In Zhejiang province economic development and changes in nutrition appear to have increased both life expectancy and nutrition-related chronic disease morbidity. Life expectancy is longer in urban populations than in rural and in both urban and rural females. From 1997 to 2002 urban females had an average life expectancy of 81.4 years. In 2002 the estimated incidence of ischaemic heart disease was higher in rural males and females whereas diabetes mellitus was higher in urban males and females. From 1990 to 2002 lung cancer had large increases in all groups, cancers of the oesophagus and stomach increased in rural males and females, and cancer of the large intestine increased 40 per cent in urban males. In 2002 deaths from cerebrovascular disease were much higher in rural males and females. Apart from differences in lifestyle factors between urban and rural, access to medical resources may also be relevant to the differences within the province in chronic disease rates and in life expectancy.