Aging Of China
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China's population is aging faster than almost all other countries in modern history. In 2050, the proportion of Chinese over retirement age will become 39 percent of the total population according to projections.
China China, officially the People's Republic of China (PRC), is a country in East Asia. It is the world's most populous country, with a population exceeding 1.4 billion, slightly ahead of India. China spans the equivalent of five time zones and ...
is rapidly aging at an earlier stage of its development than other countries. Current demographic trends could hinder
economic growth Economic growth can be defined as the increase or improvement in the inflation-adjusted market value of the goods and services produced by an economy in a financial year. Statisticians conventionally measure such growth as the percent rate of ...
and create challenging
social problem A social issue is a problem that affects many people within a society. It is a group of common problems in present-day society and ones that many people strive to solve. It is often the consequence of factors extending beyond an individual's cont ...
s in China. In 1979, the
Chinese government The Government of the People's Republic of China () is an authoritarian political system in the People's Republic of China under the exclusive political leadership of the Chinese Communist Party (CCP). It consists of legislative, executive, mili ...
established a controversial
one-child policy The term one-child policy () refers to a population planning initiative in China implemented between 1980 and 2015 to curb the country's population growth by restricting many families to a single child. That initiative was part of a much bro ...
aimed at curbing the high fertility rate. With economic development, the provision of
social services Social services are a range of public services intended to provide support and assistance towards particular groups, which commonly include the disadvantaged. They may be provided by individuals, private and independent organisations, or administe ...
, and improved
welfare Welfare, or commonly social welfare, is a type of government support intended to ensure that members of a society can meet basic human needs such as food and shelter. Social security may either be synonymous with welfare, or refer specificall ...
conditions,
life expectancy Life expectancy is a statistical measure of the average time an organism is expected to live, based on the year of its birth, current age, and other demographic factors like sex. The most commonly used measure is life expectancy at birth ...
in China has also increased. These two factors have directly contributed to China's aging population, which has significant ramifications on China's society, politics, and economy. In October 2015, a two-child policy was introduced in an attempt to deal with the aging problem. In May 2021, the Chinese government introduced the
three-child policy Three-child policy ( zh, , p=Sānhái Zhèngcè, s=三孩政策), whereby a couple can have three children, was a family planning policy in the People's Republic of China. The policy was announced on 31 May 2021 at a meeting of the Politburo of t ...
in a further attempt to address the issue. After only two months, in July 2021, all family size limits as well as penalties for exceeding them were removed. Between 2021 and 2022, the Chinese population decreased by 850,000 people, the first decrease since 1961.


Overview

From 1950 to 2020, the
total fertility rate The total fertility rate (TFR) of a population is the average number of children that would be born to a woman over her lifetime if: # she were to experience the exact current age-specific fertility rates (ASFRs) through her lifetime # she were t ...
in China dropped from 6.11 to 1.3 births per woman while the
mortality rate Mortality rate, or death rate, is a measure of the number of deaths (in general, or due to a specific cause) in a particular population, scaled to the size of that population, per unit of time. Mortality rate is typically expressed in units of de ...
also decreased, from 22.2 to 7.1 per 1,000 people. Life expectancy rose from 44.6 to 77.47 years during this period and is expected to reach about 80 years in 2050. In 2018, 249.49 million people over 60 years old constituted 17.9 percent of the total population. In the rural area, the percentage of the elderly population is slightly higher than that in the city. The fastest aging region is
Western China Western China (, or rarely ) is the west of China. In the definition of the Chinese government, Western China covers one municipality (Chongqing), six provinces (Sichuan Sichuan (; zh, c=, labels=no, ; zh, p=Sìchuān; alternatively r ...
.


Causes

China's aging population is caused by a low birth rate together with prolonged human life expectancy.


Low fertility rates


One-child policy

In order to suppress excessive population growth, the one-child policy was introduced in 1979. The enforcement methods include financial penalties, widespread use of various contraceptive methods, as well as more severe
forced abortion A forced abortion may occur when the perpetrator causes abortion by force, threat or coercion, or by taking advantage of a situation where a pregnant individual is unable to give consent, or when valid consent is in question due to duress. This ma ...
and sterilization. As a result, birth rates and population growth rates have drastically decreased. Previously, the fine is so-called "social maintenance fee" and it is the punishment for the families who have more than one child. According to the policy, the families who violate the law may bring the burden to the whole sociey. Therefore, the social maintenance fee will be used for the operation of the basic government.


Reproductive health of couples

With economic growth and social development, increasing smoking, alcohol use, unhealthy diets, and
psychological stress In psychology, stress is a feeling of emotional strain and pressure. Stress is a type of psychological pain. Small amounts of stress may be beneficial, as it can improve athletic performance, motivation and reaction to the environment. Exces ...
have an effect on lowering the fertility rates of couples. Surging
pollution in China Pollution in China is one aspect of the broader topic of environmental issues in China. Various forms of pollution have increased as China has industrialised, which has caused widespread environmental health problems.Jared Diamond, '' Collapse: ...
also has an impact on male sperm count, which has been declining since the 1970s. At the
Chinese University of Hong Kong The Chinese University of Hong Kong (CUHK) is a public research university in Ma Liu Shui, Hong Kong, formally established in 1963 by a charter granted by the Legislative Council of Hong Kong. It is the territory's second-oldest university an ...
, a team of scientists studied the sperms from approximately 6,500 men and found a "strong correlation" between high levels of air pollution and "abnormal sperm shape". Researchers point out that many particulate matter components are associated with sperm damage in experimental studies. Exposure to air pollutants may cause free radicals to exceed body's regulation ability, adversely altering biologically relevant molecules such as DNA and triggering human diseases. These conditions may be associated with a significant number of infertile couples, lowering the fertility rate.


Cultural impact

China's
sex ratio The sex ratio (or gender ratio) is usually defined as the ratio of males to females in a population. As explained by Fisher's principle, for evolutionary reasons this is typically about 1:1 in species which reproduce sexually. Many species devia ...
is the most skewed in the world. The country's ratio of males to females is skewed 3% to 4% higher towards males. In the traditional, patriarchal society, many Chinese people believed that men were more important than women. This mindset has continued to be prevalent in modern China, especially in rural areas, resulting in high female fetal abortion rates and even
female infanticide Female infanticide is the deliberate killing of newborn female children. In countries with a history of female infanticide, the modern practice of gender-selective abortion is often discussed as a closely related issue. Female infanticide is a ma ...
. The imbalance in sex ratio has led to a decrease in marriage rates and birth rates in China.


Extension of human life span

The improvements in social welfare and the medical system have prolonged people's life span. Since 1949, the general health of the Chinese people has greatly improved, and the life expectancy has increased by about 30 years, from 44.6 to 75.3 years from 1950 to 2015. It is expected to reach approximately 80 years in 2050. The minimum income security in rural areas has been expanded and is covering more than 50 million residents in poor areas. The Chinese government has unified the welfare systems of urban and rural migrants, and the
pension system A pension (, from Latin ''pensiō'', "payment") is a fund into which a sum of money is added during an employee's employment years and from which payments are drawn to support the person's retirement from work in the form of periodic payments ...
covers nearly 700 million people. Despite the improvement of China's social welfare system, there are still huge inequalities in health between urban and rural areas. Compared with urban peers, the number of medical service providers for rural residents is significantly reduced, and the utilization rate of facilities is low, resulting in their poor health. Since the late 1990s, three new
medical insurance Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among ma ...
systems have been established by the government to provide more
health care Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profe ...
services. In 2009, urban and rural health insurance reforms achieved greater coverage. More advanced medical techniques have reduced the prevalence of diseases and increased survival.


Impacts

The demographic trend of aging population has social, political and economic ramifications in China. The growth of the elderly population has increased the
dependency ratio The dependency ratio is an age-population ratio of those typically not in the labor force (the ''dependent'' part ages 0 to 14 and 65+) and those typically in the labor force (the ''productive'' part ages 15 to 64). It is used to measure the press ...
and the prevalence of many
chronic disease A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term ''chronic'' is often applied when the course of the disease lasts for more than three mo ...
s. Aging society has also brought about changes in public policy. The weakening of the
labor force The workforce or labour force is a concept referring to the pool of human beings either in employment or in unemployment. It is generally used to describe those working for a single company or industry, but can also apply to a geographic regio ...
has negative impacts on China's economic growth and development, which was originally driven by the labor market.


Social

Rapid aging could create challenging social problems and increase the risk of social instability in China. Due to the lower fertility rate and extension of the human life span, the population in China is aging faster than almost all other countries. In 2050, the proportion of Chinese over retirement age will become 39 percent of the total population. At that time, its dependency ratio will rise to 69.7%, almost twice as high as that in 2015, which was about 36.6%. The higher dependency ratio is associated with the greater pressure placed on those who are working to support the rest of the population. Even if the Chinese government provides part of the financial support for the elderly through social welfare, such as pensions and public welfare homes, there are still many elderly people in China who are unable to be taken care of. In 2015, there were, on average, 27 beds per 1,000 elderly in nursing homes in China, far fewer than those in the United States or Germany. The aging population in China has increased the incidence and types of chronic diseases. Chronic diseases include four basic types:
cardiovascular disease Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, h ...
s,
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
,
respiratory disease Respiratory diseases, or lung diseases, are pathology, pathological conditions affecting the organs and tissues that make gas exchange difficult in Breathing, air-breathing animals. They include conditions of the respiratory tract including the t ...
s, and
diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ap ...
. There are nearly 300 million chronic patients in China, half of whom are over 65 years old. During aging, many cellular and molecular events break down and eventually lead to a variety of chronic diseases, such as
coronary heart disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic pla ...
s (CHD). The number of CHD incidents and deaths in China will increase dramatically from 2010 to 2029; among Chinese adults aged 35–84, a 64% increase in CHD occurrences is predicted between 2020 and 2029.


Political

A large number of the elderly population has increased the pressure on the Chinese government to allocate the pensions and make social welfare more accessible. The lack of conventional financial infrastructure and the extent of the aging population make it difficult for China to provide a holistic solution. Even at an economic growth rate of 8 percent, pension spending is growing much faster at a rate of 15 percent per year. Pension expenditure increased by 11.6% in 2016, reaching 2.58 trillion yuan, with a shortfall of 429.1 billion yuan, requiring government subsidies. Since the establishment of the pension system, China has been paying the income of retirees with the contribution of the working population. As more people retire and fewer people enter the labor market, the gap between income and expenditure will continue to widen. China's Working Committee on Ageing suggested that the inclusion of improved care services for the elderly in the national development road-map would be a key measure for the top leadership to cope with population aging. The elderly care service market provides more opportunities for private capital and non-governmental organizations so that the elderly can have more service choices.


Geopolitical

China's aging population could hinder economic growth, create challenging social problems, and limit its capabilities to act as a new global hegemon. Ryan Hass, a senior fellow in foreign policy at the
Brookings Institution The Brookings Institution, often stylized as simply Brookings, is an American research group founded in 1916. Located on Think Tank Row in Washington, D.C., the organization conducts research and education in the social sciences, primarily in ec ...
, said, "China is at risk of growing old before it grows rich, becoming a graying society with degrading economic fundamentals that impede growth." He went on to say, "The working-age population is already shrinking; by 2050, China will go from having eight workers per retiree now to two workers per retiree. Moreover, it has already squeezed out most of the large productivity gains that come with a population becoming more educated and urban and adopting technologies to make manufacturing more efficient."
Nicholas Eberstadt Nicholas Eberstadt (born 1955) is an American political economist. He holds the Henry Wendt Chair in Political Economy at the American Enterprise Institute (AEI), a political think tank. He is also a Senior Adviser to the National Bureau of Asia ...
, an economist and demographic expert at the
American Enterprise Institute The American Enterprise Institute for Public Policy Research, known simply as the American Enterprise Institute (AEI), is a center-right Washington, D.C.–based think tank that researches government, politics, economics, and social welfare. ...
, said that current demographic trends will overwhelm China's economy and geopolitics, making its rise much more uncertain. He said, "The age of heroic economic growth is over." Brendan O'Reilly, a guest expert at Geopolitical Intelligence Services, wrote, "A dark scenario of
demographic Demography () is the statistical study of populations, especially human beings. Demographic analysis examines and measures the dimensions and dynamics of populations; it can cover whole societies or groups defined by criteria such as edu ...
decline sparking a negative feedback loop of
economic crisis An economy is an area of the production, distribution and trade, as well as consumption of goods and services. In general, it is defined as a social domain that emphasize the practices, discourses, and material expressions associated with the p ...
, political instability, emigration and further decreased fertility is very real for China".


Economic


Labor force

Since economic expansion is the sum of input factor growth and productivity growth, it will require a substantial increase in
labor productivity Workforce productivity is the amount of goods and services that a group of workers produce in a given amount of time. It is one of several types of productivity that economists measure. Workforce productivity, often referred to as labor product ...
to sustain the same top-line growth as the population ages. China's aging population has led to a contraction of the labor force that induces a slowing economic growth. In 2017, China's total working-age population (aged between 15 and 64) was 988.3 million, which dropped by a large margin of 70 million from the end of 2016. China is urged to raise the legal age of retirement to cope with the problem of a reduced labour force. In 2016, the Chinese government announced plans to gradually raise the retirement age from 50 years old to over 60 years old. It may expand productivity and improve the sustainability of national pension accounts by improving the level of education and skills of Chinese workers to make up for the gap from the decreasing proportion of the working-age population. In order to improve the quality of the labor force, the number of university enrollment has increased by seven times since 1999 in China. Aging in China has affected women's labor force participation to a certain extent. A large proportion of grandparents in China provide the free services of raising grandchildren for their children. This constitutes a main reason why women decide to stay in the labor market. China has a relatively high female labor force participation rate of 61.5%.


Allocation of government funds

An increase in the number of retirees and a decrease in the number of
taxpayer A taxpayer is a person or organization (such as a company) subject to pay a tax. Modern taxpayers may have an Taxpayer Identification Number, identification number, a reference number issued by a government to Citizenship, citizens or Company, f ...
s will affect the government's allocation of funds. The expansion of the elderly ratio forces the government to support them by providing pensions and expanding social welfare, which will affect the
government budget A government budget is a document prepared by the government and/or other political entity presenting its anticipated tax revenues (Inheritance tax, income tax, corporation tax, import taxes) and proposed spending/expenditure (Healthcare, Educa ...
. China's pension funds accounted for nearly 70% of China's social security income in 2017. Without subsidies from the central government, many local pension funds will run into a deficit, of which the total is expected to rise from 234 billion yuan to 534 billion yuan in 2022.


Government policies

In order to alleviate the population aging in China, the Chinese government has relaxed and ultimately abolished its child limitation policies.


Two-child policy

In October 2015, the two-child policy was introduced to replace the one-child policy. China has been taking gradual measures to eliminate the one-child policy. In 2009, if both parents were only children, they were allowed to have two children. In 2014, most provinces in China further relaxed their policies, allowing families to have two children if one of the parents was an only child. However, since the implementation of the two-child policy, there has been no significant improvement in China's population aging. It is expected that the effect of the policy will not be significant until two decades later. After the relaxation of the one-child policy, 17.9 million babies were born in 2016, an increase of 1.3 million over the previous year, but only half of what was expected. In 2017, the birth rate fell to 17.2 million, far below the official forecast of more than 20 million.


Three-child policy

In May 2021, the Chinese government introduced the
three-child policy Three-child policy ( zh, , p=Sānhái Zhèngcè, s=三孩政策), whereby a couple can have three children, was a family planning policy in the People's Republic of China. The policy was announced on 31 May 2021 at a meeting of the Politburo of t ...
in a further attempt to address the issue. However, the improvement has been limited since the implementation of the policy, largely due to the impact of
COVID-19 Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was COVID-19 pandemic in Hubei, identified in Wuhan, China, in December ...
, economic uncertainty and people's current struggles in supporting children as well as old parents.


Policy support for the elderly

Article 28 of the 1980
New Marriage Law The New Marriage Law (also First Marriage Law, ) was a civil marriage law passed in the People's Republic of China on May 1, 1950. It was a radical change from existing patriarchal Chinese marriage customs , and needed constant support from propag ...
formalizes the obligations of supporting grandparents for those "who can afford it Reinforcing this responsibility, the 1985 Inheritance Law provides that if a parent dies without a will, the disposition of property is applied heavily in favor of children who cared for the deceased. The 1996 Law to Protect the Rights and Interests of the Elderly (''laonianren quanyi baozhang fa'') obligates children to provide for their elderly (defined as aged sixty or greater) parents, including providing housing, living costs, and health care. Article IV prohibits discriminating against, maltreating, or forsaking the elderly.


References

{{Asia in topic, Aging of Demographics of China
China China, officially the People's Republic of China (PRC), is a country in East Asia. It is the world's most populous country, with a population exceeding 1.4 billion, slightly ahead of India. China spans the equivalent of five time zones and ...