Thursday, April 23, 2009

Getting Old

Men grow old, pearls grow yellow, there is no cure for it.
- Chinese proverb

From The Associated Press:

Photo from

BEIJING (AP) — China's rapidly aging population threatens the country's social and economic stability and could affect the prospects of other countries around the world, a U.S. study says.

The current ratio of 16 elderly people per 100 workers is set to double by 2025, then double again to 61 by 2050, according to the Washington-based Center for Strategic and International Studies.

By 2050, there will be 438 million Chinese aged 60 and over, said the study, jointly produced with the Prudential Foundation. Of those, 103 million Chinese will be 80 or older.

China, however, remains a relatively poor country and only about one out of three urban workers has any sort of pension coverage, the report said. The burden of supporting the growing number of elderly would pass to a proportionately shrinking working population.

By the 2020s, demographic trends may be "weakening the two principal pillars of the government's political legitimacy — rapidly rising living standards and social stability," the report said.

Read On
The report that this article refers to from CSIS can be downloaded here. There are lots of interesting things to note in the lengthy report. This paragraph, in particular, really struck me:
China may be the world's oldest living civilization, but for most of its history it has been a demographically young society. As recently as the mid-1960s when Mao Zedong called on the nation's youth to launch the Cultural Revolution, China's median age was 20, meaning that half of the population were children or teenagers. The elderly made up just 7 percent of the population, about what they had since time immemorial.
This graph, from the report, is a useful way of looking at China's aging problem:

This problem of China getting too old can, more-or-less, be boiled down to the following two things: improved quality-of-life standards that now let Chinese people reach their elderly years and China's one-child policy.

One of the many benefits of China's modernization is that its citizenry can now enjoy a longer and more healthy life. This is mildly surprising given China's pollution problems. But, in fact, modern advancements in medicine and living standards are outweighing any problems associated with pollution. As the report states, the age-expectancy of a Beijing resident is 80 and a Shanghai resident 81, older expectancies than people in most other developed nations enjoy.

Then there is the one-child policy. On China's male/female ratio crisis, I was hesitant to say that the one-child policy is 100% to blame for the problem. I conceded that there are a lot of cultural things in play as well. But on this issue of aging though, I believe that the one-child policy is directly leading to crisis.

It's pretty simple; if children do not replace elderly people, the population will age and ultimately contract. The CSIS report talks about how the people who decided to implement the one-child policy knew that it would eventually cause problems. But the out-of-control population at the time was seen as a bigger threat than too many old people in a generation or two. So the policy was put in place with little thought about the future consequences. (This kind of reminds me of the "don't give up eating for fear of choking" situation I discussed the other day.)

The consequences of those decisions in the late 1970s and early 1980s are now crystallizing.

China is going to have a massive problem when all of the millions of single children out there, the ones who will be responsible for making China a superpower, are going to have to take care of two elderly parents.

I wonder how long China will be able to avoid putting their elderly into nursing homes, a practice that is widely thought to be degrading and undignified in Chinese society. I don't see how China will be able to avoid going in that direction.

The social consequences of a society that is so elderly are going to be massive. Add China's aging crisis in a generation or two to the long list of problems that the country, and the world, are going to have to deal with.


Thomas said...

Quote: "But on this issue of aging though, I believe that the one-child policy is directly leading to crisis. It's pretty simple; if children do not replace elderly people, the population will age and ultimately contract"

On this bit, I sort of disagree with you: China's fertility rate appears to be around 1.7 (at least I remember reading this number some time ago). As such, it is far higher than fertility rates in Germany, Italy, Spain, Eastern Europe, Russia, Japan, South Korea and Singapore.

Population will contract, but comparatively slowly (as opposed to the various countries named above, where it will contract much faster). Considering China's overpopulation, I don't see why this is such a bad thing (assuming the process is properly managed, and assuming the country keeps growing richer and can therefore afford to put aside more money to subsidise the elderly).

pug ster said...

I agree with Thomas. I doubt that China's aging population is as severe as other countries and they can afford to defer this problem now as to later.

It is not that they are not addressing this issue:

I know that many nursing homes in the US are just plain horrible. My neighbor recently have to go to a nursing home because she has rehabilitate from knee surgery. I have heard horror stories from there that the treatment of the people there because of severe budget cuts. This is the reason why 'visiting nurse services' has become so popular. If US help subsidize these nursing homes where people can be treated with some dignity, we won't need those visiting nurse services.

Mark said...

Pugster, I'm not sure the article you referenced is really supporting your claim that China is addressing the issue.

Fromt the NY Times article:
Ma Li, deputy director of the government-linked China Population and Development Research Center, said the country still must do more.

“China is not yet ready for an aged society,” she told Xinhua, the official news agency, last month. “It does not have a complete old-age social security system. There are not enough resources. Fiscal support is scarce. And the risk is ever-rising.”
While both of you guys don't seem to think that a country where there are 61 elderly people for every 100 workers is much of a problem, I think it is.

Those numbers will put a huge financial burden on the "productive" members of Chinese society.

Even if China is able to get richer and develop a better infrastructure for taking care of elderly people before this problem really unfolds, once this aging generation does reach retirement and old age, who's going to keep the wheels of China's economy spinning? The amount of money and resources that taking care of all those old people will require is going to be astronomical.

A well-setup infrastructure to deal with the elderly non-workers will still need the people doing the work to sustain those not working.

Pete Murphy said...

The fact is that there is no alternative to dealing with an aging population, because simple laws of physics dictate that the human population cannot grow forever. So, for China and for every nation, the question is this: will it be easier to deal with the problem of an aging population now or later, when a larger population will make the problem that much worse?

The biggest obstacle we face in changing attitudes toward overpopulation is economists. Since the field of economics was branded "the dismal science" after Malthus' theory, economists have been adamant that they would never again consider the subject of overpopulation and continue to insist that man is ingenious enough to overcome any obstacle to further growth. This is why world leaders continue to ignore population growth in the face of mounting challenges like peak oil, global warming and a whole host of other environmental and resource issues. They believe we'll always find technological solutions that allow more growth.

But because they are blind to population growth, there's one obstacle they haven't considered: the finiteness of space available on earth. The very act of using space more efficiently creates a problem for which there is no solution: it inevitably begins to drive down per capita consumption and, consequently, per capita employment, leading to rising unemployment and poverty.

If you‘re interested in learning more about this important new economic theory, then I invite you to visit either of my web sites at or where you can read the preface, join in the blog discussion and, of course, buy the book if you like.

Please forgive the somewhat spammish nature of the previous paragraph, but I don't know how else to inject this new theory into the debate about overpopulation without drawing attention to the book that explains the theory.

Pete Murphy
Author, "Five Short Blasts"

Thomas said...


I'm not saying it won't be a problem. I do agree it will be a difficult transition, and so far, China isn't yet ready. Totally true.

But I think it is better than the alternative: The world has way too many people anyway, and not too long ago, everybody was worried about China buying up the world's oil and commodities to fulfill its ever-growing needs. Due to the crisis, that worry has abated for now, but it will come back. Now imagine 2 billion Chinese instead of 1.4 billion. I for one think that the one-child policy was by and large the responsible thing to do, though I also agree that some of the methods went a bit overboard, and they could have phased it in a little more slowly.

Regarding the scary number of 61 elderly per 100 working-age people: Looking closely at the data, it seems that they defined elderly as "60+". Now, in most Western countries, standard retirement age is 65. Germany recently legislated to increase it to 67. If you redo the numbers based on age 65, I'm sure the ratio goes down quite a bit, probably to less than 50 vs 100.

In any case, it will be lower than in Japan, Germany, Italy, Russia etc. - if there are unsurmountable problems, those countries will be hit quite a bit harder than China...

Thomas said...

By the way, three of my wife's grandparents are still alive, all of them aged 90+. None of them needs nursing care, they cook and clean and do just about everything themselves. All they need is a roof over their head, food, and a doctor's visit every now and them (in fact, on of her grandmother's recently complained that her health was failing. What she meant was: The doctor had told her she should take some pills every now and then to control some minor ailment...)

Mark said...

Fair enough, Thomas. I probably generalized a bit too much saying that you don't think China's aging "is much of a problem."

For a long time, I've heard about "aging Europe." I'm not aware that the countries you just mentioned are going to be in a worse state than China. That is pretty screwed up.

You bringing up your wife's grandparents is funny. Qian still has three grandparents left too (one died of a brain hemorrhage at a younger age). They are incredibly cute. They're all about eighty years-old and just plugging along walking up to their 6th floor apartments and such.

Maybe the toughness that Chinese people build up gives them an advantage when they get to the advanced stages of life. I wouldn't be at all surprised if this is the case.

pug ster said...

The problem is that not many families in China want to put their grandmothers to nursing homes because kids should take care of their parents. 2nd, people can hire domestic helpers cheap, often these are women whom are 40-50 years old and couldn't find a job somewhere else. They can probably be hired for about 2,000 yuan a month easy.

Mark said...


Don't worry about "spamming" these comments. You're obviously adding thoughtful comments, so no apology is necessary.

I'm having a bit of trouble opening up your site. Wordpress blogs are pretty hit or miss on being viewable over here in the Middle Kingdom.

Your ideas are very interesting from the way you presented them in these comments.

It's true, when I've heard of Malthus in the past in school, it was in a mocking tone. Maybe he was on to something, just a couple hundred years too early.

I can see how the 7 billion or whatever currently populates the Earth is, in fact, pushing things to the brink.

uncle gedek said...

Getting old: One day, you’ll look in the mirror and not recognize yourself. That is not something I look forward to…

Thomas said...

Quote Mark: "For a long time, I've heard about aging Europe. I'm not aware that the countries you just mentioned are going to be in a worse state than China."

In China, the average number of children per women currently stands at 1.6-1.7 (if the official statistics are correct).

In Germany, it has been at 1.3-1.4 for the last 30 years.

Add to that a somewhat higher life-expectancy in Germany (i.e. the old people stay around for a few years longer than in China), and you can get a feel for the magnitude of the problem.

Germany has the advantage that the process wasn't as abrupt as in China (which went from lots and lots of kids to less than 2 in the space of just a few years), and I suppose it also helps that Germany is richer. But the ratio of old to young people will definitely stay worse than in China.

By the way, Korea and Taiwan are down to roughly 1.0 kids per woman, and Hong Kong has apparently fallen to 0.9, the world's record low (If I remember the numbers correctly, it's been a while since I've looked them up).

Mark said...

Solution here? :)

Thomas said...

With a few days' delay, your post on China's ageing society inspired this follow-up over on my blog:

JStone said...

I am an Australian married to a Chinese woman.

My wife's mother is in great health and is a very intergral and active part of my wife's life, and as a result mine and our son's. She is also quite elderly.

Although my wife and her mother have on the surface a close relationship, my wife has made it clear that as soon as her mother becomes a burden, through illness or age, she will send her back to China, either to her sister or to a nursing home.

This is a very pragmatic approach, and oddly, her mother is in complete agreement with this.

Now my wife claims to have been raised in a very close family, and this is borne out of the ongoing contact she maintains with the rest of her family, but something about the pragmatism of these relationships doesn't sit well with me.

They tend to represent relationships of convenience, which in my 'Western' world is the anti-thesis of the foundation for family. In any case, it has worked well for their whole family so far, and given that there has never been any family inheritence to fight over, the relationships have remained symbiotic and mutually beneficial.

Of course, this is the easy part. If or when her mother ages to a point where she herself needs ongoing help, the pressures on the whole family will be compounded. Although I have some work colleagues who have easily transitioned their parent's into a nursing home facility, the emphasis on family within the Chinese culture, I expect, would make this a more difficult proposition.

Only time will tell, and although my mother-in-law is in great shape for her age, both mentaly and physically, she does have a worriesome tremor and increasing rigidity in her body, which is looking more and more like Parkinson's disease.

For those who know about this disease, it is progressive and insidious, and takes a terrible toll on the whole family in terms of the level of care that is required. For my mother-in-law's sake, I hope that this care, no matter how difficult, is provided by us, and not a nursing home. It just wouldn't be right.

Unknown said...

I've always been fascinated by China, and have wondered (in terms of a Communist/post communist country) how healthcare works, is it effective? I'm thinking of moving out there because I have the opportunity with work and have read a few things like;

but a new perspective would be good!