China: Developing Solutions to Population Aging

Abstract and Introduction

Abstract

As the world's most populous country with the largest aging population and a rapidly growing economy, China is receiving increased attention from both the Chinese government and the governments of other countries that face low fertility and aging problems. This unprecedented shift of demographic structure has repercussions for many aspects of development including economic growth, social welfare, elder care, and other public welfare issues in China. Balancing population aging and economic growth requires innovative strategies and represents both challenges and opportunities for China.

Introduction

"Here lies a sleeping giant, let her sleep, for when she wakes, she will shake the world." The French Emperor Napoleon made this prediction 200 years ago for the world's oldest civilization and most populous country—China. As China has modernized, its economy has expanded tenfold as measured in gross domestic product (GDP) because groundbreaking economic reforms began in 1978. It now stands as the second largest economic entity and the largest exporter in the world (International Monetary Fund, 2011). Napoleon's words sound even more prescient regarding the economy of China in the early 21st century. However, what Napoleon could not foresee was that, when China awoke from a two-century long sleep, rapid population aging and economic growth would become the two most distinguishing characteristics. Managing the aging challenge and its impact on social structure and economic sustainability will become a priority in the next few decades.

This paper briefly reviews the history, current status, and future outlook of aging demographics in China and presents concurrent and emerging public policy challenges and opportunities in the fields of economics, social security, family support, and health services as a result of population aging. Current directions of research on aging and relevant research databases in China are also discussed.

Table 1. National Survey Data of Older Adults in China
Title (years)	Design	Contents and comparability	Notes
Chinese Longitudinal Healthy Longevity Survey (1998, 2000, 2002, 2005, and 2008–2009)	Longitudinal panel design with refresh samples Covers 22 of the 34 provinces in China Focused on the oldest old aged 80 and older in 1998 and 2002 surveys Includes those young elders aged 65–79 as a comparison from 2002 forward	Focused on healthy longevity (rather than on a specific disease or disorder) Demographic, socioeconomic, family, and behavioral risk factors for mortality and healthy longevity, health status, disability, care needs and costs, and end of life care	Microdata publicly available via www.geri.duke.edu/china_study/Currently, all the four waves of data are publicly available. The four waves of data are also available on National Archive of Computerized Data on Aging (NACDA) site http://www.icpsr.umich.edu/icpsrweb/NACDA/studies/03891 and Institute for Social Science Research Data Archives site: http://www.sscnet.ucla.edu/issr/da/da_catalog/da_catalog_titleRecord.php?studynumber=I3891V1 PIs: Yi, Z., Vaupel, J. M. Funded by the U.S. National Institute on Health (NIH)/National Institute on Aging (NIA), the United Nations Population Fund (UNFPA), the China Social Sciences Foundation, the Max Planck Institute for Demographic Research, China Natural Sciences Foundation, and the Hong Kong Research Grants Council (RGC)
China Health Aging and Retirement Longitudinal Study (2008, 2011)	Aims to be a longitudinal panel data with national representative sample of Chinese aged 45 and older The baseline of the CHARLS pilot took place in two provinces (Hangzhou and Gansu) using multistage sampling methods	Demographics, family, health status and functioning, health care and insurance, work, retirement and pension, household and individual income, expenditure and assets, community, interviewer observation Comparable to Health and Retirement Study (HRS) in the United States, the Survey of Health, Aging, and Retirement in Europe in continental Europe, the English Longitudinal Study of Aging in the United Kingdom, and the Japanese Study of Aging and Retirement in Japan	Microdata publicly available via http://charls.ccer.edu.cn/charls/ Currently, the 2008 pilot data are publicly available PIs: Zhao, Y., Lin, J. Y., Strauss, J, Park, A. Funded by the U.S. National Institute on Aging (NIA), World Bank, National Natural Science Foundation of China
China Health and Nutrition Survey (1989, 1991, 1993, 1997, 2000, 2004, 2006, 2009, 2011)	Longitudinal panel design A multistage, random cluster process was used to draw the samples from nine provinces that vary substantially in geography, economic development, public resources, and health indicators	Demographics, family support, lifestyle, income, economic activities, health status, nutrition, physical examination, medical insurance, health service use, community	Microdata publicly available via http://www.cpc.unc.edu/projects/china/data Currently, data up to 2009 are publicly available PIs: Popkin, B., Zhai, F.Funded by the U.S. National Institute of Health (NIH), the Carolina Population Center (CPC), the Ford Foundation, the National Science Foundation (NSF), the National Institute of Nutrition and Food Safety (INFS), and the Chinese Centers for Disease Control and Prevention (CCDC)
National Sample Survey on Disability (1987, 2006)	A stratified, multistage random clustering sample design was used to select from noninstitutional population in China	Demographic, employment, housing conditions, family, health status, community Focus on various types of disability (e.g., visual, hearing and speech, physical, intellectual, and mental disability)	Led by a group comprised 16 ministries and agencies including the National Bureau of Statistics, the Ministry of Civil Affairs, the Ministry of Health, and China Disabled Person Federation
Sample Survey on Aged Population in Urban/Rural China (2000, 2006)	A stratified multistage sample design was used to select older adults aged 60 and older from 20 provinces in 20002006 survey sampled older adults in 20 provinces, but 6 of them were different from the 2000 survey Parts of the sample are followed-up cases	Demographics, income, housing conditions and household assets, daily life, family, caregiving, health status, health care access and cost, social service	PIs: China Research Center on Aging Founded by the China National Commission on Aging (CNCA) and the National Bureau of Statistics of China

Table 1. National Survey Data of Older Adults in China

Title (years)

Design

Contents and comparability

Notes

Chinese Longitudinal Healthy Longevity Survey (1998, 2000, 2002, 2005, and 2008–2009)

Longitudinal panel design with refresh samples
Covers 22 of the 34 provinces in China
Focused on the oldest old aged 80 and older in 1998 and 2002 surveys
Includes those young elders aged 65–79 as a comparison from 2002 forward

Focused on healthy longevity (rather than on a specific disease or disorder)
Demographic, socioeconomic, family, and behavioral risk factors for mortality and healthy longevity, health status, disability, care needs and costs, and end of life care

Microdata publicly available via www.geri.duke.edu/china_study/Currently, all the four waves of data are publicly available. The four waves of data are also available on National Archive of Computerized Data on Aging (NACDA) site http://www.icpsr.umich.edu/icpsrweb/NACDA/studies/03891 and Institute for Social Science Research Data Archives site: http://www.sscnet.ucla.edu/issr/da/da_catalog/da_catalog_titleRecord.php?studynumber=I3891V1
PIs: Yi, Z., Vaupel, J. M.
Funded by the U.S. National Institute on Health (NIH)/National Institute on Aging (NIA), the United Nations Population Fund (UNFPA), the China Social Sciences Foundation, the Max Planck Institute for Demographic Research, China Natural Sciences Foundation, and the Hong Kong Research Grants Council (RGC)

China Health Aging and Retirement Longitudinal Study (2008, 2011)

Aims to be a longitudinal panel data with national representative sample of Chinese aged 45 and older
The baseline of the CHARLS pilot took place in two provinces (Hangzhou and Gansu) using multistage sampling methods

Demographics, family, health status and functioning, health care and insurance, work, retirement and pension, household and individual income, expenditure and assets, community, interviewer observation
Comparable to Health and Retirement Study (HRS) in the United States, the Survey of Health, Aging, and Retirement in Europe in continental Europe, the English Longitudinal Study of Aging in the United Kingdom, and the Japanese Study of Aging and Retirement in Japan

Microdata publicly available via http://charls.ccer.edu.cn/charls/
Currently, the 2008 pilot data are publicly available
PIs: Zhao, Y., Lin, J. Y., Strauss, J, Park, A.
Funded by the U.S. National Institute on Aging (NIA), World Bank, National Natural Science Foundation of China

China Health and Nutrition Survey (1989, 1991, 1993, 1997, 2000, 2004, 2006, 2009, 2011)

Longitudinal panel design
A multistage, random cluster process was used to draw the samples from nine provinces that vary substantially in geography, economic development, public resources, and health indicators

Demographics, family support, lifestyle, income, economic activities, health status, nutrition, physical examination, medical insurance, health service use, community

Microdata publicly available via http://www.cpc.unc.edu/projects/china/data Currently, data up to 2009 are publicly available
PIs: Popkin, B., Zhai, F.Funded by the U.S. National Institute of Health (NIH), the Carolina Population Center (CPC), the Ford Foundation, the National Science Foundation (NSF), the National Institute of Nutrition and Food Safety (INFS), and the Chinese Centers for Disease Control and Prevention (CCDC)

National Sample Survey on Disability (1987, 2006)

A stratified, multistage random clustering sample design was used to select from noninstitutional population in China

Demographic, employment, housing conditions, family, health status, community
Focus on various types of disability (e.g., visual, hearing and speech, physical, intellectual, and mental disability)

Led by a group comprised 16 ministries and agencies including the National Bureau of Statistics, the Ministry of Civil Affairs, the Ministry of Health, and China Disabled Person Federation

Sample Survey on Aged Population in Urban/Rural China (2000, 2006)

A stratified multistage sample design was used to select older adults aged 60 and older from 20 provinces in 20002006 survey sampled older adults in 20 provinces, but 6 of them were different from the 2000 survey
Parts of the sample are followed-up cases

Demographics, income, housing conditions and household assets, daily life, family, caregiving, health status, health care access and cost, social service

PIs: China Research Center on Aging
Founded by the China National Commission on Aging (CNCA) and the National Bureau of Statistics of China

China: Awakening Giant Developing Solutions to Population Aging

Abstract and Introduction

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Introduction

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China: Awakening Giant Developing Solutions to Population Aging

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