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Elderly Care: Major Concerns and Causes
2017-10-16
By Feng Wenmeng
Research Report Vol.19 No.5, 2017
From June to September 2016, the livelihood survey project team of the Development Research Center of the State Council (DRC) conducted a telephone survey nationwide and a household survey in eight provinces concerning people’s lives and their satisfaction about livelihood. A total of 51,092 people participated in the telephone survey, of which 6,387 were aged 60 to 75, accounting for 12.5% of the total. Among the 9,744 respondents of the household survey, there were 2,755 people aged 60 and over, accounting for 28.3% of the total. Data analysis shows that China is faced with three outstanding problems in the provision for the aged, and needs to take measures to address them as soon as possible.
I. Life and Satisfaction Level of the Aged
1. The proportion of the elderly living alone increases with age
Among the 2,755 elderly people of the household survey, 1,755 were male and 999 were female, accounting for 63.7% and 36.3% of the total, respectively. 919 people had non-agricultural registered residency of the city (county/district) they were living in, and 1,773 had local agricultural registered residency, accounting for 33.4% and 64.4%. As to educational attainment, 55.4% of the respondents received primary education and below, 29.7% finished junior middle school, and 14.9% had a high school diploma and above. In terms of marital status, 84.9% of them had a spouse and 13.7% were widowed, divorced or unmarried.
“Family size” refers to the number of family members living together in thesame household and sharing the income and expenditures. The average family size of the elderly was 3.56, slightly lower than the 3.78 for the non-elderly. The family size varies greatly in different regions. Specifically, the average family size of the elderly living in rural areas was 3.83, significantly larger than the 3.15 in the city proper and 3.09 in the suburbs. 5.4% of the elderly lived alone, and the proportion increases with age, which was 5.1%, 7.6% and 13.8% respectively among people aged 60-69, 70-79, and 80 and over. By region, the suburbs saw the highest proportion of the elderly living alone (7.2%), followed by the city proper and rural areas (4.9%).
2. Higher level of satisfaction among the elderly
63.0% of the elderly said they were “very satisfied” or “basically satisfied” with their life, while 12.5% said they were “not very satisfied” or “very dissatisfied”. When asked about the items they were dissatisfied with, 40.5% of the elderly chose “nothing to be dissatisfied with”; 20.3% and 18.7% of them said they were most dissatisfied with income and health care. As to social environment, 55.9% said they “nothing to be dissatisfied with”. Environmental pollution was the most unsatisfactory item, with 12.1% of the elderly dissatisfied about it.
According to the livelihood satisfaction telephone survey, the satisfaction level of the elderly was higher than that of non-elderly people in all fields except social security, housing and environment. A satisfied elderly population is a positive factor for the smooth operation of a society. The relatively high satisfaction level among the elderly is delighting, and attention and efforts are required to maintain it.
II. Major Concerns on Elderly Care
1. Nearly 60% of the elderly worried about income
According to the survey, the aged were most dissatisfied about the income level in their family life. 95.3% of the elderly population was covered by old-age insurance of different types, 16.2% received grants from government in the past year①, and 35.4% had jobs with income②. In addition, 34.8% of the aged received financial support from their children or relatives in the past year.
Despite the extensive coverage of old-age insurance and the relatively high labor participation rate, the income status of the elderly is not optimistic. The proportion of middle- and low-incomers among the elderly is higher that among the non-elderly. Moreover, special attention should be given to the income status of urban residents not covered by basic old-age insurance for urban employees and old-age insurance for civil servants and employees of public institutions, as well as the elderly people in rural areas.
In 2015, the proportion of the elderly aged 60-69, 70-79, and 80 and above with household income below RMB30,000 was 41.0%, 55.7% and 44.8%, respectively (see Figure 1), much higher than that of non-elderly people[]③. Those with household income of less than RMB10,000 accounted for 20.9%, 35.7% and 13.8% in the three age groups. This shows that the income level of the elderly was lower than that of the non-elderly, and a considerable proportion of the elderly belonged to the low-income group. In this context, as high as 58.6% of the elderly surveyed said they were “a little worried” or “very worried” about their income.
Household income varies greatly by registered residency. Households with annual income of less than RMB30,000 and RMB10,000 accounted for 53.3% and 30.7% of the elderly with local agricultural registered residency, the highest among the six types of registered residency and higher than the proportion among the elderly with local non-agricultural registered residency by 30.3 and 24.6 percentage points (Figure 2).
Due to the rising living cost, rumors about deficits of the pension fund and the unclear roadmap of the old-age insurance reform, the elderly have become more worried about future income. According to the survey, 62.4% of the working population under 60 was worried about future income (Table 2). By type of old-age insurance, 70.2% of people covered by the new-type rural social old-age insurance were worried about future income, followed by those covered by old-age insurance for non-working urban residents (67.5%), basic old-age insurance for urban employees (60.8%), and old-age insurance for civil servants and employees of public institutions (44.7%). It can be seen that the old-age insurance system has important influence on the sense of security of the elderly.
2. 90% of the elderly looked after themselves or were looked after by their spouse
According to the fourth sample survey on the living conditions of urban and rural senior citizens, about 40.63 million elders were incapacitated or half-incapacitated, accounting for 18.3% of China’s elderly population[]④. This means that a large number of elderly people need to be looked after.
The survey reveals the gaps between the expectations and the actual situation of the provision of care for the aged (Table 3). Among the non-elderly respondents of the survey, 39.4% expected themselves to be looked after by their spouse, and 36.8% by their children. In contrast, 53.8% of the elderly respondents said they and their spouse took care of each other, 35.2% took care of themselves, and only 10.4% were looked after by their children. This suggests that children play a less-than-expected role in taking care of the elderly, and even fewer of them turn to specialized institutions or other channels. Hence, to build a diversified elderly care system still has a long way to go.
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