Luoyang Institute of Science and Technology, PR of China
Corresponding Author’s Email: maryhuang72@163.com
In recent decades, China’s population structure has undergone sharp changes. This is due to the reasons like one child policy, various changes of lifestyle and rapid development of economy that lead to the gradual increase in the number of old individuals. So, the demands and big challenges for age care service are increasing day to day in China. The ageing population will have negative influences on Chinese economy and society due to a less productive work force and increased expenditure on welfare provisions. Currently, on account of aging population in China the government had introduced its national strategy to satisfy their demand of the health, medical service and pension.
Keywords: Ageing Population, Senior Citizens, Health Status, Nursing Care, Pension
Since the reform and openings were initiated in 1978, China’s population structure has undergone drastic changes, including the increase in the population mobility, imbalance in the population distribution, the transformation of surplus labour and high-level of unemployment (Li & Shen, 2013). According to internationally recognized standards, if citizens aged 60 and above account for 10% of the population of a nation, this country is considered an ageing society (Zhang, 2002). It is predicted that by 2025, one third of Chinese population will be elderly and a dependent populace (Zhang, Guo, & Zeng, 2012; Mai, Peng & Chen, 2013). Moreover, England (2005) demonstrated that the number of Chinese individuals aged 65 and older will increase from 7% to 23% and by the end of 2050, the number will reach
over 332 million in China.
It is obvious that China is already an ageing society (Zhang, 2002). In other words, this phenomenon may greatly affect various aspects of human social life. In addition, as reported by China Economic Net (2006) compared to decades or even hundreds of years for well developed nations, the demographic change from an adult society to an ageing society took nearly 20 years in China.
According to Zhang (2002), in 1978, there was one retired person for every 30.3 employees. In 1999, the ratio had soared to one retired person for only 3.7 employees. If the current retirement age remains unchanged at 55 for women and 60 for men, the ratio may climb further to one per 2.4 employees by 2030. Consequently, it is generally acknowledged that China, being the biggest developing country in the world, such demographic development will have negative impacts on the pattern of labor supply (Zhang, 2002). Therefore, it is projected that the social-security fund for the Chinese elderly will be unable to make ends meet.
As mentioned above, the issue is that China is facing a vital challenge concerning the ageing community. So, the most urgent problem for Chinese government at present is problems faced to provide for these vulnerable people along with considerate care and complete support. Undoubtedly, this will have profound influences on the Chinese present pattern of welfare for the elderly.
A literature search was performed using the following electronic databases: MEDLINE, CINAHL, Expanded Academic ASAP, ProQuest Central. We included studies published from 2000 to 2019 and used the following keywords, namely ageing population; senior citizens; health status; nursing care. We also examined the reference lists of included articles to identify additional studies.
China is the world’s most populous country with the largest amount of aging population. Undoubtedly it faces the consequences of the phenomenon of an ageing population. Nowadays, China begins to be more concerned about big issues, such as
low fertility and aging problems (Zhang, Guo, & Zeng, 2012). Even worse, economic growth, social welfare, aged care and other public welfare issues have great impact on different aspects of Chinese society (Zhang, Guo, & Zeng, 2012).
In China, senior citizens have their unique characteristics, such as advanced age, incapacitating, empty-nest, old before rich, regional development imbalance, urban and rural inversion, and gender differences as they age. With the deterioration of the ageing population, the previous 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 with financial support and physical care (Zhan, 2013). In addition, the elderly benefits, such as pensions and assistance with health care will also in turn create a greater financial burden on the Chinese government (Zhang, Guo, & Zeng, 2012). This may have great influences on the pension system and the medical insurance system.
Traditionally, in the previous decades, the family is expected to take major responsibility for looking after the elderly being influenced by Confucianism. Such a tradition has been preserved throughout South-East- Asia. Chinese policies and social context lead to the 4-2-1 model of care. A married Chinese couple might be responsible for taking care of 4 parents, 8 grandparents plus the demands of work and a child (William & Hong-kin 2008). Specifically, daughters-in-law would take
responsibility for majority of the care giving work and the sons would shoulder the financial burden. Nevertheless, most women in Chinese urban regions are involved in the work force, which may in turn lead to the lack of care on the women’s part (England, 2005).
Zhan (2013) claimed that 80% of elderly adults had this view, since there were no institutional services available to them when they had children. Furthermore, Li and Shen (2013) illustrated that Chinese aged adults now choose to live in nursing homes or alone rather than living with families. This is related to the fact that cultural attitudes towards looking after the elderly may be changing. In this situation, the adult children are more likely to provide their ageing parents with financial support, rather than physically taking care of their parents at home (Zhan, 2013). Also, ‘Little Emperor’s Syndrome’ may have negative impacts on aged care. This is because the only male son is generally regarded as precious treasure in a family in Chinese culture. Consequently, this great responsibility may be extremely disturbing for these adult children (England, 2005).
In addition, according to National Statistics Bureaus of China (2001), more than 64% of the Chinese old people live in rural regions. This phenomenon may lead to a series of problems, among which the most serious one is who can take care of their aged parents. Du et al., (2004) illustrated that the elderly in rural areas were more likely to experience psychological issues due to feelings of loneliness and abandonment in the absence of children. Besides, this also exerts huge pressures on the health care and social insurance systems.
In general, China currently does not have a large of number of organizations that can take care for the elderly, such as nursing care institutions, rehabilitation institutions and hospice care institutions for aged patients, especially in those third-line cities and fourth-line cities. According to China Economic Net (2006), Shanghai, as the biggest city in China that has became an 'ageing society' in 1999, earlier than any other city in
China. By the end of 2016, the city had 50,000 beds in nursing homes, and the number was expected to double within five years to cope with the great demand (China Economic Net, 2006). Thus, the phenomenon of ageing population put forward higher demands and challenges to nursing care facilities.
The alternative nursing care method is providing older pensioners with nursing facilities. In 1999, China’s elderly population reached 10%, which designates China to be an ageing society by international standards. In order to solve this issue, the Chinese government offers tax exemptions, low interest rates and direct financial contributions to those who would construct aged care facilities (Zhan, 2013).
Despite gaining the government’s full support, there is still a dramatic gap between market supply and demand. What’s more, lack of medical services and management training programs are also big issues. Staffing in these nursing institutions are also insufficient. Wages are generally low and therefore, there is a high staff turning around due to the stressful nature of the job (Understanding Modern China, 2014).
To conclude, although the elderly population are unable to work, they are still precious assets of society. This is because they still play an important role in the aspects of social development and stability. As a result, the government should protect senior citizens' interests and their rights by the legal system.
Overall, establishing the comprehensive nursing system is not easy. For the long run, it needs the cooperation and efforts of the whole society to seek the suitable strategies
in order to satisfy the older generation’s health and medical needs. Fortunately, currently, a growing number of nursing facilities are built up and they are playing vital roles in looking after old adults. It has been proven that a multiple security network -- including a government-operated public pension fund, compulsory individual savings and a complementary voluntary endowment policy -- will be the most suitable method for an ageing society.
China Economic Net (2006). Ageing population tests social security. Available at: http://en.ce.cn/National/Politics/200612/13/t20061213_9746160.shtml.
China Economic Net (2006). Shanghai tackles ageing issue, Retrieved from: http://en.ce.cn/National/Local/200606/28/t20060628_7546456.shtml.
Du, P., Ding, Z., Li, Q. & Gui, J. (2004). The impact of out labor migration on the elderly stayers in rural areas. Population Research, 28, 6, 44–52. [In Chinese.]
England, R.S. (2005). Aging China. The demographic challenge to China’s economic prospects. Westport papers: Praeger Publishers.
International Monetary Fund. (2011). World economic outlook: Slowing growth, rising risks. Available at: http://www.imf.org/external/pubs/ft/weo/2011/02/.
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Mai, V., Peng, X., & Chen, W. (2013). How fast is the population ageing in China. Asian Population Studies, 9(2), 216-239.
National Statistics Bureaus of China (2001). China Statistical Yearbook: 2001. China Statistics Press, Beijing.
Understanding Modern China (2014). The problems of China’s ageing population. Available from:
https://uosm2018.wordpress.com/2014/03/06/the-problems-of-chinas-ageing-p opulation/.
Zhan, H. (2013). Population ageing and long-term care in China. American Society on Ageing, 37(1), 53-58.
Zhang, B.B. (2002), China Faces the Challenge of an Ageing Population, China Daily,
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William, L.K.M. & Hong-kin, K. (2008). Ageing in the People's Republic of China: Developing a National and Local Framework for Elderly Care, Retrieved from http://www.tasa.org.au/conferences/conferencepapers04/docs/FAMILY/LEE_ KWOK.pdf.