
China: The mediating effects of sunlight, physical activity, and neighborly
reciprocity. Journal of affective disorders, 249, 8-14.
Zhang, R., Eschler, J., & Reddy, M. (2018). Online support groups for depression in China:
Culturally shaped interactions and motivations. Computer Supported Cooperative
Work (CSCW), 27(3-6), 327-354.
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