Family Dynamics and Living Arrangement of Elderly Persons Acknowledgement

4 Discussion and Policy Considerations

A combination of rapid fertility decline since 1970, continued decrease in mortality, and the large baby-boom cohorts born in the 1950s, 1960s and early 1970s is the demographic base for the extremely rapid population aging in China. Total fertility rates in China tremendously declined from about 6 children per woman before 1970 to about 2.6 children by the end of the 1970s, cut by more than a half in a decade. Chinese fertility continued to steadily fall (with some fluctuation around 1987) to slightly below replacement level today. While the tremendously declined fertility since 1970 has resulted in smaller cohorts of young persons, the large cohorts born during the first and second baby booms in the 1950s, 1960s and early 1970s will become elderly in the first half of next century. There were 172 million persons age 35-44 (born in 1950-1959) in 1995, and they will become elders age 65+ after 2015-2024. There were 355 million persons age 20-34 (born in 1960-1974) in 1995, and they will be age 65+ after 2025-2039. Continued mortality decline will enable more members of those huge baby boom cohorts to survive to old ages. As indicated by Grigsby and Olshansky [7, p328], at least 50 percent of the projected increase in population aging between 1980 and 2050 in China is a product of the momentum for aging that is already built into the present age structure and vital rates.

Obviously, the trend of Chinese population aging is not avoidable, and further declines in mortality and fertility will accelerate this trend. What can we do in responding to such extremely rapid aging in China? Analyses presented in this paper suggest that strengthening family support for the elderly is one policy strategy that needs to be investigated and adopted. As discussed above, large majorities of Chinese elderly, especially the oldest old persons, live with their children including grandchildren. The strong cultural preference of the Chinese elderly for living with children has lasted for thousands of years. The benefits of co-residence with children among the majority of the Chinese elderly are not only financial and material support, but also psychological satisfaction (Lin 1995: 141). The Chinese government needs to consider a series of policies that aim at strengthening family support for the elderly. For example, adequate tax exemption and favorable housing policy may be awarded to persons living with old parents. To encourage family support for the elderly and satisfy the increasing needs of privacy and independence in daily life, the so-called parent-child proximity apartment units need to be promoted through governmental subsidies. The basic idea is to have two kitchens, two living rooms and at least two bathrooms in one apartment unit. The unit is structured such that old parents and one of their adult children and his or her family live in the same housing unit, while both generations can also enjoy their own privacy and independence. Elderly can easily receive assistance from children and they may conveniently provide help to care for grandchildren, and at the same time, generation differences with respect to preferences for eating, watching TV, and time schedules of daily activities etc. can be preserved.

Population aging in China in the next century will lead to a heavy burden of support for a mass of elderly people, and aging problems will be more serious in rural areas than in urban areas. How to respond to the problems of population aging in rural areas is an urgent issue on China's agenda for the 1990's and the next century. Given the strong cultural preference of the Chinese elderly for living with children and the possibility of maintaining or even strengthening family support in China, should government give all or major responsibilities of old age care to families? Because there is so far very little social insurance program in the Chinese rural areas and limits on government resources, some people including some policymakers proposed an official statement that old age support in rural areas should mainly rely on family. We think that this policy idea is inappropriate for several reasons. First, mainly relying on family for old age support in rural areas may not be feasible in the next century, because the aging problems will be more serious in rural areas than in urban areas. The future rural elderly will have on average 2 or a little bit more children, and many of their children may migrate to urban areas (in contrast to the rural elderly in the past and today who had about 6 children staying in rural areas). The joint survival of parents and children will substantially increase [39] in the future, so that the future burden of caring for old parents per child will be much larger than today. Second, mainly relying on family support without social security would largely limit the independence of the elderly in decision-making concerning their own private lives. Family support plus social security would place elderly in a much better position for enjoying happiness. Third, couples in many less developed rural areas still bear three or more children. One of the popular ideas and practical needs for having more children especially sons is expressed in the old Chinese saying "having sons for old age care" (yang er fang lao). When fertility is greatly reduced, the practical needs of "having sons for old age care" have led people to try to conduct prenatal sex determination by ultrasound diagnostic and other techniques, and sex-selective abortions [49]. The reported sex ratio at birth reached 117.0 boys per 100 girls in 1997 [36], in contrast to the normal value of about 106. If the government officially states that "old age supports mainly rely on family in rural areas", peasants may say: "if we do not have more children and at least one son, how could the elderly be supported?" Obviously, such a policy will not good for family planning and reversing the dangerous trend of a rising sex ratio at birth. Establishment of an old age insurance system in rural areas is therefore an extremely important response to population aging, family planning and reversing the sex ratio at birth in China. However, is it practical and how can peasants who were just lifted out of poverty be mobilised to make contributions of premium for old age insurance? Is it feasible and how can an old age insurance program be implemented in the less developed rural areas? With such questions in mind, the first author went to Shandong and Shichuan provinces, which are the experimental areas for the old age insurance program in rural areas, to conduct field studies in 1993 and 1996. The evidence gathered in this and other studies show a promising trend in the direction of establishing the old age insurance programs in rural areas. However, this great engine has just started and it is facing and will continue to face many problems and difficulties. The Chinese government and the society at all levels should pay more attention and make more efforts in this area [52].

The old pension system that was implemented in the state-owned enterprises in the urban areas in China was established in the 1950s and based on the former Soviet Union's model at that time. Many Chinese reformers have recognised the urgent needs for reforming the old pension system in urban areas. Moreover, the new system should also cover all other citizens who are not working in state-owned enterprises. Chinese policymakers should continue to act effectively to establish and reform old age insurance systems in both rural and urban areas, which may be regarded as building a new Great Wall to prevent the possible crises that may be caused by extremely rapid population aging in China in the next century.

In addition to an old age insurance program that is critical to respond to aging challenges and reduce son preference, another important policy recommendation is to encourage elders to live with their daughters. This study has shown that this policy option is highly feasible, given the fact that nearly 30 percent of the elderly in urban areas lived with their daughters in 1990, and this figure was nearly 18 percent for rural and urban areas combined. If the government provides economic or moral rewards and the public media give more publicity to families with old parents and their daughters living together, the traditional preference for sons may gradually lose its market. Since daughters and their spouses are usually more willing and able to provide better physical and psychological care to their old parents, a policy for promoting living with daughters may be beneficial for the elderly as well.

Data analyses presented in this paper have shown that elderly women are much more likely to be widowed, and more likely live alone. Elderly women are economically more dependent and less likely to use long-term care facilities. The disadvantages of older women in marital status and living arrangements are substantially more serious at advanced ages and in rural areas. This is another important issue, which needs serious attention from society and government. Any kind of long-term care services sponsored by the government should take into account the disadvantaged status of elderly women, and give them favorable policy. Very careful attention should be given to make sure that any old age insurance programs to be developed or reformed must benefit older women and men equally.

Numerous studies have shown that the elderly are not only consumers and care receivers, but also producers and care providers, especially when they are still healthy. Based on a elderly survey conducted in the Wuhan area in China, Liang, et al. [18, p58] found that Chinese elderly usually provide a substantial amount of help to others while they receive care, and they are satisfied with such interpersonal supportive ties. In addition to helping their children with housework and caring for grandchildren, the younger and healthy elderly can provide supplementary assistance in caring for older and frailer elderly, either within or outside of their own families. For example, the success of care services organized by the neighborhood committee in Shanghai illustrates the value in fostering community programs, which mobilize younger and healthier elderly to provide accessible services for the dependent elderly [19, p145]. It was estimated that one-fourth to one-third of China's elderly continue to be employed in paid or volunteer work. Many retired professionals, for example, provide technical consulting services to small firms located in towns or villages [24, p19]. Properly mobilizing and organizing the elderly to participate in community services and interpersonal exchange programs also will improve elderly persons' spiritual wellbeing, particularly continuing to feel needed and productive. This is one of the important policy actions to be considered to resolve the serious aging problems in the next century.

Facing the extremely rapid population aging, we believe that China needs to start from now on to smoothly transit to a "two-child plus spacing" policy. This policy would promote later marriage, later first birth, and appropriate spacing (4-5 years) between the first and second child. Couples who voluntarily chose to have only one child should be continuously rewarded. As shown in some limited experimental areas discussed elsewhere [54], the two-child plus spacing policy can help to reduce the still high fertility in many rural areas, because it meets better the practical needs of peasants and is thus more acceptable by rural couples. Couples who obey the current one-child policy in urban areas, and the 1.5-child policy (e.g. if the first child is a girl, the couple is allowed to have the second birth) in rural areas will have much less family support when they become old, as compared to those who have more children by violating the policy. This is unfair, but very difficult to change because the one-child and the 1.5-child policy do not meet peasants' practical needs. The universal two-child plus spacing policy will better realise the principles of equality among citizens. Later birth and longer spacing will enable future elderly to enjoy a longer period with support from their young and middle age children, as compared to the usual practice of early childbearing under the current policy. The current 1.5-child policy in the rural areas implicitly gives more value to a boy than a girl. The two-child plus spacing policy can help to eliminate such bias and to equalise the familial position of sons and daughter and thus to reverse the trend of increases in sex ratio at birth. We have many reasons to believe that the two-child plus spacing policy is better for China in the next century, especially in dealing with the extremely rapid aging. However, we also realise that any sudden relaxation in population policy with no appropriate operational preparations in such a large country with many poor and backward rural areas may cause a new baby boom. China does need carefully designed scientific research to convince policymakers to move towards the two-child plus spacing policy. China also needs solid operational studies by setting up more experimental areas in different parts of the country to ensure a successful transition of the policy.


Family Dynamics and Living Arrangement of Elderly Persons Acknowledgement

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Family Dynamics of 63 Million (in 1990) to more than 330 Million (in 2050) Elders in China
Zeng Yi, Linda George
© 2000 Max-Planck-Gesellschaft ISSN 1435-9871