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BEIJING -- Soaring medical costs are the most notable social problem in China, according to a social blue book issued Monday.

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This was the first time that concerns over medical and health care had exceeded other worries in similar surveys, researchers said.

According to the blue book, medical expenses had risen to 11.8 percent of household consumption in China, surpassing expenditure on education and transportation.

"This is a very high percentage even compared with developed countries," said Li Peilin, chief editor of the blue book.

China's health care sector has been under constant criticism over soaring costs and inaccessibility. Most rural dwellers have no medical insurance.

Statistics from the Health Ministry show that one third of poor rural patients in China choose not to go to hospital and 45 percent of the hospitalized farmers ask to be discharged before they have recovered.

"Soaring medical costs have plunged many rural and urban Chinese back into poverty," Li said.

Unemployment was the second major concern, followed by the wealth gap, corruption, pensions, educational charges, housing prices, public security, social values, and pollution, according to the blue book.

The blue book was based on a survey by the Chinese Academy of Social Sciences, conducted from March to July. The survey covered 7,140 households in 28 provinces, municipalities and autonomous regions.

The book also said that about 90 percent of Chinese sampled are optimistic of the country's social and economic development.

It said 83.4 percent believe the social problems are temporary and 91.6 percent believe the Communist Party of China and the government are able to deal with the problems satisfactorily.