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Environment Magazine September/October 2008

March/April 2010

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Made in China: Cancer Villages

A new phenomenon has appeared in China: Aizheng Cun, or cancer villages. Various forms of Chinese media and Internet sources have reported a total of 459 cancer villages across 29 of China's 31 provincial units, the two exceptions being Tibet and Qinghai. Some English media have also reported on cancer villages in China.1 While there is no English or official Chinese definition of “cancer village,” the Chinese Wikipedia defines “cancer village” as a post-reform phenomenon in mainland China, where the number of cancer patients in some villages is extraordinarily high, and water contamination from industries is often the likely cause.2 In most cases, there is a single cancer village in a county, while the number of cancer villages in one township can reach 21. Outside China, the term “cancer cluster” has been used to refer to a local area where cancer is more prevalent as a result of cancer-causing pollutants. While the public typically thinks of cancer clusters in terms of cancer caused by industrial pollution, scientists tend to see them as a geographic area, time period, or group of people with a greater than expected number of cases of cancer.3 China's cancer villages are cancer clusters in farming villages.

The cancer-village phenomenon reflects the Third National Survey on Causes of Death, which found a rapidly rising death rate due to cancer in China.4 In the past 30 years, death rate due to lung cancer increased by 465 percent and has become the most deadly cancer in China. Cancer, the number one cause of death in urban China, accounts for 25% of deaths. In rural areas, it is the second cause of death (after cerebrovascular disease), responsible for 21 percent of deaths. However, rural areas have experienced higher mortality rates than urban areas from liver, stomach, oesophageal, and cervical cancers.5 Particularly, the survey included 13 areas where cancer villages had been reported. Four of them have cancer death rates above the national average: Yingdong District of Xinyang in Anhui, Shenqui and Jun Counties in Henan, and Yingcheng in Hubei.6 The survey was conducted at the county level and was not designed to confirm cancer village reports. However, Ministry of Health official admits that the high death rates in the four areas were due to concentrations of cancer deaths in some villages, which agrees with cancer village reports by the media.7

The cancer-village phenomenon provides a focal point to examine worsening environmental health problems in China and raises critical questions for sustainability research and policy. This article addresses six questions:

  1. How real is the cancer-village phenomenon, and who is spreading the word?

  2. What geographic areas tend to have cancer villages?

  3. How do nongovernmental organization (NGO) activities and local protests affect the situation?

  4. Why does the cancer-village phenomenon appear in China?

  5. What is likely to happen in the future?

  6. What are the implications for sustainability research and policy

How Real Is the Cancer-Village Phenomenon, and Who Is Spreading the Word?

China Central Television (CCTV) and Shenghuo Shibao (Life Times) were among the earliest Chinese media to report on cancer villages. Their 1998 reports gave an account on industrial water pollution on the Hai River flowing through Tianjin and neighboring Hebei, where COD (chemical oxygen demand) was over 1,300 mg; it requires only 25 mg to downgrade water to Grade 5, the lowest level in the five-grade Chinese water quality classification. In Xiaojizhuang Village in Hebei, one out of 10 people had died of cancer, while fertile fields became barren.8. More and more cancer villages have been reported by some well-known Chinese media sources, including Nanfang Dushi (Southern Metropolis) Daily, People's Daily, China Daily, Xinjin (Beijing) News, China Youth Daily, CCTV, provincial TVs and newspapers, and government and media Internet sites.9

The Chinese Science and Technology Journals Databank includes 19 journals that carried 22 articles with “cancer village” in their titles. The China Knowledge Resource Integrated Database (CNKI) Academic Literature Full-Text Database contains 20 journals that published 25 articles, from 1998 to July 2009, with “cancer village” in the title or as a keyword.10 The journals include those run by the government, national professional associations, and universities.

Many Chinese scholars have been studying cancer villages. One of them is Jingxing Lin, Director of the Center for Modern Ecological Geology at the Chinese Academy of Geological Sciences. Lin and his colleagues examined Longling, a cancer village in Shaanxi, in 2001. With a population of 154, the village had its first cancer victim in 1974. By 2001, 36 villagers had died of cancer and 22 had died of heart and brain diseases. Only four of the 30 families had not had a cancer victim, while cancer killed four entire families.11 Air pollution from nearby fertilizer and steel factories was regarded as the cause. Many cancer-causing metals were found, several times exceeding the safety limit, in the villagers' hair, buildings, fields, and crops.12 A Global People article reports that Chinese Premier Wen Jiabao asked local government to solve the problem, as a response to Lin's report on his cancer-village research funded by the Ministry of Land and Resources of China.13

As more and more cancer villages were reported, authors started to examine the cancer-village phenomenon nationwide. Guangdong's Chaozhou Daily Commentator, Qiaojun Hong examined cancer villages in different parts of China with a focus on two villages on the Hai River in Tianjin, where over 300 people died of cancer in five years, with 60 to 80 cancer victims struggling to survive in Xiditou Village and in Liukuaizhuang Village, where over 150 villagers died of cancer.14 Tianjin government records showed that cancer rates were 1.3 and 2.1 percent in Xiditou and Liukuaizhuang villages, respectively, and 0.12 percent in Tianjin, significantly higher than the national average of 0.07 percent.15 High incidence about cancer has been reported for villages almost all over China and become an inescapable reality in polluted rural areas.16

Fenghuang Zhoukan (Phoenix Weekly), a Hong Kong weekly journal, carried a cover story on cancer villages in its April 2009 issue. That report caused strong reactions in China after the reporter posted the article on his blog that included a list of 71 cancer villages from 32 reports.17 The Chinese search engine Baidu published reports on 18 cancer villages. These cancer villages were Google-mapped by Doubleleaf, providing a visual version of cancer villages in many parts of China.18 The Tianya Community Website published a collection of cancer villages believed to have been caused by industrial pollution.19 The collection includes 207 villages in 108 counties. Geography teacher and Eastern China Normal University Graduate, Yuefei Sun's undergraduate thesis listed 247 cancer villages from 126 counties in 27 provinces.20 He raises awareness that cancer villages tend to cluster in eastern China.

Based on an examination of 68 cancer villages, Jialing Yu and Qiuyu Zhang of Beijing University found that poorer provinces tend to have more cancer villages.21 Chuyong Lu and Xiaohui Zhong at Central China Normal University argue that the level of economic development is associated with the number of cancer villages as more developed areas have more cancer villages.22 The sources discussed above do not give the same number of cancer villages. Reports were usually backed by cancer death records and water quality test results. For example, cancer villages occur where the river water quality is Grade 5 or worse, indicating a correlation between water pollution and cancer villages.23 However, political, financial, and technical restraints do not allow tests to be conducted to scientifically establish a cause–effect relationship.

Because Chinese media and academic journals are governmentally controlled, their reports tend to be conservative about politically sensitive and negative subjects. However, there have been no reports disputing the cancer-village phenomenon. There is no known national ban on cancer-village reporting, though new cancer-village reports are rare after May 2009. There are reports that local government agencies and polluting factories threatened, harassed, and assaulted investigators and reporters.24 The government often disciplines and removes newspaper and journal editors who publish politically sensitive and negative reports. If reports on cancer villages were found to be untruthful, the editors and reporters could be charged with the crime of endangering national security, which carries a penalty from years in prison to death. Some environmentalists and lawyers, even though they claimed to be telling the truth, have been imprisoned for endangering national security, illegal possession of national secrets, or illegally providing intelligence to overseas media.25 In addition, the traditional Chinese culture continues to identify people with the particular village where they are from. A personal label of “cancer village” would turn away potential investors, tourists, friends, and spouses. The cancer-village phenomenon is likely to be more prevalent than has been previously reported.

Different from the above sources, which use all cancer village reports as if they have the same level of credibility, this article divides the cancer villages into “officially reported” and “unofficially reported.” The “officially reported” refer to those that have been reported by journals, magazines, CCTV, provincial TV stations, newspapers, and/or government Web sites. The “unofficially reported” cancer villages are those that have been reported only on Internet sites such as Tianya Community, 163.com, sina.com, and xinhuanet.com. There are 241 officially reported cancer villages in 117 counties from 22 provinces and about as many unofficially-reported cancer villages (Table 1).

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What Geographic Areas Tend to Have Cancer Villages?

Hebei and Henan have the largest number of officially reported cancer villages (Table 1). Guangdong and Jiangsu, China's richest provinces, have the largest number of counties with officially reported cancer villages. Hunan has the largest number of unofficially reported cancer villages, followed by Hebei. Shandong and Hunan have more unofficially reported cancer counties. The provinces are ranked by an average score of two items: number of cancer villages and percent of total cancer counties (the total number of villages is not available for the provinces). Because the sizes of the provinces are so different, using the number of cancer villages alone is not a fair way to rank the provinces. For examples, Hainan and Chongqing are small. Although they have less than 10 cancer villages in only a few counties, they have a high percentage of counties with cancer villages.

The top-12 provinces include six coastal provinces with their six neighboring inland provinces. These provinces form a cancer-village belt in eastern China, starting with Hebei in the north and ending with Hainan in the south (see Figure 1). The belt includes 396 cancer villages – 86.3 percent of the country's total – and 203 officially reported cancer villages – 84 percent of the country's total. Those provinces also have the largest number of cancer counties (Table 1), adding up to 174 (78 percent of all cancer counties in China – see Table 2). The belt contains over 55 percent of China's population and over 59.3 percent of China's gross domestic product (GDP). It contains all China's most developed areas as well, except for Shanghai, Beijing, and Tianjin. However, there is a large income gap within the belt between the wealthy coastal provinces and their poor inland neighbors. For instance, Zhejiang and Jiangsu's per capita GDP is about three times that of their inland neighbor Anhui (Table 1).

Figure 1. The cancer-village phenomenon by province, China, 2009.

Water contamination from industrial pollution is believed to be the main cause of cancer villages, and there is a close relationship between China's major rivers and the location of cancer counties (Figure 2).26 Cancer villages tend to cluster along the major rivers and their branches. These rivers have supported high population density for thousands of years. They are also the prime location choices for industries that require cheap water, labor, and transportation. Many industrial parks have found homes along these rivers, which are now heavily polluted. While these industries have contributed to rapid GDP growth in their regions, this growth has been achieved at the expenses of the health and lives of poor villagers, in many cases, leading to the devastation of the village economies.

Figure 2. Major rivers and counties with cancer villages, China, 2009.

Figure 2. Major rivers and counties with cancer villages, China, 2009.

The largest concentrations of cancer villages are located along the lower reaches of the Yellow River and the Changjiang River and Pearl River deltas, the two most developed areas of China. Inland concentrations of cancer villages are found along the Yellow, Huai, and Changjiang rivers, as well as the Beijing-Hangzhou Grand Canal (Figure 2). Sewage monitoring inspections by the Ministry of Water Resources found all provinces in the Huai River basin guilty of water pollution.27 As Elizabeth Economy, the C.V. Starr senior fellow and director of Asia studies at the Council on Foreign Relations says in her book, “The river runs black.”28

There seems to be a spatial pattern of environmental injustice in the cancer-village belt, for the location of cancer villages within and between provinces. Cancer villages tend to be found in poorer parts of the provinces. Top-ranked cancer-village provinces such as Henan, Hebei, Hunan, and Anhui neighbor the more developed Beijing, Tianjin, Jiangsu, Zhejiang, and Shandong (Figure 1). China has made major efforts in environmental protection in the past decades, including the establishment of eco-communities and model environmental cities; however, the cancer villages prove that China's efforts are only partially successful.29 They represent a major flaw in an environmental-protection policy that focuses on producing models and bright spots in urban areas while sacrificing rural areas. Eastern China has an intensive concentration of chemical and electronic factories, some next to or within China's wealthiest counties or cities. Indicating a more serious issue, the rich, some of whom got rich through the polluting factories, live in better environmental conditions, while poor farmers live by the factories and suffer from the pollution on a daily basis.

Case Studies

Guangdong Province

China's third most developed provincial unit, behind only Beijing and Shanghai, Guangdong has four economic regions: the Pearl River Delta, East, West, and (north) Mountainous regions (Figure 3). GDP per capita in 2006 was 47,094 yuan in the Pearl River Delta, 11,325 in the East, 13,637 in the West, and 10,717 in the Mountainous regions.30 Cancer villages exist in all four regions. However, Wongyuan County in the Mountainous region is home to one of the worst cases of cancer villages in China. Iron and copper sulfide strip mining since 1970 has resulted in serious soil erosion and landslides that have dumped cancer-causing cadmium, lead, and other heavy metals into the water system and soil down the mountain. A dozen kilometers away from the mines, lush riverside agricultural settlements in the valley became cancer villages: Liangqiao, Tangxin, Yanghe, Shangba, and Xiaozhen (Figure 4). Liangqiao is the village closest to the mines and is believed to be the worst polluted. However, the death toll has been the heaviest in the most populated Shangba farther down the river. From 1978 to 2005, over 250 villagers (mostly around 50 years old) died of cancer in Shangba.31

Figure 3. Counties with cancer villages, Guangdong Province, China, 2009.

Figure 4. Google Earth map of Dabaoshan area showing the mines and five cancer villages.

The river water in Shangba was reported to be so contaminated that aquatic organisms could not survive in the water for more than 24 hours, even when the water was diluted 10,000 times.32 The water is still very toxic 50 kilometers downstream from Shangba. About 10 people die of cancer each year in this village, whose 2009 registered population was 3,329.33 The actual number of residents is much fewer, however, as some villagers, especially young people, have been moving out of the cancer villages to work in other places. Many families are in debt due to cancer treatments and are too poor to relocate. They have given up and are waiting to die. The Guangdong government has taken measures to deal with the quality of drinking water in the cancer village, but the grave situation continued as of August 2009.34 Remediation of the area is much more expensive than initially regulating the pollution, and is not likely to occur.

Henan Province

Northwest Henan is the most developed region, and the mid-eastern region is the poorest (Figure 5).35 Shenqiu, a county in the poorest region, has the largest cluster of cancer villages in China.36 Various media have reported water pollution and increased cancer rates in the county, although there has been no survey to examine the pollution and cancer rates. Lack of such a survey is partly due to funding, as the county is one of the poorest in China, and the unwillingness of the government to confirm water pollution because the Huai River pollution problem was reportedly solved.37 Shenqiu's Zhouying Township (population over 50,000) is the most severe case, with 21 officially reported cancer villages.38 The local environmental protection bureau believed the cause of the problem was water contamination from factories in industrial cities upstream. The rate of death in Huangmengying Village increased from 5 in 1,000in 1990, to 8 in 1,000 in 2004.39 Liver, rectum and stomach cancers—mostly cancers of the digestive system—claimed the lives of 118 villagers, about half of all deaths, out of 2,400 residents between 1994 and 2004. The youngest, a one-year-old, died of intestinal cancer.40 All water in the river, ponds, and channels was at Class 5 or worse.41 About 80 percent of Huangmengying's young are sick all year round. Birth defects and unidentified illnesses are common. The death rate is higher than the birth rate and is rising rapidly.42

Figure 5. Counties with cancer villages, Henan and Jiangsu Provinces, China, 2009

Jiangsu Province

Jiangsu has the fastest growing economy in China. However, some of China's earliest-reported cancer villages are here: 23 percent of all Jiangsu counties have cancer villages, the highest percentage in China (Table 1; Figure 5). In the northern city of Yancheng, a chemical plant built in 2000 turned Dongjin into a cancer village in just a few years. From 2000 to 2005, 103 villagers developed cancer and 76 of them died.43 The surviving 27 cancer victims were helpless, without money to pay for cancer treatments. By the highway in Funning County, a large sign reads “Investors are our God,” while 17 advertisement signs for cancer treatment stand along the highway to the village.44

Xingang Village, in the Yandu District of Yancheng, used to be called a Taohua Yuan (land of peach blossoms), with many rivers, productive rice fields, and lush vegetation. It was a prime getaway and tourist spot in the region. Things changed in 2001 after an industrial park was built on the village's farmland. Toxic gas and water from the chemical factory poisoned the land. Rice yield dropped from 9,750 to 2,250 kg per hectare. in four years, and the rice is toxic. Pigs died in large numbers, making villagers quit pig farming. The village fell into poverty. From 2001 to 2005, 55 villagers developed cancer and 40 of them died of cancer.45 In both cancer village cases, the local government agencies suppressed villagers with force and imprisonment when they tried to carry petitions to higher levels of government to express grievances against the polluting factories.46

How Do NGO Activities and Local Protests Affect the Situation?

Farmers tend to feel hopeless after years of failed attempts to fight the polluters, and most give up. Many of the educated, able villagers, especially the young, have moved away, leaving the least capable portion of the population behind. Desperate villagers sometimes gather to block traffic to the factories or tamper with their water supply systems in order to gain attention. These activities usually lead to riots when the police try to arrest protest leaders.

Local protests are sometimes organized and run by village leaders, mostly likely the village's secretary of the Chinese Communist Party (CCP) branch committee, the village's top leader. Dou Xian, CCP secretary of the Douzhuangzi Village, led a six-village (three from Tianjin and three from neighboring Hebei) alliance to fight against polluters, many of which were later shut down by the government.47 For telling the media how many villagers had died of cancer, Wang Linsheng in Shenqui, Henan, was fired as Huangmengying village's CCP secretary and was accused of “leaking State secrets,” a very serious crime in China.48 Laifu He, CCP secretary of Shangba Village, sought support from the press after government officials kept ignoring his village's prolonged complaints.49 Repeated press exposure led to government investment of 4 million Renminbi (RMB, Chinese currency) in building a drinking water reservoir for the village. Some cancer villages, such as Dongjing Village in Jiangsu, have successfully removed the polluters from their land through continued grassroots protests against the polluters.50

Many environmental NGOs have been helping the cancer villagers. Some NGOs work as the middlemen between protesters and the government to resolve confrontations peacefully. In the two and a half years leading up to 2006, Qiugang, a village of 2,000 people in the Huai River Basin in Anhui Province, had 53 deaths due to cancer.51 Green Anhui, founded in 2003 by 17 student organizations, helped farmers collect evidence, gain media coverage, and drive the three chemical factories away from their village, effectively removing the sources of water and air pollution that were believed to cause cancer among the villagers.52

Luo Liquan was a millionaire fish-farmer before pollution killed his fish. He and Wang Xiufeng, co-founder and director of the Chongqing Green Volunteers Alliance, have been leading the NGO Chongqing Green Volunteers Alliance to help cancer villagers and gather evidence to fight the polluters.53 The villagers were so helpless that when Wu Dengming, one of the volunteers, came to investigate the pollution problem, over 100 villagers kneeled down at the village entrance to greet him, even though some local officials pressured villagers not to leak any information to the volunteers.54 Though harassed, assaulted, and jailed for “disturbing social life,” the volunteers were able to collect credible evidence for legal actions against the polluters. After repeated media exposure, Chongqing Environmental Protection Bureau ordered chemical factories in western Chongqing to suspend their operations for inspection, and only three of them were allowed to resume production.55

Led by environmentalist Huo Daishan, the Huai River Defenders purify drinking water in polluted areas, give medical relief to cancer victims, and enlist 1,083 volunteers to track sewage outlets for evidence against the polluters. The group has documented extreme water pollution in over 20 cities and counties in Henan.56 Another NGO, the Institute of Public & Environmental Affairs, led by Ma Jun, is building an online China Water Pollution Map, a database that locates polluting businesses and pressures them to shoulder their environmental responsibilities.57 Wang Canfa, Director of the Center for Legal Assistance to Pollution Victims, has helped pollution victims through the legal system. He has put forth about 60 cases, 20 of which have been resolved successfully.58

The Chinese government has been willing to allow more political space for citizen participation in environmental protection,59 though forbidding adversarial or confrontational activities.60 While having made progress in organizing educational campaigns and conservation projects, NGOs have been less successful in influencing government decisions and official behaviours.61 The biggest challenge ahead for NGOs is to tackle the broader political, economic, and social issues that underlie environmental problems.62 Until the Chinese government removes its restrictions on NGOs, China's environmental movement may remain limited in size.63 However, the successful cases discussed above are encouraging signs. It is important that international and domestic NGOs work together to help the cancer villages. International NGOs enjoy certain privileges, such as international media coverage being outside the control of the Chinese government. Government and business leaders tend to be “nicer” to them than domestic NGOs. Domestic NGOs are more likely to better understand the local businesses and political culture and gain grassroots support from the villagers.

Why Is It in China that Cancer Villages Are So Widespread?

China appears to have produced more cancer clusters in a few decades than the rest of the world ever has. For instance, cancer clusters have seldom been reported in the United States.64 It is critical to understand why such a large number of cancer clusters have occurred so quickly in China. A combination of the following factors may have made China unique.

Development and Environmental Policies

China has followed the “grow first and clean up later” approach to development, which led to an acceleration of environmental pollution and serious environmental health problems.65 China's encouragement of the development of township and village industries in the 1980s has also caused severe pollution in rural areas.66 Furthermore, both China's development and environmental policies favor urban areas.67 Environmental programs have been urban-centered.68 These efforts focus on environmental “bright” spots and neglect “dark” spots, creating a divide in environmental protection.69 Environmental agencies lack administrative power and financial support because they are part of the government that puts economic growth first.70 The situation is even worse at the county level; many of these agencies are not funded by the local government budget. For example, the Environmental Protection Bureau (EPB) of Shenqiu County (where 21 cancer villages exist in one township), Henan Province, relies on collecting pollution fees and fines from factories for their budget.71

Economic, Social, and Political Disparities

In the United States, cancer clusters occur in industrial sites and military bases, but not rural areas, and farmers are usually not the poorest population. China's urban–rural disparity is one of the worst in the world and has been increasing.72 Many rural areas are extremely poor. Due to economic, social, and political disparities, the poor rural people continue their tradition of drinking water directly from natural sources. The villagers have no healthcare and rarely do physical exams, so cancer is usually found at a late stage, and they are too poor to pay for treatments, leading to the high death rate. Compared to their urban counterparts, the villagers are more likely to be excluded in the decision-making process when a potentially polluting factory is put in their areas; they are powerless against the alliance of corporation and government. As a result, polluters get rich quickly and are not concerned with destroying the local environment.73 Financial profits generated by polluting factories go to the corporation and government, not the villages. On the other hand, urban environmental protests are more likely to succeed. For example, protests have been successful in halting the RMB 10.8 billion yuan (about US$1.6 billion) Xiamen PX project in Fujian Province and the Panyu (near Guangzhou) incinerator project.74

Lack of Freedom and Democracy

China is well-known for its lack of freedom and democracy. This is even more so for the vulnerable groups (people at the bottom of the society). Due to strong central governmental control over the media, legal systems, and NGO activities, the voices of the victims are not heard early enough to control pollution at an earlier stage, resulting in greater damages to the environment and human health. Only when cancer is widespread might a brave reporter have a chance to make the case known. There is also a caste system in the Chinese media in the eyes of government officials, who grant great attention to only a few Chinese Communist Party media sources such as the People's Daily and its provincial counterparts. Other media sources have a much smaller impact on governmental officials. Therefore, limited governmental action has been taken, even though so many cancer-village cases have been reported. Since governmental officials are not democratically elected, they do not work for the villagers, who in turn have little influence on government policies.

Corruption and Lack of Laws and Law Enforcement

China has depended on administrative measures instead of legal means to deal with environmental violations. Polluting factories often bribe governmental officials so that they will ignore or help to disguise the pollution problem. When pollution is really out of control, factories are usually required to pay a fine, which costs a fraction of the money it would have to spend on pollution control. China has established many environmental laws, but they are seldom enforced. The environmental laws also lack specifics and miss many aspects of environmental pollution. Cancer victims have filed many lawsuits against the polluters, but few have been successful. There are no government reports that establish a direct link between a factory's pollution and villagers' cancers. As a result, it is impossible for the victims to obtain compensation. Many newly established plants are well-equipped with pollution-control facilities; however, they rarely use them because of corruption and lack of environmental law enforcement.

High Rural Population Density with Lack of Mobility

The Chinese cancer villages are often in the most populated areas of China, and the villages are often densely populated. High rural population density mixed with pollution creates a large impact in small areas. Land is owned collectively, which means families have no ownership of the land and the government decides how the land is used. Consequently, the farmers practically lose their land if they move away. Technically, they can rent the land out to fellow farmers; however, the possibility of finding a renter is slim in a cancer village. As a result, the poor are unable to leave the poisoned land. The impact of pollution on humans would have been hidden if the villagers were more mobile. In that case, the victims would have been dispersed before a cancer cluster was ever formed, and a health problem would have gone unnoticed, though pollution damage to land and water may be the same.

Inland Distribution of Polluting Industries

China's industrial distribution is often described as concentrated along the coast. Factories along the coast pollute the ocean, kill fish, and bankrupt fishing villages.75 China's coastal waters are seriously contaminated, but few coastal cancer villages are reported. People who live along the coast do not consume the polluted ocean water, and they are more mobile, reducing the opportunity for a cancer cluster to develop. A closer examination reveals that the majority of China's industrial distribution is not right on the coast. These industries pollute inland areas and produce cancer villages. Furthermore, polluting industries have been moving from coastal to inland areas because of stricter environmental control in coastal regions.

Economic Globalization

Industrial pollution would have been less severe if China were not the world leading manufacturer of chemical products. Globalization may also be related to the income and consumption disparity. China's suddenly wealthy are inspired by the lifestyle of the wealthiest people in the world. High-end luxurious goods are readily available, and their shopping habits and changing tastes are reshaping global trade flows of flashy cars, gold, elephant ivory, and dried seahorses.76 Availability of those goods and the possibility of migration to a more developed country push for a never-ending demand for wealth, and China's elite are firm supporters of the “grow first” development policy.77

Again, it is a combination of the above factors, and likely some others, that produces the cancer-village phenomenon in China. For example, globalization does not have to cause cancer clusters if other factors are not in place. On the other hand, globalization speeds up the spread of democratic ideas and practices in China. International NGOs help reduce poverty and develop and fund many domestic NGOs.

What Is Likely to Happen in the Future?

China's cancer-village phenomenon is likely to worsen in the future, partly because the health impact of environmental pollution tends to be long-lasting. In addition to cancer villages, the media has also reported electronic-waste villages, weird-disease villages, and lead-poisoned villages in China, which may lead to more cancer villages.78 Furthermore, most of the hypothesized causes of cancer villages will continue to exist. China is likely to continue its urban growth–centered policies. Zhou Zunsheng, China's Minister of Environmental Protection, states that environmental protection in China is still like a person climbing a steep hill while carrying a heavy load.79 Chinese officials tend to argue that China is still in the middle stage of industrialization, and economic growth is the priority.80 The implication is that environmental protection is still not a priority of the government. Consequently, environmental pollution will get worse—and so will the related health problems.

Economic, social, and political disparities are likely to persist. It is unlikely that we will see major improvement in terms of freedom and democracy in China. Corruption is unlikely to be controlled. Polluting industries will keep moving inland as inland regions continue to follow the “grow first” approach to development. Rural mobility has improved with rapid urbanization. As discussed earlier, a mobile rural population will not reduce the environmental impact on human health but will only disguise it, as cancer victims will be more spatially dispersed. It is also likely that we may hear less about the phenomenon if the government bans the reporting of cancer villages and silences the protesters. In that case, the phenomenon may actually become even more widespread.

On the other hand, the central government is paying more attention to pollution.81 Some local governments are taking actions to deal with cancer villages and other environmental problems. Guangdong's Humen government invested RMB40 million yuan (about US$6 million) to manage the trash mound that was blamed for causing the cancer village Yuanfeng.82 Governmental actions have not resulted in any improvement in the cancer villages, but it seems the matter at least did not get worse in some places.83 It appears that the government has been more aggressive in dealing with lead-poisoned villages than cancer villages. Reports say that the government has started relocating the 15,000 residents in the 10 lead-poisoned villages in Jiyuan, Hebei Province, while keeping lead smelters going.84 The battery factory that was blamed for causing lead poisoning in Longyan, Fujian, has been ordered to stop production.85

There has been improvement in terms of using legal means to protect the environment. For the first time in China, it is possible to charge polluters with the crime of poisoning, if serious consequences occur.86 However, current practice tends to be that the government, rather than the responsible industries, pays for the medical treatment and relocation costs of the affected villagers. If the industries have to pay for the full cost of their consequences and if NGOs and the media are given more freedom, it will be less difficult for China to control the cancer-village phenomenon.

What Are the Implications for Sustainability Research and Policy?

A priority for sustainability research is to develop a research framework that integrates global and local perspectives to shape a “place-based” understanding of the interactions between environment and society.87 The cancer-village phenomenon raises questions about conventional wisdom on environment–society relations. The environmental Kuznets curve (EKC) argues that the initial stages of economic growth are accompanied by increasing environmental degradation; however, once per capita income exceeds a given threshold, not only does the structure of the economy change, but then people can afford to demand a better environment.88 Yet, the cancer villages tell us, at least at the local scale, that severe inequalities plus environmental degradation in the early stages of development can cause such irreversible damage to the environment and society that the places will fall back to the underdevelopment stage and the environmental conditions will not improve.

Sustainability is often defined as meeting the needs of the present without compromising the ability of future generations to meet their needs. There is an implicit hierarchy of needs that favors children and people in disasters and that favors feeding and nurturing first, followed by education, housing, and employment.89 It is also difficult to determine if the “needs” are met and at what level. The poor countries need economic growth. However, such economic growth is often achieved at the expense of the poor and the environment. As a result, the poor, such as the cancer villagers, will remain poor or may get even poorer. Sustainability science needs to address the dilemma many developing countries face, which is that the needs of neither the present nor the future are being met, as resources are lacking, needs are defined differently, and high levels of inequality persist. The cancer-village phenomenon highlights that the needs of people (including children) in disasters must be met first.

After its grand celebration of economic progress at the 60th anniversary of the People's Republic of China, the government continues to follow the urban growth-centered approach to development and remains a major producer of cheap products for the global market. The cancer villages remind us that China's economic achievements have been made at the expense of the environment and human lives. We need to go beyond studying the impressive gains in China's economic growth to address important issues of social and environmental injustice, which have negatively affected the lives of a large number of the socially excluded, marginalized, and disadvantaged groups.90 China needs to change its development approach to put the environment first and pay attention to environmental justice along with social equity. Establishing environmental “bright spots” is necessary to provide examples of sustainable development and attract business investments and tourists.

However, the environmental dark spots such as the cancer villages must be rescued first before any place may boast its environmental or economic success. Cancer villages undermine China's efforts to reduce poverty, as families with cancer patients quickly fall into poverty due to the unbearable costs of cancer treatment. Most of the cancer villages were essentially meeting their basic needs of food and shelter until industrial development poisoned their land. What does development mean to these villages? To the villagers, pollution is more pitiless than poverty. Pollution causes diseases that lead to absolute poverty and death. Other developing countries should learn from China's lessons and avoid following an urban growth–centered approach to development. No places or people should be sacrificed in the name of development.

1. T. E. Lyn, “FEATURE-China's ‘Cancer Villages’ Bear Witness to Economic Boom,” Reuters, 17 September 2009, http://www.reuters.com/article/latestCrisis/idUST320607 (accessed 1 November 2009); CNN, “Red River Brings Cancer, Chinese Villagers Say,” 23 October 2007, http://www.cnn.com/2007/WORLD/asiapcf/10/23/pip.china.pollution/index.html; E. Graham-Harrison and V. Lin, “China Cancer Village Pays Ultimate Price for Growth …,” Reuters, 10 December 2008, http://www.reuters.com/article/worldNews/idUSTRE4BA0KZ20081211; D. Griffiths, “China's ‘Cancer Villages’ Pay Price,” BBC News, Beijing, 17 January 2007, http://news.bbc.co.uk/2/hi/asia-pacific/6271103.stm; C. Hatton, “China's Cancer-Causing Factories,” CBS Evening News, 12 August 2009, http://www.cbsnews.com/stories/2009/08/12/eveningnews/main5237961.shtml (accessed 1 November 2009).


2. The Chinese Wikipedia, http://zh.wikipedia.org/wiki/%E7%99%8C%E7%97%87%E6%9D%91 (accessed 1 November 2009); J. Yu and S. Zhang, “The Chinese Cancer Village Phenomenon and Its Reflection of Health-Related Environmental Pollution Problems,” Proceedings of China Environmental Science Society Annual Conference 3 (2009): 880–889.


3. Testimony of R. Hoover, M.D., Sc.D., Director, Epidemiology and Biostatistics Program, NCI, to the Senate Cancer Coalition, U.S. Senate, June 5, 2001; D. Robinson, Cancer Clusters: Findings vs. Feelings (New York: The Council, 2002).


4. Ministry of Health of China, Third National Survey on Causes of Death Press Conference, China.com, 29 April 2008, http://www.china.com.cn/zhibo/2008-04/29/content_15028586.htm (accessed 1 November 2009); Z. Chen, The Third National Survey on Causes of Death (Beijing: China Union Medical University Press, 2008).


5. Ibid.


6. H. Li, “Defeated by Cancer: Cancer Country,” Caijing 215 (7 July 2008): 80–88. Caijing is China's most widely read business and finance magazine and a news authority, with a circulation of 225,000 from readers in government, business, and academic circles (http://english.caijing.com.cn/aboutus) (accessed 1 November 2009).


7. Ibid.


8. CCTV, Hai River Pollution Control Gratitude and Grievance, Shenghuo Shibao, 9 November 1998, http://www.gmw.cn/01shsb/1998-11/09/gb/793%5ESH12-911.htm (accessed 1 November 2009). Shenghuo Shibao was the predecessor of Beijing Newspaper.


9. China Daily, “Cancer Village' in Spotlight,” 10 May 2004, http://www.chinadaily.com.cn/english/doc/2004-05/10/content_329171.htm. China Daily is China's official English newspaper geared for international readers. People's Daily is a mouthpiece of the Chinese Communist Party. People.com is affiliated to People's Daily. Some video clips showing CCTV reports on cancer villages are CCTV1 News Probe, Cancer Villages, http://you.video.sina.com.cn/b/17343949-1560017465.html, CCTV7 Spotlight on Sannong (agriculture, rural areas and farmers): Cancer Village, Deaths over Water Pollution, http://you.video.sina.com.cn/b/17348918-1560017465.html. Nanfang (Southern) Daily Press Group Web site has 25 articles on cancer villages in its publications Nanfang Metropolis Daily, Nanfang Daily, Nanfang Weekend, Nanfang Weekly, and Nanfang Rural; see G. Jiang's Blog article “Do not numb about cancer village phenomenon” talks about nearly 100 official media reported cancer villages, 10 May 2009, http://www.sciencenet.cn/m/user_content.aspx?id=231071 (accessed 1 November 2009).


10. Chinese Science and Technology Journals Databank is available at http://www.cqvip.com/asp/vipsearch.asp. The China Knowledge Resource Integrated Database (CNKI) Academic Literature Full-Text Database is available at http://epub.cnki.net/grid2008/index/ZKCALD.htm. There are indications that the actual number of journals and articles is much higher than given in the search results, because some articles on cancer villages do not use the phrase “cancer village” in their titles or as a keyword. For example, the June 2004 issue of Huanjing (Environment) had four articles on cancer villages. None of them showed up in the search results. The search on the CNKI database also resulted in four papers from four conferences from 2005 to 2009 and 24 articles in 19 newspapers from 2001 to March 2009. Apparently, many cancer-village articles are missing from the database. Many important newspapers are excluded from the database, such as the Southern Metropolitan Daily, which carried many articles on cancer villages.


11. S. Wang, J. Lin, S. Shi, and J. Zhang, “Geological Disease Caused by Ecological Environment: An Example of Cancer Village in Shaanxi Province,” Environmental Protection May (2001): 42–43, 46; R. Yi, “New ‘Cancer Village’: Cross-Examining Another Abnormal Pollution Incident,” Science Times, August 16, 2007.


12. Ibid.


13. M. Li, “Jingxing Lin: The Person Who Search for the Roots of ‘Cancer Village’,” Global People, 15 August 2007, http://env.people.com.cn/GB/6115619.html (accessed 1 November 2009). Global People is affiliated to People's Daily.


14. Q. Hong, “Why Are There More and More Cancer Villages?” Environmental Economy March (2005): 58–59. The journal is run by the Ministry of Environmental Protection (MEP).


15. China Quality Ten-Thousand-Li Journey, Undercover Investigation in Xiditou Township in Tianjin: Over 120 Cancer Victims from Industrial Pollution, 1 March 2005, http://news.china.com/zh_cn/domestic/945/20050301/12139378.html (accessed 3 December 2009).


16. Z. Ou, Y. Gao and C. Shen, “Sorrow in a Village with High Incidence of Cancer,” Environmental Economy June (2006)” 32–34.


17. F. Deng, “China's 100 Cancer Causing Places,” Fenghuang (Phoenix) Weekly no. 11, April (2009). The article was later posted on the author's blog: F. Deng, Sad Songs of China's Nearly 100 Cancer Villages: Tens of Thousands of People May Be Sacrificed, 27 April 2009, http://blog.ifeng.com/article/2647063.html (accessed 9 February 2010). Many Web sites reported the article, including people.com (“Shocking Map of China Cancer Villages,” 7 May 2009, http://cq.people.com.cn/News/200957/20095785045.htm). Fenghuang TV also reported cancer villages: Huaihe River Cancer Village Probe (http://v.ifeng.com/his/200804/15ee3866-ec41-4fbd-b568-4befd5810b5e.shtml), and Cancer Village Diaries (http://www.56.com/u28/v_MzExOTc0MjU.html) (accessed 1 November 2009).


18. Baidu is a Chinese search engine. It reports 18 cancer villages. http://baike.baidu.com/view/1237914.htm (accessed 9 September 2009); Double Leaf, “China Cancer Villages Map,” created 7 May and updated 1 June 2009, http://maps.google.com/maps/ms?hl=en&ie=UTF8&lr=lang_en&msa=0&msid=104340755978441088496.000469611a28a0d8a22dd&ll=34.098728,117.292099&spn=0.268943,0.4422&z=11 (accessed 1 November 2009).


19. Tianya Freeyq2009 posted 79 short accounts of cancer villages and a list of 169 reports on 200 villages. Tianya Community, Folks' Voice, List of China's Environmental Pollution Induced Cancer Villages. 4 August 2009. http://www.tianya.cn/techforum/content/828/6907.shtml. The author claimed that most of the reports were from media. The others were from village petitions online. The author posted the list in the hope it would be updated by Web users. However, the list was never updated. The link was broken by 22 October 2009.


20. Y. Sun, The Geographic Distribution of Cancer Villages of China, Undergraduate Thesis, East China Normal University, May 2009, http://blog.sina.com.cn/zjhn1122; http://blog.sina.com.cn/s/blog_623f55e50100fvyc.html (accessed 1 November 2009).


21. Yu and Zhang, note 2.


22. C. Lu and X. Zhong, “Spatial and temporal patterns of cancer villages in China,” Modern Agricultural Sciences 16 (2009): 243–244.


23. Li, note 6.


24. Deutsche Welle, “German Journalist Arrested in China for ‘Illegal Interviews,’” 7 July 2007, http://www.dw-world.de/dw/article/0,2144,2082164,00.html (accessed 1 November 2009). Deutsche Welle is Germany's international broadcaster.


25. Radio Free Asia, “Sun Xiaodi allowed to meet with wife and lawyers,” 5 August 2009, http://www.rfa.org/cantonese/news/dissident_jail-08052009114136.html?encoding=simplified; W. C. Zhao, “Environmentalist Tan Kai in Shaoxing, Zhejiang, Released after Serving Prison Sentence,” Voice of America, 1 May 2007, http://www.voanews.com/chinese/archive/2007-05/w2007-05-01-voa29.cfm (accessed 1 November 2009).


26. J. D. Li, “Huai River Branches: Pollution Produced a Cluster of Cancer Villages,” Xinhua Daily, 9 September 2004, page 1; Lyn, note 1; H. Li, “Cover Story: Spotlight on ‘Cancer Villages’ at the Lower Reaches of the Huai River,” Caijing, no. 215, 9 July 2008, http://www.caijing.com.cn/20080705/73156.shtml; Q. Fang and C. Yang, “Guangdong Wengyuan Cancer Village Survey: More than 250 People Died Due to Pollution,” Southern Metropolis Daily (Guangzhou), 18 November 2005.


27. R. Ge and Y. He, “Ministry of Water Resources Sewage Monitoring Results: All Provinces in the Huaihe River Basin Exceeded Their Waste Water Emission Limits,” XinhuaNet, 31 July 31 2007, http://news.xinhuanet.com/photo/2007-07/31/content_6456172.htm (accessed 1 November 2009).


28. E. C. Economy, The River Runs Black: The Environmental Challenge to China's Future (Ithaca, NY: Cornell University Press, 2004).


29. L. Liu, “Sustainability Efforts in China: Reflections on the Environmental Kuznets Curve Through a Locational Evaluation of ‘Eco-Communities’,” The Annals of the Association of American Geographers 98, no. 3 (2008): 604–629; Z. Zhang, L. Liu, and X. Li, “Ecotourism and Nature Reserve Sustainability in Environmentally Fragile Poor Areas: The Case of the Ordos Relict Gull Reserve in China,” Sustainability: Science, Practice, & Policy 4, no. 2 (2009): 12–22; L. Liu, “Urban Environmental Performance in China: A Sustainability Divide? Sustainable Development 17, no. 1 (2009a): 1–18; L. Liu, “A Sustainability Divide in China: Geography, Governance, and GDP,” Sustainable Development 17 (2009), published online in Wiley InterScience (www.interscience.wiley.com) DOI: 10.1002/sd.432.


30. X. Feng, “Regional Differences in Economic Development in Guangdong: An Evaluation and Suggestions,” Guangzhou Science and Technology, 31 January 2008, http://www.gzkj.gov.cn/rkx/newsDetail.jsp?infoId=89952 (accessed 1 November 2009).


31. Hong, note 14; W. Zhou, M. Yang, Y. Peng, S. Lin, Z. He, and S. Shang, “State and Reflection of Cancer Villages on the Hengshi River,” Zhongshan University, College of Life Sciences, 3 March 2006, Green Web Information Center, http://www.green-web.org/infocenter/show.php?id=18120 (accessed 1 November 2009); Fang and Yang, note 26.


32. Ibid; C. Yang, “Cancer Village Revisited,” Southern Metropolis Daily (Guangzhou), 1 August 2009, http://gcontent.nddaily.com/4/65/465636eb4a7ff4b2/Blog/8ef/121ac7.html (accessed 1 November 2009).


33. Ibid.


34. Yang, note 32.


W. Zhang and J. Hong, “Spatial Relevancy between County-Level Economic Strength and Their Industrial Structure in Henan Province,” Journal of Henan University, January 2008, http://www.eywedu.com/Hndx/hnxs2008/hnxs20080115.html (accessed 12 September 2009).


36. Li, note 26.


37. Li, note 26; Economy, note 28.


38. Li, note 26.


39. Q. Liu and L. Chen, “On the Lack of Operation System of Environment Law of China in View of a Cancer Village,” Journal of Shiyan Technical Institute 20, no. 2 (2007): 18–20; Li, note 26.


40. W. Wang, “Campaigner Wages War on Cancerous River,” Global Times, June 21 2009, http://special.globaltimes.cn/2009-06/438481.html. Global Times is affiliated with the People's Daily.


41. lbid.


42. L. Xu and D. Huo, “Survival on the Bank of the Polluted River,” Rural Work Communications January: (2004): 27–31; see 7 CCTV1 and CCTV7 for video clips, note 7.


43. W. T. Ye, “Behind the Deadly GDP: Investigating Jiangsu Yancheng Cancer Village and Industrial Chemical Pollution,” Village and Township Forum May (2006): 40–41.


44. Q. Hua, “Cancer Map Shows Poverty Areas,” China Reform Daily, 10 November 2006; Ye, note 9.


45. K. Nan and H. Su, “Who Turned the Peach Orchard into a Cancer Village?” Village and Township Forum December (2006): 41–43.


46. lbid; Ye, note 43.


47. CCTV, note 8.


48. Wang, note 40.


49. CCTV-2, “Hengshi River Flows Through Dead Village,” Economy 30 Minutes, 3 June 2005, http://finance.sina.com.cn/g/20050603/01441651306.shtml.


50. Y. Luo, “An Environmental Sociological Perspective on Environmental Health Problem: The Case of Dongjing Village,” Journal of Haihe University 10 (2008): 34–37.


51. S. Gilbert, “Victory: A Grassroots NGO Empowers a ‘Cancer Village’ to Take Action,” China Environment Forum, Woodrow Wilson International Center for Scholars, January 2009, http://www.wilsoncenter.org/index.cfm?topic_id=1421&fuseaction=topics.documents&doc_id=496146&group_id=233293 (accessed 3 December 2009).


52. lbid.


53. F. Zhou, “Environmental Volunteers in Cancer Villages,” Oriental Outlook Weekly, 3 September 2009, http://www.lwdf.cn/oriental/community/2009090315529622.htm.


54. lbid.


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56. Wang, note 40.


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63. Economy, note 58.


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69. Liu 2009a, 2009b, note 29.


70. Ibid.


71. Xu and Huo, note 42.


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Lee Liu is an associate professor in the Department of Geography at University of Central Missouri (UCM), where he also serves as Chair of the Curriculum and Education Sub-Committee of the President's Commission on Sustainability. His research and teaching focus on issues of sustainability including population trends and policy, rural poverty, urban-rural inequality, sustainability practices and policy, and sustainable places, with an area specialization in China.

This research was partially funded by a College of Arts, Humanities, and Social Science Research and Creative Assistance Award and an Honors College Faculty Fellow Award from UCM. The article benefited from discussions in the Introduction to Sustainability and Conservation of Natural Resources classes at UCM. Part of the paper was presented in a UCM Honors College Inaugurational Faculty Fellow Lecture. Special thanks to Bob Kates his assistance with this article and Richard Buford for his research assistance.

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