BEIJING – Retired doctor Chen Ju, who could have afforded a flat in one of Beijing’s exclusive retirement communities, chose to live with her retired accountant daughter. 

The 79-year-old, who spends her days gardening, going on walks and chatting with the neighbours, said she has hearing problems and some muscle weakness, but is largely healthy. 

“My old work colleagues tell me being in a retirement community home is better since there is professional medical care, but I prefer being with my daughter and her husband,” she said.

Madam Chen is one of nearly 210 million people aged over 65 in China.  

By 2050, it is estimated that some 400 million will be aged 65 and older, or nearly a third of the population.

The number of seniors is predicted to spike by some 100 million in the next decade, increasing the social and economic burden on the working population.

With increasing life expectancies – 78.2 years in 2021 – as the general health of the people has improved, and low fertility rates – 1.09 in 2022 – China’s population is ageing rapidly. The United States by comparison has a life expectancy of 76.4 years (2021) and a fertility rate of 1.66 (2021).

As China’s economic growth slows, particularly in recent months as it struggles to regain its footing after years of strict Covid-19 controls, there are concerns that the country is growing old before it gets rich.

According to the World Bank, China is an upper-middle-income country which has a significant number of people remaining vulnerable to poverty. With a rapidly ageing population, China is finding its pensions inadequate and its healthcare system poorly equipped to address the healthcare needs of the growing number of older people.

To control the booming population in the late 1970s, the one-child policy was introduced, which discouraged couples from having multiple children by penalising them if they did. 

By the time this was abolished in 2016 to boost birth rates, it appeared to be too late: Most young, highly-educated Chinese no longer wanted to have children in the numbers their forebears did.

As China’s economy developed and Chinese women got more educated and had more job opportunities, they chose to have fewer children. There have been an increasing number of couples who identify as “Dinks”, or double income, no kids.

Account director Michelle Zhuo, 48, said she and her husband decided early on in their relationship not to have children because they felt parenthood would interfere with their careers, especially after seeing how colleagues were torn when they had to work late.

“Initially it was that, then as time went on, we realised that we were more relaxed, our holidays weren’t tied to a school calendar so we could go during the off-peak season, and we have the freedom to do whatever we want,” she said.

The couple have a group of friends of about their age who, like them, are childless by choice.

And the trend is growing, with young people tired of the rat race choosing to “tang ping” (Mandarin for “lie flat”), with many disillusioned about the future, referring to themselves as the “last generation”.

In 1980, the first year after the one-child policy went into effect, there were 17.76 million babies born. This peaked at 25 million in 1987 before numbers started dipping. By the time China hosted the Summer Olympics in 2008, some 16 million babies were born.

In 2022, the population shrank for the first time in decades – Chinese mothers had only 9.56 million babies – leading policy watchers to sound the alarm that the country was ageing nearly a decade ahead of schedule. Demographers had predicted that China would enter a “high growth” period of ageing in 2030.

Playing catch-up

The next decade will be crucial in setting policies for years to come, as the population rapidly ages in an unprecedented way, said the head of Renmin University’s Gerontology Institute Du Peng.

He told online media outlet Tencent Finance that it was a “very good sign” that in 2020, pension overtook support from family members as the main source of income for seniors.

“It is of great significance for the elderly to live on their own pensions,” he said. “This means that the elderly have stronger ability to pay, the quality of life can be more stable, and the elderly can decide what they need more independently, instead of relying on children to contribute money like before.” 

However, according to a 2019 report by the Chinese Academy of Social Sciences, the country’s main pension fund could be depleted by 2035 because of a decrease in the workforce.

To address this and other economic challenges of an ageing population such as lower productivity growth, some experts say China needs to raise its retirement ages of 55 for men and 50 for women.

China has for years tried to raise the retirement age but has met with fierce resistance, and several attempts have been shelved. The resistance has come from workers in lower-income brackets because they do not want to delay access to their pensions, said Dr Zhao Litao, a senior research fellow at the East Asian Institute at the National University of Singapore who specialises in social and population policies. 

Dr Zhao noted, too, that China policies on social development have always fallen behind those governing economic development. “To be able to deal with a rapidly ageing population, you first need to make sure that the economy is doing well so there’s capital for social policies targeted at ageing,” he said.

Dignified lives

Yet, Chinese society is changing in the way it views ageing and eldercare, with more senior citizens choosing to live out their silver years independently, while more organisations are advocating for programmes that promote ageing with dignity.

Retirees are increasingly being seen as people who have full lives rather than caregivers of grandchildren. Across social media, there is an increasing number of websites and accounts dedicated to active ageing, promoting activities, holidays and even fine-dining meals targeted at those above 60. 

In a report on the silver industry at the end of August, the China Research Centre on Ageing (CRCA) noted that there is still huge potential for consumer spending. It predicted that from 2036, as those now in their 40s and 50s begin to age, there would be a more tech-savvy senior citizen population that would embrace active ageing and lifelong learning. 

It is likely that there will be two stages in China’s ageing, said head of the CRCA Wang Lili, with the elderly shifting from mere “survival” to an “improvement” in lifestyle.

Their functional needs at present include basic nursing and palliative care services, long-term care as well as rehabilitative nursing. 

But this is likely to change within the next decade as the silver population becomes more well-educated and well-informed. Some may even want to keep working as long as they feel mentally sharp, rather than simply staying home, said Ms Wang.

Experts are also now pushing for what they call “spiritual” well-being of senior citizens. 

Prof Du said that as more seniors move towards living as a couple or alone, unlike now where three generations live under the same roof, their emotional and intellectual needs will have to be considered.

“Many elderly people have (also) moved to the city with their children. Can they integrate into the circle of local elderly people without language barriers?” he asked. 

“Many elderly people have knowledge and experience so if given the opportunity to integrate into society and participate in social development, and they can do some voluntary services, they will feel happier.”

Yet it is often in the execution of such programmes, such as integrating rural elderly folk into city life or even coming up with activities for them to contribute to their new homes, that processes need to be refined, said Dr Zhao of the EAI. 

Companies providing residential and day care have mushroomed across the country. Many recruit workers from rural areas but that can pose a problem because it concentrates such resources in urban areas, when in fact most of the country’s elderly are in the countryside.

As a more educated population ages, the way China looks at eldercare and its peripheral services such as home nursing will have to be refined. Rather than simply seeing it as providing an essential service, the industry needs to consider how it can help people grow old with dignity, Dr Zhao added.

Certainly, some of the elderly want to be treated with more respect.

“I’ve seen some senior activities where volunteers come and put up a show for residents of a retirement home, but it can feel quite condescending,” said Madam Chen, the retired doctor in Beijing.

She added that she admires the West for how it encourages more independence in the elderly. Western-style retirement homes that allow seniors their own private apartments and day trips out on their own, but with on-site medical support facilities, are expensive and considerably rare in China.  

“We’re old, but we’re not stupid. After all we’ve done for the country, surely we should be allowed to choose how we want to grow old and die?” she said. 

• OCBC is the presenting sponsor for the Asia Future Summit 2023. The event is also supported by Guocoland and Kingsford Group.