Analysis of the dissemination and development pathways of Traditional Chinese Medicine health knowledge in China

Abstract

Against the backdrop of China’s aging society and under the macro policy of building a Healthy China proposed at the Fifth Plenary Session of the 18th Central Committee of the Communist Party of China, the dissemination of Traditional Chinese Medicine (TCM) health knowledge has emerged as particularly crucial and imperative. This paper systematically examines the current status of TCM health knowledge dissemination in China. It identifies multiple challenges in the dissemination process, including multidimensional constraints related to content dissemination, media channels, and audience characteristics. Drawing on these findings, this paper proposes a strategic framework centered on high-quality content, with standardized media platforms as key hubs and audience empowerment as the ultimate goal.

1. INTRODUCTION

The world is currently confronted with the challenge of population aging, and the issue of population aging in China has emerged as particularly salient in this new era. According to the data released in the 2024 National Development Bulletin on Aging,¹ by the end of 2024, the population aged 60 and over in China had reached 310.31 million. This figure exceeded 300 million for the first time, accounting for 22.0% of the total national population. With the continuous growth in the size and proportion of the elderly population, the demand for health services among the elderly is on the rise and is becoming increasingly diversified. Since the 18th National Congress of the Communist Party of China, the Central Committee of the Communist Party of China, with Comrade XI Jinping as the core, has prioritized the development of TCM. The successive issuance of a series of documents such as the 14th Five-Year Plan for the Development of Traditional Chinese Medicine,² the Three-Year Action Plan for Enhancing Public Health Literacy (2024-2027)³ and the Development Plan for Promoting the High-Quality Integration of Traditional Chinese Medicine into the Belt and Road Initiative (2021-2025),⁴ has offered robust support for the dissemination of TCM health knowledge both within China and across the globe.

2. CURRENT STATUS OF DISSEMINATION

According to the 2018 National Survey on Residents' Knowledge of TCM Health Culture,⁵ the TCM health knowledge dissemination rate reached 63.94%. Citizens' health literacy in TCM has risen steadily from 12.85% in 2016 to 26.85% in 2024, achieving the target set in the 14th Five-Year Plan ahead of schedule.⁶ This indicates that the level of health literacy regarding TCM among Chinese citizens is steadily improving year by year. The public's understanding and recognition for TCM are continuously deepening, and the health philosophy of TCM is gradually taking root in the public's mindset. Currently, the dissemination of TCM health knowledge in China presents a distinct dual-track featuring the coexistence of traditional and new media. Traditional media, such as authoritative books and television programs, leverage their systematic nature and credibility to exert authoritative influence, providing robust support for the inheritance and popularization of TCM health knowledge. Survey findings⁷ suggest that television acts as the primary channel for elderly to access TCM health knowledge. Programs such as China's health-focused TV program “Health Preservation Hall” have demonstrated remarkable effectiveness in disseminating TCM health information.⁸ A study by Guo et al ⁹ indicated that traditional media (e.g., health newspapers, magazines, and books) are among the most common communication channels previously accessed by rural residents. The findings of Li et al ¹⁰ are consistent with this result. New media, with its convenience, interactivity, and broad reach, has successfully engaged younger demographics that were previously difficult to reach, emerging as a new platform and primary means for disseminating TCM health knowledge.¹¹ The Shenzhen Health Commission account has become a model for health-related short videos by creatively disseminating health knowledge through the Douyin platform.¹² This dual-track model not only diversifies communication channels but also promotes the advancement of TCM culture. Meanwhile, the scope of communicators continues to broaden. Beyond traditional TCM experts and scholars, a growing number of health bloggers, social media influencers, and ordinary citizens are joining the dissemination of TCM health knowledge, creating a collaborative landscape where government, academia, media, and the public collectively participate in its promotion.

The global dissemination of TCM has also achieved remarkable accomplishments. To date, TCM has spread to 196 countries and regions across the globe. China has signed specialized cooperation agreements on TCM with more than 40 foreign governments, regional regulatory authorities, and international organizations. Additionally, it has established 30 high-quality overseas TCM centers, 75 international TCM cooperation bases, and 31 national TCM service export bases.¹³ Among the members of the World Health Organization (WHO), 113 countries recognize TCM therapies, such as acupuncture. Of these, 29 countries have formulated relevant laws and regulations governing the standardized application of TCM, while 20 countries have incorporated TCM therapies like acupuncture into their healthcare systems. These data indicate that TCM is gradually gaining recognition within the international mainstream community, thereby catering to the needs of a growing number of people overseas.¹⁴

3. REAL-WORLD CONSTRAINTS

3.1. The structure of disseminated content is imbalanced, with mixed quality

The content disseminated constitutes a crucial factor in determining whether the communication of TCM health knowledge can capture public interest. Communication entities play a leading role in the dissemination process,¹⁵ and their professional competence and ethics standards directly influence communication effectiveness. On one hand, traditional media primarily rely on TCM practitioners or authoritative experts from TCM research institutions as communicators. This approach often results in content that is rigorous yet obscure and difficult to comprehend, lacking sufficient appeal. Particularly due to the unique nature of TCM's theoretical framework, it is challenging for non-specialists to grasp, frequently leading to communication barriers.¹⁶ On the other hand, with the diversification of communication channels, some individuals lack professional medical ethics and excessively pursue economic interests. One-sided interpretations and false information, driven by the pursuit of traffic, have become commonplace. TCM knowledge is increasingly being exploited as a marketing tool,¹⁷ making it difficult for the public to distinguish between authentic and misleading health information. This not only deepens misunderstandings about TCM but also undermines the value of its health-related knowledge.

The primary challenge in the international disseminating of TCM health knowledge resides in ensuring the accuracy and standardization of content. On one hand, the richness and profoundness of the Chinese language — which encapsulates millennia of Chinese experience in health preservation and disease treatment alongside profound philosophical concepts—makes direct translation inadequate for conveying TCM's complex and nuanced meanings, leading to potential distortion of its core essence. For instance, fundamental TCM concepts such as “Yin-Yang” and “Five Elements” often lack precise equivalents in Western languages. Mere literal translations fail to adequately articulate their profound philosophical implications and medical significance. On the other hand, regarding standardization, TCM confronts intense international competition for recognition, with the global race to establish unified TCM standards being particularly fierce. As early as 2008, during the WHO’s development of international standards for acupuncture points, the Korean Medicine Association proactively claimed that the proposed WHO standards were predicated on the criteria of Korean medicine.¹⁸

3.2. Lack of media rules, rigid channels

Currently, new media communication is thriving, with diverse communication channels offering robust support for the international dissemination of TCM health knowledge. At the same time, numerous issues have emerged. On one hand, the lack of unified industry standards and regulations has resulted in prominent deficiencies in media operation and management. These deficiencies include inadequate verification of content creators' identities, insufficient scrutiny of the authenticity and scientific rigor of disseminated information, and lax governance of content dissemination processes.¹⁹ Some platforms suffer from missing oversight mechanisms and algorithmic bias, which diminish content credibility and exacerbate homogenization. This overemphasis on presentation from over substantive content hinders the exploration of TCM’s intrinsic value and impedes the dissemination of TCM knowledge.²⁰ Moreover, a comprehensive regulatory framework for new media has yet to be established. The lack of government oversight has caused chaotic governance of TCM health knowledge dissemination platforms, leading to notable inconsistencies and arbitrary practices in TCM health knowledge dissemination across diverse platforms. Such issues as overly lax review standards for WeChat Official Accounts and excessively stringent regulations constraints on Douyin⁸ have undermined the authority and credibility of TCM. In overseas TCM health knowledge dissemination, notable deficiencies also exist in the utilization of social media and new media tools, as well as in public opinion tracking and monitoring mechanisms.²¹ Meanwhile, the dissemination of TCM health knowledge currently relies predominantly on new media platforms represented by WeChat,²² and the corresponding communication channels remain relatively inflexible. This approach overlooks the potential for innovation in other communication channels, which boast strong vitality and extensive market prospects. Such alternative channels are equally capable of effectively fulfilling the mission of TCM health knowledge dissemination. For instance, the development and application of TCM-themed animation have not garnered adequate attention.²³

3.3. Limited audience reach and insufficient awareness

The current dissemination of TCM health knowledge is confronted with notable constraints regarding its target audience. There is a distinct demographic skew toward older populations, where middle-aged and elderly individuals serve as the primary recipients. In contrast, younger demographics demonstrate relatively low levels of interest in and acceptance of TCM health information. Concurrently, most recipients lack adequate professional knowledge of TCM, leading to constrained cognitive abilities and discernment regarding TCM health concepts. This not only hinders their comprehension of the theoretical essence of TCM but also impairs their capacity to integrate TCM knowledge into daily health practices. Furthermore, misconceptions and biases toward TCM remain unresolved. A subset individuals question the efficacy and safety of TCM, which further compromises their ability to distinguish accurate health information. Another segment of the population harbors deep-seated skepticism toward TCM, often engaging in unfounded criticism and disparagement. In the overseas dissemination of TCM health knowledge, constraints such as language barriers and cultural differences limit the avenues through which the general public can access relevant information. Consequently, most people abroad express a lack of understanding regarding TCM knowledge.²⁴ These aforementioned phenomena have posed substantial obstacles to the effective dissemination of TCM health knowledge.

4. OPTIMIZATION PATH: CENTERED ON PREMIUM CONTENT, ANCHORED BY STANDARDIZED MEDIA, AND AIMED AT EMPOWERING AUDIENCES

4.1. Standardize communication entities and strictly control communication content

The dissemination entity constitutes the core determinant in the process of TCM health knowledge dissemination. Confronted with the challenges of obscure content and inconsistent quality in TCM health knowledge dissemination, dissemination entities are required to enhance their professional competence and medical ethics, abide by ethical norms, and rigorously screen scientifically valid and practically applicable TCM health knowledge. They should align with the needs of target audiences, prioritize the improvement of the public's basic TCM literacy,²⁵ avoid disseminating unverified folk remedies or exaggerated assertions, guarantee the professionalism and rigor of disseminated information, and strike a balance between authenticity and appeal. Concurrently, dissemination entities should explore diversified dissemination formats, gain an in-depth understanding of the operational mechanisms of different platforms, and attach great importance to content quality, release timing, dissemination frequency, and presentation styles. Strengthening interaction with the audience and promptly responding to their feedback can transform recipients from passive information recipients into active information disseminators.¹⁵ Furthermore, it is imperative to promptly address the barriers and bottlenecks in international TCM communication, establish a comprehensive TCM discourse system,²⁴ improve the effectiveness of its global dissemination, and intensify efforts in cultivating multidisciplinary professionals specialized in TCM communication. Special emphasis should be placed on developing and nurturing talents competent in overseas communication localization, breaking down cultural barriers, and facilitating the sustainable development of TCM health knowledge dissemination overseas. Currently, many developed countries have established training mechanisms and evaluation systems to enhance experts' science communication skills.²⁶ These experiences can be leveraged by implementing language adaptation strategies in the overseas dissemination of TCM health knowledge²⁷ and cultivating professionals competent in translating specialized TCM knowledge into accessible and understandable language.

4.2. Regulate media outlets and innovate communication channels

The dual-track communication model, while expanding coverage breadth, also presents challenges. The core to its future effectiveness lies in leveraging the strengths of both tracks and fostering synergy to transition from coexistence to integration. This process entails guiding authoritative professional resources to collaborate with new media platforms, thereby correcting misinformation via content that achieves a balance between entertainment value and scientific rigor. Value-related factors are serve as primary drivers influencing the sharing of health knowledge.²⁸ New media platforms should establish a unified and appropriate push mechanism to incentivize the development of high-quality TCM health knowledge content. By leveraging algorithmic empowerment, these platforms should give priority to recommending content from credible accounts, such as authoritative medical institutions, certified TCM practitioners, and official media outlets. Meanwhile, government authorities should continue to refine relevant laws and regulations, actively promote the construction of a comprehensive regulatory framework, strengthen public opinion monitoring and analysis capabilities, and proactively guide the direction of public discourse on TCM health knowledge. This includes implementing a classified management system for TCM content on platforms, defining the scope of content that requires pre-publication review by licensed TCM practitioners; constructing a unified national database of qualified TCM science communication experts to participate in platform content review; establishing an inter-departmental joint disciplinary mechanism; encouraging public participation in supervision and reporting; and integrating administrative penalties for non-compliant accounts into social credit records. Collectively, these initiatives will cultivate a new dynamic and trustworthy ecosystem for TCM health knowledge dissemination. While maintaining a domestic focus, international communication strategies must also prioritize compliance. When disseminating TCM health knowledge through digital platforms, it is essential to take into account the laws and regulations of different countries and regions. Take Thailand as an example: its Personal Data Protection Act, which came into full effect in 2022, establishes strict standards for the collection, processing, and cross-border transfer of health data, adding legal complexity to the overseas promotion of TCM knowledge_.²⁹ Therefore, when establishing an international communication system, efforts should be made to simultaneously strengthen research into the regulations of target countries regarding data protection, medical advertising, and internet information management. Corresponding compliance review and risk assessment mechanisms should be established to ensure that TCM health knowledge can be promoted overseas in a robust and lawful manner.

Currently, the dissemination of TCM health knowledge predominantly relies on new media platforms, while its communication methodologies remain relatively limited. Most new media platforms still concentrate on basic formats such as text-image combinations and short video explanations. It is imperative to further innovate TCM health knowledge communication channels. For instance, integrating TCM health knowledge education into bedside consultations, where healthcare professionals deliver targeted knowledge to patients.³⁰ This approach can directly and effectively enhance patients' understanding of TCM knowledge, thereby advancing its dissemination. Zhang et al ³¹ recommend integrating online and offline communication approaches, leveraging the advantages of the internet to establish a five-dimensional cross-platform model for promoting TCM culture. Additionally, emerging technologies can be actively adopted to synergistically advance the dissemination of TCM health knowledge. For example, augmented reality technology can be utilized to render TCM health knowledge more intuitive and three-dimensional.³² Similarly, virtual reality technology can be employed to reconstruct TCM diagnostic and treatment scenarios, addressing diverse user demands while improving user engagement and participation levels.

4.3. Strengthen cultural education and reach diverse audiences

Studies have demonstrated a highly significant correlation between the intention to share TCM health knowledge and actual sharing behavior.²⁸ It is essential for society to strengthen public health literacy education, such as prioritizing formal TCM health knowledge instruction in schools and integrating TCM health education into the public's lifelong development process. Additionally, a dedicated section should be established to empirically verify scientific TCM content and authoritatively refute TCM-related rumors, thereby improving the public's health literacy and critical thinking abilities, as well as enhancing individuals' self-efficacy in sharing TCM health information. The general public should actively learn traditional Chinese culture, master media literacy skills for screening TCM health knowledge, enhance their ability to discern authentic TCM health information, and strive to apply TCM thinking in daily life practices. Currently, TCM health knowledge dissemination targeting middle-aged and elderly populations has attained a relatively mature stage, while effective communication strategies for younger demographics remain remarkably inadequate. For distinct audience segments, differentiated communication strategies should be adopted,³³ with a focus on reaching diverse groups through targeted and precise communication approaches. For instance, middle-aged and elderly individuals can acquire health knowledge through lectures and wellness experiences activities; younger demographics can be engaged by integrating their practical needs with popular cultural elements to attract their attention and participation in TCM health education initiatives; student groups, meanwhile, can learn through study tours and similar educational travel programs. In the overseas dissemination of TCM health knowledge, some scholars have proposed targeting three key groups for communication: individuals with social influence and decision-making power, local Chinese communities or Chinese-funded enterprises, and groups with specific health needs.²⁷

5. CONCLUSION

In conclusion, against the dual backdrop of accelerating population aging and the in-depth advancement of the “Healthy China” Strategy, the popularization and dissemination of TCM health knowledge have become a crucial pathway for enhancing national health literacy and addressing the challenges of aging. Given the multidimensional challenges in the current dissemination of TCM health knowledge — such as inconsistent content quality, inadequate media regulation, and biases in audience perceptions — relevant initiatives should adhere to a development path centered on high-quality content, anchored by standardized media governance, and oriented toward audience empowerment. This integrated approach will provide robust support for promoting the inheritance and innovative development of TCM culture, contribute to the construction of a healthy aging society, and offer Chinese wisdom and solutions to the global health governance community.

Funding Statement

Supported by Asian Development Bank Technical Assistance TA 10393-PRC: Integration of Traditional Chinese Medicine Into Elderly Care through Smart Technology (58235-001); Special Scientific Research Project of the National Administration of Traditional Chinese Medicine: a Study on the Application of the “Internet Plus” Smart Traditional Chinese Medicine Health Communication Cloud Platform in Integrated Medical and Elderly Care (No. GZY-KJS-2025-022); China Population and Family Welfare Foundation: a Study on the Current Status and Development Trends of Traditional Chinese Medicine Services in Integrated Healthcare and Elderly Care (No. SLB-2-20241101-627)