Graphical Abstract
View original image
Download original image
Review | Open Access
China's aging population: A review of living arrangement, intergenerational support, and wellbeing
Litao Zhao 
(
)
()Abstract
China's rapid population aging and remarkable family‐level changes have raised concerns about the weakening of its family‐based elderly care. The last decade indeed has seen a clear departure from multigenerational living to alternative living arrangements such as living with spouse only and solo living. However, ample evidence suggests that Chinese families have demonstrated considerable resilience amidst profound sociodemographic changes. This review article highlights the importance of government–society cooperation in meeting the social challenges of population aging. A key factor is the persistient filial piety norms, which enable children living far or close, migrant or nonmigrant, to rearrange financial, instrumental, and emotional support to aging parents. Equally important is the step‐in of the government to share elderly care responsibilities, provide support through deepening pension and healthcare reforms, and implement the active and healthy aging agenda. How the two factors play out over the next decade and beyond will have profound implications on the living arrangement, intergenerational support, and wellbeing of older adults in China.
References
1
Yip W, Fu H, Chen AT, Zhai T, Jian W, Xu R, et al. 10 years of health‐care reform in China: progress and gaps in universal health coverage. Lancet. 2019;394:1192–204. https://doi.org/10.1016/S0140-6736(19)32136-1
2
Zhao L, He X. Lessons from China on different approaches to pension coverage extension. Int Soc Secur Rev. 2021;74(1):5–34. https://doi.org/10.1111/issr.12255
3
Du P, Dong T, Ji J. Current status of the long‐term care security system for older adults in China. Res Aging. 2021;43(3–4):136–46. https://doi.org/10.1177/0164027520949117
4
Zhao L. A review of healthy aging in China, 2000–2019. Health Care Sci. 2022;1:111–8. https://doi.org/10.1002/hcs2.9
5
Chen X, Giles J, Yao Y, Yip W, Meng Q, Berkman L, et al. The path to healthy ageing in China: a Peking University–Lancet Commission. Lancet. 2022;400:1967–2006. https://doi.org/10.1016/S0140-6736(22)01546-X
6
Hofman B, Tong SY, Zhao L. The economic and social impacts of population ageing: China in a global perspective. China Int J. 2021;19(3):3–7. https://doi.org/10.1353/chn.2021.0024
7
Yang W, Wu B, Tan SY, Li B, Lou VWQ, Chen Z, et al. Understanding health and social challenges for aging and long‐term care in China. Res Aging. 2021;43(3–4):127–35. https://doi.org/10.1177/0164027520938764
8
Han WJ, Li Y, Whetung C. Who we live with and how we are feeling: a study of household living arrangements and subjective well‐being among older adults in China. Res Aging. 2021;43(9–10):388–402. https://doi.org/10.1177/0164027520961547
9
Zhou Z, Mao F, Ma J, Hao S, Qian Z, Elder K, et al. A longitudinal analysis of the association between living arrangements and health among older adults in China. Res Aging. 2018;40(1):72–97. https://doi.org/10.1177/0164027516680854
10
Gu D, Feng Q, Yeung WJJ. Reciprocal dynamics of solo‐living and health among older adults in contemporary China. J Gerontol Ser B. 2019;74(8):1441–52. https://doi.org/10.1093/geronb/gby140
11
Gruijters RJ. Daughters' and sons' remittances in rural China: findings from a national survey. J Fam Issues. 2018;39:2929–34. https://doi.org/10.1177/0192513X18755196
12
Chen F, Liu G, Mair CA. Intergenerational ties in context: grandparents caring for grandchildren in China. Soc Forces. 2011;90(2):571–94. https://doi.org/10.1093/sf/sor012
13
Zimmer Z, Kwong J. Family size and support of older adults in urban and rural China: current effects and future implications. Demography. 2003;40:23–44. https://doi.org/10.1353/dem.2003.0010
14
Deutsch FM. Filial piety, patrilineality, and China's one‐child policy. J Fam Issues. 2006;27:366–89. https://doi.org/10.1177/0192513X05283097
15
Gruijters RJ. Family care‐giving and living arrangements of functionally impaired elders in rural China. Ageing Soc. 2017;37:633–55. https://doi.org/10.1017/S0144686X15001397
16
Bao L. Children's relative living proximity and intergenerational support to older parents in China. Res Aging. 2022;44(3–4):241–53. https://doi.org/10.1177/01640275211020790
17
Lei X, Strauss J, Tian M, Zhao Y. Living arrangements of the elderly in China: evidence from the CHARLS national baseline. China Econ J. 2015;8(3):191–214. https://doi.org/10.1080/17538963.2015.1102473
18
Liu J. Ageing, migration and familial support in rural China. Geoforum. 2014;51:305–12. https://doi.org/10.1016/j.geoforum.2013.04.013
19
Cong Z, Silverstein M. Intergenerational exchange between parents and migrant and nonmigrant sons in rural China. J Marriage Fam. 2011;73(1):93–104. https://doi.org/10.1111/j.1741-3737.2010.00791.x
20
Hu A. Providing more but receiving less: daughters in intergenerational exchange in mainland China: daughters in intergenerational exchange in China. J Marriage Fam. 2017;79(3):739–57. https://doi.org/10.1111/jomf.12391
21
Xie Y, Zhu H. Do sons or daughters give more money to parents in urban China? J Marriage Fam. 2009;71(1):174–86. https://doi.org/10.1111/j.1741-3737.2008.00588.x
22
Hu Y, Scott J. Family and gender values in China: generational, geographic, and gender differences. J Fam Issues. 2016;37(9):1267–93. https://doi.org/10.1177/0192513X14528710
23
Zhao L, Qian J, Shan W. Filial piety, pension policy and changing perceptions of elderly care responsibility: evidence from China. China Int J. 2021;19(3):112–31. https://doi.org/10.1353/chn.2021.0031
24
Chen T. Living arrangement preferences and realities for elderly Chinese: implications for subjective wellbeing. Ageing Soc. 2019;39(8):1557–81. https://doi.org/10.1017/S0144686X18000041
25
Brasher MS. Filial norms, altruism, and reciprocity: financial support to older parents in China. J Popul Ageing. 2022;15:259–77. https://doi.org/10.1007/s12062-020-09316-0
26
Chen F. Residential patterns of parents and their married children in contemporary China: a life course approach. Popul Res Policy Rev. 2005;24:125–48. https://doi.org/10.1007/s11113-004-6371-9
27
Zhang Z, Gu D, Luo Y. Coresidence with elderly parents in contemporary China: the role of filial piety, reciprocity, socioeconomic resources, and parental needs. J Cross Cult Gerontol. 2014;29(3):259–76. https://doi.org/10.1007/s10823-014-9239-4
28
Li W, Liu E, Balezentis T, Jin H, Streimikiene D. Association between socioeconomic welfare and depression among older adults: evidence from the China Health and Retirement Longitudinal Study. Soc Sci Med. 2021;275:113814. https://doi.org/10.1016/j.socscimed.2021.113814
29
Song Q, Wang H, Burr JA. Depressive symptoms among rural “left‐behind” older adults: a test of the high outmigration penalty hypothesis. J Gerontol Ser B. 2022;77(3):592–603. https://doi.org/10.1093/geronb/gbab040
30
Zhang X, Silverstein M. Intergenerational emotional cohesion and psychological well‐being of older adults in rural China: a moderated mediation model of loneliness and friendship ties. J Gerontol Ser B. 2022;77(3):525–35. https://doi.org/10.1093/geronb/gbab122
31
Zhong BL, Chen SL, Tu X, Conwell Y. Loneliness and cognitive function in older adults: findings from the Chinese longitudinal healthy longevity survey. J Gerontol B Psychol Sci Soc Sci. 2017;72(1):120–8. https://doi.org/10.1093/geronb/gbw037
32
Han J, Zhang X, Meng Y. The impact of old‐age pensions on the happiness level of elderly people—evidence from China. Ageing Soc. 2022;42:1079–99. https://doi.org/10.1017/S0144686X20001452
33
Lei X, Bai C, Hong J, Liu H. Long‐term care insurance and the well‐being of older adults and their families: evidence from China. Soc Sci Med. 2022;296:114745. https://doi.org/10.1016/j.socscimed.2022.114745
34
Zhang Y, Qin Gao. Catastrophic health expenditure and health‐related quality of life among older adults in China. Ageing Soc. 2021;41:1474–94. https://doi.org/10.1017/S0144686X19001661
35
Zhu H, Walker A. Pensions and social inclusion in an ageing China. Ageing Soc. 2019;39:1335–59. https://doi.org/10.1017/S0144686X17001593
36
Hu A, Wang Y. Multi‐track pension system and life satisfaction of urban elders in China. Ageing Soc. 2020;40:1887–905. http://doi.org/10.1017/S0144686X19000333
37
Li J, Lai DWL, Chappell NL. The older, the happier?: A cross‐sectional study on the “paradox of aging” in China. Res Aging. 2022;44(1):34–43. https://doi.org/10.1177/0164027521994225
38
Liu J, Chen F. Intergenerational caregiving patterns, living arrangements, and life satisfaction of adults in mid and later life in China. Res Aging. 2022;44:545–59. https://doi.org/10.1177/01640275211058433
39
Sun R, Zimmer Z. Is transition in living arrangements associated with older adults' life satisfaction when preference is considered? J Gerontol Ser B. 2022;77(12):2296–305. https://doi.org/10.1093/geronb/gbac099
40
Cong Z, Silverstein M. Parents' preferred care‐givers in rural China: gender, migration and intergenerational exchanges. Ageing Soc. 2014;34(5):727–52. https://doi.org/10.1017/S0144686X12001237
41
George LK. Still happy after all these years: research frontiers on subjective well‐being in later life. J Gerontol B Psychol Sci Soc Sci. 2010;65(3):331–9. https://doi.org/10.1093/geronb/gbq006
42
Feng J, Wang Z, Yu Y. Does long‐term care insurance reduce hospital utilization and medical expenditures? Evidence from China. Soc Sci Med. 2020;258:113081. https://doi.org/10.1016/j.socscimed.2020.113081
Pages 317-327
DOI: 10.1002/hcs2.64
Cite this article:
Zhao L. China's aging population: A review of living arrangement, intergenerational support, and wellbeing. Health Care Science, 2023, 2(5): 317-327. https://doi.org/10.1002/hcs2.64
Metrics & Citations
Article History
Copyright
Rights and Permissions
京公网安备11010802044758号