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Running head:  AGING IN CHINA

A 7 Pages Term Paper on Aging in China

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Aging in China


     Aging is the process where the bodies go through many changes. However, the three most significant changes are physical changes, personal changes and emotional changes. As young, the cell growth is fast enough that worn out cells are quickly replaced. With older age, the cell growth slows and the body doesn't function as well. The brain is affected by this as well. The chemical communicators which the brain uses are produced at a decreasing rate, and the brain receives less circulation. These all add up to a slower response time in our reactions to different stimulus.

     China is facing much more rapid population growth decline and population aging, and their situations and eventual solutions may provide the useful basis of study in which we can begin to evaluate the utility of our system and its alternatives, which China is currently experimenting with. To understand why China is facing its massive population aging rates, however, one would find it useful to start with analysis with China's growth patterns in the recent past and how it has resulted in the demographics China faces today before analyzing its option in the future.

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     A more passive change to the body is personal care. The way it is being treat bodies throughout our lives has a large effect on the way it functions in our old age. If we can take care of ourselves well when we are young, then our bodies can function more properly later on in life.

     Emotional health is also an important factor when a person gets old. Due to the strain on the bodies in the later stages of life, one may feel more pessimistic and depressed. Change is a hard thing to deal with, and many changes happen to us in this period. This may, in turn, affect our physical health.

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Demography of Aging Population

     Demko states that there are currently 580 million older people in the world, according to the World Health Organization. Most older people, over 60% of them, are clipping coupons in developing countries. 355 million of the world's 580 million elders live in developing countries. By 2020, there will be 1,000 million elders, with over 700 million in the developing world.

     Demko reports that in China, where the 'one-child-per-family' policy was officially introduced in 1979, the total fertility rates fell from 5.5 in 1970 to the current 1.8, which is below the 2.1 replacement level. This trend by which more people live to reach older age while fewer children are born is referred to as "population aging". While it has taken France 115 years for the proportion of older people to double from 7 to 14%, it will take China only 27 years to achieve the same increase, between 2000 and 2027.

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     China's population is projected to increase from around 1.3 billion people in 2001 to about 1.5 billion in 2040, after which it will start to decline slowly, if present fertility patterns are maintained. Over the next forty years China will have to deal with several problems as a result of the increasing population, described throughout the second part of this report (urbanization, sustainable agriculture, environment, health). China also faces the important problems associated with the increasing proportion of elderly people, which is mainly due to decreasing fertility, though also decreasing mortality.

     The proportion of those aged over 65 will increase from 7% of the population in 2000 to about 20% in 2040. Furthermore, the very old, those aged over 80, will increase from about 8 million to about 50 million. Matching this, there will be a decrease in the ratio of working age people to support each elderly person from 5 to 1 to 3 to 1. This essentially means that each working individual will be obliged to pay more to support the elderly as, to date, a market-oriented social security system has not succeeded in replacing the old all-encompassing state-run system. Of course, a market-oriented system will also face similar problems.

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     Young people between the ages of 10 and 24 constitute one-sixth of China's total population. This age group, traditionally seen as the healthiest segment of society, is now threatened by the consequences of its own changing behavioral patterns and is increasingly at risk of HIV/AIDS and other sexually transmitted diseases.

     Sharp increases in life expectancy have been accompanied by substantial falls in fertility all over the world, mainly due to modern contraceptive methods (Demko). With the economic and social reforms that have occurred since the early 1980's, people in China are living longer than ever before.

     As more people reach a 'ripe old age' they also enter a period in their lives when they are at higher risk of developing chronic diseases, which in turn may result in disability. In fact, chronic diseases including cardiovascular diseases, diabetes and cancer are predicted to be the main contributors to the burden of disease in developing countries by 2020. Infectious diseases - although declining - will continue to add to the burden of disease in those regions. It is projected that in many countries with fertility rates below replacement level, the proportion of older people is expected to exceed the proportion of the very young (aged up to 19 years) by 2050. However, there is mounting evidence from developed countries that people are maintaining better health in later life than ever before. It is estimated that in 1996, there were 1.4 million fewer disabled older persons in the USA, than would have been expected if the health status of older people had not improved since the early 1980s.

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General Level of Health in Elderly

     Nutrition remains important throughout life. Many chronic diseases that develop late in life, such as osteoporosis, can be influenced by earlier poor habits. Insufficient exercise and calcium intake, especially during adolescence and early adulthood, can significantly increase the risk of osteoporosis, a disease that causes bones to become brittle and crack or break easily.

     But good nutrition in the later years still can help lessen the effects of diseases prevalent among older Americans or improve the quality of life in people who have such diseases. They include osteoporosis, obesity, high blood pressure, heart disease, certain cancers, gastrointestinal problems, and chronic under-nutrition.

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     Studies show that a good diet in later years helps both in reducing the risk of these diseases and in managing the diseases' signs and symptoms. This contributes to a higher quality of life, enabling older people to maintain their independence by continuing to perform basic daily activities, such as bathing, dressing and eating.

     Poor nutrition, on the other hand, can prolong recovery from illnesses, increase the costs and incidence of institutionalization, and lead to a poorer quality of life.

Helpful Tips for Aging

  • Eat more small meals a day instead of a few large meals
  • Try not to avoid foods which are fattening
  • Make sure you have enough rest every day; eight hours is optimal
  • Exercise outdoors regularly with low contact activities
  • Try to avoid temperature extremes such as chilly winters
  • Try to keep a positive outlook on life; a healthy mind can lead to a healthy lifestyle

If an old person is ever unsure of the advice which a practitioner may give

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     The kidneys play a vital role in aging according to Traditional Chinese Medicine (TCM). They control the growth, development, maturity and decline of a person. The perspective of the kidneys differs in TCM and Western medicine. While the TCM concept would include the anatomical organs and the group of related tissues and functions, the Western medicine concept would include the brain, hormonal systems and the genital organs. This is due to the fact that the Chinese have discovered that any changes in the Kidney would affect the other related systems as well.

Perception of Aging: Aging in Chinese Culture and Society

     Social perceptions of the value and benefits of old age vary in different cultures. Non-western cultures don't always take such a dim, negative view of aging and older people. For example, in many African and Asian countries, words which describe older people characterize elders as 'someone with knowledge'. It is important to recognize that aging is not an affliction but a great opportunity to make use of resources acquired over the life course. The World Health Organization believes that older people can be a tremendous asset to families and communities. Good idea. Sounds like what we need is a new image of aging that more accurately reflects the true diversity of aging, elder potential and late-life roles (Demko).

     Age is very important in the Chinese culture. Many Chinese people feel that the elderly should be respected because of the wisdom that they have gained throughout their lives. Stemming from this attitude is an extremely well developed system of treatment for any problems which people have when they are older. The goal of this system of treatment is to keep the elderly alive and healthy so that they can further contribute to society.

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     Jernigan (1992) reports the impact of rapid cultural change on the elderly in two predominantly Chinese societies--Taiwan and Singapore. As Taiwan and Singapore become more urban and industrial, and large, extended families shrink and become more isolated, experiences of older family members become very different from those in traditional Chinese society. Aging in Chinese Society describes these changes and discusses how the elderly cope with them. Interviews with Chinese elders and consultants knowledgeable about their situations, along with data from an extensive survey of the aging population conducted by the government of Singapore, illustrate how many aspects of modern life are threatening the quality of life of the elderly. Emphasizing the importance of the cultural context in which attitudes and values are formed, this book raises questions about how modernization has affected the aging experience in the United States as well as in China.

     Aging in Chinese Society develops a holistic approach to aging which emphasizes understanding the aging experience from the perspective of the elderly themselves (Jernigan, 1992). Jernigan (1992) in his book has included brief stories of individual experience to supplement information from interviews and surveys and to illustrate ways in which elders respond to change. Geographical, historical, and cultural contexts of the aging experience in Taiwan and Singapore are considered, as are interactions of personality, culture, and religion in the quality of life of individual Chinese elders. He points to the nature of the cultural changes which have taken place in Singapore and Taiwan in the last forty years; changes in the role, status, and function in the family of the elderly; and responses of the governments of the two countries to the changing situation of Chinese elders. Aging in Chinese Society provides helpful and interesting material for gerontologists and psychologists interested in ethnicity, aging, and the impact of cultural change on the experiences of the elderly. Everyone interested in a holistic approach to the interactions of personality and culture or who wish to understand the importance of the holistic approach in working with the elderly will also find much valuable information (Jernigan, 1992).

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Government policy and programs for the elderly

     According to study by McCarthy, Desmond, and Zheng. (1996) Using an integrated simulation model, this research estimated the scope and speed of population aging in China, the cost of supporting the old, and the impact of different reform options and pension arrangements.

     The results show that the scope and speed of population aging in China make the present pension system financially unsustainable, even assuming that GDP grows steadily in the long term. Moving the retirement age back would provide a temporary fix for the current pay-as-you-go pension system but would be politically viable only where there is great demand for labor.

     Pension funds could be made more sustainable by increasing GDP growth, raising contribution rates, or gradually reducing benefit rates. But the financial costs and social obstacles of those reform options must be carefully assessed. Fully funded, privately managed pension schemes might be feasible, but require a sound regulatory framework and institutional infrastructure, including financial markets that provide adequate savings instruments and insurance options.

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     Pension reform is a long-term, multidimensional problem involving economic, social, political, and cultural factors. Governments should not focus only on taxes and transfers to redistribute income to and among the elderly. Real income growth is needed to cope with poverty among the elderly, especially in developing countries.

     Experience in Europe and Latin America suggests that China may benefit from moving toward a transparent and decentralized system with (1) a fully funded, portable, defined-benefit pension plan, designed to meet basic needs, and (2) occupational pension plans or personal savings accounts to satisfy demand for maintaining or improving living standards. Although China's overriding concern currently is with overall population size (Bongaarts and Greenhalgh, 1983) not only in academic circles but also among government policy makers, there has recently been an increased awareness of policy needs to handle the formidable socio-economic problems likely

to arise from the aging of the population. In response to the increased awareness of policy needs, the Government of China established the China National Committee on Aging (CNCA) in 1982 as a secretariat for co-ordinating its activities related to the problems of aging in China.

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     Historically, China's pension scheme applied to workers of State owned enterprises (SOE's) located in urban cities and towns only. In the late 1980's, the pension scheme was extended to some of the workers of large Collective Owned Enterprises (COE's - owned by local government or enterprises). The coverage, however, did not generally apply to workers in the non-state sectors and in the rural areas. In recent years, there have been pilot pension schemes implemented in a number of rural areas on a limited basis. Only about 200 million employees (including 100 million employees covered under the pilot schemes) out of working population of 700 million were covered by pension scheme (Wu et al., 2000).

     For instance, the urban elderly retired from state-owned enterprises receive free medical care services, whereas the medical care costs of all other urban elderly are paid by municipal governments. In rural areas, the problems of health care for the elderly are more serious (Goldstein and Goldstein, 1986).

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Aging in China versus USA

Based on the World Bank database, data compares the projected percentage of population aged 65+ and the ranking among China and USA in 2000, 2020 and 2040, which is as follows.

2000 2020 2040 Incr. 2000 to 2040

     % rank % rank % rank Ratio rank US 12.4% 8 17.4% 9 22.8% 9 183% 8 China 7.0% 11 10.8% 10 19.4% 10 277% 2

     It is interesting to observe that China at present is a relatively "young" country when compared to the USA. However the growth of aging population in China is among the highest over the next forty years.

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     Under the current demographic assumptions and the continuation of the one-child policy, the population in China will start to decrease in 2030 with the aged dependency rate increasing from 13% in 2000 to 33% in 2040. A modest relaxation in the one-child policy starting with the large urban cities and a gradual increase in retirement age over 20 years will help alleviate the funding problem. Under economic reform, it is clear that the government is determined to shift the social burden to enterprises and employees. With the market economy, companies and individuals are also more responsible for the risks and rewards of economic performance. The government still needs to build a safety net for those who are unemployed. As an integral part of the social reform, a multi-tier pension system will spread the burden and make pensions more affordable by lowering future pension contribution rates down the road. A unique problem facing China is the large percentage of population living in rural areas earning substantially lower wages. According to Wu et al., (2000) the multi-tier pension will equally apply to people living in urban and rural areas. It is possible that people in rural areas could be subject to a different scheme with a lower pension contribution and replacement rate. As the country moves to a new pension scheme, there should be a smooth integration of benefits for people retiring before and after the implementation of the new scheme. However, more research work is needed in these areas (Wu et al., 2000).

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Bongaarts, John, and Susan Greenhalgh (1985). "An Alternative to the One-Child Policy in China," Population and Development Review, vol. 11, No. 4, pp. 585-618.

Davis- Friedmann, Deborah S. (1994) Long Lives: Chinese Elderly and the Communist Revolution. Stanford University Press. 0804718083

Demko, David China's Population Leads World Aging Trend. "AgeVenture News Service, www.demko.com"

FDA Highlights: Health Care for the Elderly. March 9, 1995. March 8, 2002

Goldstein, Alice, and Sidney Goldstein (1986). "The Challenge of an Aging Population: The Case of the People's Republic of China," Research on Aging, vol. 8, No. 2, pp. 179-199.

Jernigan, Homer. (1992) Aging in Traditional Chinese Society. Aging in Chinese Society. ISBN: 1560242736

McCarthy, F. Desmond, and Kangbin Zheng. 1996. "Population Aging and Pension Systems: Reform Options for China." Policy Research Working Paper 1607. World Bank, Office of the Senior Vice President, Development Economics, Washington, DC.

Wu, Xiaoping., Wei, Yingning., Li, Zhenghuai., Fu, Anping & Chow, August. (2000) The Demography of Aging in China and its Implications for Old Age Pension. March 8, 2002 http://www.actuaries.ca/meetings/aging/Chow.pdf


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