The Aging of Population in China

Wu Cangping

CICRED INIA Paris Valletta FRANCE MALTA The Aging of Population in China

Wu Cangping, The Institute of Population Research, The People's University of China, 39 Hakian Road, Beijing, China Published by the International Institute on Aging (United Nations — Malta)

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the author.

Wu Cangping The Aging of Population in China ISBN 92-9103-013-9

Set by the International Institute on Aging (United Nations - Malta) Design and Typesetting: ^ Antoinette Scicluna Printed in Malta by Union Print Co. Ltd, MALTA Foreword

The present series of country monographs on "the demographic and socio-economic aspects of population aging" is the result of a long collaborative effort initiated in 1982 by the Committee for International Cooperation in National Research in Demography (CICRED). The programme was generously supported by the United Nations Population Fund and various national institutions, in particular the "Université de Montréal", Canada and Duke University, U.S.A. Moreover, the realisation of this project has been facilitated through its co-sponsorship with the International Institute on Aging (United Nations - Malta), popularly known as INIA.

There is no doubt that these country monographs will be useful to a large range of scholars and decision-makers in many places of the world. The monographs are the expression of the great dedication of the researchers participating in the endeavour and of their Coordinator, George C. Myers. We would like to congratulate them for such an achievement.

As stated in the introduction by George C. Myers, the programme would not be possible without the tenacious efforts of Jean Bourgeois-Pichat, who was the Chairman of CICRED from 1972 to the 15th April 1990, date of his death. In remembrance of what he has done, we dedicate this series to his memory.

Léon TABAH Alfred GRECH Chairman of CICRED Director of INIA

Contents

Preface 17

1 Introduction 1 g

1. Definition of population aging 18 2. Demographic features of population aging 18 A. Trends of change in the elderly population of China and the world 18 B. Demographic transition in China 22 C. Change in causes of death 25 2 Trend of Population Aging in China 26

1. Size and composition of the elderly 26 2. Trend of change in age composition of the elderly population 28 3. Trend of change in old-age dependency ratio 29 4. Trend of change in population pyramid 30 5. Trend of change in sex structure of the elderly population 35 6. Trend of aging of China's future population 35 7. The quality of data 36

3 Major Determinants of Population Aging in China 37

1. The rapid and substantial decline in fertility is the major factor leading to the aging of China's population. 37

2. The effect of mortality decline on the aging of China's population 38

4 Population Distribution and Migration 42

1. Distribution and its trend of change 42 A. Urban-rural distribution 42 B. Regional difference in population aging of China 46 C. The time ahead of aging process in metropolises 49 2. Internal migration 51 5 Family, Household and Housing 52

1. Marital status of the elderly 52 A. Trends in elderly population 60 years and over by sex 52 B. Age patterns by sex 54 C. UrbanAural difference in marital status of the elderly population 54 2. Household structure — Living arrangements 55 A. Household type of the elderly in China 55 B. Urban/rural difference in living arrangement 56 C. Sex difference in living arrangement 58 3. Housing characteristics for older persons 53 A. Types of housing 5g B. Size of housing 59

6 Social and Economic Characteristics of the Elderly 61

1. Labour force 61 A. Description of main features of retirement programme 61 B. Trends in labour force participation by sex 64 C. Industrial classification 67 D. Occupational classification 69 2. Income 72 A. Levels and trends for older persons 72 B. Sources of income 75 C. Individual and household patterns 77 D. Consumption expenditures 78 3. Education 80 4. Composition of nationality • 81

7 The Health Status of China's Older Population 83

1. Morbidity levels 83 2. Health care costs 88 3. Daily life support 93

8 Policy Implication 95

1. Health 95 2. Economic 96 3. Family 97 4. Housing 98 5. Other issues 98

References 99 List of Tables and Figures Page Chapter 1

Table 1.1 Population, Aged 60 and Over, 1950-2025, for the World, the Developed Regions, Developing Regions and China 19 Table 1.2 Speed of Population Aging in Selected Countries 20 Table 1.3 Population Growth and Annual Growth Rate in China, 1953-2050 21 Table 1.4 Average Annual Percent Growth and Percent Change of Aged ^ 23 Table 1.5 Birth Rate, Death Rate and Natural Growth Rate of Population, China, 1949 - 1988 24

Figure 1.1 Elderly Population, 65 Years and Over, 1985 19 Figure 1.2 Percent Increase in Elderly Population, 65 Years and Over, 1985 to 2025 20 Figure 1.3 Annual Growth Rate of China's Population, 1964-2050 21 Figure 1.4 Birth, Death and Natural Growth Rates, China, 1949-1988 25

Chapter 2

Table 2.1 Selected Statistics on Population, 60 Years and Over, China 26 Table 2.2 Age Distribution for China, 1953-2050 27 Table 2.3 Dependency Ratios in China, 1953-2050 29 Table 2.4 Sex Ratios for Five-year Age Groups of the Aged Population, China, 1953-1987 35

Figure 2.1 Age Distribution for China, 1953-2050 28 Figure 2.2 Dependency Ratios in China, 1953-2050 30 Figure 2.3 Population Pyramid of China, 1953 31 Figure 2.4 Population Pyramid of China, 1964 31 Figure 2.5 Population Pyramid of China, 1982 32 Figure 2.6 Population Pyramid of China, 1987 32 Figure 2.7 Population Pyramid of China, 2015 33 Figure 2.8 Population Pyramid of China, 2030 33 Figure 2.9 Population Pyramid of China, 2040 34 Figure 2.10 Population Pyramid of China, 2050 34

Chapter 3

Table 3.1 Total Fertility Rate of China, 1950-1987 37 Table 3.2 Age-Specific Mortality Rate of China, 1981 39 Table 3.3 Life Expectancy at Different Ages, 1981 40 Table 3.4 Life Expectancy of China, 1949-1982 41

Figure 3.1 Total Fertility Rate of China 38 Figure 3.2 Age-Specific Mortality Rate, 1981 40 Figure 3.3 Age-Specific Mortality Rate, China, 1957 and 1981 41

Chapter 4

Table 4.1 Number and Percentage of Aged Population in China, 1953-1987 42 Table 4.2 Population in Cities, Towns and Counties by Broad Age Groups, China, 1982 44 Table 4.3 Growth of Aged Population, 60 Years and Over, by Region, China, 1982-2050 45 Table 4.4 Regional Age Composition, by Age Groups, China, 1982 and 1987 46 Table 4.5 The Regional Difference of Percentage of Aged Population, 60 Years and Over, China, 1964-1987 47 Table 4.6 Change of the Total Population and Aged Population in Shanghai, 1953-1982 49 Table 4.7 Growth Rate of the Aged Population and Total Population, Beijing 50 Table 4.8 Age-Specific Migration Rate of Various Areas, China, 1986 51 Figure 4.1 Number of Aged Population, China, 1953-1987 43 Figure 4.2 Percentage of Aged Population, China, 1953-1987 43 Figure 4.3 Percent of Population by Region, China, 1982 44 Figure 4.4 Growth of Aged Population, 60 Years and Over, China, 1982-2050 45 Figure 4.5 Percentage of Aged Population, 60 Years and Over, China, in Different Regions 48 Figure 4.6 Growth Speed of Aged Population, 60 Years and Over, China, in Different Regions 48 Figure 4.7 Change of the Total and Aged Population in Shanghai, 1953-1982 49 Figure 4.8 Growth Rate of Aged and Total Population, Beijing, 1949-2032 50

Chapter 5

Table 5.1 Marital Status of the Male and Female Population, Aged 60 and Over, China, 1982 and 1987 52 Table 5.2 Marital Status of the Male and Female Population, Aged 60 and Over, as at 1 July 1982, China 52 Table 5.3 Composition of the Single Aged Population by Sex, 60 Years and Over, China, 1982 and 1987 53 Table 5.4 Marital Status of Population, Aged 60 and Over, by Sex and Age Groups, China, 1982 54 Table 5.5 Household Type of the Aged Population, 60 Years and Over, China, 1987 56 Table 5.6 Distribution of Household Type of the Aged Population, 60 Years and Over, in Selected Countries 56 Table 5.7 Economic Status of the Aged Population in Family, 60 Years and Over, China, 1987 57 Table 5.8 Age-Specific Distribution of Household Type of the Aged Population, 60 Years and Over, China, 1987 58 Table 5.9 Per Capita Room Size of the Aged Population, 60 Years and Over, China, 1987 59 Table 5.10 Comfortable Degree of the Room that the Aged Live in, China, 1987 60

Figure 5.1 Marital Status of Population, Aged 60 and Over, Male, 1982 53 Figure 5.2 Marital Status of Population, Aged 60 and Over, Female, 1982 53 Figure 5.3 Household Type of Aged Population, 60 Years and Over, 1987 55 Figure 5.4 Economic Status of Aged Population in Family, 60 Years and Over, 1987 57 Figure 5.5 Per Capita Room Size of Aged Population, 60 Years and Over, China, 1987 59

Chapter 6

Table 6.1 Pension of Retired Workers in Rural Area, Shanghai, 1985 62 Table 6.2 Pension of Retired Workers in Shanghai, 1978-1986 63 Table 6.3 Pension of Retired Workers by Ownership, China, 1978-1985 64 Table 6.4 Age-Specific Economic Activity Rate of Male Population 65 Table 6.5 Employment Rate of Aged Population Over 60 Years, China, 1987 66 Table 6.6 Age-Specific Economic Activity Rate of Male Population, China 67 Table 6.7 Working Status of the Aged Population, 60 Years and Over, 1986 67 Table 6.8 Industrial Composition of Employed Aged Population, 60 Years and Over, China, 1987 68 Table 6.9 Structure of Industries of Employed Aged Population, China, 1982 69 Table 6.10 Occupational Structure of Employed Population, China, 1987 70 Table 6.11 Occupational Structure of Employed Elderly Population, 1982 71 Table 6.12 Occupational Structure of Employed Population, Aged 60 and Over, in Cities and Towns, 1987 71 Table 6.13 Income Level of Aged Population Over 60 Years, China, 1987 72 Table 6.14 Age-Specific Monthly Income of Aged Population, China, 1987 73 Table 6.15 Sex-Specific Monthly Income of Aged Population, 60 Years and Ov,er, China, 1987 73 Table 6.16 Monthly Income of Aged Population, 60 Years and Over, by Educational Level, China, 1987 74 Table 6.17 Monthly Income of Aged Population and their Occupation before they Retired, 60 Years and Over, Cities, China, 1987 74 Table 6.18 Income Sources of Aged Population, 60 Years and Over, China, 1987 75 Table 6.19 Age-Specific Main Income Sources of Aged Population in Cities, China, 1987 76 Table 6.20 Sex-Specific Main Income Sources of Aged Population, 60 Years and Over, 1987 77 Table 6.21 Average Monthly Income of Aged Population, 60 Years and Over, Shanghai, 1987 78 Table 6.22 Average Monthly Expenditure of Aged Population, 60 Years and Over, Shanghai, 1987 79 Table 6.23 Type of Monthly Expenditure of Aged Population, 60 Years and Over, Shanghai, 1987 80 Table 6.24 Educational Level of Aged Population, 60 Years and Over, China, 1982 81 Table 6.25 Number and Proportion of Aged 60 and Over, by Nationality, China, 1982 82

Figure 6.1 Pension of Retired Workers in Rural Area, Shanghai, 1985 63 Figure 6.2 Pension of Retired Workers by Ownership, China, 1978-1985 64 Figure 6.3 Male Economic Activity Rate 65 Figure 6.4 Employment Rate of Aged Population, 60 Years and Over, China, 1987 66 Figure 6.5 Income Level of Aged Population, 60 Years and Over, China, 1987 75 Figure 6.6 Income Sources of Aged Population, 60 Years and Over, China, 1987 76 Figure 6.7 Age-Specific Main Income Sources, Aged Population, in Cities, 1987 77 Figure 6.8 Sex-Specific Main Income Sources, Aged Population Over 60 Years, China, 1987 78 Figure 6.9 Type of Monthly Expenditure of Aged Population, 60 Years and Over, Shanghai, 1987 79 Figure 6.10 Educational Level of Elderly, 60 Years and Over, China, 1982 80

Chapter 7

Table 7.1 Health Status of Aged Population Over 60 Years, by Region, China, 1987 84 Table 7.2 Age-Specific Health Status of Aged Population by Sex, 60 Years and Over, Cities, 1987 84 Table 7.3 Age-Specific Health Status of Aged Population by Sex, 60 Years and Over, Towns, 1987 84 Table 7.4 Age-Specific Health Status of Aged Population by Sex, 60 Years and Over, Counties, 1987 85 Table 7.5 Ten Main Causes of Death in Some Cities of China (1) 85 Table 7.6 Ten Main Causes of Death in Some Cities of China (2) 86 Table 7.7 Ten Main Causes of Death in Some Counties 87 Table 7.8 Way of Medical Payment of Aged Population Over 60 Years, China, 1987 88 Table 7.9 Age-Specific Way of Medical Payment of Aged Population, 60 Years and Over, by Region, China, 1987 89 Table 7.10 Way of Medical Payment of Aged Population, 60 Years and Over, by Region, China, 1987 89 Table 7.11 Medical Payment Paid by Monthly Income by Aged Population, 60 Years and Over, by Region, China, 1987 91 Table 7.12 Availability of Medical Care of Aged Population, 60 Years and Over, by Monthly Income and Region, China, 1987 92 Table 7.13 Status of Daily Life Support and Dependence of Aged Population Over 60 Years, 1987 93 Table 7.14 Status of Daily Life Support and Dependence of Aged Population, 60 Years and Over, by Sex, 1987 94

Figure 7.1 Health Status of Aged Population, 60 Years and Over, by Region, China, 1987 83 Figure 7.2 Way of Medical Payment of Elderly, 60 Years and Over, China, 1987 88 Figure 7.3 Way of Medical Payment of Elderly, 60 Years and Over, China, 1987 90 Figure 7.4 Medical Payment Paid by Monthly Income by Aged Population, 60 Years and Over, by Region, China, 1987 91 Figure 7.5 Availability of Medical Care of Elderly, 60 Years and Over, by Region, China, 1987 * 92 Figure 7.6 Daily Life Support and Dependence of Aged Population Over 60 Years, by Region, China, 1987 93

INTRODUCTION

George C. Myers, PhJ). Center for Demographic Studies Duke University Durham, North Carolina, ILS.A.

The decade of the 1980s heralded the coming of age, with worldwide attention to population aging and its implications for societal development and the well-being of older persons. The appearance of this series of national monographs on the demographic features of population aging attests to the vigorous research activity that has occurred recently within both developed and developing countries. The scries fulfills a main goal of the International Program on Population Aging, initiated in 1982 by the Committee for International Cooperation in National Research in Demography (CICRED) based in Paris, France. The inspiration for the creation and maintenance of the lengthy effort is due primarily to the President of CICRED, the world-renowned demographer Jean Bourgeois- PichaL Our esteemed colleague provided the basic formulation for the Geld of the demography of aging with his primary contributions to the now classic United Nations volume on The Aging cf Population and Its Economic and Social Implications, published in 1956. The past 35 years have seen ample fulfillment of the message conveyed in that study:

... it is reasonable to expect a continuation of the aging process among populations both economically and demogra- phically advanced. With regard to the under-developed countries... the aging process seems, however, to have begun, and although accurate forecasting is difficult, this trend will likely become accelerated in the more distant future.

An examination of these trends toward population aging, its determinants and implications for countries at different levels of social and economic development served as the impetus for the international research effort

The CICRED project held its initial meeting in Montebello, Canada in 1983. The meeting drew 45 participants from 20 countries who decided upon three main objectives for the project Subsequent conferences were held in Florence, Italy in 1985 and at Duke University, in Durham, North Carolina in 1988, which enabled the participants to meet and discuss progress in achieving the following goals:

1. A sound database of national statistics should be developed to capture the dynamic aspects of the rapid growth and increasing proportions of the older population throughout the countries of the world. 2. Demographic centers in a large number of countries should be encouraged to undertake a series of systematic studies, which would provide information not only on population aging and its main determinants, but also the societal implications of these demographic changes. 3. Results of these research investigations should be presented in the form of national monographs, which would be published in an integrated series.

The systematic collection of national statistics, it was agreed, would provide a much-needed data source for the assessment and evaluation of older populations in countries around the world. A set of model tabulations was envisioned to capture the historical changes in population aging as well as projections of future developments. Data were to be drawn from national censuses for the most part, particularly the round of 1980 censuses that had been recently conducted. Especially important would be more detailed age/sex breakdowns within the older population to aid in understanding the diversity of social, economic and health characteristics of these persons.

Such statistics were supplied from a number of countries and constituted a sound initial basis for the International Database on Aging (IDBAX which the Center for International Research of the U.S. Bureau of the Census graciously offered to coordinate and disseminate. At present, that effort continues through support from the U.S. National Institute on Aging and VS. Agency for International Development The IDBA, in an expanded form, is presently available for researchers on computerized files from the Inter-university Consortium for Political and Social Research/National Archive of Computerized Data on Aging (ICPSR/NACDA) located in Ann Arbor, Michigan.

The participation of a large number of demographic centers was sought to systematically obtain data on a broad Tange of topics. These included the life conditions of older persons with respect to dimensions such as family and kin, economic, housing, health, and culture. Also deemed important was how these conditions might vary by geographic regions within countries, especially between rural and urban areas. The second conference of national representatives that was convened in Florence, Italy in 1985 provided an opportunity to further elaborate on the research objectives and to coordinate the national efforts. To structure the preparation of national monographs, a comprehensive chapter outline was prepared before the Florence meeting, along with a set of suggested tables and graphs.

The third and concluding meeting at Duke University in Durham, North Carolina in 1988 was attended by 40 persons. Several completed monographs, as well as others in progress, were discussed at the meeting. This enabled participants to assess the overall project and draw conclusions about the rapid changes in population aging taking place throughout the world. A positive collaborative arrangement with the newly-established United Nations International Institute cm Aging (INIA) in Malta has now made the monograph series a reality. In addition to monographs prepared for the CICRED project, the series has been augmented by the inclusion of three additional monographs that resulted from a project on Population Aspects of Aging: Their Economic and Social Consequences, sponsored by the Population Division of the United Nations.

Country monographs, such as those in the series, are first, but necessary, steps towards understanding the main descriptive aspects of population aging and its major determinants and consequences. Such information forms the basis for future studies that can periodically update information on a country's aging population structure, as new census and supplementary data become available. The effective achievement of comparative, cross-national investigations, however, will continue to require attention to standardized measurement and reporting of the main parameters of the aging process. So too, the conceptual framework and analytic procedures for examining intra-country and inter-country patterns win need to be more systematically advanced. Concrete steps can be taken, for example, in drawing detailed demographic, social and economic data for older age and sex groups from the round of censuses undertaken in 1990 and the years ahead. There also is a great need for more detailed tabulations by geographic and regional classifications within countries that will facilitate further research. These goals seem to be well within the grasp of researchers and international organizations. y

However well these initial efforts have been established, further steps are needed toward more in-depth research. A second stage of research was explicitly recognized by those responsible for the CICRED project The original research program envisioned both a core set of activities - which has largely been realized in the country monographs - and another set of more specialized research efforts. In hindsight, the agenda was probably too ambitious at the time, but certainly seems feasible for the decade ahead. Let us examine briefly the types of studies of importance in several domains.

Demographic. These might include: a) cohort studies of the changing size and composition of generational groups as they pass through the life course and , particularly, as they reach old age and beyond; b) studies of oldest-old populations, which consist of persons, often predominantly female, who are subject to high risks of disablement that requires external support from families and state welfare systems; c) research on geographical/locational patterns of older persons and how those are influenced by migration of both younger as well as older persons; d) assessment of the quality of data used in research as a primary requirement for sound knowledge.

Social and Economic Among the many topics of importance, several priority areas can be noted: a) studies of changing family and kinship structures from the standpoint of demographic factors (e.g, survival risks) and behavioural patterns (e.g., marriage and divorce); b) following from this, studies of the living arrangements of older persons, which have profound implications on the life conditions of older persons; housing requirements; and the support systems often necessary for their maintenance; c) examination of the economic conditions of older persons in sufficiently greater detail for assessing the relative importance of wealth and assets, income from employment, social welfare payments (e.g, social security payments upon retirement), intergenerational flows of monetary resources, and consumption patterns of older persons; d) studies of the collective attitudes of both young and older generations towards societal developments emerging from the aging of populations, including political participation.

Health. Concerted attention also needs to be directed toward a broad range of health factors involved in the process of individual aging, which includes disease onset, disability and death. Major issues include: a) the issue of whether prolongation of life expectancy has been accompanied by associated extension of life years free of major chronic diseases and disabilities; b) examination of long term care of older persons and the financial and emotional costs of such care on the recipients and providers (often families, but increasingly the state); c) important differentials in the health status of older persons that exist with respect to sex, socio-economic status, race and ethnicity and residence.

The research topics that have been suggested confront major issues that are likely to shape societal policies and programs in the future. To effectively link research to policy will require more explicit acknowledgement that findings must be incorporated into models that can help forecast further developments. To do so, the research is likely to be multidisciplinary in focus, capable of yielding quantitative results that are national and regional in scope, and designed to examine dynamic perspectives. There is clearly a need for both synchronie (cross-sectional) and diachronic (longitudinal) studies. A fundamental premise of the CICRED project, and one clearly shared by INIA and other UN organizations, is that cross-national, comparative investigations can enable individual countries to assess the implications of population aging more effectively if the phenomenon is seen as world-wide and shaped at particular points in time by Die progression of the demographic transition within countries with varied social and cultural conditions. ' Our knowledge about ourselves is incremented by knowing more about our neighbours. This is as true for developing countries beginning to experience the aging of their populations as it is for developed countries that have been involved in the process for more protracted periods of time.

The CICRED project has served an important function in stimulating die preparation of these country monographs, but the successful completion of this project mainly derives from the voluntary efforts of researchers who have collaborated in these efforts. The Aging of Population in China

The Aging of Population in China Preface

The World Assembly on Aging held at Vienna in 1982 marked the starting point of world concern about the understanding and solving of the aging issues. The increase in the number of the elderly population has become a global phenomenon. The natural tendency of population development decides the inevitable occurrence of population aging, and China is of course no exception. As a result of drastic decline in mortality and rapid increase in average life expectancy, and particularly due to the significant fertility decline in the country, many cities and regions in China begin to see the aging of population, which will spread over most parts of it before long. The aging issue is of great importance for China during its current socio-economic development. China's population is very influential as it accounts for more than one fifth of the world's 5 billion. The resolution of China's aging issues will exert important impact on the whole world.

This monograph includes the following eight parts:

1. Introduction 2. Trend of Population Aging in China 3. Major Determinants of Population Aging in China 4. Population Distribution and Migration 5. Family, Household and Housing 6. Social and Economic Characteristics of the Elderly 7. Health Condition of the Elderly 8. Policy Implication 18 Wu Cangping

I Introduction

1. Definition of population aging

Generally speaking, the aging of the population refers to the dynamic process in which the proportion of the elderly increases as a result of the increase in the number of the elderly people of the population. As for China, being still at a low level of socio-economic development, and with a mortality of the elderly higher than that in developed countries, it is more practical to take 60 years of age and over as the criterion of the elderly, in conformity with the document of World Assembly on Aging. Thus, the size of the elderly is the total of persons aged 60 and over, whereas the proportion of the elderly is the proportion of persons aged 60 and over to the total population. The dynamic course in which this proportion increases gradually is called the aging of the population.

2. Demographic features of population aging

A. Trends of change in the elderly population of China and the world

(1) The distribution of the absolute number of the elderly has shown changes over time (Table 1.1). In 1950, the number of the elderly aged 60 and over in the world recorded 202 million. During the period from 1950 to 1975, nearly one half of the world's elderly people lived in developed countries and regions, where the absolute number of the elderly people increased from 94.56 million to 166.42 million, that is, an increase of 71.86 million, giving an annual growth rate of 2.29%. During the same period, the elderly people in the developing countries increased from 107.75 million to 181.30 million, an increase of 73.55 million, showing an annual growth rate of 2.1%, a slightly lower rate than that of developed countries. In the case of China, the elderly people aged 60 and over numbered 41.57 million in 1950 and increased to 64.34 million in 1975, showing an annual growth rate of 1.76% which is lower than these rates in both developed and developing countries. This indicates that during the period from 1950 to 1975 China's population showed a trend of being younger with a rather low growth rate and low proportion of the elderly to the total population.

Change has taken place since 1975, involving a much rapid increase in China's elderly population, during the ten years from 1975 to 1985, with an excess over the average increase rates of both developed and developing countries. In 1985, the absolute number of China's elderly people was 1.35 times as large as the 1975's size, while the corresponding increase in developing countries was 1.33 timers and 1.12 times in developed countries. Also, the annual growth rate of the elderly population in China, being 3.05%, was higher than those of developing and developed countries which were 2.90% and 1.12% respectively. Table 1.1 shows that China had the largest number of the elderly population in the world accounting for 20% of the world elderly population in 1985 and equalling the total of the elderly people of the U.S.A., Japan, Canada, Australia, Spain and Mexico. The growth of China's elderly population will continue up to the next century, and it is estimated that people aged 60 and over in China will account for 24% of the world elderly population in 2025, which means that the aging process of China's population will be much faster than the world average.

(2) The decline in fertility and the increase in the number of the elderly population have led to a continuous rise in the proportion of the elderly to the total population. The developing countries differ from the developed countries greatly in the proportion of the elderly population, indicating that the two groups of country are at different stages of their population aging. As shown by Figure 1.1, in nearly all developed countries, the people aged 65 and over have a proportion of > 10% which is 3-5 times as large as the figure of developing countries (with the exception of few small countries) which ranges from 2.9% to 5.2%. China ranks among the first ones of developing countries in terms of the proportion of the elderly aged 65 and over, with the figure being, however, only one-third or one-half of the proportions of the elderly in developed countries. Thus, China is still at a low level of the aging of the population, i.e. at the beginning of the aging process. The Aging cf Population in China 19

Table 1.1 Population, Aged 60 and Over, 1950-2025, for the World, the Developed Regions, Developing Regions and China

Age 1950 1975 1985 2000 2025

I. Population Sizes (In thousands)

1. World Total 60 and over 202310 347722 427291 608694 1171375 60-69 128617 211364 245068 346722 607546 70 and over 73693 136358 182223 261972 500829 2. Developed Regions 60 and over 94559 166423 185948 234563 329534 60-69 55909 93675 93426 120057 166860 70 and over 38650 72748 92522 114506 162674 3. Developing Regions 60 and over 107752 181299 241344 374130 841842 60-69 72709 117690 151643 226666 503686 70 and over 35043 63609 89701 147464 338156 4. China 60 and over 41572 64335 86871 131741 283980 70 and over 24851 40830 56078 90129 189693 n. Proportion to the World Total (percent) 2.DevelopedRegions 60 and over 47 48 44 39 28 60-69 43 44 38 35 25 70 and over 52 53 51 44 32 3. DevelopingRegions 60 and over 53 52 56 61 72 60-69 57 56 62 65 75 70 and over 48 47 49 56 68 4. China 60 and over 21 19 20 22 24 70 and over * 19 18 20 22 24

Source: Global Trends and Prospects of Age Structure of Population, P33, — the paper of U.N. international symposium on population structure and development. World Population Prospects, U.N. 1984

Figure 1.1 Elderly Population, 65 Years and Over, 1985 20

15 •

10 -• 11111111 HUH

Country Source: An Aging World, p6, U.S. Department of Commerce, Bureau of the Census, September 1987; International Population Reports Series P-95, No. 78 20 Wu Cangping

Table 1.2 Speed of Population Aging in Selected Countries

Year in which percent of population 65 and over reached or will reach Country

5% 7% Number of years 7% 14% Number of years required required

China 1987 2000 13 2000 2032 32 Japan 1905 1970 20 1970 1996 26 Britain 1907 1930 23 1930 1975 45 United Sutes 1925 1944 19 1944 2010 66 Sweden 1855 1890 75 1890 1975 85

Source: An Aging World, International Population Reports Series P-5 Calculated from : The Aging of Population and its Economic and Social Implications. Report of comparative study on population aging

Despite the not very large proportion of the elderly in China at present, the aging process develops at a higher rate than that in many other countries. From Table 1.2 it can be seen that, as compared with developed countries, it will take the least time for China to make the increase of the proportion of the elderly aged 65 and over from 5% to 7%; a similar short time as that was needed for Japan from 7% to 14%, which shows the highest speed of population aging in the world.

On the other hand, according to the report made by the U.S. Bureau of the Census in September of 1987, China ranks among the top ten in the world in the growth rate of its elderly population. As shown by Figure 1.2, from 1985 to 2025, China's elderly population will increase by 238%, i.e. 2.2% annually, which is much more rapid than the developed countries but slower than several developing countries including Mexico, the Philippines, Indonesia, Brazil and India. This fact is associated with the characteristic of China's demographic dynamics in terms of fluctuating fertility and margin of fertility decline, thus indicating that the growth rate of the elderly population, i.e. the aging of the population in China, is not the most rapid one in the world.

Figure 1.2 Percent Increase in Elderly Population, 65 Years and Over, 1985 to 2025 400

IlllllilIMIlMIWmmMI 1111ll|¡¡11¡1I 1 11 ¡i f 1IE1I1MJ 1 a I 2 °JJj

Country

Source: An Aging World, p7, U.S. Department of Commerce, Bureau of the Census, September 1987, International Population Reports Series P-95, No. 78 The Aging of Population in China 21

Table 1.3 Population Growth and Annual Growth Rate in China, 1953-2050

Total 60 years Population, growth Annual growth rate population and over Year (in thousand) (in thousand) Total(%) Total(%)

1953 567446.8 51438.4 1964 694581.8 42254.8 22.40 1.72 1.85 .16 1982 1003914.9 76637.8 44.54 81.37 2.07 3.36 1987 1067930.8 90495.6 6.40 18.08 1.24 3.38 2000 1270101.0 129337.0 18.93 42.92 1.34 2.79 2010 1373500.0 162575.0 8.10 25.70 .79 2.31 2020 1459950.0 222033.0 6.29 36.57 .61 3.17 2030 1525086.0 311493.0 4.46 40.29 .43 3.44 2040 1544001.0 341015.0 1.24 9.48 .12 .91 2050 1547177.0 330795.0 .21 -3.00 .02 -.30

Source: (1953-1982) Almanac of China's Population, 1985 (1987) Population Research Center, CASS Tabulations of China 1% Population Sample Survey (National Volume) Department of Population Statistics, State Statistical Bureau (2000-2050) Population Projection for China, Naohiro Ogawa, et al., UNFPA Assisted Project: CPR/85/P54 "Development of Research on the Aged for Policy Making Purposes", Research Report No.l, JOICFP

(3) Another characteristic of the aging of China's population is the great difference between the increase rate of the elderly people aged 60 and over, and the increase rate of the total population. Table 1.3 and Figure 1.3 provide the average growth rates of China's total population as well as of the elderly population during the period from 1953 to the mid of next century.

Figure 1.3 Annual Growth Rate of China's Population, 1964-2050 4

1964 1982 1987 2000 2010 2020 2030 2040 2050 Year Source: See Table 13 22 Wu Cangping

From 1953 to 1964, China's population annual average increased by 1.85% (including years from 1958 to 1964 during which unusual variations took place due to social and economic reasons), whereas the annual increase rate of the elderly was only 0.16%. After 1964, the increase rate of the total population declined, giving an annual increase rate of 2.07% from 1964 to 1982, while that of the elderly was 3.36%, higher than the former.

When the increase rate of the total population slows down gradually as a result of the decline in birth rate, the increase rate of the elderly population will exceed remarkably that of the total population; obviously because the elderly people are those who have already been born and their increase rate is no more affected by the birth rates and only attributed to the decline in mortality. It is estimated that, from 1987 to 2000, the annual growth rate of the elderly population will be about 2.79% while that of the total population will be around 1.32%. Then, from 2000 to 2030, the annual growth rate of the elderly will keep at the level of 3% while that of the total population will gradually drop to below 1%. From 2030 to 2050, the annual growth rate of the elderly will be 1% while the total population will by and large stop growing.

(4) Still another characteristic of the aging process in China is the difference in the increase rate between age groups within the elderly population (Table 1.4); According to the U.S. Bureau of the Census which made a report on the aging of the world population ("An Aging World") in September, 1987, from 1985 to 2005, the highest annual increase rate among different age groups of China's elderly population will be seen in the age group 75 and over, being 3.4%, while 2.5% for age group 65-74 and 2.0% for age group 55-64. Nevertheless, from 2005 to 2025, this difference will diminish and the age group 55-64 will show the highest increase rate, being 3.9%. The above difference is the result of the two baby booms which took place after the founding of the People's Republic. The first baby boom took place from 1950 to 1958 and those who were born during this baby boom will reach the age of 55 starting from 2005.Those who were born during the second, which took place from 1962 to 1975, will reach the age of 55 after 2017. As the two baby booms had a small interval and continued for a long period of time, the difference in the increase rate between age groups within the elderly population was not so large as shown by Table 1.4. On the other hand, it should be noted that, according to the report, the elderly people ~ aged 75 over in China numbered 17.715 million in 1985 accounting for 1.4% of the total population. Moreover, people in this age group show a higher growth rate. During the period from 1985 to 2005, the annual increase rate of this age group will be 1.7 times higher than that of age group 55-64.

Data in Table 1.4 show that the increase rates of different age groups within the elderly population in China refer to a pattern of developing countries. First, the increase rates of the three age groups are higher, ranging from 2.0% to 4.0%, whereas these rates of developed countries are mosüy below 2.0% or even below 1.0%. Second, in developing countries, from 1985 to 2025, the age groups under the age 75, i.e. the younger elderly, show a higher increase rate, while in developed countries the age groups of 75 and over show a higher increase rate.

B. Demographic transition in China

The aging of the population is an inevitable process during the demographic transition from a rapid increasing state to a relatively stable one, rather than a sudden change. The developed and developing countries take different ways during their transitions. In developed countries, as the demographic transition toward low birth rate, low mortality and low increase rate has been accompanied by the process of industrialization, urbanization and modernization, the aging of population developed slowly. Nevertheless, in developing countries, the mortality decline takes place earlier than the change in birth rate. In some developing countries, the aging of population has just come into being or is- still at the latent stage in some others. Thus, the aging of the population in developing countries is at the level corresponding to that of the developed countries 70 or 80 years ago. The aging process in former countries, however, will be more rapid and by no means negligible because the mortality transition there takes place in a shorter period and the fertility declines faster. The Aging cf Population in China 23

Table 1.4 Average Annual Percent Growth and Percent Change of Aged

Average Annual Percent Growth

1985 to 2005 2005 to 2025

COUNTRY 55-64 65-74 75+ 55-64 65-74 75+

United States 1.4 .3 2.3 1.2 3.1 1.6

WESTERN EUROPE Austria .5 .7 .3 1 1.2 .8 Belgium .1 1.1 .7 .8 1.3 .8 Denmark 1.5 .6 1.3 1.3 France .6 1.9 .5 .7 1.5 1.1 W. Germany .5 1.8 .2 .8 .2 .9 Greece -.1 1.5 1.6 1.3 .2 .6 Italy .1 1.4 1.6 1.1 .5 .7 Luxembourg .8 1.6 .9 .3 .8 1.1 Norway 1 -.9 .7 .7 2.2 .9 Sweden 1.1 -.6 .4 -.2 1.1 1.1 United Kingdom .4 -.3 .3 .8 1.2 1

EASTERN EUROPE Bulgaria -.1 1.8 2.3 .1 .3 .7 Hungary .2 1 1 -.5 1.2 .8 Poland .7 2.4 1.8 .6 2.2 1.3

OTHER DEVELOPED COUNTRIES Australia 1.7 1.2 2.2 1.6 2.7 2.2 Canada 1.8 1.2 2.2 1.2 3 2.3 Japan 2.1 2.7 2.9 -.8 .2 2.5 New Zealand 1.5 .4 1.4 2 2.9 2.2

DEVELOPING COUNTRIES Bangladesh 2.4 2.3 1.7 4 3.5 3.1 Brazil 2.8 3 4 3.2 3.6 3.3 China 2 2.5 3.4 3.9 3.4 3.2 Guatemala 3.5 4.4 5 2.9 3 3.2 Hong Kong 1.9 2.1 3.7 2.3 3.6 2.3 India 2.2 2.6 2.7 3.2 3.5 4.8 Indonesia 2.3 3.2 3.2 3.6 3.5 4.5 Israel 2 1.1 1.3 2.2 2.9 2.4 Mexico 3.3 3.4 3.3 4.1 4 3.7 Philippines 3.7 3.3 3.6 3.3 3.7 3.6 Singapore 3.5 3.1 3.4 2.1 4.4 4.2 Uruguay .9 1.9 1.6 .7 .5

Source: An Aging World, p50 U.S. Department of Commerce, Bureau of the Census, September 1987 International Population Reports Series P-95, No. 78

(1) Characteristics of China's demographic transition

First, mortality has declined rapidly. During the period from 1949 to the mid of 1960s (with the exception of the years of hard time 1958 - 1961), the death rate of population in China declined from 20 per thousand to 10 per thousand and the average life expectancy had an increase of, more than 20 years. In other words, it took only more than ten years for China to achieve the mortality transition from high to low (Table 1.5 and Figure 1.4). Next, the birth rate .has also declined rapidly. Starting in the mid-1960s, the birth rate declined from nearly 40 per thousand to 20 per thousand or so (Table 1.5 and Figure 1.4). The decline is so drastic that it is rarely seen elsewhere in the world. At present, the birth rate of population in China is kept at the level around 20 per thousand while the natural increase rate around 15%. 24 Wu Cangping

Table 1.5 Birth Rate, Death Rate and Natural Growth Rate of Population, China, 1949 - 1988 Per thousand

National Cities Counties

Year CBR CDR NCR CBR CDR NGR CBR CDR NGR

1949 36.00 20.00 16.00 1950 37.00 18.00 19.00 1951 37.80 17.80 20.00 1952 37.00 17.00 20.00 1953 37.00 14.00 23.00 1954 37.97 13.18 24.79 42.45 8.07 34.38 37.51 13.71 23.80 1955 32.60 12.28 20.32 40.67 9.30 31.37 31.74 12.60 19.14 1956 31.90 11.40 20.50 37.87 7.40 30.44 31.24 11.84 19.40 1957 34.03 10.80 23.23 44.48 8.47 36.01 32.81 11.07 21.74 1958 29.22 11.98 17.24 33.55 9.22 24.33 28.41 12.50 15.91 1959 24.78 14.59 10.19 29.43 10.92 18.51 23.78 14.61 9.17 1960 20.86 25.43 -4.57 28.03 13.77 14.26 19.35 28.58 -9.23 1961 18.02 14.24 3.78 21.63 11.39 10.24 16.99 14.58 2.41 1962 37.01 10.02 26.99 35.46 8.28 27.18 37.27 10.32 26.95 1963 43.37 10.04 33.33 44.50 7.13 37.37 43.19 10.49 32.70 1964 39.14 11.50 27.64 32.17 7.27 24.90 40.27 12.17 28.10 1965 37.88 9.50 28.38 26.59 5.69 20.90 39.53 10.06 29.47 1966 35.05 8.83 26.22 20.85 5.59 15.26 36.71 9.47 27.24 1967 33.96 8.43 25.53 1968 35.59 8.21 27.38 1969 34.11 8.03 26.08 1970 33.43 7.60 25.83 1971 30.65 7.32 23.33 21.30 5.35 15.95 31.86 7.57 24.29 •1972 29.77 7.61 22.16 19.30 5.29 14.01 31.19 7.93 23.26 1973 27.93 7.04 20.89 17.35 4.96 12.39 29.36 7.33 22.03 1974 24.82 7.34 17.48 14.50 5.24 9.26 26.23 7.63 18.60 1975 23.01 7.32 15.69 14.71 5.39 9.32 24.17 7.59 16.58 1976 19.91 7.25 12.66 13.12 6.60 6.52 20.85 7.35 13.50 1977 18.93 6.87 12.06 13.38 5.51 7.87 19.70 7.06 12.64 1978 18.25 6.25 12.00 13.56 5.12 8.44 18.91 6.42 12.49 1979 17.82 6.21 11.61 13.67 5.07 8.60 18.43 6.39 12.04 1980 18.21 6.34 11.87 14.17 5.48 8.69 18.82 6.47 12.35 1981 20.91 6.36 14.55 16.45 5.14 11.31 21.55 6.53 15.02 1982 21.09 6.60 14.49 18.24 5.28 12.96 21.97 7.00 14.97 , 1983 18.62 7.08 11.54 15.99 5.92 10.07 19.89 7.69 12.20 1984 17.50 6.69 10.81 15.00 5.86 9.14 17.90 6.73 11.17 1985 17.80 6.57 11.23 14.02 8.96 8.06 19.17 6.66 12.51 1986 20.77 6.69 14.08 1987 21.04 6.65 14.39 1988 20.78 6.58 14.20

Source: Statistical Yearbook of China, 1988, 1987. 1986, 1985 State Statistical Bureau

(2) China's current aging of the population and its causes

The rapid demographic transition in China, and particularly the rapid decline of birth rate from a high level, have resulted in an accelerated aging process of China's population. At present, the age structure of China's population shows a beginning of aging, and the proportion of the elderly is rather small. After 1982, the population became an adult pattern in terms of age structure and, in 1987, the people aged 60 and over accounted for 8.5% of the total population. The Aging cf Population in China 25

Figure 1.4 Birth, Death and Natural Growth Rates, China, 1949-1988 50 — CBR

CDR 40 -- •-NGR

30 --

1 20 -r.---

10 --

0 --

-10 I 1 I I I 1 I 1 1 I I I I 1 I 1 I I 1 I I 1 1 I I I 1 1 I I I I 1 I 1

Year

Source: See Table 1.5

Various stages of the aging of the population are associated with different causes of population aging. While China is at present at the beginning of the aging process, the developed countries have already reached their mature and stable stage of aging. As for the developed countries, both fertility and mortality have declined to a low level and the current and future aging of population is caused mainly by the decline in mortality of. the elderly people, which leads to the increase in the proportion of the elderly to the total population. The direct cause for the current aging of China's population is the fertility decline which leads to a decline of the proportion of people at younger ages to the total population and thus to a relative increase in the proportions of the rest of the population, that is, a relative aging of the age structure of the total population. The rapid decline in mortality in China will cause directly an increase in the proportion of people at younger ages making the population younger instead of older.

C. Change in causes of death

After the founding of the People's Republic of China in 1949, with the rapid socio-economic development, medica and health care services have been greatly improved. As a result, the incidence of acute infectious diseases has been reduced, which took seventh place among the various causes of death in 1963 instead of the previous second place. By the 1980s, cerebro-vascular diseases, heart diseases and malignant tumours have become the major causes of death.

On the other hand, death rates of people at different ages have changed remarkably. Since the founding of the People's Republic, the rapid decline in children mortality has been most impressive. The infant mortality declined from around 200 per thousand live births in the first years of the People's Republic to around 40 per thousand in 1981. This will have a late intensifying effect on the future aging process of China's population. Despite a significant decline in the mortality of the elderly, the age-specific death rates of the elderly are still high as compared with those in developed countries. Thus, there is much to do to achieve a further decline in mortality of the elderly in China. 26 Wu Cangping

2 TVend of Population Aging in China

1. Size and composition of the elderly

Table 2.1 and Table 2.2 provide the number of the elderly people aged 60 and over, their composition and proportion to the total population during the period from 1953 to 2050. The number of the elderly people aged 60 and over was 41.54 million in 1953 and this increased to 76.64 million in 1982 and further to 90.50 million in 1987. Given that the total fertility rate will be 2.1 and the average life expectancy will be 71 years after 2000, the number of the elderly people will increase to 312 million in 2030 and to 331 million in 2050. This fact is unchangeable, because all those who will be the aged in the mid of the next century have already been born, and their size mainly depended on their mortality.

Table 2.1 Selected Statistics on Population, 60 Years and Over, China

Numbers in thousands

1953 1964 1982 1987 2000 2010 2020 2030 2040 2050

Total Population 567446.8 694581.8 1003913.9 1067930.8 1270101 1373500 1459950 152086 1544001 1547177

60 years and over 41538.4 42254.8 76637.8 90495.6 129337 162575 222033 311493 341015 330795

Percent Aged (%) 7.3 6.1 7.6 8.5 10.2 11.8 15.2 20.4 22.1 21A Aged-Number 60-64 16500.2 17671.5 27362.2 31947.2 40507 55538 68252 106543 78214 86119 65-69 11755.2 11635.1 21260.4 21240.5 35104 38498 67117 83838 89590 69489 70-74 7815.8 7378.2 14348.0 17225.5 25331 30037 41650 51067 81075 59783 75-79 3592.5 3757.4 8617.0 10154.8 16190 21455 23739 41913 53339 56712 80-84 1428.4 1439.2 3704.6 4996.7 8259 11392 13594 19305 23481 38673 85+ 426.3 373.4 1345.6 1930.9 3946 5655 '7681 8827 15316 20019

Aged-Percent in total population 60-64 2.9 2.5 2.7 3.0 3.2 4.0 4.7 7.0 5.1 5.6 65-69 2.1 1.7 2.1 2.3 2.8 2.8 4.6 5.5 5.8 4.5 70-74 1.4 1.1 1.4 1.6 2.0 2.2 2.9 3.3 5.3 3.9 75-79 .6 .5 .9 1.0 1.3 1.6 1.6 2.7 3.5 3.7 80-84 .3 .2 .4 .5 J .8 .9 1.3 1.5 2.5 85+ .1 .1 .1 .2 .3 .4 .5 .6 1.0 1.3

Aged-Percent 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 60-64 39.72 41.82 35.70 35.30 31.32 34.16 30.74 34.20 22.94 26.03 65-69 28.35 27.54 27.74 26.77 27.14 23.68 30.23 26.92 26.27 21.01 70-74 18.81 17.46 18.72 19.35 19.58 18.47 18.76 16.39 23.77 18.07 75-79 8.65 8.89 11.24 11.22 12.52 13.20 10.69 13.46 15.64 17.14 80-84 3.44 3.41 4.83 5.52 6.39 7.01 6.12 6.20 6.89 11.69 85+ 1.03 .88 1.77 2.13 3.05 3.48 3.46 2.83 4.49 6.05

Older Population Structures Ratios (60-64)/60+ 86.89 86.82 82.17 35.30 78.08 76.32 79.73 77.51 72.98 65.11 75+/60+ 13.11 13.18 17.83 18.80 21.95 23.68 20.27 22.49 27.02 34.89 85+/60+ 1.03 .88 1.76 2.13 3.05 3.48 3.46 2.83 4.49 6.05 85+7(60-64) 2.58 2.11 4.92 6.04 9.74 10.18 11.25 8.28 19.58 23.25

Source: (1953-1982) Almanac of China's Population, 1985 Population Research Center, CASS (1987) Tabulations of China 1% Population Sample Survey (National Volume) Department of Population Statistics, State Statistical Bureau (2000-2050) Population Projection for China, Naohiro Ogawa, et al., UNFPA Assisted Project: CPR/85/P54 "Development of Research on the Aged for Policy Making Purposes", Research Report No. 1, JOICFP The Aging of Population in China 27

Table 2.2 Age Distribution for China, 1953-2050

Numbers in thousands

0-14 15-59 60+ Year No. % No. % No. %

1953 205840.9 36.28 320067.5 56.40 41538.4 7.32 1964 220671 40.41 371656 53.51 42254.8 6.08 1982 337251.2 33.59 590024.9 58.57 76637.8 7.64 1987 307164.5 28.76 670267.7 62.77 90495.6 8.47 2000 330835 26.05 809929 63.77 129337 10.18 2010 311593 22.69 899332 65.48 162575 11.84 2020 300975 20.58 937442 64.21 222033 15.21 2030 318230 20.87 895363 58.71 311493 20.42 2040 303274 19.64 899712 58.27 341015 22.09 2050 306178 19.79 910204 58.83 330795 21.38

Source: (1953-1982) Almanac of China's Population, 1985 Population Research CenteT, CASS (1987) Tabulations of China 1% Population Sample Survey (National Volume) Department of Population Statistics, State Statistical Bureau (2000-2050) Population Projection for China, Naohiro Ogawa, et al., UNFPA Assisted Project CPR/85/P54 "Development of Research on the Aged for Policy Making Purposes", Research Report No. 1, JOICFP

The increase in the elderly population of China from 1953 to 2050 demonstrates various trends of change (Table 1.3). During the period from 1953 to 1964, the total population increased by 22.4% while the elderly population increased only by 1.72%. The relatively low increase rate of the elderly population was associated with the negative impact of the economic conditions during the years of hard time (in the late 1950s and early 1960s) on the life of the elderly. From 1964 to 1982, the total population increased by 44.5% while the elderly population by 81.4%. The much higher increase rate of the elderly population was associated with, by and large, the decline in mortality. From 1982 to 2000, the elderly population will increase by 68.8%, or 1.6 times higher than the increase rate of the total population. After 2000, the increase in the elderly population will be accelerated. From 2000 to 2030, the elderly population will have an increase of 140.8%, whereas the total population will increase about 20%. Then, from 2030 to 2050, the increase in the elderly population will be only 6.2%; nevertheless, the total population will stop increasing during this period.

Despite significant variations in the size of the elderly population since the founding of the People's Republic, the proportion of the elderly has shown small variations from 1953 to 1982, i.e. a period of nearly 30 years. During the period from 1953 to 1964, the proportion of the elderly people aged 60 and over decreased from 7.3% to 6.1% and rose again to 7.6% during the period from 1964 to 1982 which approximated the 1953's figure, and then further to 8.5% during the period from 1982 to 1987 (Table 2.2 and Figure 2.1). This can be explained by the two baby booms which took place in the 1950s and 1960s. Nevertheless, after the turn of the century, the proportion of the elderly population in China' will have a rapid increase. According to estimates shown in Table 2.2 during the period from 2000 to 2030, the proportion of the elderly population will increase from 10.2% to 20.4%, or will be doubled in 30 years. This will be a period of most rapid aging process of China's population in the future which can be explained by the momentum lagged behind, as a result of the fact that those who were bom during the two baby booms will reach their advanced years during the period from 2010 to 2030. Because of the fertility decline to a rather low level in China after 1980, those who were born then will not lead to big change in the proportion of the elderly when they reach old age. The proportion of the elderly population, therefore, will be stabilised at around 20% during the period from 2030 to 2050.

During the period from 1953 to 2050, the size of the elderly people in different age groups and their proportion to the total population vary with periods. Prior to 2030, the age groups 60-64 and 65-69 will show a more rapid growth, while the age groups of 70 and over will show a more rapid increase after 2030 (Table 2.1). 28 Wu Cangping

Figure 2.1 Age Distribution for China, 1953-2050

1953 1964 1982 1987 2000 2010 2020 2030 2040 2050 Year

Source: See Table 2.2

2. Trend of change in age composition of the elderly population

Table 2.1 provides statistical data on the age structure of the elderly population in China.

During the period from 1953 to 2050, the age composition of the elderly population in China will demonstrate the following features of change which can be described by dividing the period into four stages. The first stage (1953 - 1982) is characterized by the largest proportion of the younger elderly people aged 60 - 74, who account for around 86% of the total elderly people (aged 60 and over), whereas the middle aged elderly people (aged 75 - 84) account for around 13% and those very elderly ones (aged 85 and over) for only about 1%. The shift rate of the elderly which is the ratio of the elderly aged 85 and over to the elderly aged 60 - 64 is only 2%; in other words, there are two old persons aged 85 and over for every 100 old persons aged 60-64.

The second stage (1982 - 2000) shows a decline in the proportion of the younger elderly people which will be below 80% by 2000, while the proportion of the middle aged elderly people will increase rapidly from 13.18% to 21.95% and that of the very elderly ones also will increase to 3.05%. And, the metabolic rate of the elderly rises to 10%, that is, there will be 10 old persons aged 85 and over for every 100 old persons aged 60 - 64.

During the third stage (2000 - 2030), the proportions of the younger and middle elderly people will be stabilised around 77% and 21% respectively. This is associated with the fact that those who were bom during the two baby booms will reach, before 2030, the younger or middle elderly age. Thus, during the second and third stages, the structure of elderly population will change slowly, and the impact of population aging on the socio-economic situation will not be very sudden.

The fourth stage (2030 - 2050) is, characterized by a rapid reduction in the proportion of the younger elderly people due to the rapid reduction in the births in China after 1975. On the other hand, during the period from 2030 - 2050, the proportions of the middle and very old elderly people will increase remarkably, and the metabolic rate of the elderly will rise to 23%. It should be noted that the elderly people aged 70 and over will account for more than half of the total elderly people, and there will be one old person aged 70 and over out of eight persons. So, the rapid aging of the elderly population is tremendously noteworthy. The Aging of Population in China 29

In short, during the period from 1953 to 2050, the proportion of the younger elderly people shows a trend to decline while those of the middle and very old elderly people will increase. This indicates that the total population itself will also become older and older.

3. Trend of change in old-age dependency ratio

Table 2.3 and Figure 2.2 provide statistical data on the age-dependency ratio in China during the period from 1953 to 2050. Changes in the age structure of China's population have brought about changes in distribution of old-age dependency ratio and child dependency ratio (Figure 2.2). For the period from 1953 to 1987, the old-age dependency ratio showed little change while the child dependency ratio decreased substantially from 64.31%- in_1953 to 45.83% in 1987 as a result of the implementation of a strict birth control policy in China after the 1970s. - _

Due to historical and policy reasons, the aging process of China's population is developing very fast. The population pyramid of China in 1987 shows (Figure 2.6) two bulges at ages 8-19 (the birth cohort of 1968 - 1979) and 24-34 (the birth cohort of 1953 - 1963), suggesting a significant excess of people over those in other age groups. By the end of the century, people of these two cohorts will become working age population and thus provide a broader socio-economic and labour basis for those in the dependency ages. After 2015, the birth cohort of 1953 - 1963 will reach the advanced age, while the birth cohort of 1968-1979 will mostly become the aged around 2030, so that the size of the elderly will increase greatly. According to the estimates shown in Table 2.1, the number of the elderly people aged 60 and over will increase from 90.41 million in 1987 to 331 million in 2050. /^~

Table 2.3 and Figure 2.2 show that, by 2030, the old-age dependency ratio in China will be very approximate to the child dependency ratio. From 1987 to 2010, the age-dependency ratio in China will be declining due to the decline in child dependency ratio and, from 2010 to 2035, the child dependency ratio will keep stable while the old-age dependency ratio will rise quickly. At that time, the age-dependency ratio in the country will have a slight increase as the result of the rise in the old-age dependency ratio. As for the period from 2035 to 2050, both child dependency ratio and old-age dependency ratio will show a trend of decline leading to a decline again in the country's age-dependency ratio. During this period, the old-age dependency ratio will exceed the child dependency ratio and the elderly population will be the main burden on the society as the result of a rather high level of aging.

Table 2.3 Dependency Ratios in China, 1953-2050

Percent %

(0-14)+60+ 0-14 60+ 60+ Year 15-59 15-59 15-59 0-14

1953 77.29 64.31 12.98 20.18 1964 70.74 59.37 11.37 19.15 1982 70.15 57.16 12.99 22.72 1987 59.33 45.83 13.50 29.46 2000 56.82 40.85 15.97 39.09 2010 52.72 34.65 18.08 52.18 2020 55.79 32.05 23.68 73.89 2030 70.33 35.54 34.79 97.88 2040 71.61 33.71 37.90 112.44 2050 69.98 33.64 36.34 108.04

Source: (1953-1982) Almanac of China's Population. 1985 Population Research Center, CASS (1987) Tabulations of China 1% Population Sample Survey (National Volume) Department of Population Statistics, State Statistical Bureau (2000-2050) Population Projection for China, Naohiro Ogawa, et al., UNFPA Assisted Project: CPR/85/P54 "Development of Research on the Aged for Policy Making Purposes", Research Report No.l, JOICFP 30 Wu Cangp'ing

Figure 22 Dependency Ratios in China, 1953-2050

••• (0-14)+(60+)/(15-59)

'** (0-14)/(15-59)

•*' (6O+)/(15-59)

1953 1964 1982 1987 2000 2010 2020 2030 2040 2050

Year

Source: See Table 23

4. Trend of change in population pyramid

Changes in the age structure of China's population can be illustrated vividly by changes in population pyramids. Figure 2.3 to Figure 2.10 show population pyramids in different years. The 1953 and 1964 pyramids are both typical for young population with a broad bottom and ä narrow top showing a large size of young people and a small size of old people, whereas the 1982 and 1987 pyramids turn into ones with a constrictive bottom suggesting a decrease in the size of young people and a same narrow top indicating an aging process of the bottom part of the pyramid. The broad part of the pyramid moves upward with time passing, and by 2015 the upper bulge of the 1987's pyramid will move into old age groups enlarging the top of the pyramid and making the width of the bottom same as that of the top; that is, the aging process will shift from the bottom to the top. This indicates that the size of young people will be comparable to that of the old people. After 2030, the lower bulge of the 1987's pyramid will move into old age groups leading to a great increase in the size of the elderly and an aging at the apex. After 2040, the bottom of the pyramid will be constricted and become- narrower than the top indicating a surpass of the size of the old people over that of young people. The Aging of Population in China 31

Figure 2.3 Population Pyramid of China, 1953 2.00

1.00 -

0.00 nn

(1.00) -

(2.00) 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100+

Source: Almanac of China's Population, 1985 Population Research Center, CASS Chinese Social Sciences Publishing House

Figure 2.4 Population Pyramid of China, 1964

3.00

2.00

1.00

Illllllll 0.00

(1.00) -H

(2.00) -M

0.00) 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100+

Source: Almanac of China's Population, 1985 Population Research Center, CASS Chinese Social Sciences Publishing House 32 Wu Cangping

Figure 2.5 Population Pyramid of China, 1982 1.50

1.00

0.50 -

0.00

(0.50) -

(l.oo) --

(1.50) 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100+ Age Source: Almanac of China's Population, 1985 Population Research Center, CASS Chinese Social Sciences Publishing House

Figure 2.6 Population Pyramid of China, 1987 3.00

2.00

1.00

c 8 o.oo

(1.00)

(2.00)

(3.00) 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100+ Age Source: Tabulations of China 1% Population Sample Survey (National Volume) Department of Population Statistics State Statistical Bureau The Aging cf Population in China 33

Figure 2.7 Population Pyramid of China, 2015

6.00

3.00

0.00

(6.00) 4-1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 \

Age Source: Population Projection for China, Naohiro Ogawa, et al., UNFPA Assisted Project CPR/85/P54 "Development of Research on the Aged for Policy Making Purposes", Research Report No. 1, JOICFP

Figure 2.8 Population Pyramid of China, 2030

4.00 Male

Female

2.00

0.00

(2.00) - -

(4.00) -H 1 1 H 1 1 1 1 1 1 1 1 1 1 I 1 1 1 h

Source: Population Projection for China, Naohiro Ogawa, et al., UNFPA Assisted Project CPR/85/P54 "Development of Research on the Aged for Policy Making Purposes", Research Report No. 1, JOICFP 34 Wu Cangping

Figure 2.9 Population Pyramid of China, 2&40 4.00

(4.00) -H 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ocOi

Source: Population Projection for China, Naohiro Ogawa, et al., UNFPA Assisted Project CPR/85/P54 "Development of Research on the Aged for Policy Making Purposes", Research Report No. 1, JOICFP

Figure 2.10 Population Pyramid of China, 2050 4.00 T

2.00-

0.00 , h,

(2.00)-- I

(4.00) -H 1 1 1 1 1 1 1 1 1 1 1 1 1 h H 1 1 1 h if o\ •» o\ + O m O m O trt « 2 Age Source: Population Projection for China, Naohiro Ogawa, et al., UNFPA Assisted Project CPR/85/P54 "Development of Research on the Aged for Policy Making Purposes", Research Report No. 1, JOICFP The Aging of Population in China 35

5. Trend of change in sex structure or the elderly population

As shown in Table 2.4, the sex ratio of the elderly population was 81.7 in 1953 and declined to 75.5 in 1964, and then increased to 86.7 in 1982 and 88.6 in 1987. The overall trend has shown an increase in the sex ratio of the elderly population. The age-specific death rates of the female elderly have been lower than those of male elderly population, resulting in a decrease in the sex ratio of the elderly people with the rise in age. The sex ratio was highest in age group 60-64, showing a similarity in the size of male population to that of female one. The sex ratio of age group 65-75 was above 70.

Table 2.4 Sex Ratios for Five-year Age Groups of the Aged Population, China, 1953-1987

Age groups 1953 1964 1982 1987

Total 107.52 105.22 105.45 103.89 60+ 81.69 75.53 86.65 88.58 60-64 94.26 85.12 100.41 102.84 65-69 84.73 78.29 91.74 94.15 70-74 73.39 68.61 81.32 84.74 75-79 61.53 57.89 68.29 71.43 80-84 49.52 47.23 57.39 57.88 85-89 39.80 38.42 46.14 45.61 90-94 34.30 36.64 37.60 38.18 95-99 35.26 50.66 43.68 36.67 100+ 88.63 77.15 41.79 61.29

6. Trend of aging of China's future population

Data in Table 2.2 show that the future aging process can be divided into three stages:

(1) 1987 - 2000 — The population will change from an adult type to an aging one.

During this stage, the proportions of the elderly and working population will increase and that of children will decrease. The proportion of people aged 60 and over will increase from 8.5% to 10.2% and the proportion of people aged 15-59 from 62.8% to 63.8%, i.e. with a moderate change. The proportion of children, however, has a greater decrease, from 28.8% to 26.1%. Hence, during this stage, the aging process is rather slow while, structurally, the process refers to the aging at the base.

(2) 2000 - 2025 — The population grows into a mature aging population.

During this 25 years' period, the aging process develops rapidly with the proportion of the elderly rising from 10.2% to 17.6%, and the bulge at the apex of the pyramid appears. The proportion of children decreases slowly. During this stage, the age structure of China's population shows an accelerated aging process leading eventually to a rather high level of aging. This fact will have a great impact on China's socio-economic development.

(3) 2025 - 2050 — The aging process becomes more serious.

During this 25 years' period, the proportion of the elderly will increase to 21.4% while that of children will decrease to 19.8%. By then, the proportions of the elderly, the working age population and children will all be relatively stable. As there will be one person aged 70 and over out of eight persons in China then, the society will be a very aged one. 36 Wu Cangping

7. The quality of data

This chapter used data from the first, second and third national population censuses as well as the 1987's 1% population sampling survey data. As for estimates after 1987, they are based on forecasts made by Chinese and Japanese scholars in 1985. Chinese and Japanese scholars made a forecast of China's population in 1985. The features of the forecast are:

1) The time of the forecast spanned a period of about 70 years (from 1982 to 2050). It covers a period which monitors the whole process from the start of population aging to its stabilization.

2) The data of China's third national census have been used as the basic materials for the forecast; hence very reliable.

3) Many programmes are available for choice. Attention is made to the changes in birth rate. Meanwhile, different patterns of changes have been planned so as to gauge the impact of death rate on the aging of the population. The improved forecast method has enhanced the academic and practical value of the forecast

The population forecast has furnished a wealth of data and information for other comparative re- searches, such as the impact of birth rate and death rate on the process of population aging, the general trend of China's population aging, the peak period and peak period value of population aging, changes in the dependency ratio and changes in the proportion of the old and young.

The assumptions in the programme are:

In order to achieve the goal in accordance with China's current population policy, that is, to control the size of population at around 1.2 billion by the end of the century, it is necessary to have the fertility declined to the replacement level. On the other hand, China's fertility has shown a trend of rise since 1985 with the figure of TFR rising again to 2.61 in 1988 which is close to the 1982's level, i.e. 2.63. In the light of this trend, a TFR of 2.1 was used in providing the 2000 - 2050 projections. Moreover, the basic figures used for the projection are data from the 1982's third national population census.

Life expectancy (e) Male: 1981 — 66.43 years, 2000 — 69.10 years, 2050 — 71.80 years Female: 1981 — 69.35 years, 2000 — 72.70 years, 2050 — 75.50 years TFR: 1982 — 2.63, 2000 — 2050 — 2.1

Some formulas used in this chapter are:

population aged 0-14+ population aged 60 and over Age-dependency ratio = *100 population aged 15-59

population aged 0-14 Child dependency ratio = *100 population aged 15-59

population aged 60 and over Old-age dependency ratio = *100 population aged 15-59 The Aging of Population in China 37

3 Major Determinants of Population Aging in China

The aging of the population is a sign reflecting changes in the age structure of the population. Factors of population aging are also the factors which cause changes in age structure, i.e. the demographic variables, namely, births, deaths and migration. The births at a given time point, being population aged 0, enter into the total population by taking part in the lowest bottom of the population pyramid. Deaths may take place at all ages, giving a potential reducing effect on all age groups of the pyramid. Taking China as a whole, both immigrants and emigrants are of a very small amount, so migration has negligible impact on the aging of population. The decrease in the birth rate reduces the proportion of young people to the total population and increases relatively the proportion of the older people so as to make the population more aged. The impact of mortality decline on the population aging is more complicated. On the one hand, the decline in the overall mortality level generally makes the infant mortality decline, which leads to the increase in the absolute number of the young population, making the population tend to be younger. On the other hand, the decline in the overall mortality level will eventually result in the decline in the elderly's mortality, leading to an increase in the absolute number of the elderly people, which makes the population tend to aging. In the meantime, the young people will grow and become old people so that the increased size of young people will finally result in the increase in the absolute number of the .old people. This will, to a certain extent, intensify the trend of population aging. As regards the aging of China's population, the fertility decline is a much more important factor as compared with mortality decline.

1. The rapid and substantial decline in fertility is the major factor leading to the aging of China's population

The history of changes in age structure in western European countries has shown that fertility decline had far greater effect than mortality decline on population aging, and the fertility decline is the decisive cause of aging.

Table 3.1 Total Fertility Rate of China, 1950-1987 Year TFR Year TFR 1950 5.81 1969 5.72 1951 5.70 1970 5.81 1952 6.47 1971 5.44 1953 6.05 1972 4.98 1954 6.28 1973 4.54 1955 6.26 1974 4.17 1956 5.85 1975 3.57 1957 6.41 1976 3.25 1958 5.68 1977 2.84 1959 4.30 1978 2.72 1960 4.01 1979 2.75 1961 3.29 1980 2.31 1962 6.02 1981 2.61 1963 7.50 1982 2.86 1964 6.18 1983 2.42 1965 6.08 1984 2.35 1966 6.26 1985 2.20 1967 5.31 1986 2.42 1968 6^ 1987 2^59

Source: (1950-1979)7% Fertility Sample Survey, 1982 State Plan Commission, 1982 (1980-1987) National Sample Survey of Fertility and Contraception, State Family-Planning Commission, 1989

Changes in fertility in China have also provided evidence. Table 3.1 and Figure 3.1 illustrate changes in total fertility rate. It can be found that prior to the 1970s China's TFR had been at a high level, around 6 (with the exception of the years of economic difficulties from 1959 to 1961 which caused unusual fertility rates). Later, the TFR declined steeply from 6.45 in 1968 to 3.25 in 1976, in other words, reduced by 50% in an eight years' period. Such a drastic and rapid decline is a veritably rare case in the world. The speed of China's fertility decline is much greater than that in developed countries and is comparable to the speed of fertility decline in Japan which recorded a most rapid decline in fertility after the Second World War. After 1976, 38 Wu Cangping

China's TFR continued to drop from 3.25 to 2.2 in 1985. That is to say, the fertility rate has declined from a high level to the replacement level during a period of more than 20 years. Due to the third baby boom and other socio-economic reasons as well, the TFR rose again after 1985 and increased to 2.59 in 1987.

The fertility decline has direct impact on change in age structure, reducing greatly the proportion of population aged 0-14 to the total population (Table 2.2). This is particularly evident in some metropolises, and in 1987 the proportion of population aged 0 - 14 has dropped to below 20% in Shanghai, Beijing and other metropolises (Table 4.4). The fertility decline has inhibited the growth of young people, leading to a relative increase in the proportion of the elderly, i.e. to population aging.

Figure 3.1 Total Fertility Rate of China

3 --

2 --

1 --

1 1 1 1 1 1 1 1 1 1 1 1 1 I I I 1 1 I 1 I 1 I 1 I I I 1 I 1 I I 1 1 1 1 1950 1955 1960 1965 1970 1975 1980 1985 1988 Year

Source: See Table 3.1

2. The effect of mortality decline on the aging of China's population

Table 1.5 and Figure 1.4, providing data and curve of death rates in China from 1949 to 1988, show clearly a continuous decreasing trend of China's mortality. The most rapid decline took place in the 1950s. After the 1970s, the death rate has kept at around 7 per thousand. It is expected that, with the increase in the level of aging, China's mortality will rise after 2000 as a result of the increase in the proportion of the elderly.

The average life expectancy of China's population has been increasing correspondingly (Table 3.4). The increase was largest in the 1950s with an annual increase being more than one year. The increase in life expectancy slowed down after the 1960s and 1970s. In 1981 the life expectancy of China's population was 67.88 years. As the infant mortality has dropped to a considerably low level, a further increase in the life expectancy will rely upon the control of cardiovascular disease, malignant tumours as well as geriatric diseases. It is anticipated that the average life expectancy of China's population will increase slowly in the 1980s and 1990s. At present, China ranks among the first ones of developing countries in this aspect; however, its life expectancy is ten years lower than the world's highest level. The Aging cf Population in China 39

The curve of age-specific death rates of China's population in 1981 took a shape of the letter "J" (Table 3.2 and Figure 3.2). The death rate of children was low and the rate increased remarkably after the age of 50. Also, as shown in Table 3.3 which provides age-specific life expectancies, after the age 50, life expectancy decreases significantly. For people aged 50 - 70, the average life expectancy has a decrease of 7 years for every increase in age of 10 years.

Table 3.2 Age-Specific Mortality Rate of China, 1981

Per thousand

Age Mortality Rate Age Mortality Rate Age Mortality Rate

0 38.802 34 1.887 68 36.670 1 7.032 35 2.096 69 39.290 2 4.608 36 2.191 70 46.581 3 3.171 37 2.250 71 48.032 4 2.195 38 2.510 72 55.183 5 1.720 39 2.536 73 59.244 6 1.399 40 2.896 74 64.135 7 1.094 41 2.912 75 68.362 8 .945 42 3.203 76 76.116 9 .816 43 3.443 77 81.301 10 .758 44 3.725 78 93.514 11 .709 45 4.064 79 96.150 12 .678 46 4.392 80 116.810 13 .714 47 4.785 81 124.546 14 .758 48 5.309 82 142.995 15 .787 49 5.651 83 149.936 16 .906 50 6.868 84 162.661 17 1.019 51 6.764 85 173.909 18 1.076 52 7.714 86 189.841 19 1.264 53 8.298 87 199.447 20 1.438 54 9.287 88 227.064 21 1.217 55 10.322 89 215.668 22 1.407 56 11.091 90 278.883 23 1.353 57 11.978 91 273.253 24 1.490 58 14.183 92 292.466 25 1.494 59 14.623 93 313.674 26 1.421 60 18.199 94 287.161 27 1.461 61 17.692 95 306.807 28 1.524 62 21.680 96 344.306 29 1.459 63 23.070 97 296.578 30 1.669 64 24.407 98 282.664 31 1.541 65 26.888 99 494.943 32 1.782 66 30.030 100+ 476.770 33 1.780 67 31.464

Source: Almanac of China's Population, 1985, p88O Population Research Center, CASS 40 Wu Cangping

Figure 3.2 Age-Specific Mortality Rate, 1981

500

400 --

300 -- 1 IA

200 --

100 --

0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100+ Age

Source: See Table 3.2

Table 3.3 Life Expectancy at Different Ages, 1981

age age Ex 0 67.88 45 29.30 1 69.30 50 24.95 5 66.47 55 20.84 10 61.85 60 17.00 15 57.07 65 13.59 20 52.34 70 10.55 25 47.69 75 8.06 30 43,02 80 5.93 35 38.37 85 4.49 40 33.79 90 3.44

Source: Almanac of China's Population, 1985 Population Research Center, CASS

Figure 3.3 shows curves of death rate of China's population in 1957 and 1981. It can be seen from the comparison made between the 1957 - 1981 death rate curves that the children death rate showed an evident decline. On the other hand, there was a little rise in the death rate of the elderly people aged 60 and over. This indicated that, during the period after the founding of the People's Republic up to the 1980s, the mortality decline of China's population was ascribed mainly to the decline in children mortality. As a result, the proportion of children has increased. Thus, it can be said that China's mortality decline has resulted in the present rather young age structure. The Aging of Population in China 41

Figure 33 Age-Specific Mortality Rate, China, 1957 and 1981 300 — 1957*

1981 250 - -

200 --

150 --

100 - -

Age Groups * Survey data in some regions

Source: Population Handbook, 1986 Population Information and Research Center of China

Table 3.4 Life Expectancy of China, 1949-1982

Year Ex Year Ex 1949 *35.0 1967 59.4 1953 40.3 1968 60.3 1954 42.4 1969 60.8 1955 44.6 1970 60.8 1956 47.0 1971 62.0 1957 49.5 1972 62.3 1958 45.8 1973 63.0 1959 42.5 1974 63.4 1960 24.6 1975 63.8 1961 38.4 1976 64.2 1962 53.0 1977 64.6 1963 54.9 1978 65.1 1964 57.1 1979 65.0 1965 57.8 1980 64.9 1966 58.6 1981 •67.9

Note * Almanac of China's Population, 1985 Population Research Center, CASS Source: (1953—1980) Mortality in China POR, March 1981, Judith Banister

It is noteworthy that China's mortality decline will have a lagged momentum effect on the future aging process of the population. After a certain period of time, the present relatively increased young people will become old, increasing indirectly the absolute number of the elderly population. Moreover, in the presence of fertility decline, the increase in the absolute number of the elderly population means the rise in the proportion of the elderly, i.e. population aging. At that time the mortality decline will involve the older age groups, which will further raise the level of aging. Hence, the young age structure, mainly at the bottom of the pyramid, caused by the current mortality decline in China, will accelerate the aging process in the coming several decades. 42 Wu Cangping

4 Population Distribution and Migration

1. Distribution and its trend of change

China is the most populous country with a vast territory. It has the largest size of the elderly population in the world. During the past 40 years, the structure of China's population has experienced great changes. The proportion of the elderly people aged 60 and over increased from 7.32% in 1953 to 8.47% in 1987 (Table 4.1, Figure 4.1 and Figure 4.2), and it is expected to reach 10.18% by 2000 (Table 2.2). Although China has not ranked among countries with a population of old pattern yet, it cannot be said that the problem of population aging has not taken place in the country. This is because, for such a large country like China, there exists a variety of regional differences. The national level of population aging, despite its generality, cannot help much to understand the more detailed pictures on the aging process of China's regional population, for this indicator conceals the regional differences in the level of aging. Thus, it is necessary to have more information about the urban-rural distribution, regional and nationality distribution of the elderly population and their aging process in China.

Table 4.1 Number and Percentage of Aged Population in China, 1953-1987

Total 60 and % of 65 and Index of Year population over aged (%) over aged (%)

1953 567446758 41538443 7.32 25038257 4.41

1964 694581759 42254788 6.08 24583334 3.54

1982 1003913927 76637753 7.63 49275549 4.91

1987 1067930800 90495600 8.47 58548400 5.48

Source: (1953-1982) Almanac of China's Population, 1985 Population Research Center CASS (1987) Tabulations of China 1% Population Sample Survey (National Volume) Department of Population Statistics, State Statistical Bureau

A. Urban-rural distribution

China has a uniquely large size of elderly population. Nevertheless, due to significant regional differences in fertility and mortality levels as well as in geographical, climatic and socio-economic development aspects, the urban-rural distribution of the elderly people is uneven. As a result, the urban and rural old people enjoy very different living conditions, welfare, medical and health care and pension system.

According to the 1982's third national population census data, out of the 76.638 million of old people aged 60 and over in the country, 10.702 million lived in cities, 3.959 million lived in towns and 61.977 million in counties, accounting for 14.0%, 5.2% and 80.8% of the total elderly population respectively. In other words, four-fifths of the elderly population lived in rural area while one-fifth in urban area, which is consistent with the level of urbanization of the population. In terms of the total population, those who lived in cities, towns and counties accounted for 14.47%, 6.08% and 79.45% respectively.

The 1987's one percent population sampling survey data showed that those who lived in cities, towns and counties accounted for 18.07%, 18.81% and 63.12% of the total population respectively, indicating a greater increase in town population. It is expected that the proportion of those elderly people who lived in small cities and towns had also some increase, while that of the rural elderly people decreased. The Aging cf Population in China 43

Figure 4.1 Number of Aged Population, China, 1953-1987

1200

060 and over

lïJ 65 and over

1953 1964 1982 1987 Year Source: (1953-1982) Almanac of China's Population, 1985 Population Research Center, CASS (1987) Tabulations of China 1% Population Sample Survey (National Volume) Department of Population Statistics, State Statistical Bureau

Figure 4.2 Percentage of Aged Population, China, 1953-1987

9 ^ 60 and over

«3 65 and over

1953 1964 1982 1987 Year

Table 4.2 Population in Cities, Towns and Counties by Broad Age Groups, China, 1982 (in thousand) 0-14 15-59 60+ Areas Total Number % Number % Number %

Cities 145253 37783 26 96768 66.6 10702 7.4 Towns 61056 17290 28.3 39807 65.2 3959 6.4 Counties 797604 282178 35.4 453449 56.9 61977 7.8

Source: 1982 Population Census of China, State Statistical Bureau of China, • March 1985, Beijing

In 1982, people aged 60 and over accounted for 7.4%, 6.4% and 7.8% (Table 4.2 and Figure 4.3), whereas people aged 65 and over for 4.67%, 4.22% and 5.01% of the population in cities, towns and counties respectively. In other words, the rural area had a higher proportion of the elderly population as compared with the urban area. Nevertheless, the trend of development showed that the aging process will take place in urban area earlier than in rural area. According to the 1982's one-per-thousand population fertility sampling survey data, the TFR of the country as a whole was 2.63. As for the rural area where the proportion of population aged 0-14 was high (35.4%), the TFR was 2.9. On the other hand, the TFR in urban area was only 1.39, and the low fertility rate reduced the proportion of population in young age groups. In 1982, the proportions of population aged 0-14 in cities and towns were 26% and 28.3%. The reduction and further reduction in the size of young people will exert decisive impact on the aging process of urban population (Table 4.2). As the fertility rate of cities and towns declined earlier and the decline continued for a rather long period, the proportion of young population has been low, leading to change in population structure, but the rural area showed another picture. On the other hand, despite the rather young age structure of rural population, the proportion of the elderly people in rural area was the highest. This can be explained by the migration of the working-age population from rural area to cities and towns, and particularly to towns located near the rural area. As a result, the proportion of the elderly people in rural area increased relatively, and the proportion of adults in cities and particularly in towns increased.

Figure 43 Percent of Population by Region, China, 1982 70

60 -

50 -

40 - I 30 -

20 -

10 -

Counties

Source: See Table 4.2 The Aging cf Population in China 45

The difference in the level of aging between the urban and rural populations reflects the fact that urban- rural differences in fertility rate, mortality rate and in socio-economic and cultural aspects cause differences in population variables. During the past two years, with the improvement in agricultural labour productivity, the surplus rural labour, the majority of whom are young and middle-aged adults, flow to the cities and towns, resulting in an increase in the adult population and a relative decrease in old people and children there. A different case took place in rural area, showing a relative increase in old people and children and a decrease in adult population. Viewing from the long-term development, the increase in the level of urbanization in China will make the level of aging of urban population surpass that of rural one. The farmers who have migrated into urban area will be assimilated in terms of birth intention and life style so that the aging process of urban population will be accelerated. Moreover, as the result of the increase in the proportion of urban population accompanied by the decrease of rural one, the aging process of the whole population will develop more rapidly to a higher level. It is noteworthy that as China adopts the strategy of "controlling the size of metropolises, developing mid-sized cities rationally and developing small cities with great efforts", the size of immigrants into metropolises will be limited. Because of the lowest fertility level in the metropolises, the aging of population will take place firstly in there. On the other hand, as the small cities will be developed rapidly, a large amount of young people will migrate into the small cities with the development of economy, which will delay the aging process there.

Table 43 Growth of Aged Population, 60 Years and Over, by Region, China, 1982-2050

cities and towns counties Year aged % growth % aged % growth 1982 7.10 100.00 7.78 100.00 1987 8.41 118.45 8.52 109.51 2000 12.21 171.97 10.07 129.43 2025 22.99 323.80 17.79 228.66 2050 26.97 379.86 25.61 329.18

Source: The Emerging Problem of Population Aging in China, Xu Qin (ed.) p25 1988

Despite a slightly higher proportion of the elderly in rural area as compared with the urban case, the growth rate of the urban elderly population is different from the rural one. The difference in the aging index (i.e. the percentage showing the proportion of the old people aged 60 and over to the total population) as well as in the increase of the index may provide evidence. In 1982, the urban aging index was lower than the rural one; nevertheless, the former grows more rapidly than the latter, and it is expected that after 2000 the urban aging index will exceed the rural one (Table 4.3).

Figure 4.4 Growth of Aged Population, 60 Years and Over, China, 1982-2050 30 '"" cities and towns

25 •- counties

20 -

1982 1987 2000 2025 2050 Year Source: The Emerging Problem of Population Aging in China, ,Xu Qin (ed.) p25 1988 46 Wu Cangping

B. Regional difference in population aging of China

Since China has a vast territory, regional differences have been found in economic development, in age structure of population and thus in the level of aging among provinces, autonomous regions and municipalities. Table 4.4 lists three indicators of the level of aging for all the regions derived from the third population census data and the 1987's one percent population sampling survey data. Figures from the table show that, in 1987, Shanghai had the highest level of aging in the country with the proportion of elderly people aged 65 and over being 8.49%, and it had already become a population of old type (7.42%) as early as in 1982. On the other hand, the Qinghai province had the lowest level of aging with the proportion of the elderly being only 3.39%. The difference between the highest and lowest levels of aging was 5.1% in 1987 and 4.72% in 1982, showing an enlargement in the difference. As regards the proportion of population aged 0-14, the highest and lowest figures in 1987 fell on Tibet and Shanghai, being 36.74% and 18.36% respectively. The difference between the highest and the lowest proportions of children was 18.38%. As for the median age, Shanghai had the highest (32.02 years) and Qinghai had the lowest (20.35 years) with a difference of 11.67 years. Viewing from the age structure of population in 1987»- only Shanghai was characterized by an old type of population. There were 15 provinces having a population of adult type, in six of which the proportion of the elderly population was 6%- 7% and in nine of which it was 5%-6%. Thus, the provinces with an adult type of population accounted for 51.7% of the 29 provinces. Thirteen provinces (44.8%) had a population of young type, i.e. the proportion of the elderly population being below 5%, in six of which the proportion was below 4% accounting for 46.2% of the 13 provinces with a young population.

In accordance with the level of aging, China can be divided into three types of region. The first type of region is the eastern coastal region which is characterized by a high population density and high level of aging. The second type of region is the middlepart of the country with a mid-level of aging. The third

Table 4.4 Regional Age Composition, by Age Groups, China, 1982 and 1987

Children (0-14)% Aged (65+) % Mean age (years) Areas 1982 1987 1982 1987 1982 1987

"Total 33.60 28.68 4.91 5.46 22.91 24.13 Shanghai 18.10 18.36 7.42 8.49 29.28 32.02 Zhejiang 29.33 23.51 5.76 6.80 24.69 27.84 Hebei 30.98 28.25 5.67 5.57 24.72 24.91 Beijing 22.12 20.35 5.65 6.66 27.19 29.74 Shandong 31.02 27.31 5.62 6.31 24.56 25.19 Tianjin 24.24 22.17 5.58 6.54 26.60 29.51 Jiangsu 28.99 22.15 5.54 6.82 25.54 28.61 Guangdong 33.87 31.49 5.43 6.01 22.54 23.54 Henan 34.92 30.26 5.23 6.76 22.27 23.42 Guangxi 37.39 34.43 5.11 5.82 20.01 21.79 Shanxi 33.31 28.92 5.00 5.28 22.99 24.66 Hubei 32.76 28.17 5.03 5.46 23.02 24.15 Hunan 33.92 29.01 4.97 5.51 22.48 23.43 Liaoning 28.78 24.16 4.81 5.29 24.58 27.08 Sichuan 34.42 26.53 4.68 5.40 23.41 24.15 Guizhou . 40.88 35.48 4.67 4.78 18.76 20.82 Tibet 36.98 36.74 4.60 4.16 21.64 20.73 Shaanxi 33.09 29.01 4.57 5.03 22.89 23.99 Yunnan 39.17 34.13 4.50 4.90 19.39 21.67 Jiangxi 38.90 35.09 4.50 4.98 19.67 21.37 Fujian 36.53 32.74 4.38 4.95 20.68 22.57 Anhui 36.15 28.88 4.08 4.89 20.18 23.00 Jilin 33.18 26.82 3.98 4.34 22.33 24.63 Xinjiang 39.72 35.29 3.68 3.88 19.48 20.95 Neimeng 35.41 30.81 3.61 3.68 21.19 23.39 Gansu 36.36 29.75 3.49 3.94 20.13 22.31 Heilongjiang 34.83 29.01 3.42 3.65 21.58 23.94 Ningxia 41.44 36.38 3.19 3.73 18.32 20.54 Qinghai 40.78 35.76 2.70 3.39 18.42 20.35

Source: (1982) Aging Atlas of China, Map Press, 1986 (1987) Tabulations of China 1% Population Sample Survey (National Volume) Department of Population Statistics, State Statistical Bureau The Aging of Popuhüon in China 47 type of region is the northern, western and southern remote provinces where many people of national minorities live; this region has a less developed economy and is more sparsely populated and, moreover, the fertility level has been rather high in past dozen of years resulting in a young age structure and a low level of aging. As regards the three municipalities, namely, Shanghai, Beijing and Tianjin, the fertility rate has already reached or approximated the world's lowest level so that the aging of population there will be among the highest levels in future in case of continued low fertility.

From the above analysis, the following conclusions can be drawn:

1. In terms of the age structure of different provinces in China, it has included all types, namely, the old type, adult type and young type. The proportions of the elderly population in the provinces differ from each other greatly.

2. As a result of the regional difference in the level of aging, the aging of population will take place consecutively in different places of the country. In 1987, in Shanghai, the largest city in the country, people aged 60 and over accounted for 13.14% while those aged 65 and over for 8.5% and the median age of population was 32.02 years; in other words, Shanghai has already become a population of old type. Another two municipalities (Beijing and Tianjin) and two provinces (Zhejiang and Jiangsu) have a high proportion of the elderly and a low proportion of children. The proportion of the elderly people aged 60 and over in these places has surpassed 10.2% and increased one-fifth as compared with 1982. The median age of population there approximates to 30 years. So, they will become populations of old type in the coming years successively (Table 4.5 and Figure 4.5). As for the remote provinces where the proportion of the elderly is low, the aging of population will take place later. Hence, the time lag in becoming an aging population between various places in the country is about 30 years.

Table 45 The Regional Difference of Percentage of Aged Population, 60 Years and Over, China, 1964-1987 Area 1964 1982 1987 82/64 87/82 87/64 Total 6.08 7.63 8.47 1.25 1.11 1.39 Beijing 6.66 8.56 10.36 1.29 1.21 1.56 Tianjin 6.37 8.53 10.25 1.34 1.20 1.61 Hebei 7.55 8.41 8.65 1.11 1.03 1.15 Shanxi 7.03 7.77 8.29 1.11 1.07 1.18 Neimenggu 5.35 5.80 6.06 1.08 1.04 1.13 Liaoning 5.60 7.40 8.31 1.32 1.12 1.48 Jilin 5.49 6.31 7.01 1.15 1.11 1.28 Heilongjiang 5.07 5.47 6.04 1.08 1.10 1.19 Shanghai 6.08 11.51 13.14 1.89 1.14 2.16 Jiangsu 6.41 8.68 10.34 1.35 1.19 1.61 Zhejiang 7.02 8.69 10.39 1.24 1.20 1.48 Anhui 4.67 6.78 8.15 1.45 1.20 1.75 Fujian 5.41 6.93 7.82 1.28 1.13 1.45 Jiangxi 6.54 7.26 7.75 1.11 1.07 1.19 Shandong 7.33 8.65 9.42 1.18 1.09 1.29 Henan 6.98 8.16 8.97 1.17 1.10 1.29 Hubei 6.38 7.98 8.63 1.25 1.08 1.35 Hunan 5.94 7.73 8.42' 1.30 1.09 1.42 Guangdong 6.42 8.12 9.03 1.26 1.11 1.41 Guangxi 5.82 7.66 8.47 1.32 1.11 1.46 Sichuan 5.04 7.38 8.42 1.46 1.14 1.67 Guizhou 5.29 6.86 6.88 1.30 1.00 1.30 Yunnan 5.45 6.95 7.50 1.28 1.08 1.38 Xizang / 7.34 7.10 / .97 / Shaanxi 6.03 7.44 7.79 1.23 1.05 1.29 Guansu 4.11 5.74 6.36 1.40 1.11 1.55 Qinghai 3.99 4.54 5.72 1.14 1.26 1.43 Ningxia 4.32 5.06 5.76 1.17 1.14 1.33 Xinjiang 6.16 5.83 6.19 .95 1.06 1.00 Source: (1964-1982) Almanac of China's Population, 1985 Population Research Center, CASS (1987) Tabulations of China 1% Population Sample Survey (National Volume) Department of Population Statistics, State Statistical Bureau 48 Wu Cangping

Figure 4.5 Percentage of Aged Population, 60 Years and Over, China, in Different Regions 14 — 1964

12 -• - -1982

10 - • -- 1987

2 -"

1—i—i—I—I—HH—h

Province Source: See Table 4.5

3. The adult type is the main age structure of China, and more than half of the provinces have a population of adult type. Nevertheless, out of the 29 provinces, 13 have a proportion of the elderly below 5%, i.e. a young population, which account for 44.8%. Therefore, at present, the main goal of population policy in China is to control the high fertility level in these provinces. The aging of population is not serious yet in the country as compared with the world's high level.

4. The speed of the aging process showed difference among provinces. The order of precedence in the proportion of the elderly proportion of all provinces showed changes, when the 1964, 1982 and 1987 data are compared. The proportion of elderly in the eastern provinces (Jiangsu, Zhejiang and Shandong provinces and the three municipalities), where the proportion of the elderly population has been high, increases rapidly. On the other hand, it grows slowly where it has been low. The difference in the level of aging in different places of the country shows a trend to increase (Table 4.5, Figure 4.5 and Figure 4.6).

Figure 4.6 Growth Speed of Aged Population, 60 Years and Over, China, in Different Regions

Z5 — 1982/1964

--1987/1982 Z0-- - - 1987/1964

1.5--

-f-H—I—I—I—I—I H—h—+-

Proviitct

Source: See Table 45 The Aging of Population in China 49

C. The time ahead of aging process in metropolises

As the starting point of fertility level in urban area is lower than the total one and, moreover, the fertility decline in urban area develops very fast, the aging process in urban area is much faster than the rural one. So, it can be said that China's aging population is shown mainly by the aging of population in the metropolises.

Table 4.6 Change of the Total Population and Aged Population in Shanghai, 1953-1982 (in 10 thousand)

1953 1964 1973 1982

Total 624.44 1081.65 1070.01 1185.97 Growth speed (%) (No. of 1953 100 174.34 172.46 191.15 as 100.0)

65+ 12.25 38.99 63.3 88.1 Growth speed (%) (No. of 1953 100 318.29 516.73 719.18 as 100.0)

Source: Study of Aging Problem and Policy Implication 'm Shanghai, Chen Xian-Huai (ed.) Society of Gerontology in Shanghai. 1988

Figure 4.7 Change of the Total and Aged Population in Shanghai, 1953-1982, (1953's as 100) 800

600 --

400 --

200 -

1953 1964 1973 1982

Year Source: See Table 45

Shanghai, Beijing, Tianjin and Guangzhou have the highest level of aging and highest speed of aging as well in the country. According to 1982's population census data, the total population of Shanghai recorded 11.8697 million and the people aged 65 and over 1.365 million. The proportion of people aged 60 and over to the total population was 3.68% in 1953, increased to 11.51% in 1982 and further to 13.14% in 1987. It is estimated that the proportion will increase to 16.16% by 2000. During the period from 1953 to 1982, the size of the total population in Shanghai had an increase of 91.15% whereas the size of the people aged 65 and over had an increase of 619.18%, showing a surprisingly high speed of aging of the Shanghai population (Table 4.6 and Figure 4.7). 50 Wu Cangp'mg

The elderly people aged 60 and over in Beijing registered 0.714 million in 1979, accounting for 8.2% of the total population of the municipality. The proportion increased to 10.75% in 1988, and the number of the elderly people recorded 1.07 million. Given that the current family planning policy (i.e. the one-child family policy) will remain unchanged, it is estimated that by 2000 the number of the elderly people will increase to 1.611 million and their proportion will be 14.7%. Starting from 1965, the speed of increase in the elderly'population has been exceeding that of the total population in Beijing. Such a case will continue up to the 2030s (Table 4.7). Data from Table 4.7 show that the difference between the growth of the elderly people and the growth of total population is enlarging, and the trend to enlarge is more significant after 1982 (Figure 4.8). Moreover, it took only 5 years for Beijing to increase the proportion of people aged 60 and over from 8% to 10% compared with 15 years for the country; in other words, 10 years faster.

Table 4.7 Growth Rate of the Aged Population and Total Population, Beijing Percent

Growth Täte of Growth rate of Stage total population % aged population %

1949—1964 3.9 3.1 1964—1982 1.2 3.1 1982—2000 1.0 4.0 2000—2020 .3 3.3 2020—2032 -.4 1.3

Source: Study Report of Population Aging and Life Quality of the Aged Population in Beijing Study Group On This Topic, July 1989, Beijing

Similar to the case of Beijing, the elderly population in Tianjin has increased rapidly. In 1987, the people aged 60 and over made up 10.25% of the total population, an increase of 20% over the 1982*s figure. The median age of the population has reached 29.51 years; in other words, the municipality has become a city with an old type of population. As for Guangzhou, by the end of 1987, people aged 60 and over accounted for 12% of the total population. Thus, it is evident that the speed of aging in China's metropolises has been surprisingly high, even higher than that of Japan which is the highest in the world.

Figure-4.8 Growth Rate of Aged and Total Population, Beijing, 1949 - 2032

4 '•'Total pop.

°60+

-1 1949-1964 1964-1982 1982-2000 2000-2020 2020-2032

Period

Source: See Table 4.6 The Aging cf Population in China 51

To take China as a whole, it will take a dozen or so years, or two or three decades, for many regions in China to have a population of old type. Nevertheless, the metropolises have already, in advance, had a population of old type. As a result, the burden on these cities will increase and a number of urban problems will be brought about. In order to ensure the leading role of the metropolises in future socio-economic development, it is necessary to formulate proper population policy and strategy by taking the special nature of the population development in metropolises into consideration.

2. Internal migration

China's migration rate has been for long rather low because the Chinese people are attached to their native land and unwilling to leave it as well as because of the strict practice of household registration system. Survey data showed that in 1986 the migration rate of city population was about 4% while 7.34% for town population, which was associated with a more strict policy of controlling the development of urban population in cities than in towns.

The age-specific patterns have shown that the migration rate of the old people was lower than those of middle-aged and young people (Table 4.8). This indicates that the migration behaviour of the elderly has been in an even smaller amount due to ideological, physical and economic reasons.

Table 4.8 Age-Specific Migration Rate of Various Areas, China, 1986 (Per thousand) Age Large-size Med.-size Small-size Groups Metropolis Cities Cities Cities Town

0-4 18.67 12.69 19.25 34.78 65.26 5-9 23.68 13.18 24.11 36.66 88.97 10-14 29.14 42.95 31.02 56.19 89.58 15-19 70.18 60.18 52.51 77.23 115.61 20-24 55.97 123.60 91.37 111.34 109.52 25-29 27.89 40.56 40.57 72.19 76.48 30-34 23.31 26.97 27.99 44.54 70.40 35-39 21.76 27.52 24.53 45.27 64.17 40-44 18.56 23.08 19.65 45.16 54.21 45-49 11.78 16.92 13.35 42.32 30.95 50-54 7.65 11.67 13.96 7.22 26.05 55-59 11.66 8.18 10.61 10.66 36.05 60-64 13.22 39.13 10.90 10.93 22.39 60+ 13.77 18.42 10.73 13.60 32.82

Mean 27.77 43.87 34.54 53.34 72.80

Source: Preliminary Analysis of Migrants' Age Composition in 74 Cities and Towns, China, by Wang Wei-Zhi Population and Economy, March 1988

The major reasons of migration of the elderly were: to go and live with relatives, to seek retirement and to migrate with their relatives. Survey data showed that of migrants, by reason of retirement, those aged 60- 64 accounted for the largest proportion and of migrants, who went and lived with relatives, those aged 65 and over made up a larger proportion. The amount of old people who migrated with their relatives increased with the increase in their age because those very old people are difficult to take care of themselves and have to be cared by children.

The sampling survey data from Shanghai's elderly (the same source as Table 4.6) have also shown a very low migration rate of the elderly. In 1987, those who have never migrated after they entered the old age accounted for 95.14% while those who have migrated once or twice for 4.62% and three times or more for only 0.24%.

The overall migration rate of the Shanghai's elderly was less than 5%. Those old people who lived in towns had the highest migration rate, being around 13.74%. The urban and rural elderly's migration rates were 4.76% and 3.39% respectively. 52 Wu Cangping

5 Family, Household and Housing

1. Marital status of the elderly

A. Trends in elderly population 60 years and over by sex

The marital status of the elderly population has direct impact on the life of old people. Statistical data have proven that the mortality of people with spouse is lower than that of people bereft of spouse or divorced. Moreover, the demands of the old people and the problems they are faced vary with their marital status.

According to the 1982's third national population census data, out of the 76.501 million old people aged 60 and over, 1.0335 million old persons were unmarried, 41.422 million old persons had spouse, 33.36 million were bereft of spouse and 0.695 million were divorced, accounting for 1.35%, 54.13%, 43.61% and 0.91% of the elderly population respectively. In 1987, the shares were 1.28%, 58.08%, 39.86% and 0.78% respectively. Hence, those who had spouse and who were bereft of spouse accounted for the majority of the elderly population whereas the percentages of unmarried and divorced were very low (Table 5.1).

Table 5.1 Marital Status of the Male and Female Population, Aged 60 and Over, China, 1982 and 1987 (Number in 10 thousand)

1982 1987

Marital status (No.) (%) (No.) <*)

Total 7650.10 100.00 904955 100.00 Single 103.35 1.35 11536 1.27 Married 4142.23 54.13 525627 58.08 Widowed 3336.00 43.61 360710 39.86 Divorced 69.50 .91 7082 .78

Source: 1) State Statistical Bureau of China. 1982 Population Census of China, March 1985, Beijing 2) Figures in this table refer to population of 29 provinces, municipalities and autonomous regions (excluding Tibet) on the mainland

When the marital status of the elderly people is studied by sex, it can be found that most of the unmarried old persons are males. Again, according to the 1982's census data, the unmarried male old persons aged 60 and over recorded 0.911 million, accounting for 88.15% of the total unmarried old persons and 2.56% of the total male old persons. On the other hand, the unmarried female old persons recorded only 0.1225 million, accounting for 11.85% of the total unmarried old people and 0.3% of the total female old people. The corresponding figures in 1987 were 87.81%, 2.38% and 12.29% and 0.29 respectively; in other words, little change has taken place (Table 5.2 and Table 5.3, Figure 5.1 and Figure 5.2).

Table 5.2 Marital Status of the Male and Female Population, Aged 60 and Over, as at 1 July 1982, China (Number in thousand)

Male Female Marital status (No.) (No.)

Total 35,521.8 100.00 40.979.2 100.00 Single 911.0 2.56 122.5 0.30 Married 24,509.7 69.00 16,902.6 41.25 Widowed 9,557.0 26.91 23,803.0 58.08 Divorced 544.1 1.53 151.1 0.37

Figure 5.1 Marital Status of Population, Aged 60 and Over, Male, 1982

26 91%

• Single

m Married 1.53% 236% m Widowed

m Divorced

69%

Male

Source: See Table 5.2

Table 5.3 Composition of the Single Aged Population by Sex, 60 Years and Over, China, 1982 and 1987 Percent

Percentage in Percentage in single (%) own-sex (%) Sex 1982 1987 1982 1987

S ingle,total 100.00 100.00 1.35 1.27

Single.male 88.15 87.81 2.56 2.38

Single.female 11.85 12.19 .30 .29

Source: (1982) Population Census of China, State Statistical Bureau of China, March 1985, Beijing (1987) Tabulations of China 1% Population Sample Survey (National Volume) Department of Population Statistics, State Statistical Bureau, 1989

Figure 5.2 Marital Status of Population, Aged 60 and Over, Female, 1982

58.1%

• Single 0.3% Married

037% Widowed

Divorced

41.3%

Female

Source: See Table 5.2 54 Wu Cangping

B. Age patterns by sex

The excess of unmarried old men over unmarried old women can be explained by the fact that many old men were unable to marry when they were young due to disadvantageous economic status in the Old China. Moreover, the percentage of unmarried old men aged 60-79 is similar to that in age group 80 and over, and so is the case of old women. The corresponding figures are 2.56%, 2.63% for men and 0.3% and 0.29% for women. So, the unmarried old people, and particularly unmarried old women, account for a very low percentage of the elderly population in China (Table 5.4). As for the divorced old persons, men have also evident excess over women. In 1982, men accounted for 78% while women-for 22% of the divorced old persons. They accounted for 1.53% and 0.37% of the male elderly and female elderly people "respectively. In 1987, divorced old men accounted for 73.6% and women for 26.4% of the total divorced old people. They made up 1.23% and 0.39% of the male and female elderly people respectively (the same source as Table 5.3). Thus, the percentage of divorced old women had a slight increase; nevertheless, they were only one-third of the divorced old men.

Table 5.4 Marital Status of Population, Aged 60 and Over, by Sex and Age Groups, China, 1982 (%) Male Female Marital status 60-79 80+ 60-79 80+ Total 100.00 100.00 100.00 100.00 Single 2.56 2.63 .30 .29 Married 70.65 37.32 44.21 7.17 Widowed 25.22 59.23 55.10 92.41 Divorced 1.57 .82 .39 .13 Source: 1) State Statistical Bureau of China. 1982 Population Census of China, March 1985, Beijing 2) Figures in this table refer to population of 29 provinces, municipalities and autonomous regions (excluding Tibet) on the mainland

From these statistical data, the following characteristics of the marital status of the elderly people in China can be found:

(1) The unmarried old persons make up a very small portion, as those who have spouse plus divorced and widowed make up 98.73% (1987, see Table 5.1). This indicates the great impact of traditional marriage concept which leads to a high marriage rate among the Chinese people.

(2) The rate of divorce is very low, and the divorced old persons make up only 0.78% of the old people aged 60 and over (1987, see Table 5.1). This is evidence of the stability of marriage and family relation among oriental people.

(3) The male elderly population shows a higher proportion of people having a spouse than the female elderly, i.e. 69% and 41.25% (1982, see Table 5.2), while the female elderly population has a higher proportion of widowhood (the widowed old men account for 26.91% while the widowed old women account for 58.08%). This can be explained by the higher age-specific death rates among old men as compared with those among old women as well as by a longer female life expectancy than the male one. The higher remarriage rate in male old people than in female should also be taken into consideration.

C. Urban/rural difference in marital status of the elderly population

Most of the unmarried old persons are rural male elderly. The Chinese Academy of Social Sciences has conducted a "China 1987 aged population over 60 years sampling survey", which provided the following figures: in cities, towns and counties of China in 1987, the unmarried old men made up 0.41%, 0.28% and 1.37% respectively. As the majority of China's elderly population are rural people, the amount of rural unmarried old men determines the total number of the unmarried old people.

This phenomenon is associated with better economic conditions in urban area than in rural one and, moreover, the urban social contacts are more active than the rural ones. Not a few rural old men were unable to marry when they were young due to poverty and, later, their opportunity to marry was limited because rural people migrated and moved less frequently than urban people. The Aging of Population in China 55

Different marriage customs between rural and urban areas serve as another cause for the phenomenon. In the past, rural marriage custom emphasised the amount of dowry and marriage expenses. This made a part of peasants unable to afford marriage in rural area. As for urban people, they put less emphasis on the traditional marriage customs. As a result, the rural old people have a higher rate of unmarried men than the urban people.

2. Household structure — Living arrangements

The living arrangement of the old people depends upon many socio-economic factors, such as, age, marital status and economic condition. During the youngest stage of the old people, most of them are able to support themselves and to take care of themselves, and they live mostly with spouse or with unmarried offspring. When they grow older, their ability to support themselves weaken, and they are more and more dependent and mostly live with married children in case of widowhood. This is particularly evident in China's rural area where the pension system has not been practised yet. The living style of the elderly people is determined, on one hand, by the economic status, health, marriage, children's conditions, cultural and psychological conditions of the old people and, on the other hand, by the family living style of the whole society, the socio-economic structure and cultural traditions as well.

A. Household type of the elderly in China

The average family size of aged population is larger than that of the whole population. According to 7957 Aged Population Over 60 Years Sampling Survey Data, the average family size of aged population is 4.9, while the family size of the whole population is 4.4 (calculated from 1982 population census) and 4.2 (estimated from 1% population sample survey held in 1987).

According to the same survey, the three-generation family had the largest proportion, accounting for about 50% of all the families of the elderly people. The two-generation family came next, accounting for 29%. These indicate that the old people in China live, by and large, with children. The one-couple family accounted for 12.9% and the one-person family for 3.4% (Table 5.5 and Figure 5.3).

Figure 5.3 Household Type of Aged Population, 60 Years and Over, 1987

ou - B 1 person

0 1 couple 50 - || 1 HI 2 generations 40 - I J§ 1 I Q 3 generations [jjj 4+generations S 30 - S S other 20 - Mi

10 - J 1 1 I

n — Whole Cities Towns Counties country Region Source: See Table 55 56 Wu Cangping

Table 5.5 Household Type of the Aged Population, 60 Years and Over, China, 1987

Household Type Whole country Cities Towns Counties

Total 100.0 100.0 100.0 100.0 One person 3.4 5.2 6.5 1.9 One couple 12.9 20.9 22.5 7.5 2 generation 29.2 34.6 31.1 26.9 3 generation 50.0 36.9 37.6 58.0 4 generation and over 3.0 1.6 1.7 3.8 Single and other relatives .4 .4 .2 .6 and non-relatives Other 1.0 .4 .3 1.4

Source: China 1987 Aged Population Over 60 Years Sample Survey Data, Special Issue (1), Population Science of China, January 1988

The household type of the elderly population in China differs greatly from that of European countries and the U.S.A. In the U.S.A., U.K and France, most of the elderly people aged 60 and over live in one-couple families, accounting for 40.03%, 46.1% and 46.3% respectively as well as in one person families, accounting for 41.3%, 41.6% and 30.0%. The difference may be explained by economic reason as well as by social custom. The western developed countries are characterized by higher income and living standard accompanied by better social services so that the elderly people can live on their own income, independently by themselves. Also, the social custom plays a role as seen in the case of Japan which, being a developed country, shows a preference of the elderly people for living with their children, and the two-generation and three-generation families together account for 52.1% whereas the one-couple family accounts for 25.1% and the single-person family for 5.7% (Table 5.6).

Table 5.6 Distribution of Household Type of the Aged Population, 60 Years and Over, in Selected Countries

Household Type China Japan Thailand U.S.A U.K France

1987 1981 1981 1981 1981 1981

Total 100.0 100.0 100.0 100.0 100.0 100.0 One person 3.4 , 5.7 . 4.7 41.3 41.6 30.0 One couple 12.9 25.1 6.2 40.0 46.1 46.3 Couple and unmarried 29.2 * 15.2 / / / / children Couple and married 53.0 ** 36.9 38.9 1.6 .7 3.5 children Other - .. .. - . 1.4 . •-.. 17.0 ; 1 / / /

*: Data of two generations ••: Data of three and over generations Source: China 1987 Aged Population Over 60 Years Sample Survey Data, Special Issue (1), Population Science of China, January 1988 Life and Consciousness of the Aged Population, State Council of Japan, March 1982

As regards China's case, both the low level of economic development and social custom play a role. As most of the elderly people are living in rural area where the pension system has not been established, they have to live on their children's support. On the other hand, similar to Japan, the oriental tradition of preference for living in large families is prevalent in China, and according to social and traditional moral norms, supporting the elderly is taken as the children's obligation. Therefore, at present, most of the elderly in China live with their children (82.2%, Table 5.6), showing a very small proportion of old people who live by themselves.

B. Urban/rural difference in living arrangement

The rural area has a much larger proportion of the three-generation family among the elderly people, being 58% as compared with the proportion in urban area which is 36.9%. On the other hand, the urban area has much higher proportions of one-person family (5.2%) and of one-couple family (20.9%) compared with The Aging of Population in China 57

corresponding figures of rural area, 1.9% and 7.5% respectively (Table 5.5). Hence, there are remarkable differences in economic development and social conceptions between the urban and rural people.

The fact that more urban old people live by themselves as compared with the rural ones can be explained by the following factors: most of the urban old people are retired workers who enjoy a pension and have a house to live in which is allocated to them by the institutions at which they had worked; medical and health care and social services in urban area are much more developed than in rural area; and the "generation gap" in the family exists between the old and young people. In contrast with the urban case, the rural old people have to live on their children's support because they do not enjoy a pension system and, furthermore, the traditional family concept has a much larger impact in rural area. So, most of the rural elderly people are living in three-generation families. '":

Table 5.7 Economic Status of the Aged Population in Family, 60 Years and Over, China, 1987 Percent %

Status Cities Towns Counties

Dominant 41.5 39.9 18.7 Dominant Partly 22.7 21.9 18.4 Dominant Oneself 13.3 14.2 13.2 Dependent 18.5 20.5 49.7 Unknown 4.0 3.5 .0

Source: China 1987 Aged Population Over 60 Years Sample Survey Data Special Issue (1), Population Science of China, January 1988

Moreover, the elderly's economic status in family may indicate the impact of economic conditions on the living arrangement of the elderly. In the Chinese society, the dominant position of the elderly in family is determined, to a rather great extent, by the economic condition of the elderly. Thus, those old people who enjoy a dominant position in family account for 41.5% in'urban area, while only 18.7% in rural area, compared to 18.5% of urban old people who are not in a dominant"position in family but a much higher figure in rural area, being 49.7%. Those who enjoy a dominant position in family are more likely living by themselves, showing a larger proportion among urban old people than that among rural elderly (Table 5.7 and Figure 5.4).

Figure 5.4 Economic Status of Aged Population in Family,. 60 Years and Over, 1987 50 H Dominant

0 Dominant Partly

Ü Dominant Oneself

H Dependent

IÜJ Unknown

Counties

Source: See Table 5.7 58 Wu Cangping

C. Sex difference in living arrangement

Similar to many other countries, the elderly people in China show a sex difference in their living arrangement which is associated evidently with the different income and social status between the male and female old people. A survey was conducted in 1987 on the living arrangement of the old people in Jiangsu and Hubei provinces and the survey data show that more old men live in one-couple family and more old women live in one-person, two-generation and three-generation families. This is consistent with the socio-economic development in China.

Table 5.8 Age-Specific Distribution of Household Type of the Aged Population, 60 Years and Over, China, 1987 Percent %

Household Type 60-64 65-69 70-74 75-79 80-84 86-89 90+

Total 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 One person 1.95 3.11 3.04 3.72 3.82 3.88 8.00 3.45 4.63 5.59 5.32 4.58 3.49 5.00 One couple 14.65 18.42 18.59 16.08 12.63 10.19 14.00 15.42 15.02 10.44 6.91 3.79 2.09 2.86 2 generations 47.73 32.36 21.43 13.87 12.63 9.71 10.00 36.60 18.27 10.52 7.92 8.45 9.07 14.29 3 generations 33.54 43.55 53.76 60.72 61.09 61.65 62.00 42.33 59.44 68.60 71.01 70.54 63.72 55.71 4 generations .97 1.30 1.77 4.16 7.49 11.65 6.00 and over 1.08 1.27 3.47 7.21 11.14 18.84 19.29 Other 1.15 1.26 1.40 1.45 2.35 2.91 .00 1.12 1.37 1.38 1.63 1.50 2.79 2.86

Source: China 1987 Aged Population Over 60 Years Sample Survey Data Special Issue (1), Population Science of China, January 1988

The majority of the old people aged 60 and over are living in rural area where a very large proportion of the old people are living with their children. Moreover, the female life expectancy in China exceeds the male one so that most of widowed old women live with their children due to a very, very low rate of remarriage among the Chinese old women. As for the urban old women, many of them do not enjoy a pension because they were not employed and thus have to live with children. As a result, the old women are more likely living in three-generation and four-generation families (Table 5.8).

3. Housing characteristics for older persons

A. Types of housing

The types of housing of the old people in China depend greatly on the region where they live. Owing to differences in traditional housing custom and economic conditions, most of the rural old people live in one-storey house. The style of rural houses varies with region, nationality and geographical location. The majority of urban old people live in buildings of two or more storeys, i.e. in flats, and it is expected that these old people will increase with the development of the urban construction.

The different ownership of house serves as another urban-rural difference of the elderly's housing condition in China. The majority of rural old people are owners of their house while most of the urban elderly's houses are owned by enterprise or institutions, so that the urban old people have to pay monthly rent for house although the rent is very cheap, whereas the rural old people do not. The Aging of Population in China 59

B. Size of housing

The rural old people enjoy more freedom in terms of the style and size of their house whereas the urban old people have restricted size of housing and are unable to build a house themselves.

The rich rural families can build larger and better houses while the urban ones cannot. Although some individual rich urban families can rent houses from others, the majority of urban old people live in houses allocated by the state or institution so that difference in size of housing among urban old people is small.

As a result, the rural old people in China enjoy a larger size of housing compared with the urban old people.

Table 5.9 Per Capita Room Size of the Aged Population, 60 Years and Over, China, 1987 Percent

Per Capita Room Size (metre square) Area Total 4< 4-6 6-8 8-10 10-12 12+

Cities 100 5.03 17.99 20.79 16.26 12.63 27.29 Towns 100 2.28 11.85 17.56 15.35 15.02 37.94 Counties 100 3.77 6.36 9.97 13.14 11.80 54.96

Source: Calculation based on data from: China 1987 Aged Population Over 60 Years Sample Survey Data Special Issue (1), Population Science of China, January 1988

According to the 1987's survey by CASS, 43.81% of urban old people in the country live in families with a per capita size of house less than 8 square metres and only 27.29% enjoy a per capita size of house more than 12 square metres. On the other hand, in rural area, 54.96% of the elderly's families have a per capita size of house larger than 12 square metres. The old people living in towns enjoy a size of house which is in between that of cities and that of counties. The old people living in towns who enjoy a per capita size of house more than 12 square metres account for 37.94% (Table 5.9 and Figure 5.5).

Figure 5.5 Per Capita Room Size of Aged Population, 60 Years and Over, China, 1987

ou • 3

50 •

40 • =

•H | 30 • 1* Illlllll l

20 -

'r1 lllBSll;L ! fcrn 10 • z

r mm Jill m 0 - UJ Cities Towns Counties Per Capita Room Size (metre square)

Source: See Table 5.9 60 Wu Cangping

Nevertheless, the living condition of the elderly cannot be examined only by the per capita size of house, and it is necessary to take the quality of house into consideration. In China, the urban houses have better facilities in terms of sanitary equipment, heating system and water supply than those in rural area.

Table 5.10 Comfortable Degree of the Room that the Aged Live in China, 1987 Live in one Two generations Three générations Region Total room oneself live in one room live in one room

Cities 100 73.50 18.23 5.92 Towns 100 77.10 17.19 3.94 Counties 100 49.52 40.70 8.02

Source: Calculation based on data from: China 1987 Aged Population Over 60 Years Sample Survey Data Special Issue (1), Population Science of China, January 1988

According to data of the same survey, in cities and towns of China, those old people who enjoy living in a separate room by themselves account for 73.50% and 77.10% respectively; in other words, most of the old people have their own room. However, only 49.52% of the rural old people reported to have an enough comfortable room while 40.70% of them reported a moderate case (Table 5.10).

Hence, the urban and rural old people in China have different problems of housing. While the size is a problem for the former, the comfort and convenience of the rural elderly people's housing need to be improved. When these problems are tackled, namely, the increase in the size of house for the urban elderly and the upgrading of facilities for rural ones, the living of the elderly population will be further improved. The Aging of Population in China 61

6 Social and Economic Characteristics of the Elderly

1. Labour force

A. Description of main features of retirement programme

The elderly's social security system was started in 1951 and developed step by step. At present, the social security system of the elderly in China includes two parts, namely, security and welfare. The workers and staff members of State-run and collective-run enterprises as well as governmental organizations enjoy a retirement system, making up the major part of the country's social security system of the elderly. The five guarantees (food, clothing, house, medical care and burial expenses) enjoyed by rural and urban childless and infirm old persons and the subsidy for rural old people, a system developed in recent years, constitute the welfare system in China.

In China, those who enjoy retirement and pension are mostly urban population. They, being the major part of industrial population, play an important role in the development of national economy and social stability and are directly related to the financial situation of the State as well.

The elderly's security system was set up in 1951 in industrial enterprises. "The Labour Insurance Regulations of PRC", promulgated in February 1951 by the Government Administration Council (now the State Council), stipulated definite regulations of social insurance provided for the elderly in Article 15 of Third Chapter and Article 19 of Fourth Chapter. The regulations were implemented in industrial enterprises with a staff size of more than 100 persons. The current pension system in the country which has developed is based on these Regulations.

The Regulations were revised in January 1953. Then, in December 1955, the State Council worked out regulations of retirement of workers of governmental organizations. Still later, in 1958, the State Council separated the elderly's social insurance from the "Labour Insurance Regulations" and worked out legislation of retirement and pension for workers of governmental organizations and staff members of enterprises. Three revisions were made in 1978, 1980 and 1982.

The. current security system of the elderly practised in governmental organizations, state-run enterprises and institutions includes the following major contents:

(1) Requirements: (a) Those male workers and cadres aged 60 and female workers aged 50 and female cadres v - aged 55 may enjoy retirement All of them should have a length of service longer than 10 years in succession. (b) Those workers who are exposed.to jobs which are harmful to health may enjoy retirement earlier, i.e. male workers and staff members aged 55 and female workers and staff members aged 45. (c) Ministers working in central departments and those working at provincial level and ranking as a minister enjoy retirement at age 65 while professors, senior researchers and specialists may enjoy retirement at age 70.

(2) Pension: (a) The amount of pension, varying with the length of service, is equal to 60%-70% of the retiree's original wage. The pension is enjoyed until the death of the retiree. (b) Those who are granted an honourable title or have made special contributions enjoy a larger amount of pension, i.e. an increase of 5-15%. Nevertheless, after the increase, the amount of pension should not exceed the amount of the retiree's original wage.

The requirements have been gradually more liberalised. According to the 195 l's "Labour Insurance Regulations", those who enjoy retirement must have a general length of service of 25 years and a length of service in the very enterprise of 5 years. Later, it has been revised so that those who have worked for 10 years in succession may enjoy retirement Moreover, the amount of pension has been increased to 60-75% of the original wage instead of the 50%-70% as written in the 1951's Regulations. 62 Wu Cangping

In addition to state-run enterprises and institutions, the collective-run economic organizations at district and county levels also implement the labour insurance regulations which are practised in state-run enterprises. As regards collective-run economic organizations below district and county levels, there was no social insurance system prior to 1983. Since 1983, the retirement system has been also practised in these institutions, .including pension, subsidies for medical care, burial expenses and for bereft family members.

At present, the majority of rural elderly people live on their own income and are also supported by their children; in other words, social security of the elderly does not exist among rural population. In 1984, only 0.8 million of old people in rural area of 22 provinces enjoyed a retirement system. The social welfare for the rural elderly takes the form of "five guarantees". The system, started in 1956, provides childless and infirm old persons with food, clothing, housing, medical care and burial expenses. According to statistical data by the end of 1986, in rural area of the country, those old people who are to be provided with five guarantees amounted to 3.153 million, out of which 2.841 million have already enjoyed them. This portion of population accounted for 0.75% of the total agricultural population in that year. The source of the fund used for providing five guarantees are the public welfare fund at village level.

Table 6.1 Pension of Retired Workers in Rural Area, Shanghai, 1985

Monthly Pension Sample Size Percent (Yuan) (Person) (%)

Total 114 100.00 0 12 10.53 1-10 12 10.53 11-20 25 21.93 21-30 11 9.65 31-40 9 7.89 41-50 0 .00 51-60 10 8.77 61-70 8 7.02 71-80 6 5.26 81-90 13 11.40 91-100 3 2.63 101+ 5 4.39

Source: Study of the Support Problem of the Aged in Shanghai Rural Area, Gui Shi-Xun (ed.) The Shanghai Committee on Aging, and The Society of Gerontology in Shanghai

According to data of the sampling survey conducted in 1987 among old people aged 60 and over, pension accounted for the major part of urban elderiy's income while it was negligible for rural old people. Pension accounted for 63.7% of the elderiy's income in cities while 56.3% in towns and only 4.7% in counties where the income of all kinds from working of the old persons accounted for 50.7% of the elderiy's total income. Thus, the social security of rural elderly people are to be improved. Moreover, the amount of pension paid to rural retirees is also smaller than that to urban ones. According to a survey conducted in counties of Shanghai outer suburbs, the mean monthly pension of the rural industrial workers retirees (the rural industrial workers retirees are mostly retirees from township-run and village-run enterprises so that they enjoy a pension) was 40.8 yuan in 1985 (Table 6.1 and Figure 6.1), and 39.47% of these retirees enjoyed a pension higher than the average while 60.53% of them enjoyed a pension which was less than the average. As regards those old persons who had been engaged in planting, they enjoyed an even smaller amount of pension. According to survey data on the elderly people who were engaged in fanning, those who did not enjoy a pension accounted for 23.14%, those who received a monthly pension of 1-10 yuan accounted for 40.48%, while a pension of 11- 20 yuan was enjoyed by 26.99% and a pension of 21 yuan over by only 8.88%. The mean amount of their monthly pension in 1985 was 11.41 yuan for males and 9.35 yuan for females. On the other hand, as for urban retirees, according to statistical data of 1984, only 31.1% of the retirees of the city enjoyed a pension which was lower than 40 yuan. Nevertheless, the urban retirees enjoy subsidies for foodstuffs which amounted to 10-20 yuan but the rural retirees did not enjoy them (the same source as Table 6.1). Thus, the amount of pension enjoyed by only a small portion of rural old people is relatively small. The Aging of Population in China 63

Figure 6.1 Pension of Retired Workers in Rural Area, Shanghai, 1985

20 ••

15 •

I 10 -•

5 •

1-10 11-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90 91-100 101+ Pension (Yuan) I Month

Source: See Table 6.1

The difference in the amount of pension also exists among urban retirees. Retirees from the state-own enterprises enjoy a higher pension than those retirees from collective-own enterprises. To take Shanghai with the largest size of retirees of industrial workers as an example, of 1987's retirees in the city, 0.98 million were from state-own enterprises while more than 0.4 million from the collective-own enterprises. The former enjoyed an amount of pension in accordance with the labour insurance regulation and received a higher pension than the latter who enjoyed an amount of pension in accordance with a regulation similar to the labour insurance. Table 6.2 lists the data for years from 1978 to 1986. Data show a consistent increase in both the total amount of retirees and the total amount of pension in Shanghai during these nine years. Microscopically, taking the mean monthly pension as examples, that of retirees from state-own enterprises was remarkably higher than that of retirees from the collective-own enterprises. This difference has been found in many parts of the country (Table 6.3 and Figure 6.2).

Table 6.2 Pension of Retired Workers in Shanghai, 1978-1986 Number of Total State Ownership Collective ownership retirees pension of Year at the end the year Retirees Total amount Average Retirees Total amount Average of the year (in 10,000) number of pension pension number of pension pension (in 10 yuan) (in 10,000) (in 10,000) I(yuan/month) (in 10,000) (in 10,000) (yuan/month) thousand) 1978 48.1 25300 36.98 20800 11.12 2600 1979 88 53473 62.66 43632 72.98 25.34 9841 44.99 1980 96.47 66518 68.24 53744 71.72 28.23 12774 39.74 1981 106.79 73007 75.73 58944 68.24 31.06 14064 39.53 1982 116.13 78279 82.79 62587 72.45 33.34 15692 40.61 1983 122 88257 86.25 70457 69.47 35.94 17800 42.82 1984 128.53 97186 89.59 76465 72.47 37.67 20722 46.92 1985 135.82 131337 95.37 101601 91.55 39.57 28860 62.27 1986 138.77 135000 97.85 104200 89.88 40.14 29972 62.67 Source: Statistical Yearbook, Shanghai, 1978-1986 Statistical Bureau of Shanghai 64 Wu Cangping

Table 63 . Pension of Retired Workers by Ownership. China, 1978-1985

Annual average Annual average pension (Yuan) ** Year wage of workers (Yuan)* State Collective Total Ownership ownership

1978 644 551 574 333 1979 705 714 764 471 1980 803 714 781 465 1981 812 706 774 464 1982 836 709 774 480 1983 865 726 787 507 1984 1034 766 815 615 1985 1213 935 1034 662

Source: * Statistical Yearbook of China. 1987 ** Statistical Data of Labour and Wage in China, 1949-1985 Statistical Press of China, 1987

Hence, the pension system has been prevalent in urban area of China but has not been practised, by and large, in rural area. Moreover, there are differences in the amount of pension between urban and rural areas as well as between enterprises of different ownership.

Figure 6.2 Pension of Retired Workers by Ownership, China, 1978-1985 1200 — Total

1000 -- State

- - Collective 800 --

600

400 -- ..*

200 -•

0 -f- 1978 1979 1980 1981 1982 1983 1984 1985

Year

Source: See Table 63

B. Trends in labour force participation by sex

China has practised a system of full employment for long. As a result, the total and age-specific labour participation rates have been high. The estimated labour participation rate for the whole country in 1982, based on the third population census data, was 82.1% (89.6% for males and 74.1% for females). The figures are higher than most countries.

The rate of economically active population aged 50 and over in 1982 was slightly higher than that of the USA's 1979 level but lower than that of Japan and of other parts of the world (Table 6.4 and Figure 6.3). As for the pattern of economic activity participation for population aged 50 and over, China's pattern is little different from that of other countries and regions with the exception of the 1950's pattern of developing countries, as shown by Figure 6.3. The Aging of Population in China 65

Table 6.4 Age-Specific Economic Activity Rate of Male Population

China Japan U.S.A Developing Developed Semi-D Age Region Region Region Groups 1982 1980 1979 1950 1950

10-14 / / / 30.8 4.9 15-19 72.5 17.4 50.2 81.8 68.9 20-24 96.8 69.6 87.6 93.1 90.7 25-29 98.8 96.3 94.6 96.2 96.2 30-34 98.9 97.6 95.3 96.2 96.2 35-39 98.9 97.6 95.3 97.2 97.2 40-44 98.6 97.6 95.3 97.2 97.2 45-49 97.5 96.5 92.5 96.2 94.9 50-54 91.4 96.0 88.7 96.2 94.9 55-59 83.0 91.2 81.1 90.7 83.5 60-64 63.7 77.8 61.0 90.7 83.5 65 + / 41.0 19.2 78.5 40.6 Total 56.0 60.2 57.4 58.5 61.5 Source: (China) 1982 Population Census of China, State Statistical Bureau of China, Mar. 1985, Beijing (Japan, U.S.A) Yearbook of Labour Statistics, ILO, Geneva, 1981 (Others) The Aging of Populations and its Economic and Social Implications, U.N, New York, 1956

Figure 6.3 Male Economic Activity Rate

100 T — China (1982)

Japan (1980) 80 -- --U.S.AU979)

60 --

40 --

1 1 1 + 15-19 20-24 25-29 30-34 35-39 4044 4549 50-54 55-59 60-64 65 +

Age Group

Source: See Table 6.4

As the pension system is not widely practised in China's rural area, many rural old people aged 60 and over are still working while the urban old people are retired mostly after the age of 50-60 and the re- employment rate of urban elderly is low (being 18% in cities and 13.2% in towns in 1987). So, the rural elderly people make up the major part of labour-participating population at old age, and the labour participation rate of old people aged 60 and over in rural area is evidently higher than that in urban area (Table 6.5). 66 Wu Cangping

Table 65 Employment Rate of Aged Population Over 60 Years, China, 1987

Cities Towns Counties

Total Male Female Total Male Female Total Male Female

15.0 20.4 10.2 11.6 17.9 6.0 31.5 53.0 12.4

Source: China 1987 Aged Population Over 60 Years Sampling Survey Dala, Special Issue (1), p26 Population Science of China, January 1988

Data from Table 6.5 show that the 1987's employment rate of old people aged 60 and over in counties was 110% higher than that in cities and 172% higher than that in towns. Moreover, the employment rate of male elderly aged 60 and over was one-fold higher than the female rate in cities while twofold higher in towns and threefold higher in counties (Figure 6.4). And the rural data show that, in rural area, more than one-half of the old men aged 60 and over are engaging in various kinds of occupational labour. This can be explained by economic reasons since the pension system has not been practised widely in China's rural area. According to "China 1987 Aged Population Over 60 Years Sampling Survey Data" (1988), for elderly living in cities and towns, their income from working accounted for 14.6% and 14.7% of the total income of the elderly (ranking third place), while pension accounted for 63.7% and 56.3% (ranking first place) respectively. On the other hand, for elderly living in rural areas (in counties), their income from working accounted for 50.7% (the first place) of the elderly's income while pension accounted for only 4.7% (the third place). Thus, it is evident that, under the conditions of backward rural productive forces in China, a considerable portion of the rural old people have to support themselves by their own labour.

Figure 6.4 Employment Rate of Aged Population, 60 Years and Over, China, 1987 60

50 -"

40 -•

1 30 -•

20 -•

10 -

Source: See Table 6.5

As the pattern of labour participation in China is determined by many socio-economic factors, it will experience little change in the near future. It is expected that, with the improvement in health status, the very old people will show a slightly higher rate of labour participation. Table 6.6 shows the projections of the age- specific rates of labour participation of the male population of China.

In China, the sex difference in rate of labour participation is not significant among people at young and middle ages because the State adopts a policy that makes men and women enjoy equal opportunity of employment and equal pay for equal work. Nevertheless, the sex difference increases with the age due to physical reasons, and the difference is particularly significant in physical labour (for instance, the agricultural production). Taking the socio-economic conditions and changes in industrial structure into consideration, it can be expected that this sex difference in labour participation will also experience little change in the near future. The Aging of Population in China 67

Table 6.6 Age-Specific Economic Activity Rate of Male Population, China (Estimated Value) (%)

Age Groups 1982 1990 2000 2010 2025 2040 2050 15-19 72.5 69.8 66.4 63.1 58.2 53.3 50.0 20-24 96.8 95.7 94.4 93.1 91.2 89.9 88.0 25-29 98.8 98.6 98.3 98.1 97.7 97.3 97.0 30-34 98.9 98.8 98.7 98.5 98.3 98.1 98.0 35-39 98.9 98.8 98.7 98.5 98.3 98.1 98.0 40-44 98.6 98.5 98.4 98.3 98.2 98.1 98.0 45-49 97.5 97.5 97.4 97.3 97.2 97.1 97.0 50-54 91.4 91.7 92.1 92.5 93.1 93.6 94.0 55-59 83.0 83.2 83.5 83.8 84.3 84.7 85.0 60-64 63.7 63.9 64.1 64.3 64.5 64.8 65.0 Total 56.0 61.5 60.2 62.2 60.5 57.1 57.4 Source: (1982) Population Census of China, State Statistical Bureau of China, March 1985, Beijing (1990-2050) Characteristics, Causes and Implications of Population Aging in China, Doctoral Essay, Qu Hai-Bo, p227 People's University of China

Survey data (Table 6.7) show that, in 1986, 53.5% of the elderly labour force in the country were full- time workers, while 46.5% were part-time (half-time) workers. Male workers accounted for 74%, while female for 26%, of the full time workers. On the other hand, of the part-time workers, male accounted for 49.4% and female for 50.6%. It is also found that the proportion of the old people who were full-time workers reduced with the increase in age.

Table 6.7 Working Status of the Aged Population, 60 Years and Over, 1986 (%)

% in total aged population % of male % of female

Total 34.76 / / Full time workers 18.48 31.76 8.44 Half time workers 16.28 18.45 14.29

Source: The Emerging Problem of Population Aging in China, Xu Qin (ed.) The China National Committee on Aging, 1988, Beijing

Data from the same survey (the same source as Table 6.7) also show that the rural proportions of full- time and part-time workers, no matter whether male or female, were all higher than those in urban area; the former (50.19%) is 1.5 times higher than the latter (20.21%). This is because the rural old people are able to take part in various kind of light work whereas the urban area does not afford such opportunities. The case is particularly evident for those unskilled urban old people with low educational attainments who can scarcely find a part-time job after retirement. Moreover, as the rural old people can hardly enjoy a pension, they usually try to find some work to do.

C. Industrial classification

According to data of 1987's one percent population sampling survey, the majority of the elderly labour force engaged in productive industries, of the elderly labour force aged 60 and over, 71.8% were engaged in farming, animal husbandry, forestry and fishery, 8.8% in industry, 7.0% in commerce, catering trade, supply and marketing of commodities and storage, and only less than 4% in others (Table 6.8).

The industrial structure of the elderly population is closely associated with the general level of economic development in the country. As China is a developing agricultural country, of the total employed population, according to 1982's census data, 73.7% were engaged in farming, forestry, animal husbandry and fishery, while of the elderly employed population, 86.1% were engaged in these occupations, 5.21% in industry and 3.24% in commerce, catering, supply and marketing of commodities and storage (Table 6.9). The 1987's data show that the industrial structure of the elderly labour force has experienced certain changes. The proportion of the old people who were engaged in farming, forestry, animal husbandry and fishery showed a decrease of 14.3% as compared with the 1982's figure, and the proportion of those old people who were engaged in commerce and industry showed some rise. It can be said that the development of economic system reforms has improved the industrial structure of the elderly employed population. 68 Wu Cangping

Data by sex show that, in 1987, the proportion of female old people who worked in the agricultural sector was lower than that of male old people, although this was the primary working sector of women. The second largest sector where the female old people worked was in commerce and catering trade while, for males, it was in industry. Moreover, more elderly women worked at government agencies, party committees and people's organizations as compared with ¿he elderly men. This difference is associated with the difference in the physical condition between men and women (Table 6.8).

Table 6.8 Industrial Composition of Employed Aged Population, 60 Years and Over, China, 1987 Percent %

60-64 65 AND OVER

Industries TOTAL MALE FEMALE TOTAL MALE FEMALE

Total 100.00 100.00 100.00 100.00 100.00 100.00

1. Fanning, Animal Husbandry, 71.78 72.51 60.67 73.49 74.09 59.78 Forestry and Fishery

2 .Industry 8.82 8.90 7.45 7.34 7.39 6.16 (Mining, Quarrying, Timber Logging and Transportation, Production and Supply of Power, Gas and Running Water, Manufacturing Industries)

3. Geological Prospecting .04 .05 .00 .02 .02 .08 Censuses

4. Construction 1.30 1.36 .42 1.03 1.07 .15

5. Transoortation and 1.04 1.09 .32 .63 .65 .15 Telecommunication

6. Commerce, Catering Trade, 6.96 6.69 11.16 8.22 7.91 15.33 Supply and Marketing of Commodities and Storage

7. Management of Residential 1.63 1.53 3.04 2.08 2.04 3.00 Buildings and Public Faci- lities, Residential Services

8. Health Physical Culture 1.33 1.21 3.17 1.79 1.73 3.31 and Social Welfare

9. Education, Culture and Arts 2.66 2.46 5.63 1.98 1.91 3.47

10.Scientific Research and .32 .31 .54 .23 .23 .31 Comprehensive Technical Services

11. Finance and Insurance .31 .30 .38 .17 .17 .08

12.State Organs, Party 3.67 3.48 6.52 2.82 2.61 7.63 Committees and Mass

13.Other Trades .15 .11 .67 .18 .17 .46

Source: Tabulations of China 1% Population Sample Survey (1987), National Volume, Department of Population Statistics. State Statistical Bureau, 1989

As for age-specific data, they showed that, with the increase in age, the proportion of the elderly men who were engaged in agriculture, commerce and residential service increased while those who were engaged in industry and government agencies showed a reduced proportion, which was associated with the retirement system. As for women, with the increase in age, the proportion of those working in industry and agriculture decreased while the proportion of women working in commerce, government agencies and people's organizations increased correspondingly. The Aging cf Population in China 69

Table 6.9 Structure of Industries of Employed Aged Population, China, 1982 (in thousand)

Total Male 60+ Female 55+

Industries No. % No. % No. %

Total 24303.2 100.00 15312.3 100.00 8990.9 100.00

1. Farming, Animal Husbandry, 20925.5 86.10 12946.2 84.55 7979.3 88.75 Forestry and Fishery

2. Mining, Quarrying, Timber 73.4 .30 64.6 .42 8.8 .10 Logging and Transportation

3. Production and Supply of 15.6 .06 11.7 .08 3.9 .04 Power, Gas and Running Water

4. Manufacturing Industries 1178.8 4.85 807.2 5.27 371.6 4.13

5. Geological Prospecting 3.8 .02 3.2 .02 .6 .01 Censuses

6. Construction 165.4 .68 148 .97 17.4 .19

7. Transportation and 179.6 .74 147.8 .97 31.8 .35 Telecommunication

8. Commerce, Catering Trade, 786.9 3.24 517.5 3.38 269.4 3.00 Supply and Marketing of Commodities and Storage

9. Management of Residential 192.6 .79 112.6 .74 80 .89 Buildings and Public Faci- lities, Residential Services

10. Health Physical Culture 164.5 .68 119 .78 45.5 .51 and Social Welfare

11. Education, Culture and 270.5 1.11 186.6 1.22 83.9 .93 Arts

12.Scientific Research and 27.5 .11 20.7 .14 6.8 .08 Comprehensive Technical Services

13.Finance and Insurance 18.2 .07 14.2 .09 4 .04

14.State Organs, Party 286.4 1.18 203 1.33 83.4 .93 Committees and Mass

15.Other Trades 14.5 .06 10 .07 4.5 .05

Source: 1982 Population Census cf China, State Statistical Bureau, March 1985, Beijing

D. Occupational classification

The occupation of the majority of the elderly labour force has been associated with physical labour. According to 1982's census data, agricultural, forestry, animal husbandry and fishery workers accounted for 84.86% of the employed elderly population, amounting to 20.6246 millions. Next came the workers for production and transportation and related workers, accounting for 5.1% (Table 6.11). The 1987's one percent population sampling survey data show that the proportion of the old people who were engaged in agriculture decreased greatly, and the proportion of workers for production and transportation and related workers showed a slight increase (Table 6.10). Nevertheless, the proportion of staff for various kinds of scientific and technical work and for commerce showed a nearly twofold increase, and the proportion of working staff for service trade had also some increase. This change indicates that, with the changes in the overall structure of economic sectors, more and more elderly labourers are leaving agricultural production and taking greater part in secondary and tertiary industries. 70 Wu Cangping

Table 6.10 Occupational Structure of Employed Population, China, 1987 Aged 60 and Over

60-64 65 AND OVER Occupation TOTAL MALE FEMALE TOTAL MALE FEMALE

Total (Sample Size) 50898 47771 3127 31143 29845 1298

1. Staff for various kinds of 3022 2724 299 1654 1530 124 scientific and technical work

2. Managers for sute organs, 1884 1734 151 481 435 46 party and mass organizations, enterprises and institutions

3. Office workers and related 1032 951 81 376 355 21 staff

4. Commercial workers 1984 1716 268 1782 1613 169

5. Service workers 2684 2453 232 2072 1983 89

6. Workers for farming, 36251 34359 1893 22722 21947 775 forestry, animal husbandry and fishery

7. Workers for production 3437 3263 173 1783 1716 67 and transportation and the workers concerned

8. Other non-classified workers 31 14 17 13 12

Percentage

Total 100.00 100.00 100.00 100.00 100.00 100.00

1". Staff for various kinds of 5.94 5.70 9.56 5.31 5.13 9.55 scientific and technical work

2. Managers for state organs, 3.70 3.63 4.83 1.54 1.46 3.54 party and mass organizations, enterprises and institutions

3. Office workers and related 2.03 1.99 2.59 1.21 1.19 1.62 staff

4. Commercial workers 3.90 3.59 8.57 5.72 5.40 13.02

5. Service workers 5.27 5.13 7.42 6.65 6.64 6.86

6. Workers for farming, 71.22 71.92 60.54 72.96 73.54 59.71 forestry, animal husbandry and fishery

7. Workers for production 6.75 6.83 5.53 5.73 5.75 5.16 and transportation and the workers concerned

8. Other non-classified workers .06 .03 .54 .04 .04 .08

Source: Tabulations of China 1% Population Sample Survey (1987), National Volume, Department of Population Statistics. State Statistical Bureau, 1989

The sex difference .in occupational structure showed that less female elderly people were engaged in farming, forestry, animal husbandry and fishery and more of them were engaged in commerce as compared with their male counterparts. The older the age, the larger the difference. Both the industrial and occupational structures of the male and female elderly population maintain a too large proportion of the elderly people who were engaged in physical labour. So, there is much to do to develop a better way of employment for the elderly in line with their physical status and ability. The Aging cf Population in China 71

Table 6.11 Occupational Structure of Employed Elderly Population, 1982

Total Male 60+ Female 55+

Occupation No. No. No. %

Total 24303.2 100.00 15312.3 100.00 8990.9 100.00

1. Staff for various kinds of 485.3 2.00 373.6 2.44 111.7 1.24 scientific and technical work

2. Managers for sute organs, party 313.6 1.29 246.0 1.61 67.6 .75 and mass organizations, enterprises and institutions

3. Office workers and related staff 118.7 .49 92.7 .61 26.0 .29 4. Commercial workers 510.7 2.10 330.6 2.16 180.1 2.00

5. Service workers 1001.0 4.12 677.2 4.42 323.8 3.60

6. Workers for fanning, forestry, 20624.6 84.86 12713.3 83.03 7911.3 87.99 animal husbandry and fishery

7. Workers for production and 1238.8 5.10 871.9 5.69 366.9 4.08 transportation and the workers concerned

8. Other non-classified workers 10.5 .04 7.0 .05 3.5 .04

Source: 1982 Population Census cf China, State Statistical Bureau of China, March 1985, Beijing

There is a significant urban-rural difference in the elderly's occupational structure. The occupational structure of the elderly people in cities showed a similar trend to that in towns, indicating, however, some difference. According to data of the 1987's survey conducted by the Chinese Academy of Social Sciences (Table 6.12), of the employed elderly people in cities, workers for production made up the largest proportion (22.9%) and office workers next (17.6%), • while in towns the office workers accounted for the largest proportion (21.8%) and workers for production the next (17.9%). Data from Table 6.12 show that, at present in urban area, the proportion of elderly people working as productive workers and professionals are the largest, being about one-third in both cities and towns whereas the proportions of workers for commerce and service trade are less than one-fourth in both cities and towns. In other words, the occupational structure of the urban elderly population also shows a feature of productive pattern. Data of the same survey show that, of the rural employed elderly, those who were engaged in farming, forestry, animal husbandry and fishery accounted for 86.5%; in other words, the occupational structure of the rural employed elderly showed little difference from that of the rural adult population.

Table 6.12 Occupational Structure of Employed Population, Aged 60 and Over, in Cities and Towns, 1987 (%)

Occupation Cities Towns

Total 100 100 1. Staff for various kinds of scientific and technical work 16.5 17.9 2. Managers for state organs, party and mass organizations, 9.8 10.3 enterprises and institutions

3. Office workers and related staff 17.6 21.8 4. Commercial workers 7.1 12.1 5. Service workers 14.3 12.8 6. Workers for fanning, forestry, animal husbandry and fishery .4 .5

7. Workers for production and transportation and the 22.9 17.9 workers concerned

8. Other non-classified workers 11.6 6.7

Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p28. Population Science of China, January 1988 72 Wu Cangping

2. Income

x A. Levels and trends for older persons

The two major sources of income of the elderly people in China are pension and income from working. According to current regulations, the amount of pension equals to 75% of the original wage and, therefore, the level of income of the elderly depends upon, to a great extent, the amount of the original wage. The case is especially so for elderly living in urban area. As China is among the developing countries and has a huge population and a large size of labour force, it has adopted a policy of low wage and high employment rate over a long period of time. As a result, the amount of pension has been small.

Based on findings of the 1987's sampling survey on the elderly aged 60 and over, the income of the elderly can be summarized as follows:

(1) The urban area in China has the largest proportion of the elderly having a middle income (being 30.7 - 36.7%), while the rural area has a very large proportion (80% over) of elderly having a low income. Moreover, in urban area, 20% or so of the old people had no income. (The monthly income, less than 45 yuan, is taken as low income while 46-100 yuan as middle income and more than 101 yuan as high income) (Table 6.13).

(2) There is a large difference in income level between the younger and older elderly people, i.e. the older the age, the lower the income (Table 6.14).

(3) The sex difference in income level of the elderly is also significant. The female old people show a larger proportion of no income and low income (Table 6.15).

(4) As for the relation between the income level and educational attainments, those old people with higher educational attainments have a higher income and the illiterates have the lowest income. However, the difference is small (Table 6.16).

(5) As regards the relation between income and original occupation, those who were cadres enjoy the highest income while the professionals and office workers have also a relatively high income. The old people in other occupations have not so high an income. Nevertheless, the differences are also small CTable 6.17).

(6) Trends: The income from working and pension will increase as the result of the socio-economic development, the rise in people's living standard and the rise in price. However, it is estimated that the extent of actual increase will be limited. So, with the practice of reforms and the open policy, the income gap between the elderly and the employed population will increase.

Table 6.13 Income Level of Aged Population Over 60 Years, China, 1987 (%)

Region Total 45 Yuan < 46-100 101+ No Income

Cities 100 16 36.7 27.3 20

Towns 100 25.6 30.7 19.6 24.1

Counties 100 80.7 18.2 1.1 /

Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p24. Population Science of China, January 1988 The Aging of Population in China 73

Table 6.14 Age-Specific Monthly Income of Aged Population, China, 1987

Total 60-64 65-69 70-74 75-79 80-84 85-89 90+

Sample Size (Person)

Total 13963 5730 3693 2287 1337 655 193 68 No income 2789 808 662 539 385 267 90 38 Cities 45 Yuan< 2236 648 560 448 352 169 0 0 46-100 5130 2066 1462 930 445 165 0 0 101+ 3808 2208 1009 370 155 54 0 0

Total 3856 1457 978 726 409 188 71 27 No income 931 270 210 197 137 69 35 13 Towns 45 Yuan< 986 237 252 224 152 82 0 0 46-100 1184 490 335 217 100 33 0 0 101+ 755 460 181 88 20 4 0 0

Total 18936 6610 4919 3609 2227 1104 372 95

Counties 45 Yuan< 15279 5161 4031 3009 1837 869 0 0 46-100 3548 1350 844 570 369 224 0 0 101+ 209 99 44 30 21 11 0 0

Percentage

Total 100.00 41.04 26.45 16.38 9.58 4.69 1.38 .49 No income 100.00 28.97 23.74 19.33 13.80 9.57 3.23 1.36 Cities 45 Yuan< 100.00 28.98 25.04 20.04 15.74 7.56 .00 .00 46-100 100.00 40.27 28.50 18-.13 8.67 3.22 .00 .00 101 + 100.00 57.98 26.50 9.72 4.07 1.42 .00 .00

Total 100.00 37.79 25.36 18.83 10.61 4.88 1.84 .70 No income 100.00 29.00 22.56 21.16 14.72 7.41 3.76 1.40 Towns 45 Yuan< 100.00 24.04 25.56 22.72 15.42 8.32 .00 .00 46-100 100.00 41.39 28.29 18.33 8.45 2.79 .00 .00 101+ 100.00 60.93 23.97 11.66 2.65 .53 .00 .00

Total 100.00 34.91 25.98 19.06 11.76 5.83 1.96 .50

Counties 45 Yuan< 100.00 33.78 26.38 19.69 12.02 5.69 .00 .00 46-100 100.00 38.05 23.79 16.07 10.40 6.31 .00 .00 101+ 100.00 47.37 21.05 14.35 10.05 5.26 .00 .00

Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p245 Population Science of China, January 1988

Table 6.15 Sex-Specific Monthly Income of Aged Population, 60 Years and Over, China, 1987

Cities Towns Counties

Male Female Male Female Male Female

Total 100 100 100 100 100 100

No income 2.75 35.31 4.31 41.71 15 Yuan< .67 5.43 1.44 9.63 9.49 - 9-22 16-25 1.05 6.88 2.93 13.30 26.67 26-76 26-45 3.01 13.67 8.23 14.13 44.34 44.84 46-70 11.75 19.46 18.33 11.20 14.96 14.85 71-100 29.33 13.42 27.17 6.41 3.27 332 101-150 30.59 4.25 26.95 2.93 .88 .76 151-200 13.65 1.04 8.50 .59 .22 .10 201+ 7.21 .45 2.15 .10 .13 .09

Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p245-p249 Population Science of China, January 1988 74 Wu Cangping

Table 6.16 Monthly Income of Aged Population, 60 Years and Over, by Educational Level, China, 1987

Cities

High Secondary Primary College School School School Illiterate Total 100 100 100 100 100 No income 2.13 3.16 3.70 9.43 36.64 15 Yuan< .19 .37 .87 1.27 5.93 16-25 .39 .56 1.31 2.42 6.92 26-45 1.36 2.23 3.65 5.82 13.41 46-70 2.52 7.81 10.61 16.90 18.02 71-100 8.53 22.30 23.18 30.48 13.14 101-150 35.85 37.92 32.59 22.69 4.40 151-200 28.49 15.24 16.00 7.58 1.06 201 + 20.54 10.41 8.11 3.40 .47 Towns Total 100 100 100 100 100 No income 3.80 7.64 7.51 10.55 40.99 15 Yuan< .00 .69 .61 1.91 9.97 16-25 .00 .69 1.42 4.71 13.31 26-45 2.53 4.17 6.09 9.20 14.87 46-70 2.53 11.11 12.58 20.99 11.10 71-100 15.19 25.00 23.53 25.81 7.10 101-150 43.04 38.19 33.87 19.75 2.15 151-200 26.58 9.03 11.97 5.27 .54 201 + 3.47 2.43 1.80 .06 Counties Total 100 100 100 100 100 15 Yuan< 9.30 6.86 6.89 6.66 10.19 16-25 11.62 19.60 19.94 23.67 28.13 26-45 62.79 48.03 48.97 45.49 43.98 46-70 13.95 16.66 16.86 18.14 13.95 71-100 2.32 5.88 4.98 4.09 2.92 101-150 .00 1.96 1.75 1.21 .66 151-200 .00 .98 .29 .35 .09 201+ .00 .00 .29 .35 .04 Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p250-p253 Population Science of China, January 1988

Table 6.17 Monthly Income of Aged Population and their Occupation before they Retired, 60 Years and Over, Cities, China, 1987 (%)

Occupation rotal No 15 16-25 26-45 46-70 71-100 101-150 151-200 201+ income Yuan 1. Staff for 100 .23 .00 .11 1.13 4.96 21.42 37.66 20.97 13.53 various kinds of scientific and technical work 2. Managers for 100 .31 .10 .10 .31 1.32 7.32 38.86 33.88 17.80 state organs, party and mass organizations. enterprises and institutions 3. Office workers 100 .20 .31 .41 3.38 8.09 27.77 39.96 13.52 6.35 and related staff 4. Commercial 100 .84 .00 1.11 3.62 25.07 36.77 21.73 8.08 2.79 workers 5. Service workers 100 .90 .23 .45 3.62 22.40 40.05 24.21 4.98 3.17 6. Workers for 100 .00 .00 .00 .00 26.32 26.32 21.05 21.05 5.26 farming, forestry, animal husbandry and fishery 7. Workers for 100 .54 .14 .58 2.38 14.64 41.24 29.60 7.71 3.17 production and transportation and the workers concerned 8. Other non- 100 .86 .00 86.00 4.31 21.55 37.07 24.14 6.03 5.17 classified workers

Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p254 Population Science of China, January 1988 The Aging of Population in China 75

Figure 6.5 Income Level of Aged Population, 60 Years and Over, China, 1987

w - tÜ45Yuan< 80 - rrnnn 0 46-100 70 - ¡1 • 101+ 60 - ijiijii ™ No Income i t Percent % 30 - L ^ 20 - ft. Ijjjjlj; 10 - 0 - I Cities HTowns Counties Region

Source: See Table 6.13

B. Sources of income

During the 1987's sampling survey on the elderly, ten forms of income were inquired, including income from working (including wage paid for re-employment), pension, deposit, insurance, social relief fund, financial capital fund, support from children (or other relatives), sale of property, present from friends or relatives and so forth. It was found that pension, support from children and income from working were the three major forms in the elderly's income, accounting for more than 90% of the total income of the elderly. Nevertheless, the following variations were found In terms of structural feature.

Firstly, for urban old people, pension ranked first, accounting for 63.7% in cities and 56.3% in towns, and support from children as well as wage paid for re-employment were supplementary. The rural old people lived mostly on their own and were supported by their children as well. The income paid for or received for their participation in labour accounted for 50.7% of the total income of the rural old people (Table 6.18 and Figure 6.6).

Table 6.18 Income Sources of Aged Population, 60 Years and Over, China, 1987

Area Total Pension Given by children Work income Others Cities 100 63.7 16.8 14.6 4.9 Towns 100 56.3 21.0 14.7 8.0 Counties 100 4.7 38.1 50.7 6.5

Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p23 Population Science of China, January 1988 76 Wu Cangping

Figure 6.6 Income Sources of Aged Population, 60 Years and Over, China, 1987

80 Pension

Ü3 Given by children

60 Work income

Others r

Source: See Table 6.18

Secondly, with the increase in the age of the elderly, pension and wage took a smaller part of their income while support from children increased its proportion (Table 6.19 and Figure 6.7).

Table 6.19 Age-Specific Main Income Sources of Aged Population in Cities, China, 1987

Total 60-64 65-69 70-74 75-79 80-84 85-89 90+ Total 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 Work Income 14.59 20.52 12.43 9.79 5.07 2.18 2.73 3.13 Pension 63.66 66.06 66.33 62.34 53.63 48.30 44.55 25.00 Given by Children 16.81 9.38 16.76 21.69 34.03 41.02 45.45 62.50 Other Sources 4.94 4.04 4.48 6.18 7.27 8.50 7.27 9.37

Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p264 Population Science of China, January 1988 The Aging of Population in China 77

Figure 6.7 Age-Specific Main Income Sources, Aged Population, in Cities, 1987

Work Income

o Pension

-*.Given by Children

•0" Other Sources

60-64 65-69 70-74 75-79 80-84 85-89 90 + Age Group

Source: See Table 6.19

Thirdly, the female old people were more dependent than males; for the former, the support from children took a major part of income whereas pension and income from working took a major part of income among male old people (Table 6.20 and Figure 6.8).

Table 6.20 Sex-Specific Main Income Sources of Aged Population, 60 Years and Over, 1987

Cities Towns Counties Income Source Male Female Male Female Male Female

Total 100.00 100.00 100.00 100.00 100.00 100.00

Work Income 18.91 8.50 18.72 8.93 62.92 32.50

Pension 74.05 49.01 70.95 34.95 7.11 1.15

Given by Children 4.93 33.56 6.90 41.60 24.62 58.13

Other Sources 2.11 8.93 3.43 14.52 5.35 8.22

Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p264 Population Science of China, January 1988

C. Individual and household patterns

Generally, it was found that the lower the income, the larger the size of household, and vice versa. The six-person, five-person and two-person households served as three steps representing significant changes. Most of the old people having a low income were living in three-generation families while most of those with a high income were living in two-generation families. 78 Wu Cangping

Figure 6.8 Sex-Specific Main Income Sources, Aged Population Over 60 Years, China, 1987

I Work Income

I Pension

I Given by Children

I Other Sources

Male Female Male Female Male Female Cities Towns Counties

Source: See Table 6.20

D. Consumption expenditures

People's living standard in China has been continuously improved. According to findings of sampling survey conducted in several different years, the annual per capita net income increased from 1957's 72.95 yuan to 1985's 397.60 yuan in rural families, whereas from 253.56:yuan to 821.40 yuan in urban families. In urban area, the annual per capita living expenses increased from 1957's 222 yuan to 1985's 732.24 yuan (China Statistical Yearbook, 1985). With the improvement in families' living standard, the living standard of the elderly has also been improved. Nevertheless, the expenditure of the elderly has been mainly on food.

The significant difference in income between urban and rural elderly people exerts a decisive impact on the consumption level of the elderly.

Table 6.21 Average Monthly Income of Aged Population, 60 Years and Over, Shanghai, 1987

Yuan/Month

Number of average monthly income Total City Towns Counties

Average (Yuan) 71.61 89.44 89.16 37.23 Median (Yuan) 65.56 82.73 79.50 29.55 Mode (Yuan) 60.00 60.00 75.00 10.00 Minimum (Yuan) .00 .00 .00 .00 Maximum (Yuan) 800.00 800.00 250.00 302.00

Sample Size (Person) 2075 1237 130 708

Source: Study of Policy Implication on Aging Issue in Shanghai, pl3, Chen Xian-Huai (ed.) The Shanghai Committee on Aging, and The Society of Gerontology in Shanghai. July 1988 The Aging of Population in China 79

Data from the sampling survey conducted in February, 1987 on urban rural elderly people of the Shanghai Municipality have shown that the mean monthly income of urban and rural old people was 71.61 yuan. While the mean monthly income of the city elderly showed little difference from the income of town elderly, both being around 89 yuan, the mean monthly income of the rural elderly was only 37.23 yuan; in other words, the difference in income between the urban and rural elderly people was very large. The mean monthly income of rural old people was only about 41% of that of urban old people (Table 6.21).

Data from the same sampling survey showed that the mean monthly expense of the elderly was 60.49 yuan for the sample as a whole. Again, the mean monthly expense of the city old people was about the same as that of town old people, both being around 72 yuan. Nevertheless, the mean monthly expense of rural old people was only 37.97 yuan, showing a large difference from the consumption level of urban old people (Table 6.22 and Figure 6.9).

Table 6.22 Average Monthly Expenditure of Aged Population, 60 Years and Over, Shanghai, 1987

Yuan/Month

Number of average monthly expenditure Total City Towns Counties

Average (Yuan) 60.49 72.03 72.98 37.97 Median (Yuan) 55.16 65.02 69.67 32.87 Mode (Yuan) 45.00 75.00 70.00 30.00 Minimum (Yuan) 5.00 20.00 28.00 5.00 Maximum (Yuan) 322.00 322.00 181.00 214.00

Sample Size (Person) 2035 1220 122 695

Source: Study of Policy Implication on Aging Issue in Shanghai, pl4, Chen Xian-Huai (ed.) The Shanghai Committee on Aging, and The Society of Gerontology in Shanghai. July 1988

Figure 6.9 Type of Monthly Expenditure of Aged Population, 60 Years and Over, Shanghai, 1987 50 0 Personal food

'ersonal clothing 40 -• Personal other expense

For children and others

Î I

Total Cities Towns Counties

Region Source: See Table 6.22

While the mean monthly income of city and town old people exceeded their mean monthly expense, with a surplus of one-fourth of the mean monthly income, the rural old people showed a converse case. Apart from misreporting of the interviewed who usually estimated their income lower while expense higher than the actual level, there are a few rural old people who are unable to make ends meet. Most of the old people stated that their living standard has been improved with the development of rural economy. Moreover, 43.99% of rural old people stated they had economic difficulties due to price fluctuation and other factors. 80 Wu Cangping

When the expenditure is classified into four kinds, i.e. expenditure on food, clothing, other personal expenses and supporting offsprings or other persons, it can shed some light on the consumption tendency of the elderly (Table 6.23).

Table 6.23 Type of Monthly Expenditure of Aged Population, 60 Years and Over. Shanghai. 1987

(Yuan/Month/Person)

Expenditure on Total City Towns Counties Personal food 36.29 42.31 42.86 24.55 Personal clothing 4.54 5.35 6.02 2.83 Personal other expense 10.63 13.32 11.99 5.63 For children and others 8.98 10.98 11.43 5.02 Source: Study of Policy Implication on Aging Issue in Shanghai, pl5, Chen Xian-Huai (ed.) The Shanghai Committee on Aging, and The Society of Gerontology in Shanghai. July 1988

Data about the composition of elderly's expenditure in Shanghai show that, in both urban and rural areas, expenditure on food accounted for the largest percentage (60% over). The ratio of expenditure on food, clothing, other personal expenses and in support of children or other persons was approximately 8:1:2:2. Thus, the elderly's expenditure on clothing has been very small (Table 6.23).

3. Education

Compared with the population of the country as a whole, the educational attainments of the elderly show an even worse case. According to 1982's census data, about one-fifth of the population aged 12 over were illiterates. However, the male illiterates accounted for 60.88% of the male population aged 60 and over while the female illiterates for 95.43%. When the sum of primary school graduates and illiterates is taken into consideration, they accounted for 91.9% of male elderly people while the female's figure was 99.1% (Table 6.24 and Figure 6.10).

Figure 6.10 Educational Level of Elderly, 60 Years and Over, China. 1982

• College and High School 79.39%

«3 Secondary school

1.18% ™J Primary school

3.06% Ka Illiterate

1637%

Educational Level

Source: See Table 6.24 The Aging of Population in China 81

The very low educational attainments of the elderly in China have historical reasons. Owing to a very undeveloped economy, low living standard of people in the Old China.most of the people could not afford to go to school. Also, as a result of a backward way of agricultural production, the rural children had to take part in labour at a very young age instead of going to school. After the founding of the People's Republic, the Government developed an anti-illiteracy campaign which has reduced the number of illiterates. Never- theless, the high rate of illiteracy among the elderly people can hardly be changed radically.

Table 6.24 Educational Level of Aged Population, 60 Years and Over, China, 1982

Males Females

Level Number % Number %

Total 35578629 100.00 41059124 100.00 College 210599 .59 35839 .09 High school 552359 1.55 "105918 .26 Secondary school 2121618 5.96 225058 .55 Primary school 11034784 31.02 1508975 3.68 Illiterate 21659269 60.88 39183334 95.43

Source: 1982 Population Census of China, State Statistical Bureau of China, March 1985. Beijing

Moreover, calculations showed that, in 1987, the average duration of schooling of population aged 6 and over in the country was 4.65 years whereas the duration was 2.0 years for the old people aged 60 and over.

The educational attainments of the elderly people become even lower with the increase in the age of the old people. The 1987's survey on the elderly showed that the duration of schooling of the old people aged 60 - 64 was 2.67 years which was longer than ¿he average of the elderly as a whole (2.0 years), while the duration was 1.57 for old people aged 70-74 and 1.10 for people aged 80 and over. This indicates that the earlier the time, the lower the educational attainments of people.

There is a significant sex difference in duration of schooling of the elderly . The survey data show that, in cities, the average duration of schooling of male old people was 5.29 years while 1.73 year for females. As for the elderly living in counties, the corresponding figures were 2.13 years and 0.41 year respectively, showing the strong influence of the traditional idea of regarding men as superior to women. Also, survey data show that the durations of schooling of urban old men and women are all longer than those of rural old men and women.

It is expected that, as a result of an increasing popularisation of middle school education during the past 40 years, the educational attainments of the elderly will be gradually improved. Nevertheless, due to the impact of the socio-economic conditions in this period, the gap between the educational attainments of the elderly and the national average as well as the age, sex and urban-rural differences in duration of schooling of the old people will not vanish in the near future.

4. Composition of nationality

The population of China consists of 56 nationalities. As the size of population varies with nationalities, the number of the elderly people of each nationality also varies from each other greatly.

According to the 1982's third national population census data, people of Han nationality accounted for 93.3% of the country's total population while people of the national minorities for 6.7%. The Zhuang nationality has the largest size of population among all national minorities, recording more than 13.38 million. The smallest national minority has only one thousand or so people (Table 6.25).

The distribution of nationalities in China is uneven and shows -an evident geographical feature. The people of Han nationality live mostly in the east and central parts of the country while people of national minorities live mainly in western, southern and remote regions. As the result of differences in fertility level, mortality level and in socio-economic development among regions, the age structure of population varies with nationalities. Thus, there is significant difference in the proportion of the elderly people among various nationalities. The proportion of Han people aged 60 and over is 7.69%, which is slightly higher than the national average (7.63%). The elderly people of all 55 national minorities account for 6.8 82 Wu Cangping of the total population of all national minorities; that is, a lower proportion as compared with that of Han nationality. Among the national minorities, the Eluosi nationality has the largest proportion of the elderly people, being 11.48%, while the Elunchun nationality has the smallest one, being only 2.49%. Both the two nationalities have a very small size of population. As for other national minorities, the proportion of the elderly population ranges from 4% to 8%. It is thus clear that the size and proportion of China's elderly population are determined by changes in population of Han nationality (Table 6.25).

Table 6.25 Number and Proportion of Aged 60 and Over, by Nationality. China, 1982 in thousand

Nationality Total 60+ % Nationality Total 60+ %

Total 1003913.8 76637.8 7.63 Jinuo 12 < .8 6.70 Eluosi 2.9 .3 11.48 Shui 286.9' 18.9 6.58 She 372.0 32.7 8.78 Bulang 58.5 3.8 6.47 Naxi 251.6 20.1 8.00 Jingpe 93 6 6.47 Weiwuer 5962.5 469.7 7.86 Hui 7228.4 465.7 6.44 Buyi 2119.3 163.0 7.69 Lisu 481.9 33.6 6.34 Han 936674.9 72009.2 7.69 Miao 5021.2 316.2 6.30 Taj ike 26.6 2.0 7.68 Yi 5453.6 340.2 6.24 Tibetan 3847.9 296.1 7.58 Qiang 102.8 6.4 6.19 Zhuang 13383.1 1003.0 7.49 Li 887.1 54.9 6.19 Jing 13.1 1.0 7.40 Xibe 83.7 5.1 6.09 Achang 20.4 1.5 7.35 Wuzibieke 12.2 .7 5.99 Dulong 4.6 .3 7.19 Bao an 9 .5 5.92 Mulao 90.4 6.5 7.19 Lahu 304.2 17.5 5.75 Bai 1132.2 81.0 7.15 Hani 1058.8 60 5.66 Luoba 1.1 .1 7.13 Dawoer 94.1 5.2 5.55 Menba 1.1 .1 7.11 Dongxiang 279.5 15.3 5.47 Man 4305.0 305.8 7.10 Mongol 3411.4 185.3 5.43 Tujia 2836.8 201.2 7.09 Wa 298.6 15.9 3.32 Pumi 24.2 1.7 7.04 Tataer 4.1 .2 5.31 Nu 22.9 1.6 6.96 Gaoshan 1.6 .1 5.15 Dai 839.5 58.1 6.92 Sala 69.1 3.5 5.11 Keerkezi 113.4 7.8 6.87 Tu 150.6 7.8 4.01 Maonan 38.2 2.6 6.86 Yugu 10.6 .5 4.66 Gelao 54.2 3.7 6.81 Hasake 907.5 41.4 4.57 Dong 1426.4 97.2 6.81 Hezhe 1.5 .1 4.03 Korean 1765.2 120.3 6.81 Ewenke 19.4 .7 3.66 Yao 1412.0 95.9 6.79 Elunchun 2.1 .1 2.49 Deang 12.3 .8 6.79

Source: 1) Sute Statistical Bureau of China, 1982 Population Census of China, March 1985, Beijing 2) Figures in this table refer to population of 29 provinces, municipalities and autonomous regions on the mainland Note: Total number includes those of unknown nationality and Chinese of foreign descendant

The majority of national minorities have a smaller proportion of the elderly as compared with that of Han nationality or with the national average, which can be explained by a higher fertility level and a younger age structure of the national minorities. On one hand, the government of the People's Republic of China has given priority to the development of minority population, so that a different population policy has been implemented among the national minorities, even when family planning has been practised among people of Han nationality in order to control the size of the country's population. During the earlier period of time, family planning was not practised in regions where the people of national minorities resided, while during the later period family planning has been encouraged in accordance with the actual conditions of each national minority. On the other hand, the regions where people of national minorities live are still less developed economically and the population reproduction there is at the initial stage of transition; in other words, the birth rate there is high and the death rate is starting to drop.

The nationality difference in age structure of China's population is consistent with the regional difference. Those regions or provinces, where the majority of residents are people of national minorities, have a rather young age structure and a low proportion of the elderly population. For example, in Ningxia, Qinghai and Xinjiang, the proportion of children in 1987 was above 35% and the proportion of people aged 60 and over was around 6% (Tables 4.4 and 4.5), the lowest proportion of the elderly population in the country. As the nationality differences in socio-economic development, in family planning practice as well as in pattern of population reproduction will not vanish in a short time, the fact that the age structure of the national minority population is younger than that of Han nationality will continue for a rather long period of time in the future. The Aging of Population in China 83

7 The Health Status of China's Older Population

The health status of the elderly is an overall reflection of the level of economical development, living standard, health services and social security of the society. The health status of the elderly affects their quality of life in their remaining years, as well as the intensity of support and help the society and the family should offer.

1. Morbidity levels

According to the tabulation from the "China 1987 Aged Population Over 60 Years Sampling Survey Data", edited by the Chinese Academy of Social Sciences, the health status of the elderly was as follows (Table 7.1 and Figure 7.1): very good 16.1%, good 28.6%, fair 27.5%, poor 17.6%, and very poor 9.4%. The first two groups constituted 44.7%, while the last two 26.9%. The overall impression was that those whose health condition was not satisfactory exceeded one-fourth of the elderly, nearly one-half were Healthy, and a little more than one-fourth were fair. It should be pointed out that the health status of those elderly people who live in urban areas is better than that of the rural ones. In terms of the age-specific health status of the elderly people by sex, no matter whether in urban areas or not, among the elderly people aged 80 years and over, more than half of them are healthy (Tables 7.2 -7.4).

Figure 7.1 Health Status of Aged Population, 60 Years and Over, by Region, China, 1987

tí Very good

S Good

Eu Fair

H Poor

Ë3 Very poor

B2 Unkown

Total Cities Towns Counties

Region

Source: See Table 7.1

There was some difference between the two sexes (Tables 7.2 - 7.4). Among the healthy ones, urban men constituted 49.4%, while women 42.3%, the former being 7.1% higher, township men 49.5%, while women 42.7%, the former being 6.8% higher; county men 47.7%, while women 40.3%, the former being 7.4% higher. Among unhealthy ones, urban women occupied a remarkably higher proportion, 31.2% compared to the men's 25.6%, the women 5.7% higher than men; township women, 32.6% to 27.2%, 5.4% higher; county women, 27.3% to 23.2%, 4.1% higher. The underlying causes of the differences in health condition between men and women vary from the different constitution of the age group, income, employment, accessibility to and quality of health care, to the ability to participate in social activities. 84 Wu Cangping

Table 7.1 Health Status of Aged Population Over 60 Years, by Region, China, 1987 Total Cities Towns Counties - Total 36755 13963 3856 18936 N Very good 5931 2100 520 3311 U Good 10510 4275 1250 4985 M Fair 10110 3517 903 5690 B Poor 6478 2506 722 3250 E Very poor 3468 1478 438 1552 R Unknown 258 87 23 148 Total 00.00 100.00 100.00 100.00 Very good 16.14 15,04 13.4» 17.49 % Good 28.59 30.62 32.42 26.33 Fair 27.51 25.19 23.42 30.05 Poor 17.62 17.95 18.72 17.16 Very poor 9.44 10.59 11.36 8.20 Unknown .70 .62 .60 .78 Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p274-p278 Population Science of China, January 1988 Table 7.2 Age-Specific Health Status of Aged Population by Sex, 60 Years and Over, Cities, 1987 Percent % Total 60-64 65-69 70-74 75-79 80-84 85-89 90+ Total 100 100 100 100 100 100 100 100 Very good 17.42 18.64 16.82 15.13 15.38 21.49 20.00 14.29 Good 31.99 31.59 31.85 33.17 30.77 34.65 35.00 35.71 Male Fair 24.61 25.53 24.61 23.76 23.99 18.86 21.67 28.57 Poor 15.38 15.67 15.48 15.81 15.20 11.40 11.67 .00 Very poor 10.19 8.34 10.80 11.83 13.55 12.72 10.00 21.43 Unknown .41 .24 .45 .29 1.10 .88 1.67 .00 Total 100 100 100 100 100 100 100 100 Very good 12.92 12.52 10.12 12.02 16.18 21.55 18.80 22.22 Good 29.40 27.91 29.63 28.42 31.23 34.66 36.09 37.04 Female Fair 25.70 26.49 25.94 28.03 25.03 17.56 19.55 11.11 Poor 20.23 21.58 21.93 19.98 17.70 14.05 10.53 5.56 Very poor 10.94 11.07 11.76 10.91 8.98 9.84 13.53 7.41 Unknown .81 .42 .63 .64 .88 2.34 1.50 16.67 Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p276 Population Science of China, January 1988 Table 73 Age-Specific Health Status of Aged Population by Sex, 60 Years and Over, Towns, 1987 Percent % Total 60-64 65-69 70-74 75-79 80-84 85-89 90+ Total 100 100 100 100 100 100 100 100 Very good 15.07 15.58 14.08 15.19 13.61 20.31 13.64 16.67 Good 34.40 34.89 33.13 32.59 36.69 29.69 63.64 50.00 Male Fair 23.03 24.10 24.22 24.37 15.38 20.31 9.09 16.67 Poor 17.06 16.91 18.01 14.56 23.08 12.50 9.09 .00 Very poor 10.16 8.39 9.94 12.97 11.24 17.19 4.55 16.67 Unknown .28 .13 .62 .32 .00 .00 .00 .00 Total 100 100 100 100 100 100 100 100 Very good 12.08 9.63 11.92 11.22 12.92 18.55 26.53 33.33 Good 30.66 31.16 27.68 30.49 33.33 29.03 38.78 47.62 Female Fair 23.77 26.20 23.84 23.66 19.58 25.81 14.29 .00 Poor 20.20 21.25 23.64 19.51 18.75 12.10 10.20 4.76 Very poor 12.42 11.05 12.53 14.39 14.17 12.90 8.16 4.76 Unknown .88 .71 .40 .73 1.25 1.61 2.04 9.52 Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p277 Population Science of China, January 1988 The Aging of Population in China 85

Table 7.4 Age-Specific Health Status of Aged Population by Sex, 60 Years and Over, Counties, 1987 Percent %

Total 60-64 65-69 70-74 75-79 80-84 85-89 90+ Total 100 100 100 100 100 100 100 100 Very good 21.36 22.56 20.65 19.34 18.83 25.45 28.23 43.33 Good 26.32 25.80 26.49 25.18 27.67 30.59 29.84 26.67 Male Fair 28.61 29.16 28.90 30.35 27.55 20.31 21.77 13.33 Poor 15.75 15.45 16.42 15.88 16.19 15.42 8.87 10.00 Very poor 7.46 6.62 7.30 8.88 9.07 7.20 6.45 .00 Unknown .49 .40 .25 .36 .69 1.03 4.84 6.67 Total 100 100 100 100 100 100 100 100 Very good 14.03 13.83 12.92 13.28 12.91 19.44 20.16 29.23 Good 26.33 25.69 25.09 27.68 27.36 26.29 29.84 29.23 Female Fair 31.33 31.46 33.19 30.74 31.93 27.97 23.79 24.62 Poor 18.42 19.85 18.59 18.47 16.96 17.48 11.69 7.69 Very poor 8.85 8.56 9.29 9.06 9.88 6.71 9.27 .00 Unknown 1.04 .60 .92 .76 .96 2.10 5.24 9.23 Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p279 Population Science of China, January 1988

The type of disease bears a close relation with the age. Statistics have proven that cardiovascular diseases, cerebrovascular diseases and cancers have their highest incidence among the elderly. With the aging of the population, the number of patients affected by these diseases will inevitably increase gradually. The health service must be adjusted to cope with the situation. Statistics have shown that, among the mortalities of the first ten important diseases and the causes of death collected from some cities, the cardiovascular diseases, cerebrovascular diseases and cancers ranked the sixth, fifth and seventh respectively in 1957, while in 1975, 1980 and 1982, they invariably occupied the first, second and third places (Tables 7.5, 7.6 and 7.7). These facts warned that the above-mentioned diseases had become major diseases threatening the health of people. Increasing number of the elderly are afflicted by such diseases.

Table 15 Ten Main Causes of Death in Some Cities of China (1) 1957 Cause-specific Percentage in Order Causes of Death Mortality Rate Total Death 1/100,000 1 Respiratory diseases 120.3 16.86 2 Acute infectious diseases 56.6 7.93 3 Pulmonary tuberculosis 54.6 7.51 4 Digestive diseases 52.1 7.31 5 Heart disease 47.2 6.61 6 Cerebral haemorrhage 39.0 5.46 7 Malignant rumours 36.9 5.17 8 Nervous diseases 29.1 4.08 9 Trauma and intoxication 19.0 2.66 10 Tuberculosis of other organs 14.1 1.98 Total of Ten Causes 65.57 1963 Cause-specific Percentage in Order Causes of Death Mortality Rate Total Death 1/100,000 1 Respiratory diseases 64.57 12.03 2 Malignant tumours 46.12 8.59 3 Cerebral haemorrhage 36.87 6.87 4 Pulmonary tuberculosis 36.32 6.77 5 Heart disease 36.05 6.72 6 Digestive diseases 31.35 5.84 7 Acute infectious diseases 21.24 3.96 8 Trauma 16.19 3.02 9 Nervous diseases 13.76 2.56 10 Blood and hematopoietic disease 9.81 1.83 Total of Ten Causes 58.19 Statistical Areas: 1957's include Beijing and other 12 cities, 1963's include Beijing and other 18 cities Note: Heart diseases data in 1957 and 1963 do not include rheumatic heart disease 86 Wu Cangping

Table 7.6 Ten Main Causes of Death in Some Cities of China (2)

1975

Cause-specific Percentage in Order Causes of Death Mortality Rate Total Death 1/100,000 %

1 Cerebro-vascular diseases 127.91 21.61 2 Heart disease 115.34 19.49 3 Malignant tumours 111.49 18.84 4 Respiratory diseases 63.64 10.75 5 Digestive diseases 28.78 4.86 6 Pulmonary tuberculosis 21.15 3.57 7 Trauma 16.84 2.85 8 Infectious diseases 13.17 2.23 (excepting pulmonary tuberculosis) 9 Urinary diseases 11.63 1.97 10 Intoxication 6.27 1.06

Total of Ten Causes 87.23

1980

1 Cerebro-vascular diseases 135.35 23.36 2 Heart disease 132.51 22.87 3 Malignant tumours 113.41 19.57 4 Respiratory diseases 51.97 8.97 5 Digestive diseases 22.68 3.91 6 Trauma 18.75 3.24 7 Pulmonary tuberculosis 12.15 2.10 8 Intoxication 10.46 1.80 9 Urinary diseases 9.28 1.60 10 Infectious diseases 8.49 1.46 (excepting pulmonary tuberculosis)

Total of Ten Causes 88.88

1983

1 Heart disease 119.34 21.49 2 Cerebro-vascular diseases 118.63 21.36 3 Malignant tumours 114.23 20.57 4 Respiratory diseases 49.41 8.9 5 Digestive diseases 24.31 4.38 6 Trauma 19.39 3.49 7 Intoxication 11.38 2.05 8 Pulmonary tuberculosis 10.82 1.95 9 Urinary diseases 9.04 1.63 10 Neonatal diseases 561.41 1.54

Total of Ten Causes 87.36

Statistical Areas: 1975's include Beijing and other 11 cities, 1980's include Beijing and other 16 cities, 1983's include Beijing and other 27 cities Note: Cause-specific mortality of neonatal disease is calculated on the denominator of per 10,000 The Aging of Population in China 87

Table 7.7 Ten Main Causes of Death in Some Counties

1975

Cause-specific Percentage in Order Causes of Death Mortality Rate Total Death 1/100.000 %

1 Heart disease 123.18 18.02 2 Malignant tumours 119.57 17.50 3 Cerebro-vascular diseases 92.31 13.51 4 Respiratory diseases 88.15 12.90 5 Digestive diseases 46.30 6.78 6 Pulmonary tuberculosis 32.61 4.77 7 Trauma 24.26 3.55 8 Infectious diseases** 23.82 3.49 9 Neonatal diseases* 1194.81 2.65 10 Urinary diseases 10.16 1.49

Total of Ten Causes 84.66

1980

1 Heart disease 170.57 25.84 2 Cerebro-vascular diseases 113.06 17.13 3 Malignant tumours 96.89 14.68 4 Respiratory diseases 79.14 11.99 5 Digestive diseases 34.82 5.28 6 Pulmonary tuberculosis 21.36 3.24 7 Trauma 18.40 2.79 8 Infectious diseases 18.24 2.76 9 Neonatal diseases 720.41 1.59 10 Intoxication 9.34 1.41

Total of Ten Causes 86.71

1984

1 Heart disease 158.53 24.57 2 Cerebro-vascular diseases 98.78 15.31 3 Malignant tumours 97.02 15.03 4 Respiratory diseases 78.50 12.16 5 Digestive diseases 36.39 5.64 6 Intoxication 27.60 4.28 7 Pulmonary tuberculosis 26.86 4.16 8 Trauma 20.80 3.22 9 Infectious diseases 15.32 2.37 10 Neonatal diseases 795.34 1.62

Total of Ten Causes 88.36

Statistical Areas: In Shanghai and Jiangsu province 1975's include 18 counties total or some communes, 198O's include 38 counties total or some communes, 1984's include 70 counties total or some communes Note:* Cause-specific mortality of neonatal disease is calculated on the denominator of per 10,000 ** Infectious diseases do not include pulmonary tuberculosis 88 Wu Cangping

2. Health care costs

According to the 1987 sampling survey, the way of health care payment and its structure of the elderly population are summarized in Table 7.8. If the whole elderly population is classified, the ratio between the National Health System (NHS) / semi-NHS and self-payment groups is 3:7, while between NHS and semi- NHS / self-payment groups 2:8. This shows that the proportion of NHS is low on the whole, though there is a difference between urban and rural areas. In cities and townships, the proportion is larger. In cities, more than half of the elderly population enjoy NHS, while in townships, NHS and semi-NHS. In the counties, only a very small number of the population belong to NHS and semi-NHS. They together constitute only 5.3%, while the remaining 94.7% have to pay at their own expense (Figure 7.2).

Table 7.8 Way of Medical Payment of Aged Population Over 60 Years, China, 1987 Percent % Whole country Cities Towns Counties

Total 100.0 100.0 100.0 100.0 Self-payment 71.7 26.7 45.1 94.7 Semi-NHS* 9.9 22.1 19.2 3.1 NHS* 18.4 51.2 35.7 2.2

*: NHS - The National Health System, i.e. Public-payment Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p29 Population Science of China, January 1988

Figure 7.2 Way of Medical Payment of Elderly, 60 Years and Over, China, 1987

100 •H Self-payment

80 -- 0 Semi-NHS

ENHS

60 --

40 --

20 --

o 4-J

Whole country Cities Towns Counties

Region

*: NHS - The National Health System, i.e. Public-payment Source: See Table 7.8

The way of payment is closely related to the age structure (Table 7.9). The general trend is that the proportion of self-payment expands with the upgrading of age group, while that of NHS dwindles. The semi- NHS remains slightly changed. The trend could be seen from the self-payment weighted tabulation. The self- payment population constituted 65.4% in the 60-64 group, 76.5% in 70-74 group, 82.4% in 80-84 group and 86.5% in the above 90 group. The proportion of NHS dropped from 24.9% down to 13.7%, 7.8% and 3.7% respectively. Nearly the same "Up and Down" trend, related to the upgrading of the age group, could be seen in cities, townships and counties from the results of sampling survey, which implies that NHS is expanding with time. The Aging of Population in China 89

Table 7.9 Age-Specific Way of Medical Payment of Aged Population, 60 Years and Over, by Region, China, 1987

Total 60-64 65-69 70-74 75-79 80-84 85-89 90+

Total 13963 5730 3693 2287 1337 655 193 68 No. Self-pay 3733 1132 925 730 517 290 100 39 Semi-NHS* 3084 1057 800 581 378 192 55 21 NHS* 7146 3541 1968 976 442 173 38 8 Cities Total 100 100 100 100 100 100 100 100 % S elf-pay 26.73 19.76 25.05 31.92 38.67 44.27 51.81 57.35 Semi-NHS 22.09 18.45 21.66 25.40 28.27 29.31 28.50 30.88 NHS 51.18 61.80 53.29 42.68 33.06 26.41 19.69 11.76

Total 3856 1457 978 726 409 188 71 27 No. Self-pay 1738 478 413 386 261 127 51 22 Semi-NHS 739 283 196 143 67 32 15 3 NHS 1379 696 369 197 81 29 5 2 Towns Total 100 100 100 100 100 100 100 100 % Self-pay 45.07 32.81 42.23 53.17 63.81 67.55 71.83 81.48 Semi-NHS 19.16 19.42 20.04 19.70 16.38 17.02 21.13 11.11 NHS 35.76 47.77 37.73 27.13 19.80 15.43 7.04 7.41

Total 18936 6610 4919 3609 2227 1104 372 95 No. Self-pay 17931 6203 4627 3471 2116 1063 359 92 Semi-NHS 588 209 157 87 89 31 12 3 NHS 417 198 135 51 22 10 1 0 Counties Total 100 100 100 100 100 100 100 100 % Self-pay 94.69 93.84 94.06 96.18 95.02 96.29 96.51 96.84 Semi-NHS 3.11 3.16 3.19 2.41 4.00 2.81 3.23 3.16 NHS 2.20 3.00 2.74 1.41 .99 .91 .27 .00 *: NHS - The National Health System, i.e, Public-payment Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p299-p301 Population Science of China, January 1988

The structure of the way of payment differed between the two sexes (Table 7.10). The overall impression is that the self-payment group was much larger in women than in men, and the reverse was the case for NHS. The results of sampling survey show the following. In cities, self-payment constituted 9.0% in men and 42.5% in women, the latter being 33.5% higher; in townships, 17.7% and 69.3%, 51.6% highen in counties, 92.7% and 96.5%, 3.8% higher. The reverse was the case for NHS which, in cities, constituted 79.1% in men and 26.4% in women, the former being 52.7% higher, in townships, 60.5% and 13.9%, 46.6% higher, in counties, 4.3% and 0.3%, 4.0% higher. The male population belonging to the NHS was much larger compared to the female one. This trend was remarkable in urban areas where NHS was relatively highly developed. In rural areas, where the NHS was far from developed, the difference between men and women seemed negligible (Figure 7.3).

Table 7.10 Way of Medical Payment of Aged Population, 60 Years and Over, by Region, China, 1987

Cities Towns Counties

Male Female Male Female Male Female

Total 6578 7385 1811 2045 8927 10009 No. S elf-pay 593 3140 321 1417 8273 9658 Semi-NHS* 785 2299 395 344 270 318 NHS* 5200 1946 1095 284 384 33 Total 100.00 100.00 100.00 100.00 100.00 100.00 S elf-pay 9.01 42.52 17.73 69.29 92.67 96.49 Semi-NHS 11.93 31.13 21.81 16.82 3.02 3.18 NHS 79.05 26.35 60.46 13.89 4.30 .33 *: NHS - The National Health System, i.e, Public-payment Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p299-p301 Population Science of China, January 1988 90 Wu Cangping

Figure 73 Way of Medical Payment of Elderly, 60 Years and Over, China, 1987

100 NHS

Semi-NHS 80 -- Self-payment

60 -- 5? 1 40 --

20 --

Male Female Male Female Male Female

Cities Towns Counties

*: NHS - The National Health System, i.e.. Public-payment Source: Data From: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p299-p301 Population Science of China, January 1988

Table 7.11 shows some details of the yearly expenses on health care among the elderly. In cities, 25.4% had no personal expenses on health care, either due to NHS or complete health; 19.8% paid under 10 yuan RMB, 23.0% 11-50 Yuan RMB, 8.0% 51-80 yuan RMB, 10.6% 81-150 yuan RMB, 13.2% above 151 yuan RMB. In townships, 14.9% of the population had no personal expenses on health care, 17.0% paid under 10 yuan RMB, 27.6% 11-50 yuan RMB, 12.0% 51-80 yuan RMB, 13.3% 81-150 yuan RMB, 15.2% above 151 yuan RMB. In counties, 54.7% of the population paid under 10 yuan RMB, 29.8% 11-50 yuan RMB, 9.1% 51- 100 yuan RMB, 6.4% above 101 yuan RMB (Figure 7.4). The personal expenses on health care do not seem to be high, but it is already a heavy load in rural areas though a lesser one in urban areas, if the under- development of the economy and low income are taken into consideration. In cities, 68.5% of the population had easy access to medical care, 31.5% had some difficulties due to remoteness, reduced motion ability and other causes. Among them 14.3% had financial difficulties (Table 7.12). In townships, 64.2% had no difficulties to get access to medical care, being lower than that of city population. 20.3% had financial difficulties, being higher than that of city population. In counties, only 5.2% had no difficulties to get access to medical care, and all the remaining 94.8% had difficulties of various origins and degrees, among whom 61.8% had financial difficulties (Figure 7.5). These figures demonstrate that lack of money and difficult access to medical care remain the major problems for the rural elderly. The fundamental causes leading to these difficulties are low income and low social security. Moreover, the lagging behind of medical care, which cannot cope with the tremendous increase of population including the elderly, also contributes much to the difficulties. The Aging of Population in China 91

Table 7.11 Medical Payment Paid by Monthly Income by Aged Population, 60 Years and Over, by Region, China, 1987

Cities Towns Counties

Total 13963 3856 18963 N 0 Yuan 3546 574 10 Yuan< 10364 U 1-10 2765 655 11-50 5641 M 11-20 1112 360 51-100 1714 B 21-30 796 261 101-300 1005 E 31-50 1300 444 301-500 123 R 51-80 1112 464 501+ 89 81-150 1473 513 151-300 924 344 301-500 427 131 501+ 508 110

Total 100 100 100 0 Yuan 25.40 14.89 10 Yuan< 54.65 1-10 19.80 16.99 11-50 29.75 11-20 7.96 9.34 51-100 9.04 21-30 5.70 6.77 101-300 5.30 31-50 9.31 11.51 301-500 .65 51-80 7.96 12.03 501+ .47 81-150 10.55 13.30 151-300 6.62 8.92 301-500 3.06 3.40 501+ 3.64 2.85

Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p302 Population Science of China, January 1988

Figure 7.4 Medical Payment Paid by Monthly Income by Aged Population, 60 Years and Over, by Region, China, 1987

50 +

40 -HÜ P 20 -H

io -H

Source: See Table 7.11 92 Wu Cangping

Table 7.12 Availability of Medical Care of Aged Population, 60 Years and Over, by Monthly Income and Region, China, 1987

Cities Towns Counties

Total 13963 3856 18936

No difficulty 9560 2474 987 Can't afford 1992 781 11710 Hospital is too remote 570 129 3308 No. Too ill to go to hospital 248 75 359 Unwilling 485 78 \ Registration is difficult 149 42 \ No good doctor 224 62 \ Afraid to see doctor 34 9 \ Doctor fails to diagnose 105 24 2185 Other 596 182 387 Total 00.00 100.00 100.00

No difficulty 68.47 64.16 5.21 Can't afford 14.27 20.25 61.84 Hospital is too remote 4.08 3.35 17.47 Too ill to go to hospital 1.78 1.95 1.90 Unwilling 3.47 2.02 \ Registration is difficult 1.07 1.09 \ No good doctor 1.60 1.61 \ Afraid to see doctor .24 .23 \ Doctor fails to diagnose .75 .62 11.54 Other 4.27 4.72 2.04

Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p311-p317 Population Science of China, January 1988

Figure 7.5 Availability of Medical Care of Elderly, 60 Years and Over, by Region, China, 1987

80 La No difficulty

Es Can't afford

60 - ill «i Hospital is too remote

H Too ill to hospital

I 40 Ed Doctor fails to diagnose

S Other

20 -

Counties

Source: See Table 7.12 The Aging ofPopulation in China 93

3. Daily life support

Self-care is the main profile of daily life support of the elderly population, It is assisted by children depending upon cultural background, family type and size.

Table 7.13 demonstrates the status of daily life support and dependence of the elderly above 60, according to the results of sampling survey of the same age group conducted in 1987. Among the total population above 60, 83.8% depended on self-care, being higher in urban areas and lower in rural ones. 11.99% were taken care of by the children. The difference between rural and urban areas in this group was great. This group of elderly constituted 6.9% of the total in cities, 7.8% in townships and increased to 14.8% in counties. The results show that rural elderly were more dependent on their children. Those who were taken care of by spouses constituted 3.5% of the total elderly population, being 5.3% in cities and townships, while 2.4% in rural areas (Figure 7.6). Those who are taken care of by relatives, friends, nursing servants and other members of the community are increasing speedily in number. In the forthcoming years the types of care, other than self-care and children- and spouse-care, will develop rapidly due to the nucleation of the family and development of social security.

Table 7.13 Status of Daily Life Support and Dependence of Aged Population Over 60 Years, 1987

Percent Whole Country Cities Towns Counties Total 100 100 100 100 Self-care 83.8 86.6 85.6 82.2 Spouse-care 3.5 5.3 5.3 2.4 Children-care 11.9 6.9 7.8 14.8 Relatives and Friends .5 .5 .5 .5 Nursing Servants .1 .3 .4 .0 Neighbours .1 .2 .4 .0 Community .1 .2 .1 .1 Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p31 Population Science of China, January 1988

Figure 7.6 Daily Life Support and Dependence of Aged Population Over 60 Years, by Region, China, 1987

90 • Self-care

Spouse-care

m Children-care

60 m Other

5? i

Whole Country Cities Towns Counties

Region Source: See Table 7.13 94 Wu Cangping

Table 7.14 Status of Daily Life Support and Dependence of Aged Population, 60 Years and Over, by Sex, 1987

Percent %

Cities Towns Counties

Male Female Male Female Male Female

Total 100.00 100.00 100.00 100.00 100.00 100.00 Self-care 87.15 86.16 87.08 84.21 85.63 79.21 Spouse-care 8.29 2.60 7.68 3.13 3.08 1.87 Children-care 3.69 9.79 4.03 11.10 10.68 18.39 Relatives and Friends .43 .54 .28 .68 .52 .44 Nursing Servants .21 .38 .50 .34 .00 .03 Neighbours .09 .22 .11 .10 .07 .04 Community .14 .31 .33 .44 .03 .02

Source: China 1987 Aged Population Over 60 Years Sampling Survey Data, Special Issue (1), p365-p369 Population Science of China, January 1988

There was some difference in care between male and female. Men tended to be more independent and needed less support of their children though a higher proportion were supported by their spouses. Women were more dependent and relied more on their children, but were less supported by spouses than men (Table 7.14). In cities, men of self-care constituted 87.2%, while women 86.2%. In counties, they were 85.6% and 79.2% respectively. Among those who were taken care of by children, men constituted 8.7% while women 9.8% in cities. In counties, they were 10.7% and 18.4% respectively. Among those who were taken care of by spouses, men constituted 8.3%, while women 2.6% in cities. In counties, they were 3.1% and 1.9% respectively. The above-mentioned data indicate a greater dependence of men on spouses. In cities, the number of men who were taken care of by spouses had exceeded that of those who were taken care of by children, ranking second among all types of care. The Aging cf Population in China 95

8 Policy Implication

When the Government works out the socio-economic policies relating to the aging of the population, the following characteristics of the elderly population should be taken into consideration: the increase in the size and proportion of the elderly, the rapid population transition and the prolongation of the life-span of people. Moreover, changes in structure within the elderly population, such as, the increase in the very old elderly, change in sex ratio, regional distribution and various socio-economic characteristics of the elderly, should also be considered. Hence, the following points are important for policy formulation.

1. Health

The aging of the population has an inevitable impact on the whole society, and the impact is particularly evident on medical and health care services. Firstly, the increase in the size of the elderly will change the structure of diseases. A tremendously large amount of data show that cardiovascular diseases, cerebrovascular diseases and cancers affect mostly the old people. Survey data from China's several cities showed that, in 1957, cerebrovascular diseases, heart diseases and malignant tumours ranked the sixth, fifth and seventh place among causes of death, but they jumped to the first, second and third places in 1975, 1980 and 1982. Next, the expenses for medical care of the elderly will grow with the increase in the size of the elderly because the old people pay more hospital visits, constitute a larger number of in-patients, and have a longer duration of hospitalization and higher hospitalization expenses as compared with people of other - ages of the population. Furthermore, the treatment cost of those diseases frequently seen in old people, such as cardio-, cerebro-vascular diseases and tumours, is higher than that of other diseases.

Thanks to the great concern for the elderly shown by government at all levels, the health care services for the elderly in the country have developed rapidly, particularly in the urban area. The following measures have been adopted:

(1) The old people enjoy "three priorities" (registration, examination and supply of medicines). This has been practised in most of municipal hospitals in Shanghai and in more than 100 hospitals in Beijing. (2) The development of family beds was started in Tianjin Municipality, and the Ministry of Public Health held a meeting in 1984 in Tianjin to popularise the experience. As a result, 10,000 family beds have been developed for the elderly by the municipal hospitals in Shanghai. (3) Geriatric hospitals have been set up and geriatric outpatient departments have provided advisory services and help for old people in the field of health care. (4) Rehabilitation has been provided for the old people. In the suburbs of Beijing, 17 rehabilitation hospitals, equipped with nearly 800 beds, have been established. (5) After the establishment of the China Geriatrics Society, provincial geriatric societies have also been set up to conduct research on geriatrics.

China has its own medical system in rural area. The medical and health care workers (called the barefoot doctors in the past) work in villages, and there are commune hospitals in townships, people's hospitals, hospitals of traditional Chinese medicine and other medical research institutions at county level. Despite all these institutions, there is still much to do to improve health services in rural area.

Thus, more efforts must be made to organise professionals in various specialities to improve treatment and prevention of diseases of the elderly in order to achieve better social and economic benefits. Moreover, as the aging of the population is proceeding and the number of the elderly population is increasing, it is necessary to increase the allocation of funds from the State's budget to medical and health care expenditures, particularly to increase the amount of investment in the improvement of rural medical and health care services. Also, the medical insurance system of the elderly should be practised more widely.

Due to the gaps existing between different regions in the stages of economic development and the standards of health and medicare service, a health and medicare system for the aged should be instituted at the local administration levels according to the local needs. Rehabilitation centres and geriatric hospitals should be continuously established and improved. Services, such as, home-visit medical consultations and home helper programmes, should be applied widely. 96 Wu Cangping

Finally, the basic premise of medicare service for the elderly should be "prevention first". Educational activities on health should be promoted and disease prevention measures should be taken. Also, people should be encouraged to take responsibility for their own health.

2. Economic

The major economic problems brought about by the aging of the population are: social security, pension system, pension of agricultural workers, modification of legal age of retirement, preparations for retirement and retraining and re-employment of the old people. Policies should be worked out aiming at the solution of these problems.

China's social security system is a huge network consisting of the security system of governmental organizations, institutions and enterprises in urban area, security system of urban collective-run enterprises, security system in a small part of township-run enterprises, urban security system for childless single old people, rural old folks' homes and the five guarantees system. Moreover, the family supporting system in urban and rural areas serves as an important part of the elderly's life, although it is not included in the social security system.

China's current pension system has enjoyed only by staff members of state-own enterprises and institutions. The staff members of large collective-own enterprises may enjoy a similar pension system while those of medium-sized and small collective-own enterprises in urban area as well as self-employed labourers and the majority of people in rural area do not enjoy a formal pension system. The staff members of medium- sized and small collective-own enterprises may enjoy a certain amount of pension depending upon actual conditions of the very enterprise.

So, China's pension system has to be improved. On the one hand, a very limited amount of old people enjoy a pension while the majority of the elderly who live in rural area do not. On the other hand, as the pension of the staff members of state-own enterprises is provided entirely by the State, it increases the burden on the government's budget greatly. Therefore, the pension system must undergo reform.

For state-own enterprises and institutions, it is suggested to build up a mixed type of pension fund, i.e. "the basic portion plus the additional portion". The basic portion will still be provided by the State while the additional portion comes from insurance, including enterprise and individual insurances, and the amount of insurance may account for 3% or so of the wage.

For urban collective-own enterprises and institutions, similar measures can be adopted step by step.

For private enterprises and self-employed labourers in urban area, the State may stipulate regulations to force them to practise insurance.

In order to best accommodate the programme to the Chinese situation, separate pension schemes for public, enterprise, and self-employed workers in cities and rural areas should be set up. Pension plans currently administered on a company basis vary both in the amount of benefits and the burden on the employers. Although it is quite difficult to integrate them in a unified operation, China is advised to lay a foundation for a future unified pension insurance system in order to avoid divergence and complications.

The overwhelming majority of the aged population in China live in rural areas. Due to the rapid reform of the economic system, the pension programme for the farm workers will become an increasingly pressing problem. Due to disparity in economy and the level of development among rural villages, the pension insurance scheme for rural areas should be started where it easily can take root and be expanded later to other areas. For the time being, a cooperative old age insurance scheme to be administered on a county or township basis in areas with relatively highly developed economies is proposed. It should be operated as a pilot plan with most funds coming from groups and individuals, assisted by the government as necessary. Groups should make larger contributions than individuals at the beginning, raising the proportion of individual contributions gradually according to the income level.

As the pension system of rural elderly is the weakest link of China's security system, it is necessary to make greater efforts to develop the farmers* retirement system. This can be done by bringing the farmers' The Aging cf Population in China 97 initiative into full play; in other words, to encourage the practice of insurance and saving insurance. It is expected that, in rural area, the currently prevalent way of supporting the elderly (also the traditional way) by families will remain unchanged for a rather long period of time. Thus, this way of supporting the elderly will be accompanied by the five guarantees, social relief, cooperative support and other measures. It is also important to provide legal protection for farmers' property rights and their relations' property inheritance. Fur- thermore, in practising land contract system, the rights and interests of the elderly must be taken into consideration because the problem of supporting the elderly in rural area cannot be solved only by ethical principles and administrative measures.

The re-employment of the elderly is a problem of importance only next to the problem of supporting them. As a result of socio-economic development and improvement in medical and health conditions, the life expectancy of human beings is increasing rapidly. In the meantime, more and more old people are still strong and vigorous. Also, the improved socio-economic development, changes in industrial structure and improvement in social services have provided favourable conditions for the re-employment of the old people. On the other hand, the participation of the elderly in social development is important for both the society and the old people themselves. At present, the problem of participation of the elderly in socio-economic activities occurs only in some of the cities, but it will be a problem involving the whole society in the future when the retirement system will be practised step by step in a wider range. By that time, the Government will be faced with an increase in the number of pensioners as well as with a huge financial stress. It is, therefore, more practicable to provide the elderly with opportunities of taking part in socio-economic development. By this way, they will be able to share the achievements in social progress and make more contributions to the society.

In order to solve the problem, it is necessary to work out policies macroscopically and microscopically. Macroscopically, the policy will provide opportunity of re-employment for the elderly, including modification of the legal age of retirement, preparations for retirement, investigations into the elderly labour resource, filing details of the elderly labour force, establishing information network about demands for elderly labour force (mainly professionals and technicians needed by newly-established urban collective-run enterprises and township-run enterprises) and organizing services to mediate between demands for and supply of elderly labour force. Microscopically, social service trades must be developed in order to reduce the amount of housework of those old people who are willing to be re-employed after their retirement. Moreover, it is necessary to stipulate rules to protect the elderly labour force and to provide them with opportunities of learning and training. By this way, the old people will be able to renew their knowledge in line with the rapid progress of science and technology.

3. Family

The Chinese people, especially the elderly people, have a very strong concept of close family ties. Supporting and respecting the elderly have been the Chinese tradition. In the feudal society, the old people were most lofty in the family. After the founding of the People's Republic, the Constitution and the Marriage Law have stipulated that supporting the elderly is the children's duty and the maltreatment of the old people is illegal.

At present, in China's urban area, 40% of the elderly people are in an economically dominant position in the family as against 20% in rural families. About 20% of the urban old people have to be supported economically by others in the family while the figure for rural old people is as high as 50% and over. Generally speaking, the elderly's position in the family depends upon their economic condition, health status and personality.

Thus, in order to improve the elderly's situation in the family, it is important to improve the elderly's economic status, their independence and educational attainments in addition to carrying on the Chinese tradition of respecting the elderly and loving the children.

As regards the family life of the elderly, there is a lack of recreation and sports, and the case is particularly serious in rural area. Therefore, the community should provide more chances of social contacts, such as, old folks' home, old people's post boxes, the elderly's college, the elderly's club and so forth, to make the old people enjoy a more colourful life and to learn more new knowledge.

To help reduce the burden on families taking care of the aged, the home helper system and provision of daily necessities for the aged are available in many other countries. It is proposed that China start an 98 Wu Cangping experimental project and gradually spread such services in accordance with the economic standards and other criteria.

The Chinese government and society should encourage the inception of service industries for the aged, and help develop social service industries catering to families caring for the aged at home. The "Five- Guarantee System", which provides clothing, meals, housing, medical care and funerals for people without children in rural areas in China, is effective and should be continued.

4. Housing

In China, 80% and over of the old people are living with their children or relatives, which has been taken as rational. So, the demand for living in a separate room is not prevalent in the country. Nevertheless, the housing condition in China's rural area is poor and about one-tenth of the elderly people in urban area are not ensured in terms of housing. The Government must give priority to the increase in the housing area for the urban elderly and to the improvement of housing conditions of the rural old people.

Housing for the aged should be improved. Even if the parents are living apart from their child's family, they should be encouraged to live close enough so that "the soup does not get cool" in order to maintain family life, yet enjoy separate household. In planning housing estates, care should be given to build two-generation houses in which habitats can maintain separate lifestyles yet live close together. In urban sectors, apartment houses for the aged should be built to help reduce the burden on children with lower financial capacities.

The State has set up old folks' homes for those childless single old persons and those who prefer to live isolatedly. However, very few of these homes are luxuriously equipped, serving only those retired cadres of high rank. On the contrary, some of the old folks' homes at village level can hardly ensure a basic living standard for the elderly. So, the policy must be worked out to improve thousands of the rural old folks' homes.

The future design and construction of buildings and roads should take the principle of free accessibility into consideration as many other countries have done. The construction of houses for the elderly should be convenient, of larger size and multiple styles.

5. Other issues

A policy regarding population migration favourable to family-care for the aged should be formulated. It is advisable to adopt policies facilitating the moving-in and moving-out of the aged needing support, and for their supporters to arrange convenient care.

Along with the reform of the economic system of China, there is an exodus of rural population to cities and towns, and the mobile population in different regions is increasing daily. The separation of the aged and their supporters will become universal. This is contrary to the situation in the past, where the rural population was limited to one place due to the natural conditions of rural economies. The social support and the facilities for social services for the aged are all inadequate in view of current realistic needs, and the old people are mainly relying on their children for economic needs and care-giving. Therefore, there is a definite need for policy to facilitate the co-habitation of the elderly and their supporters.

Recreational facilities specially designed for the elderly have to be increased and improved. Moreover, social and family services should be organized to provide daily care for the very old and physically weak old people.

As regards transportation, it is suggested that free or half-fare train or ship tickets and other favourable treatments could be granted to old people.

The Government will do its best to narrow the gap between urban and rural elderly population. Not a few of the old people living in medium-sized and small cities or towns prefer to return to the countryside; the government at all levels should provide a better living environment for them. Also those urban problems which are harmful to the elderly, such as, overloaded traffic, very high buildings, atmospheric pollution and so forth, should be solved.

It is hoped that solutions to all these issues will be perfected gradually and constantly. The Aging cf Population in China 99

References

Chinese Publications

State Statistical Bureau, People's Republic of China Statistical Yearbook of China, 1980-1988.

Population Census Office of the State Council, PRC A Census of One Billion People, Papers for International Seminar on Chinese Population Census.

State Statistical Bureau, PRC Statistical Data of 1982 Census.

State Statistical Bureau, PRC Statistical Data of 1% Population Sampling 1987.

State Statistical Bureau, PRC Population Statistical Collection of PRC.

Chinese Social Sciences Publishing House Almanac of China's Population, 1985,1986,1987.1988.

Population Information and Research Center of China Population Handbook, 1983-1988.

Population Research Institute, CASS China 1987 Aged Population Over 60 Years Sampling Survey Data.

Aging Commission, Civil Bureau and Statistical Bureau of Beijing Beijing 1987 Aged Population Over 60 Years Sampling Survey Data.

Zhang Kaimin and Shanghai Academic of Social Sciences Shanghai 1987 Aged Population Over 60 Years Sampling Survey Data. t Wu Cangping, to be published in INTEGRATION, JOICFP Meeting the Challenge to the Aging Population With Confidence Keynote speech at the international symposium on aging, Dec.6-9, 1989; Beijing, China.

U.N. Publications

United Nations, World Population Prospects Estimates and Projections As Assessed in 1986.

United Nations, The Aging of Populations And its Economic and Social Implications A world-wide survey and analysis of aging, its causes and consequences.

United Nations, Economic and Social Implications of Population Aging Proceedings of the International Symposium on Population Structure and Development, Tokyo, 10-12 September 1987.

United Nations, The World Aging Situation: Strategies and Policies, 1985.

United Nations, Plan of Action And Relevant Documents World Assembly on Aging, 1982, Vienna. 100 Wu Cangping

United Nations, ESCAP, Population Aging: Review of Emerging Issues, 1987.

Other Publications

JOICFP (Japanese Organization for International Cooperation in Family Planning)

Population Projections for China 1985 by Naohiro Ogawa, Yasuhiko Saito, Yao Shuben and Xu Qin.

JOICFP, Population Aging in Asia.

The Nihon University, CNCA and JOICFP Proceedings, Japan-China Workshop on Population Aging: Policy Issues and Prospects. Bureau of the Census, U.S Department of Commerce An Aging World, International Population Reports Series p.95, No.78. History of INIA:

Tb« Vienna International Plan of Action on Aging, adopted by the World Assembly on Aging In 19Ü2 and endorsed by the United Nations General Assembly In Its résolution 37/51, recommended, Inter alia, that practical training Institutes should be promoted and encouraged hi order to act ss information exchange centres between and among developed and developing countries.

In harmony with the spirit and objectives of the Vienna International Plan of Action on Aging, the Government of Malta proposed to the Secretary General, In September 1985, that a United Nations International Institute on Aging should be established fn Malta.

The United Nations reacted favourably to this Initiative by Malta and conducted a feasibility study which was subsequently examined by an intergovernmental expert group, which recommended the establishment of an International Institute In Malta. As a result, the UN Economic and Social Council, fn its resolution 1987/41, recommended to the Secretary General the establishment of the International Institute on Aging (INIA). The Secretary General responded positively to this resolution and accepted the Government of Malta's role as host to the Institute. On October 9th, 1987, the United Nations signed an official agreement with the Government of Malta to establish IMA as an autonomous body under tbe auspices of the United Nations. INIA was Inaugurated on 15th April 1988 by the United Nations Secretary General, His Excellency Mr. Javier Pérez de Cuéllar.

INIA publishes • quarterly gerontologfcal journal, BOLD, and the papers, proceedings and recommendations of tbe Institute's Expert Group Meetings.

History of CICRED:

The Committee for International Cooperation In National Research in Demography (CICRED) was created as a result of the meeting of directors of national population research institutes, organised by the Population Division of the United Nations Secretariat in Lyons (France) from June 3rd to 11th, 1971.

At that time, the United Nations was preparing the World Population Conference, foreseen for 1974, and tbe Population Division was seeking a means of establishing some kind of link with the world community of national population research institutes. Moreover, during the Lyons meeting, a number of participants emphasised the necessity of providing support to national research and of developing mutual collaboration.

CICRED is a non-profit association, its members are all the 300 centres conducting population research In the world. Its budget is jointly shared by UNFPA and the French Government. The activities of CICRED are currently covering three fields: (1) population literature storage, retrieval and exchange; (it) promotion of inter-Institutional cooperative research on population topics; (ill) assessment of population research potentialities.

CICRED publishes a quarterly, the Review of Population Reviews, and several books gathering tbe findings of its various collaborative research projects.

The collaboration between CICRED and INIA fn the publication of this series of country monographs enhances the common aim of both institutions to disseminate information

ISBN 92-9103-013-9