Shanghai 2000s

[Agenor Ramadan]

Shanghaiis the most developed city in China and has a soaring population. This study uses forensic epidemiology to determine the relationship between unnatural deaths and the development in Shanghai, based on recently released forensic autopsy cases from the 2000s at the Shanghai Public Security Bureau (SPSB). There were 5425 accidental deaths, 2696 homicides, 429 suicides, 186 natural deaths, and 1399 deaths of undetermined cause. There was a male-to-female ratio of 2.02:1, and the average age was 40.918.7 years. Traffic accidents (84.2%) were the number one cause of accidental deaths, which decreased during the study period. Sharp force injury (50.6%) was the leading cause of homicides, different from Western countries, where firearms are the leading cause. Hanging (24.5%) was the leading cause of suicides, whereas drug and chemical intoxication was the leading cause in the previous decade; pesticide ingestion decreased in the 2000s. In addition to traffic accidents, manual strangulation was the leading cause of death in childhood fatalities. Children under age 2 were vulnerable to homicides. In the 2000s, there were a large number of drug overdoses, and illegal medical practices and subway-related deaths first appeared in Shanghai. A new type of terrorist attack that involved injecting people with syringes in public places was reflected in the SPSB archives. The forensic epidemiology and changes in unnatural deaths in this decade reflected their relationship with the law, policy and changes in Shanghai. Illegal medical practices, subway-related deaths and terrorist attacks were closely related to the development in Shanghai. Identifying the risks of unnatural deaths will improve public health.

Copyright: 2015 He et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Funding: This study is supported by Funds for Youth in Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University (FY2014-04). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

This study was a retrospective review of unnatural deaths at the SPSB over a 10-year period from 2000.1 to 2009.12. Cases were accepted for this study according to the following criteria: (1) corpses without death certificates were found in Shanghai; (2) corpse inspection was conducted by SPSB MEs; (3) manner of death was given including undetermined. A total of 10135 cases met the study criteria. These archives were kept in the SPSB records office.

Of the 10135 decedents, 6717 were male and 3327 were female, a male-to-female ratio of 2.02:1, excluding 91 decedents whose genders were unknown or unrecorded. The average age of decedents in this decade was 40.918.7 years. Table 1 and Fig 1 show that the total number of forensic cases investigated by the SPSB fluctuated throughout the decade, with a minimum of 822 in 2009 and a maximum of 1170 in 2006. Accidents and homicides followed the same trend as the total forensic cases, successively decreasing, increasing and decreasing. Suicides and deaths from natural causes remained relatively stable, approximately 42 and 18 per year, respectively. Undetermined cases increased from 55 to 236, with a slight decrease to 196 in 2009. Between 2000 and 2009, SPSB data revealed that there were 5425 accidental deaths, 2696 homicides, 429 suicides, 186 natural deaths, and 1399 deaths of undetermined cause.

Based on practice and jurisdiction, accidental deaths were divided into traffic and non-traffic. Non-traffic accidents referred to accidents that typically occurred at work, especially at construction sites. The majority of accidental deaths (84.2%) were traffic fatalities, which also comprised the largest proportion of all SPSB forensic cases (45.0%, 4567/10135). Traffic fatalities fell from 461 to 400 in 2001 and rose quickly to 577 over the next three years; they ultimate fell sharply, to 269, in 2009 (see Fig 2). The male-to-female traffic accident ratio was 2.31: 1. The average age of traffic accident victims was 44.919.2 years. The changes in traffic fatalities contributed to the trend in total accidental deaths as well as the trends in the total number of forensic cases.

There were considerably fewer accidental non-traffic than traffic fatalities. The number of non-traffic accidental deaths decreased from 195 to 65 in the first three years and remained at approximately 70 per year between 2003 and 2009. The male-to-female non-traffic accident ratio was 2.23: 1. The average age of non-traffic accident victims was 37.719.0 years.

All of the drug abuse cases were drawn from the aforementioned cases. From 2000 to 2009, a total of 38 drug abuse deaths were recorded. For the drug abuse deaths, the male-to-female ratio was 1.24:1, and the average age was 29.49.0 years; these decedents were markedly younger than all others (p

All of the illegal medical practice cases were drawn from the aforementioned homicide cases. In the decade of study, 6 deaths from illegal medical practices were recorded, with 4 deaths related to childbirth. Among these, 1 decedent was an infant who had died from dystocia, and 3 decedents were pregnant women, average age 30.7 years, who died from blood loss during delivery. In addition, the exact cause of death was unrecorded for 1 female and 1 male.

All of the subway-related deaths were drawn from the aforementioned cases. In this decade, 6 deaths from subway train impact were recorded. All decedents were males, with an average age of 36.2 years. Three accidents, 2 suicides and 1 undetermined case comprised the subway-related deaths.

Drug abuse deaths did not appear in the SPSB files until 1997 [3]. In the 1990s, 38 cases were recorded, nearly 4 times as many as those in the previous decade, and 1997 can be seen as the landmark year when drug abuse began to emerge in Shanghai. These decedents were markedly younger than the others (p

Both illegal medical practice and subway-related deaths first appeared in the 2000s; there were no recorded cases of either cause of death prior to 2000. Illegal medical practice and subway-related victims were both significantly younger than all other decedents (p

The mid-1980s saw a profound reversal of fortune for Shanghai. In 1985 the central government finally approved increased expenditures in Shanghai and in 1988 it capped Shanghai's tax contributions, freeing up a great deal of revenue for regional use. Perhaps the largest boon arrived in 1984 when the central government named Shanghai among 14 new cities that would be made open to foreign development. The CCP's attitude towards Shanghai had undergone a fundamental transformation: Rather than toiling thanklessly to provide revenue for the rest of China, Shanghai was to be reborn as a world-class city whose shining example would lead the rest of China to prosperity. This new stance is best encapsulated in Deng Xiaoping's 1992 designation of Shanghai as "the head of the dragon."

Finally obtaining the funding and approval it had long needed, new urban plans were quickly drawn up for the Shanghai area. 1986, a new Master Plan was outlined for Shanghai, calling for the city to return to international prominence by 2020 (a goal that it more than surpassed). Notably, this plan included the construction of even more satellite towns. By 1987, there were seven functional satellite towns around Shanghai (viewers can refer to the map on our "Topic: Satellite Cities" page). Shanghai was also regionalized, giving the city a larger tax base and allowing the municipal government more autonomy in directing the city's development than previous administrations had enjoyed- even those before Communist rule.

In 1986 the municipal government of Shanghai also established the Consultative Small Group for the Development of Pudong. A clear attempt at continuity with previous urban plans can be seen in Zhao Zukang's inclusion as a prominent member of that Group. Other periods of urban planning rhetoric were also drawn upon; the portrayal of Shanghai as a "key-point city" was a revival of the Soviet-influenced belief in the usefulness of large cities and their economies of scale. The 1990s can therefore be viewed as a period in which China reconciled many of the seemingly disparate urban planning policies that it had pursued over the 20th century.

In April of 1990, Li Peng, the Premier of the People's Republic of China, officially approved the beginning of the Pudong New Area project. This plan named Pudong as a new special economic zone that was open to foreign investment and was heavily influenced by the goals of the 1946 Shanghai Master Plan. Cross-river connections over the Huangpu were once again called for, and were at last actually built. The Nanpu and Yangpu bridges, completed in 1991 and 1993, respectively, are among the main arteries through which traffic passes between Pudong and Puxi. The Comprehensive Plan of Shanghai Pudong New Area, pictured below, depicts the proposed locations of these bridges on the West edge of Pudong. Also visible is the Yanan road tunnel, connecting directly with the Lujiazui financial district near the middle of the image. The complex zoning of Pudong can be seen in the array of colors marking the map, with each color designating a different type of land use. Lujiazui, marked in red as a space for commercial and public facilities, saw the construction of many skyscrapers over the 1990s, including the Oriental Pearl Tower, which was completed in 1995. Lujiazui's skyline, and Pudong as a whole, have become emblematic of China's modernization.

The two images below, taken in almost exactly the same location less than thirty years apart, highlight the dramatic and rapid transformation of Pudong's skyline between the 1990s and 2000s. The Oriental Pearl Tower, mentioned above, is visible in the later photo on the other side of the Huangpu.

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