Chapter 1 / 49 tips

How to avoid premature death✳

This section covers three main topics: preventing deaths from accidents and injuries such as car crashes, fires, and poisonings; reviewing several vaccines and screening tests backed by strong evidence; and explaining which bodily warning signs should prompt a medical checkup. The figures listed under “Benefit” come from randomized controlled trials, long-term observational studies, or official statistics. The “Cost” column offers a rough estimate based on current market prices; it is meant only for relative comparison, not for formal citations. All items here are grouped by theme, with their respective item numbers shown in parentheses. On the road: Always wear a seatbelt (Item 1), wear a helmet (Item 2), avoid speeding and driving under the influence of alcohol (Item 9), and use proper child safety seats (Item 10). Fire, gas, and electricity at home: Install smoke detectors (Item 3), replace gas hoses once they reach their expiration date (Item 4), never bring electric bicycles into stairwells or hallways (Item 6), keep fire extinguishers and first-aid kits handy (Item 26), and always use protective guards when operating angle grinders (Item 42). Accidents involving children, seniors, and outdoor activities: Fit window guards to prevent falls (Item 11), keep young children under constant supervision near water (Item 12), encourage seniors over 60 to practice balance exercises (Item 13), never eat wild mushrooms (Item 5), avoid picking up unknown metal objects (Item 36), and always measure ice thickness before stepping onto frozen surfaces (Item 41). Vaccines: Get tested for hepatitis B markers (Item 14), stay up to date with tetanus shots (Item 15), receive the HPV vaccine (Item 16), get an annual flu shot (Item 20), consider the shingles vaccine (Item 21), and get vaccinated against pneumococcal infections (Item 22). Screening and disease detection: Regularly monitor blood pressure (Item 7) and fasting blood glucose levels (Item 8); undergo routine breast cancer screening (Item 17), cervical cancer screening (Item 18), and colorectal cancer screening (Item 19). Also consider testing for Helicobacter pylori infection (Item 23), low-dose chest CT scans (Item 24), bone density measurements (Item 39), and anti-osteoporosis medications (Item 40). Physical warning signs and sexual health: Seek medical advice if blood appears in urine (Item 27); men experiencing erectile difficulties should first have their cardiovascular health checked (Item 28). Losing weight and quitting smoking can improve erectile function (Item 29). Always use condoms and never share needles (Item 30); get tested for HIV if needed (Item 31) and consider pre-exposure prophylaxis if at high risk (Item 38). Mental health crises: If you ever have suicidal thoughts, call 12356 immediately (Item 25). It also helps to confide in someone you trust (Item 32). Avoid gambling when you’re already in debt (Item 37). Finally, remember that surviving poisoning from pesticides or carbon monoxide often leaves lasting health problems (Items 33 and 34), and losing a kidney also carries significant long-term consequences (Item 35). You can also ask someone close to you directly whether they have thought about suicide (Item 43).

English, Russian and Spanish use dlgrv’s unofficial translations. Newly revised entries appear in the Chinese original until a checked translation is available. The author’s latest Chinese text is authoritative. Translation revision: dlgrv/HowToLiveBetter · b25fa8a

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01Evidence A

Always wear seat belts, both front and back

For a front-seat occupant of a passenger car, wearing a seat belt lowers the estimated risk of dying in a crash by more than 40%. For a front-seat occupant of a light truck, the reduction is 60%. Among people killed in passenger vehicles in the United States in 2022 whose restraint use was known, half were not wearing a seat belt.

Cost

No cost at all. It only adds about 2 seconds to every trip…

Benefit

The U.S. National Highway Traffic Safety Administration (NHTSA) estimates that seat belts reduce the risk of f…

02Evidence A

Wearing a helmet and fastening the strap while riding motorcycles or e-bikes

Among motorcyclists involved in accidents, deaths and head injuries are markedly less common in those wearing a helmet with the strap properly fastened. The strap must be tightened; a helmet that simply hangs loosely on the head does not count as being worn.

Cost

A helmet costs between 100 and 300 yuan. It takes just 5 s…

Benefit

Cochrane pooled data from multiple studies. Deaths and head injuries were markedly less common among motorcycl…

03Evidence B

Install smoke alarms; those heating with coal or gas in winter should also add a carbon monoxide alarm

With a working smoke alarm at home, deaths in residential fires are markedly less common. In 40% of US residential fires that caused deaths, someone was asleep when the fire started. If you burn coal or use gas indoors in winter, add a carbon monoxide alarm. In China, 11,500 people died from carbon monoxide poisoning in 2018; during the three winter months, about 70% of the deaths occurred at home.

Cost

A smoke alarm costs between 30 and 100 yuan. A carbon mono…

Benefit

A study in North Carolina examined homes that had experienced fires versus those that hadn’t. With a working s…

04Evidence C

Replace gas hoses and stoves when they reach their expiration date; never modify the piping yourself, and you may decline any unsolicited sales pitches from gas companies

Replace hoses and stoves when they expire; this is a user obligation clearly stated in China’s Regulations on Urban Gas Management. Modifying pipelines yourself or removing gas meters is explicitly prohibited by the regulations. The same regulations also state that gas companies cannot require you to purchase their specified products and services. For door-to-door sales claiming you "must replace" something, you can directly refuse.

Cost

A compliant gas hose costs only a few dozen yuan. Stoves s…

Benefit

The regulations designate “promptly replacing gas appliances and connecting hoses that have been phased out by…

05Evidence A

Do not pick, buy, or eat wild mushrooms; any “folk tricks” for identification are useless

In the single year of 2025, the Chinese Center for Disease Control and Prevention investigated 828 mushroom-poisoning incidents, affecting 2165 people, with 13 deaths. That year, 34 new species of mushrooms previously unrecorded to be poisonous were also identified. Claims such as testing with silver needles, that they are non-toxic if eaten by insects, or that only brightly colored mushrooms are poisonous, are all invalid.

Cost

No expense involved. The hard part is giving up a seasonal…

Benefit

In 2025, the Chinese Center for Disease Control and Prevention investigated 828 mushroom-poisoning incidents,…

06Evidence A

Electric bicycles must not be pushed into stairwells, elevators, or charged indoors

Parking electric bicycles or charging them in the lobbies, corridors, and stairwells of high-rise residential buildings is explicitly prohibited by the regulations of the China’s Ministry of Emergency Management. For those who do not rectify the behavior, individuals will be fined 500 to 1000 yuan, and businesses will be fined 2000 to 10000 yuan. The fine is a minor matter; the critical issue is that these are the routes needed for evacuation and escape when a fire breaks out.

Cost

No direct cost. The tricky part is having to walk a few do…

Benefit

The regulations of the China’s Ministry of Emergency Management explicitly prohibit: "It is forbidden to park…

07Evidence A

Measuring blood pressure and taking meds to reach target levels

For every 10 mmHg reduction in systolic blood pressure, the probability of major cardiovascular problems decreases by twenty percent, and the probability of stroke decreases by 27%. Heart failure decreases by 28%, and the probability of death decreases by 13%. Among people in China aged 35 to 75, 44.7% have hypertension, and only 7.2% have truly controlled it.

Cost

An electronic sphygmomanometer costs 100–200 RMB. Each mea…

Benefit

Data from 123 clinical trials involving over 610,000 participants shows that a 10 mmHg reduction in systolic b…

08Evidence A

After age 35, anyone who is overweight should get a fasting blood glucose test; if the result is normal, repeat it every three years

Spending dozens of yuan for a single blood test can detect prediabetes even when there are no symptoms at all. The official screening recommendation in the United States is: people aged 35 to 70 who are overweight or obese should be tested. Those found to be normal should be retested every three years. In the United States, a Body Mass Index of 25 is considered overweight, which is lowered to 23 for people of Asian descent; the Chinese standard is 24 to be considered overweight.

Cost

A fasting blood glucose test costs just a few dozen yuan.…

Benefit

The US Preventive Services Task Force is the official US body that issues screening recommendations. It curren…

09Evidence B

Drive without speeding, without drunk driving, without looking at your phone, and stop to rest when tired

For every 1% increase in average speed, the probability of a fatal accident increases by approximately 4%. There is no safety line for alcohol where "a little bit is fine." When handling a phone while driving, accident risk is about 3.6 times that of focused driving, and about 12.2 times when dialing. When drowsiness is obvious to others, risk is about 3.4 times as high.

Cost

It costs nothing. Driving slower means spending a few extr…

Benefit

According to the World Health Organization (WHO): for every 1% increase in average speed, the risk of fatal ac…

10Evidence A

When riding in a car, use a car seat for children under 4, don’t hold them in your arms

Infants under one year of age using car seats when traveling in vehicles have an approximately 70% lower probability of sustaining fatal injuries in car accidents. For children aged 1 to 4, the probability is lower by approximately half. Holding them in one's arms does not provide this effect.

Cost

A seat costs between 300 and 2,000 yuan and lasts several…

Benefit

According to the U.S. National Highway Traffic Safety Administration (NHTSA), car seats lower the risk of fata…

11Evidence B

If you have children at home, install restrictors or guards on windows and balconies; screens do not count as protection

A limiter costs only a few dozen yuan. New York City provided free window guards and door-to-door explanations for high-risk residents; the number of reported child falls in one district decreased by half over three years. Later, New York enacted legislation requiring landlords to install guards in homes where children aged 10 and under reside. Window screens do not count as protection.

Cost

A set of window guards or child safety locks costs just a…

Benefit

Since 1972, New York City has run a program called “Kids Can’t Fly,” which distributes free window guards in h…

12Evidence A

Keep young children in sight near water; wear life jackets when boating or swimming

When falling overboard from a boat, wearing a life jacket reduces the probability of drowning to approximately half that of not wearing one. Drowning remains the leading cause of death for children aged 1 to 14 in China. The drowning mortality rate in rural areas is approximately twice that of urban areas.

Cost

Life jackets cost between 50 and 200 yuan. Additionally, p…

Benefit

A study conducted using US Coast Guard data paired individuals with similar conditions for comparison. For tho…

13Evidence A

Exercising balance and leg strength for people over 60, plus home modifications

Practicing balance exercises two to three times a week, such as Tai Chi, reduces the number of falls in the elderly by approximately 23% and the number of people who fall by 15%. Hiring someone to conduct home assessments and modifications reduces the number of falls by approximately 20%. Falls are the leading cause of injury-related deaths among people aged 65 and over in China, and more than half of these occur within their own homes.

Cost

Aim to practice balance exercises two to three times per w…

Benefit

Cochrane analyzed 108 separate trials involving 23,407 participants. Collectively, these studies show that reg…

14Evidence A

Check hepatitis B markers and vaccination records to decide whether catch-up vaccination is needed

In the Qidong study, vaccination against hepatitis B at birth was associated with an 84% lower risk of later liver cancer. Adults cannot assume the same reduction or get three more doses solely because antibody levels are low. Immunocompetent people who completed the course and previously developed protective antibodies usually do not need a booster. If your vaccination history is unclear, take your results to a vaccination clinic for assessment.

Cost

Testing costs a few dozen yuan. For adults who need vaccin…

Benefit

That study in Qidong used group randomization rather than individual randomization and followed participants f…

15Evidence B

If you get pricked by a nail or splinter, or if a wound gets dirty with soil, seek treatment the same day and ask whether a tetanus shot is needed

Once tetanus sets in, about 1 out of every 10 people dies. The risk is highest for deep wounds or wounds contaminated with dirt. If a wound is dirty and it’s been 5 years or more since your last tetanus shot, you’ll need a booster. Getting treated the same day costs only a few dozen yuan — don’t wait until the wound starts swelling.

Cost

Seeing a doctor and having the wound treated typically cos…

Benefit

In the U.S., roughly 1 out of every 10 tetanus cases ends in death. Deep wounds and those exposed to dirt carr…

16Evidence A

The earlier women get the HPV vaccine, the better

Sweden tracked 1.67 million women. For those who received the HPV vaccine before age 17, the subsequent risk of developing invasive cervical cancer was only about one-eighth that of those who were unvaccinated. For those vaccinated between ages 17 and 30, the risk was also only about half. The earlier the vaccination, the greater the reduction.

Cost

Domestic bivalent vaccines cost around 300 RMB per dose, w…

Benefit

A study in Sweden tracked 1.67 million women: the incidence of invasive cervical cancer is lower in those who…

17Evidence A

Breast cancer screening for women: mammograms every two years starting at age 40

For women aged 40 to 74, having a mammogram every two years is a clear recommendation in official US screening guidelines. For women over 75, and for those with dense breast tissue who need extra ultrasound or MRI scans, there is currently insufficient evidence to support such screening. If a health check package includes these extra tests at an extra charge, they are not necessary.

Cost

A mammogram costs around 200–300 yuan each time. Many regi…

Benefit

The United States Preventive Services Task Force is the official US agency that provides screening recommendat…

18Evidence A

For women over 30, HPV testing should be the first choice for cervical cancer screening

In that trial in rural India, women who underwent only one HPV test had a risk of dying from cervical cancer about half that of the comparison group. The risk of detecting advanced cervical cancer was also about 50% lower. It costs one or two hundred yuan per time, and according to US recommendations, testing should be done once every 5 years.

Cost

An HPV test costs between 100 and 300 yuan. Women with a n…

Benefit

That trial in rural India used cluster randomization rather than individual randomization. The subjects were w…

19Evidence A

Starting colorectal cancer screening at ages 45–50: use fecal immunochemical tests or colonoscopies

Getting a low-cost fecal occult blood test every year or two lowers the chance of dying from colorectal cancer by roughly 16%. For people who’ve had at least one round of screening, this risk drops by about 25%. In the group invited to undergo a colonoscopy, the likelihood of developing colorectal cancer over the next decade fell from 1.20% to 0.98%.

Cost

Fecal tests cost just a few dozen yuan and can be done eve…

Benefit

Cochrane pooled data from multiple studies showing that individuals undergoing fecal occult blood screening ha…

20Evidence A

People with cardiovascular disease and older adults should get a flu shot each year

In a trial of influenza vaccination after a heart attack, deaths within one year fell from 4.9% to 2.9%. People with cardiovascular disease should get a dose each autumn. In otherwise healthy older adults, vaccination reduced influenza over a season from 6% to 2.4%, but this estimate is uncertain, and whether it reduces deaths is even less clear.

Cost

One shot costs 50 to 150 yuan. It should be given once eac…

Benefit

This trial randomly assigned 2571 participants after a myocardial infarction;

21Evidence A

Getting the shingles vaccine after age 50

In Phase 3 trials, this vaccine proved 97% effective at preventing shingles across all age groups. The downside is that both doses cost 3,000–4,000 yuan, all paid by the patient.

Cost

The recombinant shingles vaccine requires two doses, costi…

Benefit

A Phase 3 trial spanning 18 countries included 15,400 people. The trial randomly divided participants into two…

22Evidence A

Pneumococcal vaccine for people over 65

In a trial of 84,500 elderly individuals, the 13-valent pneumococcal vaccine blocked approximately 46% of the types of pneumonia that the vaccine is capable of controlling. It blocked 75% of the most dangerous invasive infections. However, no effect was observed for 'pneumonia of all causes,' so do not expect it to control all types of pneumonia.

Cost

Several hundred yuan. In some regions, it is provided free…

Benefit

Researchers in the Netherlands randomly assigned 84,500 seniors over 65 to two groups for comparison. They use…

23Evidence A

Testing for Helicobacter pylori and eradicating it if positive

In that trial from Linqu, Shandong, which tracked participants for 22 years, those who eradicated H. pylori had approximately half the risk of later developing gastric cancer. The risk of dying from gastric cancer was approximately 40% lower. A single test costs one or two hundred yuan, and eradication requires two weeks of medication.

Cost

The carbon-13 or carbon-14 breath test costs 100 to 200 yu…

Benefit

This randomized trial in Linqu, Shandong, followed participants for 22 years. In those who underwent H. pylori…

24Evidence A

Heavy smokers should get a low-dose chest CT once a year

Eligible heavy smokers undergo a low-dose CT scan once a year, and their probability of dying from lung cancer is 20.0% lower than those who only undergo chest X-rays. The overall probability of death is 6.7% lower. The cost is the follow-up examinations required after suspicious results are found, and the period of anxiety that follows.

Cost

The test costs 200–400 yuan per session and takes just 10…

Benefit

The US NLST randomized trial included 53,454 people, all of whom were aged 55 to 74, had a smoking history of…

25Evidence B

Call 12356 if you’re depressed or having suicidal thoughts; don’t keep sleeping pills or pesticides at home

Removing lethal means from immediate reach is a practice supported by increasingly strong evidence. Following the regulation of analgesics, related suicides decreased by 43%, and installing protective barriers in frequent jumping locations led to an 86% decrease. Therefore, do not stockpile sleeping pills or pesticides at home. When feeling hopeless, first call 12356; it is available nationwide in China and operates at least 18 hours a day.

Cost

There’s no cost involved. You just need to make one phone…

Benefit

A recent review of nearly a decade’s worth of research finds that the evidence for limiting access to lethal m…

26Evidence B

Purchase fire extinguishers, fire blankets, escape respirators, and first-aid kits, then inspect them once a year

Fire extinguishers, fire blankets, escape respirators, and first-aid kits are all included in the Emergency Management Department’s list of 11 essential items for household emergency preparedness. The whole set costs a few hundred yuan, and you only need to buy it once. Studies of home safety programs that included on-site guidance found these measures cut injury rates by roughly 25%.

Cost

A set of fire extinguishers, fire blankets, one respirator…

Benefit

The Emergency Management Department’s “National Recommended List of Basic Household Emergency Supplies” contai…

27Evidence B

Visible blood in urine — even if painless and gone by the next day — still warrants a check-up

In UK outpatient medical records, approximately 2.8% of people aged 60 and over who present with visible gross hematuria are eventually diagnosed with bladder cancer. For those aged 40 to 59, the rate is approximately 1.2%. While this figure is not high, it is high enough that an examination is mandatory. Even if it has only occurred once, the amount is very small, and there is no pain, you must go for a check-up.

Cost

A routine urine test costs just a few dozen yuan, while a…

Benefit

A study was conducted in the UK using electronic medical records from community general practices (primary car…

28Evidence A

If erectile dysfunction appears, check cardiovascular health first — don’t treat it as a purely sexual issue

Men with erectile dysfunction are approximately 40% more likely to later develop cardiovascular disease and about 60% more likely to suffer a myocardial infarction compared to others. The younger the individual, the greater the difference. Therefore, first check your blood pressure, blood sugar, and blood lipids; do not attempt to suppress symptoms by buying medication yourself.

Cost

A doctor’s visit costs just a few dozen yuan. Measuring bl…

Benefit

One meta‑analysis combined data from 14 long‑term studies involving 92,757 men, followed for an average of 6.1…

29Evidence A

Weight loss, quitting smoking, and controlling blood pressure and blood sugar can improve erectile function

Managing cardiovascular risk factors naturally leads to better erectile function. When multiple randomized trials are combined, questionnaire scores improve by an average of 2 to 3 points. This questionnaire has a maximum score of 25, with scores above 22 considered normal.

Cost

There is no cost involved;

Benefit

One meta-analysis evaluated six randomized controlled trials involving 740 men. Interventions included lifesty…

30Evidence A

Always use condoms during sex and never share needles

Wearing a condom throughout the entire duration every single time reduces the probability of HIV transmission between opposite-sex partners by approximately 70% or more. The effect of 'wearing it most of the time' is not much different from not wearing it at all. It also provides protection against other STIs, but cannot prevent syphilis or herpes that develop in areas not covered by the condom.

Cost

A single condom costs just one or two yuan. The challenge…

Benefit

One study pooled 25 studies involving 10,676 opposite-sex couples. All these couples were serodiscordant, mean…

31Evidence A

If you’ve engaged in high‑risk behavior, get tested for HIV — the Chinese CDC offers free testing with full confidentiality

In China, HIV testing at disease-control services is free of charge. Without your personal consent, no organization or individual may disclose your name, address, workplace, or medical history. A positive result is not a death sentence: those who consistently take medication to suppress the virus to undetectable levels will not transmit it to sexual partners. In the study, there was not a single instance of transmission between such partners.

Cost

There is no charge. You simply visit the Chinese CDC or a…

Benefit

Article 23 of China’s "Regulations on the Prevention and Control of AIDS" states that the health departments o…

32Evidence B

As soon as suicidal thoughts arise, tell someone nearby and hand over those first few minutes

In an interview, nearly half of those who attempted suicide said that the time from the emergence of the thought to the act was no more than 10 minutes. Three-quarters of people had contact with those around them during that period. For those who visited the hospital due to self-harm, approximately 2% died by suicide by the 1-year follow-up, and about 7% after more than 9 years, while the vast majority did not die by suicide during the observed follow-up.

Cost

No cost involved. The hard part is actually speaking up at…

Benefit

82 individuals who attempted suicide were interviewed within 3 days of admission: 47.6% (39 people) said that…

33Evidence B

Do not mistake "survival" for a safety net: After ingesting pesticides or inhaling gas, the emergency room can save your life, but it may not save your lungs and brain

There is no effective antidote for paraquat; over forty percent of a group of patients in Bangladesh did not survive. It causes lung inflammation and progressive scarring, and also damages the kidneys and liver. Among those rescued from carbon monoxide poisoning who received only ordinary oxygen, nearly half experienced cognitive impairment after six weeks, while one-quarter of those who underwent hyperbaric oxygen therapy also experienced it.

Cost

No cost involved. It simply helps you understand this real…

Benefit

A systematic review of paraquat poisoning: the fatality rate is extremely high because it is inherently highly…

34Evidence B

Don’t bet on “a few days of rest” after a fall from height: most patients admitted to a trauma ICU survive, though at a cost measured in years

In a hospital in Xinjiang, among those admitted to the trauma ICU after falling from heights, only 5.5% died, but injuries were severe and treatment lasted a long time. Nearly half suffered injuries to three or more body parts simultaneously, more than one-third were placed on ventilators, and the longest stay in the ICU was 132 days. Half of the people fell from a height of no more than 3 meters. Among those severely injured, less than 60% were able to return to work later.

Cost

No cost at all. It simply helps you see the full picture.

Benefit

From April 2020 to July 2024, the same ICU recorded 289 cases of falls from heights;

35Evidence A

Don’t trade “losing one kidney is no big deal” for cash: the remaining kidney has to do the work of two, and 86% of kidney sellers later say their health got worse

Among formal donors in the United States who underwent multiple layers of screening before donating a kidney, 31 per 10,000 people progressed to end-stage renal disease (ESRD) after 15 years. Among those who were equally healthy but did not donate, the rate was 4 per 10,000. For a group in India selling kidneys, 86% reported declining health after 6 years, and three-quarters remained in debt.

Cost

No cost at all. It simply requires a clear look at the fac…

Benefit

U.S. researchers compared 96,217 living kidney donors with 20,024 similarly healthy non‑donors drawn from the…

36Evidence A

Don’t pick up, disassemble, or sell unidentified metal parts; stay clear of areas marked with the clover symbol

Radiation from these sources cannot be seen with the naked eye, and a source may be a solid piece sealed in a small metal casing, so looking harmless is no basis for judging safety. Encounters are very uncommon for ordinary people; the annual accident rate is below 1 per 10,000 radioactive sources. But the consequences can be severe: in Brazil in 1987, an abandoned clinic’s radiotherapy machine was dismantled and 4 people died.

Cost

No cost involved. If you see unfamiliar metal cylinders, l…

Benefit

China’s National Nuclear Safety Administration explains that radioactive sources are solid radioactive materia…

37Evidence B

When gambling leads to borrowing money to gamble and your mood is constantly low, first call 12356, then hand your bank cards and payment passwords over to your family to manage

Individuals who have sought treatment for gambling problems are 15 times more likely to die by suicide and 1.8 times more likely to die overall compared to their peers. Depression serves as a key warning sign for potential suicide. Therefore, if you find yourself gambling despite owing money and feeling persistently down, call 12356 right away.

Cost

No cost. Just one phone call. Hand over your bank cards, p…

Benefit

A national registry study in Sweden identified 2099 people diagnosed with gambling disorder in specialized cli…

38Evidence A

Men who have sex with men at high risk of HIV infection can significantly lower their infection risk by taking pre-exposure prophylaxis from designated HIV clinics on schedule

People who aren’t yet infected can take an antiviral drug called pre-exposure prophylaxis to protect themselves. Those who take it consistently cut their risk of infection by more than 70%. On the other hand, people who take it intermittently see almost no benefit. Because it’s a prescription drug, a medical checkup is mandatory before obtaining it, and regular follow-ups are necessary thereafter.

Cost

This is a prescription drug, and in most places, it is out…

Benefit

This medication is a combination tablet of emtricitabine and tenofovir. The iPrEx trial involved 2499 men who…

39Evidence A

Women aged 65 and older should have a dual-energy X-ray absorptiometry (DXA) bone density test; postmenopausal women with osteoporosis risk factors need not wait until 65

Women aged 65 and older, and postmenopausal women with osteoporosis risk factors, should have bone density measured once. When screening starts with fracture-risk assessment and treats those at high risk, hip fractures fall by about 17%. That works out to about 5 fewer hip fractures per 1,000 people screened. Overall mortality did not change.

Cost

A hospital DXA scan of the lumbar spine and hip takes a fe…

Benefit

The U.S. Preventive Services Task Force 2025 recommendation is osteoporosis screening for women aged 65 and ol…

40Evidence A

If you are diagnosed with osteoporosis, or have fractured from a minor fall, ask a doctor for osteoporosis medication and keep taking it—do not treat calcium supplements as a substitute

For postmenopausal women who have already been diagnosed with osteoporosis or have experienced fractures, taking alendronate can reduce the risk of hip fractures by approximately half. Symptomatic spinal fractures are reduced by more than half. For elderly patients who begin receiving an annual infusion of medication after surgery for a hip fracture, the rate of subsequent fractures within two years is reduced by approximately 35%. Supplementing with calcium alone cannot replace these medications.

Cost

Prescription required;

Benefit

Fragility fracture means a fracture from minor trauma or everyday activity. The Chinese Medical Association 20…

41Evidence C

Drill holes to measure ice thickness before stepping onto it; don’t go out if it’s under 15 cm thick. Avoid ice over rivers and near ice-fishing holes

Official Chinese guidelines state that ice must be at least 15 cm thick before adults can safely skate on it. In the U.S. and Canada, the minimum threshold is 10 cm, but only for newly formed, transparent ice. White ice is only half as strong, so its thickness must be doubled to be considered safe. Even on the same body of water, ice can be 12 cm thick in one spot and just 2–3 cm a few steps away; therefore, you must measure it as you go.

Cost

The easiest and cheapest option is to visit a properly man…

Benefit

According to popular science explanations from the China Meteorological Administration, if the ice thickness r…

42Evidence C

Fit the guard and wear goggles plus a face shield before using an angle grinder; hold it with both hands, and never fit a woodworking saw blade to cut wood

Angle grinders spin extremely fast. A shattered disc can fly out and injure people, and a woodworking saw blade can cause sudden kickback. Two accidents in China involved saw blades fitted without guards: one person severed a thigh artery, another a carotid artery, and neither survived. A guard, goggles plus a face shield, and a firm two-handed grip cost little.

Cost

Goggles and a face shield cost a few dozen yuan. Before ea…

Benefit

The Canadian Centre for Occupational Health and Safety and Queensland’s safety authority recommend the followi…

43Evidence B

Ask someone whose mood seems wrong directly, “Have you thought about suicide?” Asking does not make them want it more

The worry that mentioning suicide plants the thought has not shown up in research. When suicide questions were added to a questionnaire for high-school students, those asked did not feel worse, and no more of them reported thinking about suicide. Students who were already depressed felt less distressed after being asked, and students who had attempted suicide before were less likely to report suicidal thoughts.

Cost

No money needed. Ask one question, then spend some time li…

Benefit

In 6 high schools in New York State, 2342 students were randomized by classroom into two groups. One questionn…

44Evidence A

If you have palpitations or an irregular heartbeat, get an ECG; if atrial fibrillation is found, ask a doctor to assess anticoagulants for stroke prevention, and do not substitute aspirin

Atrial fibrillation makes the heartbeat irregular. Blood can pool in the heart and form clots, which can cause a stroke if they travel to the brain. Anticoagulants prescribed after a doctor's assessment reduce strokes by about 60% and deaths by about 30%. Drugs such as aspirin reduce strokes by only about 20% and cannot replace them. In a 2014–2016 survey, only 6% of people in China with high-risk atrial fibrillation were taking anticoagulants.

Cost

An ECG costs a few dozen yuan. Warfarin is inexpensive, bu…

Benefit

In atrial fibrillation, the atria quiver irregularly, allowing blood to pool and clots to form. A clot that tr…

45Evidence A

Adults should get a one-time hepatitis C antibody test, followed by an RNA test if positive; after diagnosis, 8–12 weeks of oral medication can cure the vast majority

Hepatitis C can remain symptom-free for decades. An antibody test, followed by an RNA test if positive, can identify the infection. After diagnosis, 8–12 weeks of oral medication clears the virus in over 95% of people. Those who clear it have about 60% lower subsequent mortality risk and about 70% lower liver cancer risk. These medicines entered China's medical insurance system in 2019, with average price reductions exceeding 85%.

Cost

A blood sample is taken for hepatitis C antibody testing.…

Benefit

Hepatitis C spreads through blood, and there is no vaccine. The World Health Organization says chronic hepatit…

46Evidence C

Before entering septic tanks, manholes, sewage pits, vegetable cellars, basements, fermentation tanks or other confined spaces, ventilate, pass gas testing and arrange protection and supervision; do not enter without all conditions. If someone collapses, do not follow them in: call 119 and 120

Septic tanks, manholes and vegetable cellars can accumulate toxic gas or lack oxygen, causing collapse within seconds. Before entry, ventilate, confirm acceptable test results, use protection and have someone outside watching throughout. If any element is missing, do not enter. Opening the cover and waiting does not establish safety. If someone collapses, do not follow them in; call 119 and 120.

Cost

Ventilation, testing, protection and supervision require e…

Benefit

“Confined spaces” are enclosed or partly enclosed areas such as septic tanks, manholes, sewage pits, cellars,…

47Evidence A

From age 45, get screening gastroscopy if you live in an area with high stomach or esophageal cancer rates, have a family history, or test positive for H. pylori

Among people aged 45 and older at high risk of stomach or esophageal cancer, those who underwent gastroscopy had about half the risk of dying from these cancers. However, people who seek screening already tend to look after their health more, inflating this estimate. In the strictest comparison, esophageal cancer mortality was only about 20% lower, and the difference remained within statistical uncertainty. Guidelines do not recommend screening people outside the high-risk group.

Cost

Standard gastroscopy costs a few hundred yuan;

Benefit

China's National Health Commission defined high-risk groups in its 2024 protocols as people aged at least 45 w…

48Evidence B

Eat soaked wood ear and snow fungus at the same meal, without keeping them overnight; eat fresh rice noodles such as ho fun and rice noodle rolls on the day of purchase, and do not ferment cornmeal at home

Wood ear or snow fungus soaked too long, fresh rice noodles stored too long, and home-fermented cornmeal may develop a toxin called bongkrekic acid. Boiling does not remove it, and there is no antidote. Among cases reported nationally in China over eleven years, about 30% of people who became ill died.

Cost

No monetary cost. Soak only as much fungus as you will eat…

Benefit

China's national foodborne disease outbreak surveillance recorded 19 bongkrekic acid poisoning outbreaks from…

49Evidence A

If a cough or sputum production lasts two weeks or longer, or there is blood in your sputum, get checked for pulmonary TB at a designated TB hospital; if diagnosed, complete the prescribed treatment, even after you feel better

If you have a cough or sputum production for two weeks or longer, or blood in your sputum, get checked at a designated TB hospital. Without treatment, about 70% of people with pulmonary TB whose bacteria can be detected in sputum die within ten years. Among new and relapse patients who start treatment in China, about 95% are cured or complete their treatment on schedule. Take the full course: stopping on your own can promote drug resistance. TB resistant to several main drugs takes more than a year and a half to treat, with success in only about 70% of cases.

Cost

Go to your local designated TB hospital for a chest X-ray…

Benefit

WHO says that about 10.7 million people worldwide developed TB in 2024 and 1.23 million died from it. China ac…

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