The "Last Mile" in China's Healthcare: Observations from Rural Clinics to Urban Screens

As an example, in a small rural classroom, I was explaining some basic health knowledge to the children. Behind the scene of the media people’s daily health screen, I was delivering thyroid information to millions of urban users. The two seemingly disconnected scenes taken together in concert present the biggest problem in public health in China. How can health benefits cross geographical and cognitive boundaries to reach everyone?

In rural areas, the scarcity of health resources is apparent. I witnessed firsthand that it is not that there are no policies, rather the reimbursement procedures are too complicated, there is distrust in modern medicine, and lack of health education that together form the invisible last mile that prevents well-designed systems from reaching past the village clinic door.

In the city, the resource scarcity is implicit. It hides within the fog of information overload. Due to being inundated with more health information than they can filter, urban residents are unable to filter and discern so as to allow real scientific knowledge to get drowned. Here, the geographical ‘last mile’ has transformed into a cognitive ‘last mile’.

My work, hence, is therefore two-pronged in nature. In the countryside, I am a ‘sower’ of knowledge who rebuilds the basis of health in the simplest language. Within the city I am a kind of information “filter” who attempts to take authoritative knowledge and turn it into a weapon against noise.

My essential insight is: It must not just be an increase in the supply of “hardware” but also an upgrading of “precision” and “warmth” so as to achieve health equity. The new public health system must have the capacity to support communication during action in the field and action above the field. I am set on being a significant contributor in building that system.

Ruoxi Chen, an aspiring public health practitioner.

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