Academic journal article Generations

Population Aging and Long-Term Care in China

Academic journal article Generations

Population Aging and Long-Term Care in China

Article excerpt

China's one-child generation faces severely limited familial resources when caring for their baby boomer elders.

As a consequence of population aging, all developed nations (especially North America, Europe, and Japan) face the challenge of providing long-term care for adults with various levels of disability and morbidity. China has a unique set of long-term-care practices and challenges because of its population aging process. This article will present three characteristics of population aging that are specific to China, and elucidate the major challenges the country faces with long-term care.

Three Characteristics of Chinese Population Aging

In most European and North American societies, population aging occurs because of three demographic transitions-a change from high fertility, high mortality rates in Phase 1 of agricultural societies, to relatively high fertility but low mortality rates in Phase 2 of industrializing societies, to the final stage of low fertility and low mortality rates of the post-industrial era (Moody, 2012; Chu, 1997).

In China, this process is characterized by the one-child family planning policy, which dramatically reduced China's fertility rate in the 1980s, after the major baby booms of the 1950s, 1960s, and 1970s. While fertility rates during the baby boom era in the United States averaged 3.17, in China they averaged 5.6, reaching 7.6 at their peak (Croll, 1985; Falbo and Poston, 1996; Kane, 1985).

The one-child policy and population aging

The one-child family planning policy drastically reduced population growth in the late 1970s and 1980s, with fertility rates reduced to around two children in the 1980s, and the one-child rates (or the percentage of all births that are first-parity birth) ranged above 80 percent in urban areas of China (Tsui and Rich, 2002; Croll, 1985).

Such social engineering produced the intended consequence of a 4-2-1 family structure in which the one child, once married, will have to care for four parents, plus one child of their own. At the macro level, the sudden population shrinkage will result in a top-heavy pyramid in which the working population of the one-child generation will have to work harder to provide financial support and physical care for their aging baby boomer parents.

Urbanization and population aging

Unlike most developed nations where population aging occurs after urbanization, in the post-industrial era when a social safety net has been well-established, China is experiencing population aging and urbanization simultaneously, and those trends are expected to continue for the next three to four decades. It took 120 years-from 1840 to 1960-for the United States to undergo the urbanization process, with its population transitioning from 10 percent urban to 70 percent urban (U.S. Census Bureau, 2006). But in China, this process has taken roughly thirty years (1980 to 2010), if we include migrant workers who dwell in urban areas but are not counted by the census as urban residents.

China's urban share of the total population increased from 20 percent to 50 percent in seven years (1983 to 1989) (Wu, 1994, p. 669). In some rural areas, nearly 70 percent of these migrant laborers were younger than age 35 (Hunan Migrant Labor Research Group, 1995, p. 79). In 2004, 140 million people in China were reported to be migrating from rural to urban areas for job opportunities (Yi, 2006). The sudden shrinkage of family size and massive migration of rural residents to urban areas have a profound impact on families in rural China. While migrant rural workers could supplement labor shortages in rapidly developing urban China, rural families are often leftwith the old and young caring for each other. Urbanization consequently affects population aging in both rural and urban areas. The pace of population aging is actually faster in rural than in urban China (Luo and Zhan, 2012).

Economic reforms-from socialism to the free-market system

At the time the one-child policy was implemented, the country also embarked on large-scale economic reforms; these economic reforms changed China's employment structure and social organization. …

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