Empower elderly to be active participants

China is facing the challenge of a rapidly aging population. This is happening at a time when urbanization and industrialization are accelerating, weakening the traditional family support networks, particularly for the elderly, and new policies are needed to address this situation.

In the late 1970s, China adopted the family planning policy to limit rapid population growth and ensure economic stability. As a result, with fewer children and better living standards, the proportion of the elderly in the population has grown substantially and will continue to do so in the coming years. According to a study by the China Ageing Development Foundation, by 2050, 31 percent of the total Chinese population will be aged 60 and above.

This situation presents problems, but also unique opportunities. This century's leading countries will be those that empower their aging populations to be active participants in economic growth, rather than treating them as dependent and disabled. This has been called "active aging".

The International Monetary Fund has predicted that China's economy will surpass the US economy in real terms by 2016, but in spite of this, one of China's greatest fears is that the country will grow old before it grows rich.

The situation of older people in China will be worsened as the social security fund faces more challenges to pay a growing number of retired workers pensions and there are many retired older workers that have very low pensions which just enable them able to meet their basic needs. Not to mention the aged farmers who are not covered in the pension system while most of their adult children go to cities to work.

Though a law was passed in 1996 making it a legal obligation to take care of the elders in a family, it will be a big challenge for the only-child couples to take care of their elders in the future.

According to some estimates, 98 percent of old people in China remain in their homes, or try to do so. Many remain mostly by themselves in "empty nests," as their children migrate to cities for work or to start their own families in single-generation homes.

And, as China's population is rapidly aging, the workforce is diminishing. This may hinder not only the development of the country, but also the quality of life for its senior citizens, since the young will be less able to support their elders. It is estimated that over the next few decades the ratio of elderly dependants to people of working age will rise from 10 percent in 2012 to 40 percent by 2050.

As the number of caregivers fails to keep pace with the growing elderly population, more elderly, particularly those with poor health, will seek care in specialized institutions. Meanwhile, the proportion of elderly who develop diseases such as diabetes, heart disease, and different kinds of dementia will increase. It has been estimated that the total cost for treating these diseases could reach almost 9 percent of China's gross domestic product by 2025.

The government has responded to the challenge of caring for the elderly by constructing more nursing homes. However, most of these homes are located in big cities, and their quality varies widely. Also, they only provide basic healthcare and services, and most lack trained social workers.

As things stand now, the Chinese government has to devise new strategies to deal with the demographic challenge of a rapidly aging population. It is necessary to improve and expand the social security system for both rural and urban areas, improve the overseeing of welfare institutions and address old people's special needs, which requires not only physical, but also mental health support. China's healthcare system will also have to address the shifting burden of an older population.

At the same time, it is critical to increase the training of social workers through special courses that teach them to understand and deal with the needs of older people. It is also important, taking into account today's average life expectancy is now 73, to increase the retirement age, which is at present 60 for men and 50 for women. How the government meets this challenge will be a measure of the kind of society China intends to build in the future.

The author is an international public health consultant.

(China Daily 03/22/2012 page9)