Good knowledge, a healthy body and fresh air are the basic elements that make up a happy life. The good operation of a city is inseparable from sufficient and high-quality education and medical resources, as well as a good ecological environment.
People have the impression that large cities tend to be stronger than the scale of education and medical resources, but weaker than the ecological environment. The study found that the per capita medical resources in economically developed areas are not necessarily higher, and the ecological environment is not necessarily weaker.
The 2023 List of 57 City Residents, compiled by the Urban (Regional) Research Center of Southern Weekly, focuses on the quantity and quality of public services, as well as per capita income and individual micro-experience. The index model involved in the list includes 12 indicators, such as the ratio of primary and secondary school students to teachers, 1,000 medical beds and licensed physicians, financial investment in education and medical care, air quality rate, and per capita park green space, pointing to three dimensions: education, medical care, and environment.
According to the list, Beijing and Shanghai are firmly in the first and second places, which is the result expected by many people, while Nanjing and Hangzhou are ranked third and fourth, which is somewhat beyond people's realization, followed by Guangzhou in fifth, Qingdao in sixth and Shenzhen in ninth, Lhasa, the only one in the west to enter the top 10, and Jinan in the top 10 for the first time.
Compared with the data of previous years, the performance of the 57 cities included in the assessment is differentiated in three dimensions:
In terms of education, more than half of the cities have increased their student-teacher ratios, and 13 cities have reduced their per capita financial investment in education; in terms of medical care, most of the relevant indicators in 57 cities have set new records, but there is still a large gap between the number of beds in medical institutions with 1,000 people in 39 cities and the expected in 2025; and in terms of ecological environment, the rate of good air quality in 38 cities has decreased.
The above-mentioned data differentiation presents a complex trend, the increase in the student-teacher ratio means that a teacher needs to bear more students; the record of medical resources is gratifying, but the number of beds in medical institutions for 1,000 people in most cities does not meet expectations, and the structural problems of medical resources may lead to the coexistence of waste of medical resources and the shortage of inpatient beds; and the general decrease in the rate of good air quality has sounded the alarm bell of ecological protection.
On April 19, children were drawing a scroll on the theme of environmental protection for Earth Day. (Xinhua News Agency/Photo)
Financial investment in education in 13 cities has decreased
Education is the best investment. The sub-list of educational resources is composed of four indicators: per capita education expenditure, primary school student-teacher ratio, middle school student-teacher ratio, and the number of double first-class universities.
According to the evaluation results, the top three in the field of education are Beijing, Shanghai and Nanjing.
The student-teacher ratio of middle schools in Beijing is the lowest in 57 cities (Note: student-teacher ratio = number of students in school/number of full-time teachers, and a low student-teacher ratio means that a teacher has fewer students to bear. ), reaching 6.95, and has the largest number of double-first-class universities; Shanghai's student-teacher ratio is the lowest among the 57 cities, reaching 14.02, and the number of double-first-class universities and per capita financial investment in education are at the top; Nanjing, as an important city in science and education, is relatively balanced in terms of the performance of educational resources.
Compared with 2022, Shenzhen has caught up with Tianjin, and these two cities rank 5th and 6th respectively.
In recent years, Shenzhen has been desperately building universities and research institutes to improve the treatment of primary and secondary school teachers. The city with the highest per capita financial investment in education among the 57 cities has already shown the results of its investment, but the actual effect needs to be further observed.
In addition, cities such as Quanzhou, Yinchuan, Jinan, and Hohhot will increase their financial investment in education by more than 15% in 2022 compared with 2021, and their rankings will also rise as a result.
Quanzhou and Jinan have budgets that are more focused on higher education. Quanzhou is planning to build a university town in Quanzhou, and Jinan has been approved to build the first aerospace information university in China.
Western cities such as Yinchuan and Hohhot pay more attention to the construction of primary and secondary schools. The direct manifestation is the decrease in the ratio of primary and secondary school students to teachers. The student-teacher ratio in primary school in Hohhot is 15.95, a decrease of 4.21 from 2021, which means that the number of students to be borne by each teacher is reduced.
However, 13 out of 57 cities still have reduced their financial spending on education. In Yangzhou, Urumqi, Shantou, Zhengzhou and other cities, the financial investment in education in 2022 will decline by more than 6% year-on-year.
Education has a "positive externality", and the level of education affects technological progress and economic growth, which is the embodiment of a city's competitiveness. In 2021, the "double reduction" policy was introduced, and education returned to the public welfare attribute, which means that the government needs to invest more educational resources.
Looking at the overall data, the average student-teacher ratio of middle school students in 57 cities is 11.89. The student-teacher ratio of middle school students in Beijing is only 6.95, leading the way. Urumqi has the highest student-teacher ratio of 15.5, with most cities between 10 and 15.
According to the standards announced by the Ministry of Education, the student-teacher ratio at the junior high school level should reach 13.5:1, and the student-teacher ratio at the ordinary high school level should reach 12.5:1, using the average value of the two, and there are still 13 cities in 57 cities where the student-teacher ratio does not meet the standard.
The pupil-teacher ratio is a different story, with an average of 17.64 in 57 cities. The lowest student-teacher ratio was 14.02 in Shanghai, the highest was 25.42 in Nanchang, and higher than 20 in Urumqi, Guiyang, Shenyang, Yinchuan, Haikou and other cities. The Ministry of Education announced that the standard for the ratio of primary school students to teachers is 19:1, and there are still 12 cities that do not meet the standard.
The student-teacher ratio of primary and secondary schools is more about the number of students a teacher has to teach, and it is more about the amount of education. We still need to address the quality of education.
According to the China Education Statistical Yearbook 2021, the proportion of full-time primary education teachers with a bachelor's degree or above in Beijing, Jiangsu, Shanghai, and Zhejiang is 95%, 89%, 89%, and 87%, respectively, while Hainan, Xinjiang, and Guangxi are 47%, 54%, and 55%, respectively.
This means that the imbalance of educational resources in the country is still prominent, and economically developed regions not only have lower student-teacher ratios, but also have higher quality teachers.
The distribution of educational resources is not only unbalanced between regions, but also between urban and rural areas. In 2021, the proportion of full-time primary education teachers with a bachelor's degree or above in urban areas, towns and villages was 82%, 67% and 58% respectively. Even in the central urban area, there are structural problems with educational resources, which is intuitively reflected in the fact that the price of housing in high-quality school districts is higher than that of surrounding housing prices.
The uneven distribution of educational resources is not only due to development differences, but also to the result of market choice. Where the salary is better and the students are better, teachers are willing to go, which is not only about ideals but also about reality. How to balance the treatment and rating of teachers in different regions is still a difficult problem to be solved.
According to data released by the Ministry of Education, in 2023, the number of kindergartens in the country will be 274,400, a decrease of 14,800 from 2022, and the number of children in preschool education will be 40.93 million, a decrease of 5.3455 million from 2022. The decrease in the number of children in kindergarten will be further transmitted to primary and secondary schools, resulting in a decrease in the number of primary and secondary school students.
We should realize that the structure of the supply of educational resources should be further optimized, and the investment of educational resources should not only pay attention to quantity but also pay attention to quality.
In terms of higher education, the distribution of double-first-class universities has not changed much, and is still concentrated in Beijing, Shanghai, Nanjing and other important science and education towns. Previously, the research team released the "57 Cities Citizen Treatment List 2022", pointing out that cities lacking the accumulation of higher education resources are exploring two different talent training paths: one is the construction path of high-end research institutes represented by Shenzhen, and the other is the construction path of vocational education represented by the Suzhou-Wuxi-Changzhou metropolitan area.
The number of beds in medical institutions with 1,000 people in 39 cities did not meet expectations
Medical care is the most urgent and urgent issue of people's livelihood. In recent years, obstetrics departments have been closed due to declining fertility rates, while paediatric wards in many hospitals are operating at full capacity. To some extent, this reflects the structural problems of domestic medical care.
The sub-list of medical resources is composed of four indicators: per capita health expenditure, 1,000 beds in medical institutions, 1,000 practicing (assistant) physicians, and the number of top 100 hospitals.
Judging from the ranking of the list, the top three cities in terms of medical resources are Beijing, Shanghai and Hangzhou, and the top ten are all municipalities and provincial capitals.
Among them, Jinan, Taiyuan, Zhengzhou and Shenyang have made great progress, ranking 4th, 6th, 7th and 8th respectively. Such an outcome is to be expected. Resources such as medical care, education, and culture require long-term investment and accumulation, and are often concentrated in municipalities and provincial capitals.
However, it cannot be ignored that the economically strong city represented by Shenzhen is catching up. Excluding the factors that lead to the exponential growth of medical finance due to special reasons, Shenzhen has the highest per capita medical financial investment. The first thing that comes with higher investment is the improvement of medical quality. According to the "China Hospital Ranking 2022" released by the Hospital Management Institute of Fudan University, Shenzhen People's Hospital and Shenzhen Third People's Hospital entered the top 100 for the first time.
However, Shenzhen still needs to catch up in the construction of medical infrastructure, and Shenzhen ranks last in the two indicators of 1,000 medical institution beds and 1,000 practicing (assistant) physicians.
In terms of overall data, the per capita medical financial investment in 57 cities has generally increased. Due to special reasons, Shanghai and Sanya's financial investment in medical care in 2022 is as much as double that of 2021. In the two indicators of 1,000 beds in medical institutions and 1,000 practicing (assistant) physicians, 57 cities have also been generally improved. The distribution of the top 100 medical services in the 57 cities has not changed much overall.
In 2022, the National Health Commission issued the "Guiding Principles for the Planning of the Establishment of Medical Institutions (2021-2025)", which clarified that the guiding requirements for the number of beds per 1,000 population in 2025 are 7.4~7.5 beds, and the number of practicing (assistant) physicians per 1,000 population (person) is 3.2.
Taking this as the standard, among the 57 cities with 1,000 people of medical institutions, Harbin, Zhengzhou, Shenyang and other cities are higher than the national standard, but there are still 39 cities that do not meet the standard, of which Dongguan has only 3.36 beds, less than half of the expected; among the 57 cities with 1,000 people practicing (assistant) doctors, Beijing, Taiyuan, Jinan and other cities are higher than the national standard, but there are still 16 cities that do not meet the standard, of which Shantou has only 2.33 people.
According to the national standard, most cities have a situation of "fewer beds and more doctors". Although the number of beds in medical institutions with 1,000 people in Beijing, Shanghai, Guangzhou, Qingdao, Urumqi and other cities has not reached the standard, the number of practicing (assistant) physicians per 1,000 has far exceeded the standard. This further illustrates the need for long-term efforts in the construction of medical infrastructure.
The above data shows that more than two-thirds of the 57 cities still need to further increase the number of beds in medical institutions with 1,000 people. It should be noted that the number of beds in medical institutions with 1,000 people is not the more economically developed, and the number of beds in medical institutions with 1,000 people in cities such as Harbin, Zhengzhou, and Shenyang is about 2 higher than that in Beijing, Shanghai, Guangzhou and Shenzhen. When epidemic infections occur, megacities tend to be under more pressure.
According to the China Statistical Yearbook 2023, the average utilization rate of hospital beds in Shanghai and Zhejiang is 79.7% and 79.6%, while that of Inner Mongolia and Heilongjiang is 55.6% and 48.6%, while from the perspective of medical and health institutions, the utilization rate of hospital beds is 71%, and the utilization rate of beds in primary health centers is only 46%. This means that there are structural problems with domestic medical resources, with hospital beds in economically developed regions in short supply, and many regions and primary health institutions in oversupply.
Secondly, the number of days of inpatient treatment in China is relatively high due to the imperfection of out-of-hospital rehabilitation services and the higher proportion of inpatient reimbursement compared with outpatient reimbursement. According to the 2022 Statistical Communiqué on the Development of Health Undertakings in Mainland China, the average length of stay of patients discharged from mainland hospitals is 9.2 days, higher than the average of 7.9 days in OECD countries.
How to make the best use of every hospital bed? Haikou provides a sample of reform. In 2023, Haikou People's Hospital will implement the management model of "one bed for the whole hospital", breaking the barriers of beds between departments and improving the utilization rate of beds in the whole hospital on the premise of ensuring medical safety.
The rate of good air quality in 38 cities has decreased
The "20-minute effect in the park" is swiping on social platforms. A study published in the International Journal of Environmental Health Research showed that spending about 20 minutes in an environment such as a garden or park increased life satisfaction by about 64 percent, and people felt better even when they didn't exercise.
The quality of the ecological environment is related to people's perception and feeling of a happy life. The environmental quality sub-list is composed of four indicators: air quality rate, centralized treatment rate of sewage treatment plants, harmless treatment rate of domestic waste, and per capita park green space area.
The list shows that in the field of ecological environment, Guangzhou, Zhuhai and Guiyang won the top three. Guangzhou has ranked first in the list for three consecutive years, and is worthy of the name of the flower city.
The top 10 cities on the list also include Foshan, Sanya, Qingdao, Yantai, Chongqing, Dongguan and Yinchuan. Dongguan fell from 3rd to 9th due to the decline in per capita park green space area and air compliance rate. The other top 10 cities have risen in the rankings to varying degrees. Among them, Yinchuan rose 11 places in the ranking due to an increase of 2.15 square meters in per capita park green space.
It is worth noting that in the field of ecology and environment, the phenomenon of "not retreating or advancing" is obvious, and most cities have improved their rankings only because they have maintained the results of the previous year. Research data shows that 38 out of 57 cities have a decline in air quality. Xi'an's air quality rate in 2022 is only 52.1%, a decrease of 20.5% compared with 2021. Jiaxing, Xuzhou, Nantong, Xiangyang, Ningbo, and Dongguan all saw a year-on-year decrease of more than 6% in 2021. Even Guangzhou and Zhuhai, which are among the top of the list, saw a 4.7% and 5.2% drop in air quality rates, respectively.
The data on per capita green space in parks is also not optimistic, with 15 of the 57 cities decreasing per capita green space. Among them, the per capita green space area in Nanning decreased by 7.5 square meters, and it should be noted that the per capita park green space area in Nanning in the "2022 Urban Construction Statistical Yearbook" is 4.65 square meters, but the target set in the "14th Five-Year Plan for Municipal and Garden Development of Nanning" is greater than or equal to 14.8 square meters. In addition, the per capita green space area of Dongguan, Hohhot and Haikou has also decreased significantly. Hefei and Lhasa saw a significant increase in per capita green space, with an increase of 4.51 and 4.33 square meters, respectively.
There are two possible reasons for the decrease in air quality rate:
First, global warming and extreme weather are increasing. High temperatures tend to reduce the stability layer of the atmosphere, and it is difficult for pollutants to diffuse and dilute. The highest temperature in Chengdu in 2022 reached 43.4°C, the highest temperature since meteorological records began. In the summer of 2022 (as of August 18, 2022), Chongqing had 17 days of 40°C and above, the most in local history. In 2023, the number of days with temperatures exceeding 35°C in Guangzhou will reach 19.
Second, the resumption of economic activities and the release of production capacity may also lead to an increase in pollutant emissions. From 2019 to 2023, the average number of days with good ambient air quality in China accounted for 82.0%, 87%, 87.5%, 86.5%, and 85.5%, respectively, reaching the highest in 2021 and decreasing year by year.
Can economic activities achieve a dynamic balance with environmental quality? After comparing the GDP ranking with the environmental quality ranking, we find that there are cities that can take into account the development of the environment and the economy, and there is also a disconnect between the urban environment and the economy. Based on the environmental quality ranking of 57 cities and the 2023 GDP ranking, we find that 57 cities can be roughly divided into four categories.
1. Excellent GDP and environmental quality, represented by Guangzhou, Chongqing, Qingdao and other cities.
2. GDP is better than environmental quality, represented by Shanghai, Shenzhen, Hangzhou and other cities.
3. Environmental quality is better than GDP, represented by cities such as Guiyang, Sanya, and Zhuhai.
4. GDP and environmental quality are not dominant, represented by Taiyuan, Lanzhou, Urumqi and other cities.
The first type of cities have achieved a virtuous cycle of ecological environment and GDP, with both gold and silver mountains and lucid waters and lush mountains. As a first-tier city, Guangzhou's per capita park green space area is as high as 23.66 square meters, ranking first among the 57 cities, and Guangzhou has a high air quality rate and domestic waste and sewage treatment capacity.
The GDP advantage of the second group of cities is higher than the environmental quality, and the per capita park green space area of Shanghai and Shenzhen is not high, only 9.02 and 12.44 square meters, respectively. Clearly, these cities are aware of the problem. In order to increase the per capita area of park green space, Shanghai has built a "twin mountains" in the center of the city. The total green planting area of the artificial peak is 247,204.6 square meters, and the green space rate excluding water body area in the area is 87.70%.
The third type of cities is the development of environmental quality better than GDP, Guiyang and Sanya have 100% air quality rate, and the per capita park green space area is also more than 16 square meters. We found that while they have ecological and environmental advantages, such cities are also developing green industries such as eco-tourism, health care for the elderly, and digital economy. Guiyang is building "China's Digital Valley", and Sanya is making efforts to high-end health care.
In the fourth category, cities do not have an advantage in terms of GDP and environmental quality. The ecological environment of such cities may be affected by geographical location and meteorological conditions, and they also face the challenges of industrial structure upgrading and green development.
After solving the problem of food, clothing and housing, the ecological environment, education and medical care are the core of people's happy life. When you are sick, you have a good medical environment, you have sufficient and high-quality educational resources when you study, you can go to the park to breathe fresh air in your spare time, and walk among the verdant lawns with your relatives and friends. Isn't this exactly what we hope for in a happy life, and this is also the best treatment that a city can give its citizens.
Southern Weekly researcher Shi Dengjiang
Editor-in-charge: Dai Chunchen