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Population Ageing and Community-Based Old Age Care Supply in China

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Housing and Ageing Policies in Chinese and Global Contexts

Part of the book series: Quality of Life in Asia ((QLAS,volume 15))

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Abstract

The Chinese society is becoming old before becoming rich. It is also experiencing major social transitions such as smaller household sizes, intergenerational separation resulting from urbanisation, and the lack of community-level support networks for older people in need. These features pose hurdles to the development of an old age care system. In this chapter, the author argues that an old age care system is gradually taking shape with community-based care taking the lead. However, the current system continues to face the challenges of a lack of sustainable business models for private and social providers and the insufficient quality of labour supply. This study highlights not only the new policy changes that are being implemented to effectively address the weaknesses in the system but also the future directions related to policy reform and research.

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References

  • Aveline-Dubach, N. (2020). China’s housing booms: A challenge to bubble theory. In D. Pumain (Ed.), Theories and models of urbanization (pp. 183–208). Springer.

    Chapter  Google Scholar 

  • Bonaccorsi, G., Manzi, F., Del Riccio, M., Setola, N., Naldi, E., Milani, C., Giorgetti, D., Dellisanti, C., Lorini, C. (2020). Impact of the built environment and the neighbourhood in promoting the physical activity and the healthy aging in older people: An umbrella review. International journal of environmental research and public health, 17(17), 6127.

    Article  Google Scholar 

  • Cai, J., & Kosaka, M. (2016). Towards a service value co-creation model for older adult education. Paper presented at the International Symposium on Knowledge and Systems Sciences.

    Google Scholar 

  • Cai, J., & Kosaka, M. (2019). Learner-engaged curriculum co-development in Older Adult Education: Lessons learned from the universities for older adults in China. International Journal of Educational Research, 98, 36–47.

    Article  Google Scholar 

  • Chen, L., & Han, W.-J. (2016). Shanghai: Front-runner of community-based eldercare in China. Journal of Aging & Social Policy, 28(4), 292–307.

    Article  Google Scholar 

  • Chen, L., & Xu, X. (2020). Effect evaluation of the long-term care insurance (LTCI) system on the health care of the elderly: A review. Journal of Multidisciplinary Healthcare, 13, 863.

    Article  Google Scholar 

  • Chen, L., Fan, H., & Chu, L. (2020). The double-burden effect: Does the combination of informal care and work cause adverse health outcomes among females in China? Journal of Aging and Health, 32(9), 1222–1232

    Article  Google Scholar 

  • Chen, X., & Silverstein, M. (2000). Intergenerational social support and the psychological well-being of older parents in China. Research on Aging, 22(1), 43–65.

    Article  Google Scholar 

  • Chen, X., Giles, J., Wang, Y., & Zhao, Y. (2018). Gender patterns of eldercare in China. Feminist Economics, 24(2), 54–76.

    Article  Google Scholar 

  • Cheng, Y., Xi, J., & Rosenberg, M. (2021). Age-friendly environments and active aging for community-based older people living in Beijing, China. In F. Rojo-Perez & G. Fernandez-Mayoralas (Eds.), Handbook of active ageing and quality of life (pp. 509–519). Springer.

    Chapter  Google Scholar 

  • Cheung, P. L. A. (2019). Changing perception of the rights and responsibilities in family care for older people in urban China. Journal of Aging & Social Policy, 31(4), 298–320.

    Article  Google Scholar 

  • China Gerontologist Research Centre. (2018). The blue book on aging: A survey report on the living conditions of the elderly in China's urban and rural areas.

    Google Scholar 

  • Cong, Z., & Silverstein, M. (2008). Intergenerational time-for-money exchanges in rural China: Does reciprocity reduce depressive symptoms of older grandparents? Research in Human Development, 5(1), 6–25.

    Article  Google Scholar 

  • Cong, Z., & Silverstein, M. (2014). Parents’ preferred caregivers in rural China: Gender, migration and intergenerational exchanges. Ageing & Society, 34(5), 727–752.

    Article  Google Scholar 

  • Dong, X.-Y., Feng, J., & Yu, Y. (2017). Relative pay of domestic eldercare workers in Shanghai, China. Feminist Economics, 23(1), 135–159.

    Article  Google Scholar 

  • Du, P., Dong, T., & Ji, J. (2021). Current status of the long-term care security system for older adults in China. Research on Aging, 43(3–4), 136–146.

    Article  Google Scholar 

  • Feng, W., & Mason, A. (2007). Population aging in China: Challenges, opportunities, and institutions. In Z. Zhao & F. Guo (Eds.), Transition and challenge: China’s population at the beginning of the 21st century (pp. 177–196). Oxford University Press.

    Google Scholar 

  • Feng, Z., Glinskaya, E., Chen, H., Gong, S., Qiu, Y., Xu, J., & Yip, W. (2020). Long-term care system for older adults in China: Policy landscape, challenges, and future prospects. The Lancet, 396(10259), 1362–1372.

    Article  Google Scholar 

  • Feng, Z., Liu, C., Guan, X., & Mor, V. (2012). China’s rapidly aging population creates policy challenges in shaping a viable long-term care system. Health Affairs, 31(12), 2764–2773.

    Article  Google Scholar 

  • Feng, Z., Zhan, H. J., Feng, X., Liu, C., Sun, M., & Mor, V. (2011). An industry in the making: The emergence of institutional elder care in urban China. Journal of the American Geriatrics Society, 59(4), 738–744.

    Article  Google Scholar 

  • Gagliardi, C., Di Rosa, M., Melchiorre, M. G., Spazzafumo, L., & Marcellini, F. (2012). Italy and the aging society: Overview of demographic trends and formal/informal resources for the care of older people. Advances in Sociology Research, 13, 85–104.

    Google Scholar 

  • Grundy, E., & Holt, G. (2001). The socioeconomic status of older adults: How should we measure it in studies of health inequalities? Journal of Epidemiology & Community Health, 55(12), 895–904.

    Article  Google Scholar 

  • Hall, B. J., Garabiles, M. R., & Latkin, C. A. (2019). Work life, relationship, and policy determinants of health and well-being among Filipino domestic workers in China: A qualitative study. BMC Public Health, 19(1), 1–14.

    Article  Google Scholar 

  • Han, Y., He, Y., Lyu, J., Yu, C., Bian, M., & Lee, L. (2020). Aging in China: Perspectives on public health. Global Health Journal, 4(1), 11–17.

    Article  Google Scholar 

  • Hu, A., & Chen, F. (2019). Allocation of eldercare responsibilities between children and the government in China: Does the sense of injustice matter? Population Research and Policy Review, 38(1), 1–25.

    Article  Google Scholar 

  • Hu, B. (2019). Projecting future demand for informal care among older people in China: The road towards a sustainable long-term care system. Health Economics, Policy and Law, 14(1), 61–81.

    Article  Google Scholar 

  • Kazawa, K., Rahman, M. M., & Moriyama, M. . (2018). An investigation of factors influencing high usage of medical and long-term care services in an aging society in Japan. Asia Pacific Journal of Public Health, 30(2), 95–106.

    Article  Google Scholar 

  • Laliberté, A. (2017). Responses to abuse against migrant domestic workers: A multi-scalar comparison of Taiwan, Hong Kong, and Shanghai. In S. Michel & I. Ping (Eds.), Gender, migration, and the work of care (pp. 115–141). Springer.

    Chapter  Google Scholar 

  • Li, B. (2014). Social pension unification in an urbanising China: Paths and constraints. Public Administration and Development, 34(4), 281–293.

    Article  Google Scholar 

  • Li, B., & Shin, H. B. (2013). Intergenerational housing support between retired old parents and their children in urban China. Urban Studies, 50(16), 3225–3242.

    Article  Google Scholar 

  • Li, B., Fang, L., Wang, J., & Hu, B. (2019). Social organisations and old age services in urban communities in China: Stabilising networks? In T.-K. Jing, S. Kuhnle, Y. Pan, & S. Chen. (Eds.), Aging welfare and social policy (169–209), Springer.

    Google Scholar 

  • Li, B., Jiwei, Q., & Sisi, Y. (2021). The mindset: Tackling the challenges of old age care in communities in China. China: An International Journal, 19(3), 148–167.

    Google Scholar 

  • Lin, H.-C., Tanaka, A., & Wu, P. S. (2021). Shifting from pay-as-you-go to individual retirement accounts: A path to a sustainable pension system. Journal of Macroeconomics, 103329.

    Google Scholar 

  • Liu, C., Feng, Z., & Mor, V. (2014). Case‐mix and quality indicators in Chinese elder care homes: Are there differences between government‐owned and private‐sector facilities? Journal of the American Geriatrics Society, 62(2), 371–377.

    Article  Google Scholar 

  • Liu, J. (2014). Ageing, migration and familial support in rural China. Geoforum, 51, 305–312.

    Article  Google Scholar 

  • Lum, H. D., Sudore, R. L., & Bekelman, D. B. (2015). Advance care planning in the elderly. Medical Clinics, 99(2), 391–403.

    Google Scholar 

  • Malhotra, R., Bautista, M. A. C., Müller, A.M., Aw, S., Koh, G. C. H., Theng, Y. L., Hoskins, S. J., Wong, C. H., Miao, C., Lim, W. S. and Malhotra, C. (2019). The aging of a young nation: Population aging in Singapore. The Gerontologist, 59(3), 401–410.

    Google Scholar 

  • Meng, M. & Hunt, K. (2013). New Chinese law: Visit your parents. Retrieved October 12, 2021 from https://edition.cnn.com/2013/07/02/world/asia/china-elderly-law/index.html.

  • Ministry of Civil Affairs PRC. (2020). The number of old-age beds in our country reached 8.075 million. Xinhua News Agency. http://www.gov.cn/xinwen/2020-12/27/content_5573697.htm, Date retrieved: 15 October 2021.

  • Ning, J. (2021, May 11). Will the population peak come early? Bureau of Statistics: The specific time is uncertain, and the growth rate will continue to slow down (Rénkǒu fēngzhí shìfǒu jiāng tíqián dàolái? Tǒngjì jú: Jùtǐ shíjiān bù quèdìng, zēng sù jiāng jìxù fàng huǎn, 人口峰值是否将提前到来?统计局: 具体时间不确定, 增速将继续放缓) Jiemian News. https://www.jiemian.com/article/6075671.html, Date retrieved: 15 October 2021.

  • Pan, Y. (2017). The social security system in rural China. In Y. Pan (Ed.), Rural welfare in China (pp. 123–131). Springer.

    Chapter  Google Scholar 

  • Silverstein, M., Gong, C. H., & Kendig, H. (2020). Perceived availability of future care and depressive symptoms among older adults in China: Evidence from CHARLS. BMC Geriatrics, 20(1), 1–22.

    Article  Google Scholar 

  • Sun, R. (2002). Old age support in contemporary urban China from both parents’ and children’s perspectives. Research on Aging, 24(3), 337–359.

    Article  Google Scholar 

  • Wang, H., & Huang, J. (2021). How can China’s recent pension reform reduce pension inequality? Journal of Aging & Social Policy. https://doi.org/10.1080/08959420.2021.1926865, Date retrieved: 15 October 2021

    Article  Google Scholar 

  • Wang, J., & Wu, B. (2017). Domestic helpers as frontline workers in China’s home-based elder care: A systematic review. Journal of Women & Aging, 29(4), 294–305.

    Article  Google Scholar 

  • Wang, S., Yin, H., Meng, X., Shang, B., Meng, Q., Zheng, L., Wang, L., Chen, L. (2020). Effects of Chinese square dancing on older adults with mild cognitive impairment. Geriatric Nursing, 41(3), 290–296.

    Article  Google Scholar 

  • Wang, Y., & Zhang, C. (2018). Gender inequalities in labour market outcomes of informal caregivers near retirement age in urban China. Feminist Economics, 24(2), 147–170.

    Article  Google Scholar 

  • World Health Organisation. (2020). Decade of healthy ageing: Baseline report. Geneva.

    Google Scholar 

  • Xiao, Y., Hui, E. C., & Wen, H. (2020). The housing market impacts of human activities in public spaces: The case of the square dancing. Urban Forestry & Urban Greening, 54, 126769.

    Article  Google Scholar 

  • Xie, L. (2018). Age-friendly communities and life satisfaction among the elderly in urban China. Research on Aging, 40(9), 883–905.

    Article  Google Scholar 

  • Xu, Y. (2001). Family support for old people in rural China. Social Policy & Administration, 35(3), 307–320.

    Article  Google Scholar 

  • Yang, R. & Yang, Q. (2021). Restructuring the state: Policy transition of construction land supply in urban and rural China.“ Land, 10(1), 15.

    Article  Google Scholar 

  • Yang, W., Wu, B., Tan, S. Y., Li, B., Lou, V. W., Chen, Z., Chen, X., Fletcher, J. R., Carrino, L., Hu, B. and Zhang, A. (2021). Understanding health and social challenges for aging and long-term care in China. Research on Aging, 43(3–4), 127–135.

    Article  Google Scholar 

  • Yang, Y. (2014). Five early warnings under the deep aging of the population (深度人口老龄化下的五大预警, Shēn duó rénkǒu lǎolíng huà xià de wǔdà yùjǐng), National Governance Weekly (国家治理周刊, Guójiā zhìlǐ zhōukān) No. 24, https://read01.com/0OkQD.html#.YTWv6tMzbBs, Date retrieved: 15 October 2021.

  • Yi, Z., George, L., Sereny, M., Gu, D., & Vaupel, J. W. (2016). Older parents enjoy better filial piety and care from daughters than sons in China. American Journal of Medical Research, 3(1), 244.

    Article  Google Scholar 

  • Yu, J., Ma, G., & Wang, S. (2021). Do age-friendly rural communities affect quality of life? A comparison of perceptions from middle-aged and older adults in China. International Journal of Environmental Research and Public Health, 18(14), 7283.

    Google Scholar 

  • Yuebin, X., & X. Zhang (2012). Pensions and social assistance: The development of income security policies for old people in China. In S. Chen & J. Powell (Eds.), Aging in China (43–59). Springer.

    Google Scholar 

  • Zhan, H. J. (2002). Chinese caregiving burden and the future burden of elder care in life-course perspective. The International Journal of Aging and Human Development, 54(4), 267–290.

    Article  Google Scholar 

  • Zhan, H. J., & Montgomery, R. J. (2003). Gender and elder care in China: The influence of filial piety and structural constraints. Gender & Society, 17(2), 209–229.

    Article  Google Scholar 

  • Zhang, H., Zhang, X., Zhao, Y., Huang, J., & Liu, W. (2020a). Impact of formal care use on informal care from children after the launch of long-term care insurance in Shanghai, China. International Journal of Environmental Research and Public Health, 17(8), 2938.

    Google Scholar 

  • Zhang, J., & Zhao, A. (2021). Dietary Diversity and Healthy Aging: A Prospective Study. Nutrients, 13(6), 1787.

    Article  Google Scholar 

  • Zhang, L., Ding, Z., & Qiu, L. (2019). Old age care preferences among Chinese middle-aged single-child parents and the related policy implications. Journal of Aging & Social Policy, 31(5), 393–414.

    Article  Google Scholar 

  • Zhang, Y., & Goza, F. W. (2006). Who will care for the elderly in China? A review of the problems caused by China’s one-child policy and their potential solutions. Journal of Aging Studies, 20(2), 151–164.

    Article  Google Scholar 

  • Zhang, Y., Ge, M., Zhao, W., Hou, L., Xia, X., Liu, X., Zuo, Z., Zhao, Y., Yue, J., & Dong, B. (2020b). Association between number of teeth, denture use and frailty: Findings from the West China Health and Aging Trend Study. The Journal of Nutrition, Health & Aging, 24(4), 423–428.

    Google Scholar 

  • Zhong, X. & Li, B. (2017). New intergenerational contracts in the making?–The experience of urban China. Journal of Asian Public Policy, 10(2), 167–182.

    Article  Google Scholar 

  • Zhou, Y., Li, Y., Zhu, X., & Ma, L. (2021). Medical and old-age care integration model and implementation of the Integrated Care of Older People (ICOPE) in China: Opportunities and challenges. The Journal of Nutrition, Health & Aging, 25(6), 720–723.

    Article  Google Scholar 

  • Zhu, H. (2015). Unmet needs in long-term care and their associated factors among the oldest old in China. BMC Geriatrics, 15(1), 1–11.

    Article  Google Scholar 

  • Zhu, H., & Walker, A. (2018). The gap in social care provision for older people in China. Asian Social Work and Policy Review, 12(1), 17–28.

    Article  Google Scholar 

  • Zhu, Y., & Österle, A. (2019). China's policy experimentation on long‐term care insurance: Implications for access. The International Journal of Health Planning and Management, 34(4), e1661–e1674.

    Article  Google Scholar 

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Li, B. (2023). Population Ageing and Community-Based Old Age Care Supply in China. In: Chun Tat Shum, T., Kwong, C.C.L. (eds) Housing and Ageing Policies in Chinese and Global Contexts. Quality of Life in Asia, vol 15. Springer, Singapore. https://doi.org/10.1007/978-981-99-5382-0_5

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  • DOI: https://doi.org/10.1007/978-981-99-5382-0_5

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