When you think of population growth in China, one phrase may come to your mind: one child policy. But, the number of babies joining China’s citizenry is not the only population figure the country is concerned about. The elderly population is seeing a boom in longevity and their numbers are set to rise exponentially over the next four decades.
Chinese over sixty make up 12.5% of China’s population--that’s 167 million people, and the number isn’t set to peak until 2050 when it will reach an estimated 400 million. In 2009, the elderly population grew at its fastest pace ever, adding 7.25 million to its number (Office of the China National Committee on Aging). While the current life expectancy is 73 years, the number of octogenarians is also on the rise. According to the government, this age category will also grow by 1 million annually, ultimately raising the country’s life expectancy rate as China’s poverty decreases and quality of healthcare increases.
An article in People’s Daily outlined three estimated phases of aging for the elderly population:
From 2001 to 2020, it will be a phase of rapid aging. China's elderly population will increase by 5.96 million each year, with an expected aging population of 248 million by 2020.
From 2021 to 2050, China will experience an escalated process of aging. The elderly population will hit 400 million by 2050 and the number of people over 80 years old will be 94.48 million.
From 2051 to 2100, China will enter into the most severe aging phase with the aging population reaching a peak of 437 million. Afterwards, the number will start to decline and stabilize at 300-400 million.”
Pensions and policies
China’s pension system started in 1951 and has since been revised a number of times; however, the current system cannot meet the rapidly growing needs of most of China’s elderly and has not been implemented on a national scale. The official retirement age is relatively low with women eligible at 55 and men at 60. The huge working population of the past several decades made it necessary to maintain a low retirement age, in comparison to countries like the US and UK; however, this means that millions of retirees will be a part of the social security system for approximately 20 years. A steadily decreasing work force will need to pay for both the retirees and their own pensions. A private pension plan has been introduced to make up for the burden placed on the government, but it is still too new to cover many existing retired employees.
State Owned Enterprises (SOEs), which used to employ a large percentage of the population, provided pension plans for all of their employees. Now, however, the number of SOE employees has dropped as the private sector has grown. While pension plans do exist, they are not mandatory for all private sector employees or rural farmers (Forbes). Additionally, those who have earned a pension are tied to one place because their pensions are not portable.
Only one-third of current workers are earning retirement, according to a 2009 report. As such, if more reform is not enacted, there may not only be a problem with caring for the current senior population but also for those to come.
“The challenge of building a national pension system in China could hardly be more daunting. China faces the same obstacles to ensuring universal coverage that other developing countries do: a large informal sector, high levels of self-employment, and limited government enforcement capabilities,” states a report from China Stakes.
The state of China’s social security system is in a state of reform. Even with savings, which are much higher in China than in the West, most elderly cannot keep their finances afloat without support from their families. New policies are appearing slowly to meet the need. Private companies are now being induced to join the social security program and contribute to citywide funds that will be divvied up amongst eligible retirees.
Retirement for rural workers looks quite different because they neither have formal pension plans nor adhere to any sort of retirement norms. They may join voluntary pension plans, but beyond that their options are limited.
The government is by no means turning a blind eye to the problems facing its elderly population; however, the magnitude of the issue requires a slow and cautious approach. Reforms must be tested and implemented slowly.
Culture and compromise
Pensions were less of a consideration in the pre-one-child policy days. Traditionally, children take care of their parents into their old age, usually giving them money and providing housing for them. This family-based culture is changing rapidly though. Families have become more decentralized with the attraction of cities and the rise of migrant workers. In cities, children are becoming more independent and choosing to live apart from their parents. The 4-2-1 pyramid (4 grandparents, 2 parents, 1 child) poses a significant problem for only children, as well, who cannot afford to care for aging grandparents and parents, a responsibility that used to be distributed amongst several children. Additionally, the preference of male children over female has lead to a gender imbalance that also jeopardizes the traditional family structure. Usually, a husband’s family takes care of his parents. With fewer women in society and more women in the work place, there is no one to stay home and take care of aging family members.
The alternatives to family care for senior citizens cannot meet the current demand. The Global Times reports that senior citizen residential facilities have an insufficient number of beds to meet the towering demand for those elderly unable to care fore themselves and have no one to care for them. Additionally, even the state-owned homes are too expensive for the large percentage of elderly who need care. Private companies and NGOs are being encouraged to take over some of the responsibility, but it is unclear when the issue will be alleviated.
Although there is a demand for more senior care homes, the cultural norm must also be addressed. Besides costs, China’s elderly often opt out of retirement homes because it is socially embarrassing. As stated before, the cultural norm is for children to take care of their aging parents. When they are unable to do this, their parents often feel shame at needing to seek a third party for help. If these homes become more normal in Chinese society, there will be an even greater need for senior citizen homes.
Longevity is both a sign of a country’s prosperity and an indicator that good healthcare needs to be in place. Chronic illnesses and disabilities increase with the age of the population. The increased consumption of high fat and high calorie diets, smoking, and leisure time are also beginning to contribute to health issues in China’s elderly. With China’s centralized healthcare, there is an expectation that these illnesses will be treated at government-run facilities. Care varies widely from hospital to hospital and region to region, and despite being subsidized by the government, the elderly (and everyone else) can be charged heavy fees for services and medicines.
An article from the Population Reference Bureau explains, community programs, both official and unofficial, have begun to appear in urban areas to treat the elderly, as well as, to raise awareness about common chronic illnesses. Ultimately, there are not enough healthcare professionals trained to care for the needs of the elderly, but that may be changing. The government has plans to beef up medical training, including programs at the undergraduate level. More money needs to be invested in geriatric healthcare, as well as, more importance placed on this sector, which will encourage higher salaries and more professionalism.
As China modernizes more and more, how they care for the elderly will impact their ability to move forward. If healthcare gets out of hand, it could negatively affect their growth. Even more so, forgetting the needs of the older generations means forfeiting important lessons, ignoring history, and losing invaluable wisdom. The elderly must be treated with humanity and both citizens and the government will do well to remember their proverb: 老吾老，以及人之老 （lao wu lao, yi ji renzhi lao)—Honor the elderly as you honor your own parents.