Population ageing in China – who will take up the slack?

22 Feb

Population ageing is occurring across the world, and especially in the world’s most developed countries. This demographic trend is also taking place in China, which is categorised as an upper-middle income country by the World Bank (World Bank, 2014). Population ageing comes about from a combination of declining fertility and increasing longevity and life expectancy (Lutz et al, 2008). The pace of population ageing in China is far greater than experienced in Western developed countries and Eastern developed countries such as Japan (Joseph and Phillips, 1999). Not only are the numbers of elderly people increasing but also the age people are living to is increasing. With a population of approximately 1.4 billion, the number of elderly people (over 65 years) is exceedingly large at over 113 million (UNPD, 2014). This number is projected to increase to 195 million in 2025 and 330 million in 2050 (UNPD, 2014). The number of very old (over 80 years) is also increasing significantly and is projected to rise from 20 million in 2010 to 90 million in 2050 (UNPD, 2014). China’s population policies have, inevitably, had a role to play in this demographic trend. The dramatic drop in Total Fertility Rates (TRF) from almost 6.0 in the late 1950s to 1.8 today was largely a result of China’s population and fertility policies such as the one-child policy (Yi and Vaupel, 1989). Falling birth rates, and consequently smaller young cohorts, combined with increasing longevity result in dramatic increases in the proportions of elderly within the population.

With an increasingly elderly population the question of who is going to support and care for them arises. Since the 1980s China has experienced a demographic dividend with falling dependency ratios and a large working age population to support the young and elderly. This demographic dividend fuelled China’s industrialisation and development but has now ended as China’s dependency ratio has stopped falling and started increasing (Fang, 2010). In order to sustain its economic growth, China must respond correctly to this new challenge.  One way in which this can be done is by increasing the retirement age in order to increase the working population. This however is problematic for China as the working elderly are less educated and less skilled than the younger workforce and therefore less employable (Fang, 2010).  The ability of elderly people to work beyond retirement age is also largely dependent on their health and therefore those who are unable to work, and who have no savings or pensions to fall back on, will require care and support.

The Chinese state expects families to be self-provisioning and to provide care and support for each other (Joseph and Phillips, 1999). Within the family it is the women who are expected to take on the burden of care.  There are a number of problems with this expectation however. Women, and especially younger women, are increasingly likely to be employed and often migrate to cities in order to find work. This makes them less able to provide the support and care for their elderly parents on a regular basis. Whilst greater income as a result of women earning may allow them to provide hired care, it is often not sufficient (Joseph and Phillips, 1999). The number of women available to provide care is therefore reduced by their increasing participation in the labour force. China’s one child policy may also be a factor in the apparent lack of women.  Son preference is strong in China, partially as traditionally it is the males who look after their own parents and the females are expected to move into their husbands home and care for his parents. As a result of the restrictions in the one-child policy many female foetuses have been selectively aborted so that the would-be parents can have a son. In rural areas however the policy allowed a second birth if the first child was a girl (Joseph and Phillips, 1999). These occurrences have dramatically skewed the sex ratios at birth within China. In the 1990s there were roughly 1.14 males per female and this increased further to roughly 1.23 in 2000, compared to the natural ratio of between 1.03 and 1.07 (Joseph and Phillips, 1999: Ding and Hesketh, 2006). Skewed sex ratios alongside increases in working women have led to a deficit in the supply of carers in China.

Elderly care itself is changing in China. Increasing longevity in the population does not directly imply added years of healthy living. Often these extra years added to life expectancy are spent in poor health or disability as chronic and degenerative diseases are more common at older ages. Physical impairment and psycho-geriatric disorders such as Alzheimer’s disease make care in the home particularly difficult (Phillips et al 1994 cited in Joseph and Phillips, 1999). Consequently, the type of care and along with the type of carer has changed over the last 20 or so years (Joseph and Phillips, 1999).

It seems that China has been propelled by its demographic dividend and large workforce over the last few decades but as this is coming to, or has come to, an end China’s future is less certain. In addition to an ageing population China’s population is set to begin declining in 2030 and is projected to fall to 1.1 billion in 2100 and by 2050 India is expected to take China’s place as the most populous nation (UNPD 2014: Dyson, 2010). With dependency ratios rising again in China, as a result of the growing elderly dependent population, the time has come for policy makers to act in order to fill the vacuum of elderly care which can no longer be dependent on women.  With a decreasing proportion of its population in the workforce China needs to promote female labour force participation and therefore must find alternatives to family, or rather female-led, elderly care.​

Reference List:


  • Ding, Q.J. and Hasketh, T. (2006), Family size, fertility preferences, and sex ratio in China in the era of the one child family policy: results from national family planning and reproductive health survey, BMJ, 333, pp. 371-373.
  • Dyson, T. (2010), Population and Development: The Demographic Transition, Zed Books, London.
  • Fang, C. (2010) Demographic Transition, demographic dividend, and Lewis turning point in China, China Economic Journal, 3.2 pp. 107-119.
  • Joseph, A and Phillips, D. (1999), Ageing in rural China: Impacts of increasing diversity in family and community resources, Journal of Cross-Cultural Gerontology, 14, pp. 153-168.
  • Lutz, W. Sanderson, W. and Scherbov, S. (2008), The coming acceleration of global population ageing, Nature, (451) pp. 716-719.
  • United Nations Population Division (UNPD), (2014), World Population Prospects: The 2012 Revision, [online] Available from: http://esa.un.org/unpd/wpp/index.htm [Accessed: 22/02/2014].
  • World Bank (2014), China, [online] Available from: http://www.worldbank.org/en/country/china [Accessed: 22/02/2014].
  • Yi, Z. And Vaupel, J. (1989), The Impact of Urbanisation and Delayed Childbearing on Population Growth and Aging in China, Population and Development Review, 15.3, pp. 425-445.

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