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Older Parents Enjoy Better Filial Piety and Care from Daughters Than Sons in China

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Older Parents Enjoy Better Filial Piety and Care from Daughters Than Sons in China University of Southern Denmark Older parents enjoy better filial piety and care from daughters than sons in China Zeng, Yi; George, Linda; Sereny, Melanie; Gu, Danan; Vaupel, James W Published in: American Journal of Medical Research DOI: 10.22381/AJMR3120169 Publication date: 2016 Document version: Accepted manuscript Citation for pulished version (APA): Zeng, Y., George, L., Sereny, M., Gu, D., & Vaupel, J. W. (2016). Older parents enjoy better filial piety and care from daughters than sons in China. American Journal of Medical Research, 3(1), 244-272. https://doi.org/10.22381/AJMR3120169 Go to publication entry in University of Southern Denmark's Research Portal Terms of use This work is brought to you by the University of Southern Denmark. Unless otherwise specified it has been shared according to the terms for self-archiving. If no other license is stated, these terms apply: • You may download this work for personal use only. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying this open access version If you believe that this document breaches copyright please contact us providing details and we will investigate your claim. Please direct all enquiries to [email protected] Download date: 30. Sep. 2021 HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author Am J Med Manuscript Author Res (N Y). Author Manuscript Author manuscript; available in PMC 2017 May 19. Published in final edited form as: Am J Med Res (N Y). 2016 ; 3(1): 244–272. doi:10.22381/AJMR3120169. Older parents enjoy better filial piety and care from daughters than sons in China Zeng Yi1,2,*, Linda George1,3, Melanie Sereny4, Danan Gu5, and James W. Vaupel6 1Center for the Study of Aging and Human Development, Medical School of Duke University 2Center for Healthy Aging and Development Studies, National School of Development, Peking University 3Department of Sociology, Duke University 4Department of Sociology & Anthropology, University of Rhode Island 5Population Division, Department of Economic and Social Affairs, United Nations, NY 6Max Planck Institute for Demographic Research Abstract This study analyzes the unique datasets of the Chinese Longitudinal Healthy Longevity Survey using logistic regression and controlling for various covariates. Our analyses clearly demonstrate that disabled older parents are more satisfied with care provided by daughters than sons and that older parents enjoy greater filial piety from and better relationships with daughters than sons. The daughter-advantages of enjoying greater filial piety from and better relationships with children are stronger among the oldest-old aged 80+ than the young-old aged 65–79, and surprisingly more profound in rural areas than urban areas, while son-preference is much more prevalent among rural residents. We also discuss why China’s rigorous fertility policy until October-2015 and much less- developed pension system in rural areas substantially contribute to sustaining traditional son- preference and a high sex ratio at birth (SRB) when fertility is low. We recommend China take integrative public health policy actions of informing the public that having daughter(s) is beneficial for old age care, developing the rural pension system and implementing the universal two-child policy as soon as possible. We believe that these policy actions would help to reduce son-preference, bring down the high SRB, and enable more future elderly parents to enjoy better care from their children and healthier lives. Keywords filial piety; parent-child relation; elder care; son-preference; daughter-advantages; China *Please address correspondence to: Yi Zeng, Center for the Study of Aging and Human Development at Medical School of Duke University, and Center for Healthy Aging and Development Studies, National School of Development, Peking University. Mailing address: Box 3003, Duke University, Durham, NC 27710, U.S.A. tel. 919-6607554; fax: 919-668-0453; [email protected]. Dr. Danan Gu’s work was mainly completed when he was at Duke University. He now works at the United Nations Population Division. Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Yi et al. Page 2 Author ManuscriptAuthor 1. Manuscript Author INTRODUCTION Manuscript Author Manuscript Author Sons were preferred to daughters in most societies for thousands of years (Arnold and Zhaoxiang 1986; Johansson and Nygren 1991; Yang and Wang 2003), and this pattern still persists in China, India and many other developing countries and some Eastern European countries (Banister 2004; Echávarri and Ezcurra 2010; Edlund and Lee, 2013; Guilmoto and Duthé, 2013; Seth 2010). The sentiment behind the old Chinese saying “Yang Er Fang Lao” -- Having a son (rather than a daughter) prevents difficulties in old age-- is a belief held by many Chinese and is one of the main reasons for strong son-preference. However, after more than thirty years of dramatic economic growth and social reforms, including close exchanges with the Western world, does the traditional belief of “Having a son (rather than daughter) prevents difficulties in old ages” still match reality in contemporary China? This article aims to address this important research question and discuss the relevant public health policy implications/recommendations using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). In the following sub-sections of the introduction, we first briefly discuss the Chinese tradition of son-preference and the high sex ratio at birth (SRB) in recent decades. We also summarize existing literature on adult children’s filial piety to and relationships with their older parents. Research on the care provided by adult children to older parents in China and elsewhere is also summarized, with particular attention to comparisons between adult daughters and sons. 1.1. Traditional son-preference and high SRB in the past three decades in China Son-preference in China is based on both cultural traditions and practical beliefs. According to Confucianism, only sons can perform ancestor worship and continue the family lineage (Ng, Phillips, and Lee 2002; Ebenstein and Leung 2010). Sons are more likely to co-reside with their elderly parents and provide financial support, especially in rural China. Chinese culture is traditionally patriarchal and daughters “marry out” and become members of their husbands’ extended families; thus, they are less likely than sons to provide financial support to their natal parents (Bian, Logan and Bian 1998; Deutsch 2006). Rural household labor supply also favors sons as they are better farm laborers and can also enhance family power in local conflicts (Ebenstein and Leung 2010). Until three decades ago it was only possible for those who had strong son-preference to influence the sex composition of their children by providing better nutrition and health care to boys than girls or, rarely, through infanticide of females. Thus, when fertility was high, every family could realize their preference to have a son by continuing to bear children until a son was born. Consequently, the sex ratio at birth (SRB) was normal even in societies where son-preference prevailed, such as China before 1980. The SRB in China was rather close to the naturally normal level of about 105–106 boys per 100 girls in the 1960s and 1970s. However, after the implementation of the rigid birth-control policy accompanied with rapid economic development, fertility dramatically declined to close to -- and eventually well below -- the replacement level1, and son-preference could not be met through limited 1Replacement fertility refers to the level of fertility at which a cohort of women on average have only enough children to replace themselves and their partners in the population, and it is about 2.1 children per couple in China given the current mortality level. Am J Med Res (N Y). Author manuscript; available in PMC 2017 May 19. Yi et al. Page 3 births. The economic boom in China has made medical technology and facilities for prenatal Author ManuscriptAuthor Manuscript Author Manuscript Author Manuscript Author sex determination widely available and affordable. Thus, people who have a strong preference for sons may easily bribe medical personnel to perform illegal prenatal sex identification and the couple can consequently abort female fetuses to achieve their desire to have a son (Zeng et al. 1993; Banister 2004; Ebenstein 2010). Consequently, the SRB in China climbed quickly after 1980, up to 110.9 in 1986, 116.8 in 2000, and 120.5 in 2005 (Bhattacharjya et al. 2008). In 2010, the SRB in China was 121.2, as reported in the latest census data. The SRB in rural areas in China tends to be significantly higher than that in urban areas (Banister 2004). The skewed SRB in China is likely due to a combination of factors – sex-selective abortion, under-reporting of female births, and a small amount of female infanticide (Guilmoto 2009; Zeng et al. 1993; Zhu, Lu and Hesketh 2009; Greenhalgh 2013). Loss of female births and infants due to son- preference is already creating an unbalanced population sex structure and results in serious social problems (Hull 1990; Tuljapurkar, Li and Feldman 1995; Park and Cho 1995; Greenhalgh, 2013; Tucker and Van Hook, 2013). The problem of rising SRB associated with traditional son-preference, a low fertility regime, and the availability of new prenatal sex-determination medical technology/facilities has occurred not only in China, but also in many other developing countries where son- preference is high but fertility is quickly declining and the economy is growing. For example, in India, the SRB climbed from 104 in 1961 to 113 in the 2000s (Echávarri and Ezcurra 2010; Seth 2010) The SRB in some northern states of India persistently remains above 115 (UNFPA 2011). The SRB in South Korea increased from 107 in the mid- twentieth century to 114 in the late 1980’s, but decreased to 110 in the twenty-first century (Hesketh 2011).
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