China's elderly are poor, sick and
depressed in alarming numbers, according to the first large-scale survey
of those over 60, an immense challenge for Beijing and one of the
greatest long-term vulnerabilities of the Chinese economy.
The survey of living conditions for China's 185 million elderly
paints a bleak picture that defies the efforts of the government to
build what it calls a 'harmonious society,' one dedicated to human
welfare rather than simply economic growth. Of the generation that built
China's economic boom, 22.9%─or 42.4 million─live in poverty with
consumption of less than 3,200 yuan a year ($522).
The fear of being old and poor, which prompts many Chinese to stash
away their earnings, also cuts against another of Beijing's priorities:
to rebalance the economy toward stronger consumption.
The survey, led by Chinese and international academics, covered
17,708 individuals across 28 of China's 31 provinces and was partly
funded by the Chinese government through a science foundation. While
careful to credit the government with progress on expanding pension and
health-care coverage, it also showed that physical disability and
mental-health problems are widespread: Of those surveyed, 38.1% reported
difficulty with daily activities and 40% showed high symptoms of
International comparisons are made difficult by definitional issues.
But rates of poverty, disability and depression in China all appear
relatively high. The poverty rate for Americans aged over 65 is 8.7%
according to the Census Bureau. The U.S. Health and Retirement Study
found that 26% to 27% of elderly Americans had a disability, and
depression rates are also markedly lower than in China.
人口普查局(Census Bureau)的数据显示，美国65岁以上老年人口的贫困率为8.7%。美国健康与退休研究项目(Health and
John Strauss, a professor at the University of Southern California
and one of the leaders of the project, pointed to China's relatively low
level of development as part of the explanation for higher poverty
levels there. 'We need to remember that China is still a developing
economy, it is not yet a high-income country,' he said.
美国南加州大学(University of Southern California)教授施特劳斯(John
An ageing population means the problems are compounded. The number of
old people for every hundred working-age members of the population─known
as the dependency ratio─will rise from 11 in 2010 to 42 in 2050,
according to projections from the United Nations.
Other countries will also see a rise in the dependency ratio. But the
pace of ageing in China is particularly marked─a consequence of the
The survey finds that 88.7% of the elderly who require assistance
with daily activities receive it from family members. But the one-child
policy and the migration of many young people to China's cities for work
threaten to erode the traditional approach of children caring for
China is also unique in encountering a serious problem with ageing
while still a poor country. 'Other countries are old and rich,' said
Albert Park, a professor at Hong Kong University of Science and
Technology and another survey leader. 'China will be old at a relatively
early stage in its development.'
Yu Baihui is one of many who have fallen through the cracks. Aged 73,
Ms. Yu lives with her husband in a dilapidated house in Rensha, a town
of 31,000 on the edges of Chongqing in western China. Like many of
China's impoverished elderly, she is a former farmer, too old to benefit
from the booming economythat has swept the younger generation into
China's factories,and passed over by a benefit system that is skewed in
favor of urbanites.
'My parents don't have any pension or other allowance,' said Luo
Zhengfeng─Ms. Yu's son, who works selling umbrellas and tour maps in
Chongqing to support his wife, child and ageing parents.
China's turbulent history also appears to have had an impact on the
generation that lived through it. 'China's elderly experienced famine in
the 1950s, and the disturbance of the Cultural Revolution,' said Mr.
Park. 'Those early experiences leave a marked impact on physical and
In theory, respect for elders is deeply ingrained in China's culture.
Confucius, China's cultural lodestone who has enjoyed a revival in
popularity as leaders search for new sources of legitimacy, advocated
the honoring of all old people.
On a visit to an old people's home in Tianjin in 2009, former
President Hu Jintao echoed those sentiments and set the tone for
government pronouncements on China's aged. 'Respecting and caring for
the elderly is not only a Chinese tradition, but also a symbol of
national civilization and progress,' he said.
Mr. Hu advocated a more inclusive form of development, with expansion
of public pension and health-care coverage. The results of the China
Health and Retirement Longitudinal Study suggest those efforts haven't
so far been sufficient.
胡锦涛主张的是一种更加广泛的发展形式，扩大公共养老金和医疗保险的覆盖面。中国健康与养老追踪调查(China Health and Retirement Longitudinal Study)结果显示，这些努力到目前为止都还不够。
Widespread poverty in old age also undermines China's attempt to put
the economy on an even keel, with lower saving and investment and higher
consumption. Despite rapid increases in wages─which rose 14% last year
for workers in the private sector according to official data─ households
remain unwilling to spend. One reason: the need to guard against
poverty in old age. 'I hope the government is stung by conscience and
puts more money into pensions,' said Cecilia Wang, a 30-year-old
translator at a business magazine in Beijing, 'but as they don't we have
to save ourselves.'
China has enjoyed some success in expanding the welfare system.
Pension coverage for urban residents has expanded from 155 million in
2003, when Mr. Hu took over, to 304 million in 2012, according to data
from the Ministry of Human Resources and Social Security. Pension
coverage for rural residents has grown even more rapidly. But the
benefits provided by the expanded schemes remain inadequate in many
cases. The survey shows that on average, recipients of the government's
basic rural pension receive just 720 yuan a year.
More than 90% of the elderly population is now covered by health
insurance, but out-of-pocket costs remain high. 'Mom had a stroke last
year, and the hospital charged 18,000 yuan, but we could claim back only
1,000 yuan from insurance,' said Mr. Luo, the Chongqing umbrella
seller. The 17,000 yuan in out-of-pocket costs equaled almost half of
his annual income.
'China's government is aware of the problem and addressing it
aggressively,' said Mr. Park. But there are few easy answers. With a
growing number of elderly relying on a shrinking workforce, the existing
system of care inside the family appears untenable. But more generous
pension and health-care benefits risks putting a sharply increased
strain on the public finances.