Aging of China

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China's population pyramid, 2023 to 2100, as projected by the United Nations in 2022 China population pyramid from 2023 to 2100.gif
China's population pyramid, 2023 to 2100, as projected by the United Nations in 2022

China's population is aging faster than almost all other countries in modern history. [1] [2] In 2050, the proportion of Chinese over retirement age will become 39 percent of the total population according to projections. China is rapidly aging at an earlier stage of its development than other countries. Current demographic trends could hinder economic growth and create challenging social issues in China. [1]

Contents

In 1979, the Government of China established a controversial one-child policy aimed at curbing the high fertility rate. [3] With economic development, the provision of social services, and improved welfare conditions, life expectancy in China has also increased. [4] These two factors have directly contributed to China's aging population, which has significant ramifications on China's society, politics, and economy. [5] [6] [7] In October 2015, a two-child policy was introduced in an attempt to deal with the aging problem. [8] In May 2021, the Chinese government introduced the three-child policy in a further attempt to address the issue. [9] In July 2021, all family size limits as well as penalties for exceeding them were removed. [10]

The National Bureau of Statistics of China reported that total Chinese population decreased by 2.08 million in 2023, with the death rate reaching the highest level since 1974. [11]

Overview

Demographics of China
Death rate7.1 per 1,000 people [12]
Life expectancy77.47 years
Fertility rate1.3 births per woman [13]
China's demographic information, 2020

From 1950 to 2020, the total fertility rate in China dropped from 6.11 to 1.3 births per woman. [13] The mortality rate also decreased, from 22.2 to 7.1 per 1,000 people. [12] Life expectancy rose from 44.6 to 77.47 years from 1950 to 2020, and is expected to reach about 80 years in 2050. [14]

In 2018, 249.49 million people over 60 years old constituted 17.9 percent of the total population. [15] Chinese state media reported the country's total fertility rate dropped to 1.09 in 2022. [16]

Causes

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

Low fertility rates

One-child policy

China used the one-child policy to stabilize fertility levels One-child policy in China.jpg
China used the one-child policy to stabilize fertility levels

In order to suppress excessive population growth, the one-child policy was introduced in 1979. [17] The enforcement methods include financial penalties, widespread use of various contraceptive methods, as well as more severe forced abortion and sterilization. As a result, birth rates and population growth rates have drastically decreased. [3] [17] 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 society. Therefore, the social maintenance fee will be used for the operation of the basic government. [18]

Reproductive health of couples

With economic growth and social development, increasing smoking, alcohol use, unhealthy diets, and psychological stress have an effect on lowering the fertility rates of couples. [19] Surging pollution in China also has an impact on male sperm count, which has been declining since the 1970s.[ citation needed ] At the Chinese University of Hong Kong, 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". [20]

Researchers point out that many particulate matter components are associated with sperm damage in experimental studies. [20] 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. [21] These conditions may be associated with a significant number of infertile couples, lowering the fertility rate.

Cultural impact

China's sex ratio is the most skewed in the world. [22] The country's ratio of males to females is skewed 3% to 4% higher towards males. [17] In the traditional, patriarchal society, many Chinese people believed that men were more important than women. [17] 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. [17] 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. [14] The minimum income security in rural areas has been expanded and is covering more than 50 million residents in poor areas. [23] The Chinese government has unified the welfare systems of urban and rural migrants, and the pension system covers nearly 700 million people. [23] [24]

Despite the improvement of China's social welfare system, there are still huge inequalities in health between urban and rural areas. [24] 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. [24] Since the late 1990s, three new medical insurance systems have been established by the government to provide more health care services. [25] In 2009, urban and rural health insurance reforms achieved greater coverage. [25] More advanced medical techniques have reduced the prevalence of diseases and increased survival. [26]

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 and the prevalence of many chronic diseases. [5] Aging society has also brought about changes in public policy. [6] The weakening of the labor force has negative impacts on China's economic growth and development, which was originally driven by the labor market. [7]

Social

Rapid aging could create only a few challenging social problems and does not increase the risk of social instability in China. [1]

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. [1] [2] In 2050, the proportion of Chinese over retirement age will become 39 percent of the total population. [27] At that time, its dependency ratio will rise to 69.7%, almost twice as high as that in 2015, which was about 36.6%. [27]

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. [27] 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. [27]

The aging population in China has increased the incidence and types of chronic diseases. Chronic diseases include four basic types: cardiovascular diseases, cancer, respiratory diseases, and diabetes. [28] There are nearly 300 million chronic patients in China, half of whom are over 65 years old. [28] During aging, many cellular and molecular events break down and eventually lead to a variety of chronic diseases, such as coronary heart diseases (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. [5]

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. [6] The lack of conventional financial infrastructure and the extent of the aging population make it difficult for China to provide a holistic solution. [6] Even at an economic growth rate of 8 percent, pension spending is growing much faster at a rate of 15 percent per year. [6] Pension expenditure increased by 11.6% in 2016, reaching 2.58 trillion yuan, with a shortfall of 429.1 billion yuan, requiring government subsidies. [29]

Since the establishment of the pension system, China has been paying the income of retirees with the contribution of the working population. [29] As more people retire and fewer people enter the labor market, the gap between income and expenditure will continue to widen. [29] 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. [30] The elderly care service market provides more opportunities for private capital and non-governmental organizations so that the elderly can have more service choices. [30]

In 2022, Peking University and Lancet established a commission on healthy aging in China. [31] : 162  The Commission's purpose is to re-focus the debate on aging not just on the risks but on opportunities through "unleashing the intellectual and vocational capacities of the older population and the whole of Chinese society." [31] : 162  Also in 2022, the Fudan Institute on Aging was established as a state-level think tank aimed at developing what it describes as Chinese solutions for addressing the problems of aging and Chinese wisdom for coping with an aging society. [31] : 164 

Neighborhood committees of the Chinese Communist Party are typically staffed by older volunteers. [32] : 118 

Geopolitical

China's aging population could hinder economic growth, create challenging social problems, and limit its capabilities to act as a new global hegemon. [1] [33] [34] [35]

Ryan Hass of the Brookings Institution 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." [36]

Nicholas Eberstadt, an economist and demographic expert at the American Enterprise Institute, 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." [37] Brendan O'Reilly, a guest expert at Geopolitical Intelligence Services, wrote, "A dark scenario of demographic decline sparking a negative feedback loop of economic crisis, political instability, emigration and further decreased fertility is very real for China". [38] [39]

Economic

Labor force

A 2021 World Bank projection of the working-age population in China, 1990-2050. Working age population, China.svg
A 2021 World Bank projection of the working-age population in China, 1990–2050.

Since economic expansion is the sum of input factor growth and productivity growth, it will require a substantial increase in labor productivity to sustain the same top-line growth as the population ages. [42] China's aging population has led to a contraction of the labor force that induces a slowing economic growth. [7] 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. [43]

By 2024, China had one of the lowest retirement ages among major world economies, with many working women eligible for retirement at 50 and men at 60. [31] : 167  China is urged to raise the legal age of retirement to cope with the problem of a reduced labour force. [7] In 2016, the Chinese government announced plans to gradually raise the retirement age from 50 years old to over 60 years old. [44] 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. [44] [7] In September 2024, with rising concerns about pension insolvency and a declining workforce, China decided to increase its retirement age across the board, increasing the age of retirement from 60 to 63 for male workers, 55 to 58 for female white collar workers, and 50 to 55 for female blue collar workers. [45] [46] Another measure China has employed to mitigate an aging workforce is to improve labor force quality, boosting university enrollment by seven times from 1999 to 2018 in China. [47]

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. [44] China has a relatively high female labor force participation rate of 61.5%. [44]

Allocation of government funds

An increase in the number of retirees and a decrease in the number of taxpayers will affect the government's allocation of funds. [27] 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. China's pension funds accounted for nearly 70% of China's social security income in 2017. [48] 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. [48]

Government policies

In order to alleviate the population aging in China, the Chinese government has relaxed its child limitation policies. Under the amended Article 18 of China's Population and Family Planning Law, every married couple is allowed to have up to three children. [49]

Two-child policy

In October 2015, the national government relaxed the one-child policy into the two-child policy. [8] China had 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. [47] However, since the implementation of the two-child policy, there has been no significant improvement in China's population aging. [50] It was expected that the effect of the policy will not be significant until two decades later. [51] 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. [50] In 2017, births fell to 17.2 million, far below the official forecast of more than 20 million. [50]

Three-child policy

In May 2021, the Chinese government introduced the three-child policy in a further attempt to address the issue. [9] However, the improvement has been limited since the implementation of the policy, largely due to the impact of COVID-19, economic uncertainty and people's current struggles in supporting children as well as old parents. [52]

Policy support for the elderly

Article 28 of the 1980 New Marriage Law formalizes the obligations of supporting grandparents for those "who can afford it[.]" [53] 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. [53]

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. [53] Article IV prohibits discriminating against, maltreating, and forsaking the elderly. [53]

In 2009, China established a state-sponsored elderly insurance program. [54] : 64 

To address the aging of China's population, the Fourteenth Five Year Plan (covering 2021–2025) seeks to expand healthcare and retirement system initiatives. [55] : 201 

See also

Related Research Articles

<span class="mw-page-title-main">Demographics of China</span>

The People's Republic of China is the second most-populous country in the world and Asia with a population exceeding 1.4 billion, only surpassed by India. Historically, China has always been one of the nation-states with the most population.

<span class="mw-page-title-main">Demographics of South Korea</span>

Demographic features of the population of South Korea include population density, ethnicity, education level, health of the populace, economic status, religious affiliations, and other aspects of the population. The common language and especially culture are viewed as important elements by South Koreans in terms of identity, more than citizenship.

<span class="mw-page-title-main">Birth rate</span> Total number of live births per 1,000 divided by time period

Birth rate, also known as natality, is the total number of live human births per 1,000 population for a given period divided by the length of the period in years. The number of live births is normally taken from a universal registration system for births; population counts from a census, and estimation through specialized demographic techniques such as population pyramids. The birth rate is used to calculate population growth. The estimated average population may be taken as the mid-year population.

<span class="mw-page-title-main">Dependency ratio</span> Age-population ratio of those in the labor force to those not in the labor force

The dependency ratio is an age-population ratio of those typically not in the labor force and those typically in the labor force. It is used to measure the pressure on the productive population.

<span class="mw-page-title-main">Total fertility rate</span> Average lifetime number of children per woman

The total fertility rate (TFR) of a population is the average number of children that are born to a woman over her lifetime, if they were to experience the exact current age-specific fertility rates (ASFRs) through their lifetime, and they were to live from birth until the end of their reproductive life.

<span class="mw-page-title-main">Sub-replacement fertility</span> Total fertility rate that (if sustained) leads to each new generation being less populous

Sub-replacement fertility is a total fertility rate (TFR) that leads to each new generation being less populous than the older, previous one in a given area. The United Nations Population Division defines sub-replacement fertility as any rate below approximately 2.1 children born per woman of childbearing age, but the threshold can be as high as 3.4 in some developing countries because of higher mortality rates. Taken globally, the total fertility rate at replacement was 2.33 children per woman in 2003. This can be "translated" as 2 children per woman to replace the parents, plus a "third of a child" to make up for the higher probability of males born and mortality prior to the end of a person's fertile life. In 2020, the global average fertility rate was around 2.4 children born per woman.

Population decline, also known as depopulation, is a reduction in a human population size. Throughout history, Earth's total human population has continued to grow; however, current projections suggest that this long-term trend of steady population growth may be coming to an end.

<span class="mw-page-title-main">Population ageing</span> Increasing median age in a population

Population ageing is an increasing median age in a population because of declining fertility rates and rising life expectancy. Most countries have rising life expectancy and an ageing population, trends that emerged first in developed countries but are now seen in virtually all developing countries. In most developed countries, the phenomenon of population aging began to gradually emerge in the late 19th century. The aging of the world population occurred in the late 20th century, with the proportion of people aged 65 and above accounting for 6% of the total population. This reflects the overall decline in the world's fertility rate at that time. That is the case for every country in the world except the 18 countries designated as "demographic outliers" by the United Nations. The aged population is currently at its highest level in human history. The UN predicts the rate of population ageing in the 21st century will exceed that of the previous century. The number of people aged 60 years and over has tripled since 1950 and reached 600 million in 2000 and surpassed 700 million in 2006. It is projected that the combined senior and geriatric population will reach 2.1 billion by 2050. Countries vary significantly in terms of the degree and pace of ageing, and the UN expects populations that began ageing later will have less time to adapt to its implications.

Social welfare, assistance for the ill or otherwise disabled and the old, has long been provided in Japan by both the government and private companies. Beginning in the 1920s, the Japanese government enacted a series of welfare programs, based mainly on European models, to provide medical care and financial support. During the post-war period, a comprehensive system of social security was gradually established. Universal health insurance and a pension system were established in 1960.

<span class="mw-page-title-main">Pensions crisis</span> Predicted difficulty in maintaining pensions

The pensions crisis or pensions timebomb is the predicted difficulty in paying for corporate or government employment retirement pensions in various countries, due to a difference between pension obligations and the resources set aside to fund them. The basic difficulty of the pension problem is that institutions must be sustained over far longer than the political planning horizon. Shifting demographics are causing a lower ratio of workers per retiree; contributing factors include retirees living longer, and lower birth rates. An international comparison of pension institution by countries is important to solve the pension crisis problem. There is significant debate regarding the magnitude and importance of the problem, as well as the solutions. One aspect and challenge of the "Pension timebomb" is that several countries' governments have a constitutional obligation to provide public services to its citizens, but the funding of these programs, such as healthcare are at a lack of funding, especially after the 2008 recession and the strain caused on the dependency ratio by an ageing population and a shrinking workforce, which increases costs of elderly care.

<span class="mw-page-title-main">Ageing of Europe</span> Overview of ageing in Europe

The ageing of Europe, also known as the greying of Europe, is a demographic phenomenon in Europe characterised by a decrease in fertility, a decrease in mortality rate, and a higher life expectancy among European populations. Low birth rates and higher life expectancy contribute to the transformation of Europe's population pyramid shape. The most significant change is the transition towards a much older population structure, resulting in a decrease in the proportion of the working age while the number of the retired population increases. The total number of the older population is projected to increase greatly within the coming decades, with rising proportions of the post-war baby-boom generations reaching retirement. This will cause a high burden on the working age population as they provide for the increasing number of the older population.

<span class="mw-page-title-main">Aging of Japan</span> Demographic transition of Japan that commenced in 1888

Japan has the highest proportion of elderly citizens of any country in the world. 2014 estimates showed that about 38% of the Japanese population was above the age of 60, and 25.9% was above the age of 65, a figure that increased to 29.1% by 2022. By 2050, an estimated one-third of the population in Japan is expected to be 65 and older. Population aging in Japan preceded similar trends in other countries, such as South Korea and China.

Pensions in Spain consist of a mandatory state pension scheme, and voluntary company and individual pension provision.

<span class="mw-page-title-main">Family planning policies of China</span> Population planning policy of China

China's family planning policies have included specific birth quotas as well as harsh enforcement of such quotas. Together, these elements constitute the population planning program of the People's Republic of China. China's program should not be confused with the family planning programs instituted in other countries, which were designed to encourage parents to have the number of children they desired—in China, the provision of contraception through family planning programs was subservient to a birth planning program under which the government designated how many births parents could have in order to control the size of its population.

<span class="mw-page-title-main">Pension policy in South Korea</span>

South Korea's pension scheme was introduced relatively recently, compared to other democratic nations. Half of the country's population aged 65 and over lives in relative poverty, or nearly four times the 13% average for member countries of the Organisation for Economic Co-operation and Development (OECD). This makes old age poverty an urgent social problem. Public social spending by general government is half the OECD average, and is the lowest as a percentage of GDP among OECD member countries.

<span class="mw-page-title-main">Ageing of Australia</span> Demographic phenomenon in Australia

Australia has an ageing demographic. The proportion of the Australian population aged 65 and over was 15% in 2017, a trend which is expected to continue to grow. It is estimated that by 2057 older people will account for 22% of the Australian population which translates to 8.8 million people. This increase in elderly population is due to what is known as The Australian Baby Boom. This period refers to the post-war era in which total fertility rates (TFR) were approximately 3.0, resulting in 4.19 million births recorded. This number exceeded the number of births in Australia from the previous 20 years in which there were 1.63 million births, and the proceeding 20 years in when 2.56 million births were recorded. The baby boom children will be celebrating their 65th birthday between 2011 and 2030, the age which is referred to as elderly.

Population decline has many potential effects on individual and national economy. The single best gauge of economic success is growth in GDP per capita, not GDP. GDP per capita is an approximate indicator of average living standards, for individual prosperity. Therefore, whether population decline has a positive or negative economic impact on a country's citizens depends on the rate of growth of GDP per capita, or alternatively, GDP growth relative to the rate of decline in the population.

<span class="mw-page-title-main">Aging of South Korea</span> Overview of aging in South Korea

In demographic terms, aging refers to an increase in the proportion of senior citizens to the total population. The term "senior citizen" encompasses those aged 65 or older. In 2045, South Korea is projected to become the world's most aged population, surpassing Japan. Senior citizens will reach 46.5 percent of the population in 2067, outnumbering the working age population.

<span class="mw-page-title-main">Aging of the United States</span> Ongoing demographic trend

In recent decades, the fertility rate of the United States has declined below replacement level, prompting projections of an aging population and workforce, as is already happening elsewhere in the developed world and some developing countries. The decline has been most noticeable since after the Great Recession of the late 2000s. Nevertheless, the rate of aging in the United States remains slower than that seen in many other countries, including some developing ones, giving the nation a significant competitive advantage. Unintentional pregnancies have become less common; in particular, teenage pregnancies have dropped to record lows.

<span class="mw-page-title-main">Ageing of the United Kingdom</span>

The population of the United Kingdom is getting increasingly older, due to longer life expectancy and a sub-replacement fertility rate for little under 50 years. The society is expected to change as a result culturally and economically. By 2050, 1 in every 4 people is expected to be above the age of 65 and this will be more extreme in certain areas of the country.

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