The problems of China’s ageing population

6 Mar

China’s population structure has undergone drastic changes in recent years (Li & Shen, 2013). The one child policy saw a shift from high fertility and infant mortality to lower levels of both (Zhan, 2013). Alongside this, improved public health care system as a result of economic growth has meant life expectancy increased (Mai, Peng, & Chen, 2013). These changes mean that China is ageing much faster than most countries (England, 2005) and consequently are having to deal with the social and economic issues associated with this. Although anti-ageing has always been a prominent feature in the Chinese culture, illustrated through Chinese medicine and various lifestyle changes, the ageing problem is only predicted to increase. It is predicted that by 2025, one third of Chinese population will be elderly dependents (Zhang, Guo, & Zeng, 2012).

An increasingly mobile population has meant a distribution imbalance between the rural and urban regions. For some however, this is not seen as an issue, as agricultural productivity is fairly low in comparison to the urban environment. Therefore the migration of labour to the cities is seen as necessary (Li & Shen, 2013). The economic growth experienced by China as a result of this high labour productivity is predicted to slow with the ageing population. The one child generation, created by China’s one child policy, will have to work significantly harder with a smaller work force, to support their ageing parents (Zhan, 2013). Elderly benefits such as pensions and assistance with health care will also create a greater financial burden on the country when the period of claiming increases alongside the amount of people claiming. The growth of a dependent population will also cause labour costs to rise while production stays the same. This may result in a loss of foreign direct investment, as capital will flow to other countries where the profits will be higher (Zhang, Guo, & Zeng, 2012).

Another challenge to the economic resources of China is the need for increased disease prevention. The ageing population has led to the rise of communicable diseases such as tuberculosis and hepatitis (England, 2005). These diseases are associated with more than 8% of 10.3 million annual deaths, and the elderly are especially vulnerable. The government is tackling this issue through increased education (Zhang, et al 2012). The television show Yangshen Tang consists of a panel of experts that share information on diseases, traditional Chinese medicine, mental health and diet. This easily accessible way of educating the population was well received by all, not just the elderly (Zhang, et al 2012).  The quality of medical care has greatly improved, especially in rural areas, however patients must pay for this treatment out of their own pocket as social security benefits are not provided for the rural population. Those working in the informal sector do not receive these either (Zhang, et al 2012). The free market system and privatisation of the majority of companies mean that the ‘iron-rice bowl’ of benefits is no more. Workers used to be government hired and received a life time of job security, medical benefits and a fixed pension. Now that only 20% of enterprises are government owned, health care is difficult to access (England, 2005).

With the lack of care provided by the state, the family is expected to take on much of the responsibility. Traditionally, long term elderly care has been taken on by the adult children, this practise is known as ‘Xiao’. Prior to the 1980’s, 80% of elderly adults were looked after in this way, as no institutional services were available to them if they had children (Zhan, 2013). Although many families still express a willingness to provide care in this way, increased mobility and the decline of the traditional family structure means this is often problematic. 56% of those who moved into institutional care facilities reported their reason for doing so was because they no longer had any family living nearby. However cultural attitudes towards looking after the elderly may be changing. Research now shows that the elderly in urban areas are becoming increasingly financially independent (Li & Shen, 2013). They are now choosing to live in an institution or alone rather than living with families. Xiao has also been reinterpreted, families may now see this as more an opportunity for financial support, rather than physically taking care of their parents at home (Zhan, 2013).

The one child policy inadvertently created a 4-2-1 structure in China. Meaning that, once married, one child must care for four parents as well as how many children they may have, since the one child policy is no longer enforced (Zhan, 2013). Traditionally, daughters-in-law would take responsibility for the majority of the care work and the sons would shoulder the financial burden. However now the majority of women in urban areas are involved in the work force so this gendered practise of care may need to be reassessed. The lack of women to fulfil these caring roles is also a problem (England, 2005). The gender imbalance in China reached 116 males to every 100 females in 2000. ‘Little emperor’s syndrome’ may also have an effect on elder care. The only male son would have received vast amounts of attention from his parents due to the cultural attitude at the time. This large responsibility may be extremely intimidating to these adult children (England, 2005).

The alternative care method is placing elders in institutional facilities. In 1999, China’s elderly population reached 10% which formally makes China an ageing population by international standards. The government responded to this by offering tax exemptions, low interest rates and direct financial contributions to those who would set up care facilities (Zhan, 2013). Despite gaining popularity and acceptance, there is a dramatic gap between market supply and demand. Lack of medical services and management training are also issues. Problems with staffing in these institutions are also frequent. Wages are generally low and there is a high staff turn around due to the stressful nature of the job.

In conclusion, the ageing population will effect Chinas economy through a less productive work force and increased spending on welfare provisions. Social problems such as issues with health care and changing family relationships can be detrimental to the elderly Chinese public. However the government recognises these concerns and are doing their best to counteract them through tax breaks for institutional car facilities and a renewed focus on public health.


England, R. (2005). Aging China. The demographic challenge to China’s economic prospects. Westport: Praeger Publishers.

Li, M., & Shen, K. (2013). Population ageing and housing consumption: a non linear relationship in China. China & World Economy, 21(5), 60-77.

Mai, V., Peng, X., & Chen, W. (2013). How fast is the population ageing in China. Asian population studies, 9(2), 216-239.

Zhan, H. (2013). Population ageing and long-term care in China. American Society on Ageing, 37(1), 53-58.

Zhang, N., Guo, M., & Zeng, X. (2012). China: awakening giant developing solutions to population ageing. The Gerontologists, 52(5), 589-569.


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