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5 Biggest Health Risks to China Expats

This is a 2-part series on health risks in China for longterm expats. I decided to start off on a positive note by mentioning a few ways that you can mitigate a lot of the common health risks here. Now, I want to explore the reality of these risks for expats who want to stay in China for a year or more. 

The majority of people that go to China to teach English have lead very sheltered lives. In this context, let’s say the metric for “sheltered living” is having drinkable tap water. This is something we simply don’t need to think about as we go about our lives in the US, UK, Canada, etc. Along with all the clean water I can drink, I’ve also never experienced not having clean air to breath until I moved to China. Nor have I ever bought a beer in the shop and opened it at home to discover that it’s fake. The point is, China is likely going to be a new environment for you, complete with several risks that you’ve never had to think about. While these are not something you should obsess over every waking moment in what should be your epic China adventure, a little extra vigilance should be applied. 

1. Pollution

It feels like a strange adjective to use, but China’s air pollution is legitimately impressive to witness in person. After that novelty has worn off, it becomes something that plagues your daily existence. It knocks an average of 5.5 years off the lives of those living in Northern China. There is pretty much nothing that you nor the average Chinese citizen can do to improve the situation. Unfortunately for us expats, it’s very difficult to let it fade into the background as the locals who have grown up with it seem so adept at doing. Masks and air purifiers can make the situation somewhat bearable, but there’s no way around it - these pollutants will find a way into your bloodstream if you spend any significant amount of time in China. 

2. Secondary Pollution

Air pollution is easy to recognize and can be mitigated somewhat if you take the proper precautions. But then there’s the stuff you don’t see. Much of China’s arable land is contaminated with heavy metals from industrial runoff. Same goes for the water. All of that is going into vegetables, fruit, the feed that animals eat…and there’s no way to know what you’re getting. Every time you take a shower, there’s a chance you’re absorbing this shit through your skin. Lead poisoning is among China’s most serious pediatric complications at the moment. This is something you can literally do almost nothing about, unless you want to limit yourself to expensive imported food. The only solution? Try not to think about it. 

3. Poor Food Safety

There’s nothing quite like taking a stroll in the 90°F+ heat at high noon and seeing raw meat marinating in the hot sun outside of your favorite barbecue joint. Or watching the chef exit the stall he’s been in for the length of “My Heart Will Go On” to play on repeat a few times, and completely bypass the sink. Although it is getting better, prepare to encounter a Dark Ages view on sanitation here. Ever heard of gutter oil? (WARNING: Do not watch while eating.) I must say, I have never had crippling food poisoning in the mainland during my 3.5 years. The one time I was completely debilitated it was from food in Hong Kong. It is pure luck, and the longer you stay it is more likely to happen. For this reason, the Hepatitis A vaccine is the one can’t-miss before you come to China. 

4. Traffic Accidents

Ever seen a dead body on the side of the road? Alright, I don’t want to be too dramatic, as it’s not a common sight in China per se. However, add the sheer volume of people in the country, the exponentially growing amount of cars on the street, and completely inexperienced drivers, and you probably will see something like this if you’re staying for a year or more. Even if you don’t plan on driving, taxis are so ubiquitous and useful here that you are guaranteed to be at a certain level of risk on the road. China also has a bad reputation for some pretty terrible bus accidents, which is why I always travel by train, when possible. If you do drive, especially if you’re going to get a motorbike like many laowai do, be constantly on your guard and prepare for some of the most outrageous driving behavior you’ve ever seen - the road is the Wild West here. 

5. Fake Products

China has a reputation for some impressively convincing fake products, including but not limited to: alcohol, eggs, rice, meat, baby formula, iPhones…we’d be here all day if I listed them all. The government is improving every year at combatting these, and I have only experienced a fake once over a period of several years. It was beer. The next day was hell on earth, and trust me, it was not just a hangover. Expats tend to have a thirst, and alcohol just so happens to be one of the most common fakes out there. Especially in clubs, I would be wary of anything offered to you for free. Read the labels. If it’s marketed as imported yet has Chinglish on the label, run. 

The Law of Averages 

I want to reiterate the point of my previous post that these problems should not be enough to stop someone from coming to China. It’s easy to get frustrated at these things once you’re here for a while, but it is getting better. But it is important to be constantly vigilant about these risks because they do exist and are certainly more commonplace than in any Western country. A lot of these risks are also based on complete chance, and depending on how long you’re staying, your luck is bound to run out at some point. My last bottoming out of luck was in the form of acute bronchitis that took 6 weeks to kick. Pollution, of course. Yours might be atomic diarrhea. Stay healthy, be aware, and be prepared for these things, and they won’t defeat you. Enjoy China!

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China is a pretty crazy place, and anyone living there long-term is sure to return home with many stories to tell. I've taken some of these stories and turned them into T-shirt designs. If you're going to China, or are just another fellow traveler in general, some of my designs might vibe pretty well with you!