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THEORETICAL AND PRACTICAL RESEARCH ON CHINA'S RESPONSE TO
POPULATION AGING IN THE NEW ERA
PhD
Zhang Zhe
National University of Uzbekistan
ORCID: 0009-0005-8626-2013
Abstract.
Population aging is an important trend of social development. At present, China
is in the largest aging process in history, catching up with or even surpassing the aging speed of
Western countries in the rapid evolution, with many pressures and challenges under the complex
internal and external environment. China has put forward a series of new theories, new ideas and
new strategies on the work of aging, forming a theoretical system with rich connotation, complete
system and strict logic, which guides the practice of the Chinese government to deal with
population aging. This paper deeply analyzes the relevant theoretical basis, analyzes the current
situation, characteristics and causes of China's aging, and summarizes the practice of China's
innovative response to aging since 2010, in order to provide valuable experience for the rest of the
world to deal with aging.
Key words:
Aging, China, New Era, Innovation and Practice.
YANGI DAVRDA AHOLINING QARISHIGA XITOYNING MUNOSABATIGA
OID NAZARIY VA AMALIY TADQIQOTLAR
PhD
Chjan Zhe
O‘zbekiston Milliy universiteti
Annotatsiya.
Aholining qarishi ijtimoiy rivojlanishning muhim tendentsiyasidir. Hozirgi
vaqtda Xitoy tarixdagi eng katta qarish jarayonida bo'lib, G'arb mamlakatlarining jadal
evolyutsiyada qarish tezligiga yetib boradi yoki hatto undan oshib ketadi, murakkab ichki va
tashqi muhit ostida ko'plab bosim va qiyinchiliklar mavjud. Xitoy qarishni oldini olish bo'yicha bir
qator yangi nazariyalar, yangi g'oyalar va yangi strategiyalarni ilgari surdi, boy ma'noga ega,
to'liq tizim va qat'iy mantiqqa ega nazariy tizimni shakllantirdi, bu Xitoy hukumatining aholining
qarishi bilan shug'ullanish amaliyotini boshqaradi. Ushbu maqola tegishli nazariy asoslarni
chuqur tahlil qiladi, Xitoyda qarishning hozirgi holati, xususiyatlari va sabablarini tahlil qiladi va
dunyoning qolgan qismiga qarish bilan shug'ullanish uchun qimmatli tajribani taqdim etish
uchun Xitoyning 2010 yildan beri qarishga innovatsion munosabati amaliyotini umumlashtiradi.
Kalit so'zlar:
qarish, Xitoy, Yangi davr, Innovatsiya va amaliyot.
UO
‘
K: 330.4
IV SON - APREL, 2024
283-294
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ТЕОРЕТИЧЕСКИЕ И ПРАКТИЧЕСКИЕ ИССЛЕДОВАНИЯ РЕАКЦИИ КИТАЯ
НА СТАРЕНИЕ НАСЕЛЕНИЯ В НОВУЮ ЭПОХУ
PhD
Чжан Чжэ
Национальный
университет Узбекистана
Аннотация
.
Старение населения является важной тенденцией общественного
развития. В настоящее время Китай находится в крупнейшем процессе старения в
истории, догоняя или даже превосходя скорость старения западных стран в быстрой
эволюции, с множеством давлений и проблем в сложной внутренней и внешней среде.
Китай выдвинул ряд новых теорий, новых идей и новых стратегий в области старения,
сформировав теоретическую систему с богатым подтекстом, полной системой и
строгой логикой, которая определяет практику китайского правительства по решению
проблемы
старения
населения.
В
этой
статье
глубоко
анализируется
соответствующая теоретическая основа, анализируется
текущая ситуация,
характеристики и причины старения Китая, а также обобщается практика
инновационного реагирования Китая на старение с 2010 года, чтобы предоставить
остальному миру ценный опыт борьбы со старением.
Ключевые слова:
Старение, Китай, Новая Эра, Инновации и Практика
.
Introduction.
Population aging is an important trend of social development and an inevitable result of
population transition. Since 2022, the population born during China's second baby boom period
has entered the old age period, and the aging population has entered the "fast track" of growth,
and China will enter the stage of moderate aging. After 2022, China will enter the second peak
of elderly population growth with an average annual growth of nearly 12 million, and the aging
problem will gradually show a concentrated outbreak trend (Li, 2015). It is predicted that by
2025, the number of people aged 65 and above will exceed 210 million, accounting for about
15%; By the 2030s, 310 million people will be aged 65 or above in China, accounting for 22.3
percent of the total population. By the middle of this century, the number of people aged 65 or
above will reach 380 million, accounting for 27.9 percent of the total population (Mo, 2009).
At present, China is undergoing the largest aging process in history. It is catching up with
or even surpassing the aging rate of Western countries in the process of rapid evolution, and
faces many pressures and challenges despite the complex internal and external environment.
China has put forward a series of new theories, new ideas and new strategies on aging work,
forming a theoretical system with rich connotation, complete system and rigorous logic, which
guides the Chinese government's practice in dealing with population aging. The top-level design
for coping with population aging has been improved, major laws, policies and systems have
been gradually finalized, the material foundation has been further consolidated, various
security and service systems have been improved, and a social atmosphere of caring for the
elderly has been formed and continuously improved. All these are of great significance for other
countries in the world to cope with population aging.
Research Status and Theoretical Basis
2.1 Research Status and Review
Since 2000, with China's entry into the population aging society, scholars have paid more
and more attention to population aging, and their understanding of coping with population
aging has been constantly improved. The main conclusions focus on the following aspects:
The first is the research on the connotation and essence of population aging. According to
the definition of the Demographic Dictionary of the United Nations Population Commission,
when the proportion of the elderly in the population increases, we call it population aging. The
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statistical caliber of the elderly population generally (Drafting & Li, 2015) includes two kinds:
60 years old and (60+) and 65 years old and above (65+). Population aging is a dynamic process.
Zheng Gongcheng (2020) argued that population aging refers to the dynamic change of
population structure in which the increase of average life expectancy and the decrease of
fertility rate lead to the corresponding increase of the proportion of the elderly in the total
population. Yuan Xin and Jin Niu (2020) believed that the essence of the aging problem is an
economic problem of "making a cake". How to give full play to national value, realize personal
wealth accumulation, promote national economic prosperity, and consolidate a solid
foundation for people's livelihood for "sharing the cake" also needs to adhere to the gradual
thinking and fully recognize efficiency and fairness (Lin, 2021).
The second is the research on the characteristics and challenges of population aging. "Get
old before you get rich" and "get old before you get ready" are the basic characteristics of
China's aging population, and also the theoretical basis for understanding the problem of
population aging. They are reflected in the weak economic strength, the imperfect system and
mechanism for aging, and the unbalanced and inadequate economic and social development.
Bao (2020) believed that: first, the degree of population aging continues to increase, and the
trend of aging is obvious; Second, the speed of population aging has been significantly
accelerated; Third, the urban-rural gap in population aging has widened rapidly; Fourth,
regional differences in population aging have widened; Fifth, the speed of population aging
deviates from the speed of economic development (Tong, Wang, & Geng, 2015).
In general, the academic research on the aging problem has made some achievements, but
there is still room for further research. Firstly, the perspective of population aging research
needs to be further expanded; Secondly, the thoughts, theories and policies related to
population aging in China need to be sorted out and refined. Thirdly, the practical experience
of coping with population aging needs to be summarized and summarized. In this paper, the
practice and experience of China are tempered, in order to provide some experience for China
and other countries to cope with aging.
2.2 Theoretical Basis of China's Response to Population Aging
First, the theory of population transition. Population transition theory refers to the
process of population reproduction from primitive to traditional and then to modern. It
proposes that the population transition has gone through the development process from
primitive to traditional and then to modern population reproduction type. The original
population reproduction type is "high high low" (high birth rate, high death rate, low growth
rate), which is the starting point of population transition. The traditional population
reproduction type is "high, low and high" (high birth rate, low death rate, high growth rate),
which is the initial stage of population transition. This stage is selected by the intervention of
marriage, family, medical and health technology level. The modern population reproduction
type is "low and low" (low birth rate, low death rate, low growth rate), and the population is at
a low level of static and negative growth, due to the change of female fertility concept and the
increase of raising cost.
Second, the theory of multiple welfare. Rose, a scholar of the theory of welfare pluralism,
argued in his paper "The Same Goal, Different Roles -- The Contribution of the State to the
Pluralistic Combination of welfare" that the welfare state can easily lead to the crisis of the
welfare state by only relying on the unitary welfare supply subject of the state to solve the
welfare problem. The welfare provision should be transformed from a unitary state to a ternary
state, that is, a "welfare triangle" composed of the state, the market and the family. The sum of
the three constitutes the total social welfare (Tong, Wang, & Geng, 2015). Independent welfare
providers will have deficiencies and defects. Only when the three entities join together to learn
from each other's strengths and make up for each other's weaknesses, can the whole be greater
than the part and its welfare be maximized.
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Third, Life cycle theory. In the 20th century, Franco Modigliani and Richard Brumberg of
the United States proposed the life cycle theory, which explored the relationship between
consumption, income and savings from the perspective of human life cycle. According to the
income status of the whole life cycle, people will balance the consumption and saving behavior
ability of each stage. It emphasizes that the saving potential of consumers is the main factor that
determines the amount of personal consumption expenditure, and individuals should rationally
allocate income and wealth from the perspective of the whole life cycle to achieve the
optimization and efficient use of resources. Individuals' consumption and saving behaviors
have an important impact on families and society, which is an important theoretical basis for
analyzing the impact of age structure change on economic growth and coping with population
aging.
3. Characteristics, Causes and Impacts of Population Aging in China
Since 2010, China has entered a new era, and the degree of population aging has gradually
intensified. At the same time, due to the influence of China's previous population policy, China's
aging presents different characteristics.
3.1 Characteristics of China's Aging Population
(1) The population has maintained a low growth rate, and the degree of population
aging has deepened
Globally, China is the largest developing country with the largest population and the
largest elderly population. According to the Statistical Yearbook of the National Bureau of
Statistics (2020) and the seventh population census data, as shown in Figure 1, China's total
population was only 580 million in 1953, 690 million in 1964, more than 1 billion in 1982, 1.13
billion in 1990, 1.26 billion in 2000, 1.34 billion in 2010, and exceeded 1.4 billion in 2019. In
2020, the total population of China reached 1411.78 million, ranking first in the world. China
also has a relatively large elderly population compared with other countries. In 1953, there
were 26 million people over the age of 65 in China, accounting for 4.4% of the country's total
population. In 1964, the number of people over 65 years old decreased to 25 million, accounting
for 3.6% of the total population in China. In 1982, 49 million, accounting for 4.9%; 63 million in
1990, accounting for 5.6%; In 2000, 88 million, accounting for 7.0%. China entered an aging
society. Moreover, this trend will become more and more serious, until 2050, China's
population over the age of 60 will remain at the level of 400 million, that is to say, on average,
one out of every four elderly people in the world lives in China, and the number of elderly
people in China is more than the total number of elderly people in developed countries.
Figure 1 Number and proportion of the population aged 65 and above in
China from 2011 to 2020
12288
12714
13161
13755
14386
15003
15831
16658
17603
19064
9,10%
9,40%
9,70% 10,10%
10,50% 10,90%
11,49%
11,96%
12,60%
13,50%
0,00%
2,00%
4,00%
6,00%
8,00%
10,00%
12,00%
14,00%
16,00%
0
5000
10000
15000
20000
25000
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
Population aged 65 and above (ten thousand)
Percentage of the population aged 65 and over
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(2) Population aging started late and developed rapidly
The onset of population aging in developed countries was earlier than that in China.
France became the first country in the world to enter an aging society in 1865. It was followed
by Sweden in 1890, the United Kingdom in 1931, the United States in 1944 and Japan in 1970.
China, on the other hand, only entered the aging society in 2000. France, the first country to
start aging, was 130 years earlier than China, and Japan, also in Asia, was 30 years earlier than
China. The period from the 2020s to the 1950s was the most serious period of population aging
in China, with a growth rate of about 21%. The number of elderly people increased rapidly and
the aging of the population accelerated. Looking at the development speed of population aging
in the world, the speed of population aging in China is faster than that in other countries with
aging populations in the world. It only took 27 years for China's population aged 60 and above
to increase from 10 percent to 20 percent of its total population, compared with 140 years for
France, 80 years for Sweden and 78 years for the United States. Even Japan, which has the most
aging population, took 29 years, which is still two years longer than China.
(3) The geographical distribution of population aging is uneven, and the gap
between urban and rural areas is widening
China has a vast territory, marked differences in regional development and unbalanced
and inadequate development. The economic development in the eastern region is faster than
that in the western region, and that in the coastal region is faster than that in the interior and
border areas. The aging process of China's population also shows obvious regional differences.
As shown in Table 1.
Table 1.
Proportion of Elderly Population Aged 65 and Above in China as a
Whole and by Region (%)
95
Regions
Specific
gravity
Area
Specific
gravity
Region
Specific
gravity
Area
Specific
gravity
Nationwide
13.50
Shandong
15.13
Beijing
13.30
Fujian
11.10
Liaoning
17.42
Anhui
15.01
Zhejiang
13.27
Yunnan
10.75
Chongqing
17.08
Hunan
14.81
Inner
Mongolia
13.05
Hainan
10.43
Sichuan
16.93
Tianjin
14.75
Shanxi
12.90
Ningxia
9.62
Shanghai
16.28
Hubei
14.59
Gansu
12.58
Qinghai
8.68
Jiangsu
16.20
HEBEI
13.92
Guangxi
12.20
Guangdong
8.58
Ji Lin
15.61
Henan
13.49
Jiangxi
1189
Xinjiang
7.76
Heilongjiang
15.61
Shaanxi
13.32
Guizhou
11.56
Xizang
5.67
Among the provinces, municipalities and autonomous regions in China, only Tibet has not
entered the population aging society. Entering the new development stage, the new
urbanization process is accelerating, and the urbanization rate is greatly increased. The
developed eastern coastal areas will once again welcome the inflow of young and middle-aged
labor and children from the central, western and northeastern regions. The aging degree in the
eastern and coastal areas will be effectively alleviated, and the aging degree in the western and
northeastern regions will be increasingly high. The uneven regional distribution of China's
aging population will become more and more obvious.
(4) Population aging is ahead of modernization, from "getting old before getting
rich" to "getting old while getting rich"
In terms of the degree of aging and the international per capita GDP, in 2019, the elderly
aged 65 and above accounted for 12.6% of the total population in China, and China's per capita
GDP was US $10,000, while the elderly aged 65 and above accounted for 12.6% of the total
95
Data are from China National and Regional Statistical Yearbook
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population in the United States, Japan and the Republic of Korea in 1990, 1992 and 2015,
respectively. Their per capita GDP was about US $24,000, US $30,000 and US $27,000,
respectively. By the middle of this century, China's population aged 60 and above will reach a
peak of more than 400 million people, accounting for about 31 percent of the total population,
and enter the stage of high-level aging. However, its per capita GDP can only reach the level of
the current moderately developed countries, which indicates that the contradiction between
China's aging process and economic and social development and modernization will last for a
long time. In 2019, 18.1 percent of China's population aged 60 or above ranked 57th in the
world. China's per capita GDP has reached 10,000 US dollars, ranking 72nd in the world, and
dropped to around 30 according to the coordination index between population aging and
economic development. As a result, China has moved from "getting old before it gets rich" to
"getting old while getting rich" (Li, 2020).
3.2 Causes of China's aging population
(1) Root cause: rapid economic and social development
In the early days of the founding of China, the population structure belonged to the young
population structure, and there was no aging phenomenon. The state's attention to the aging of
the population lagged behind. Under the guidance of the idea of "strength in numbers", the
family planning policy was not implemented, which led to the birth peak in the mid-1950s and
the mid-1960s. The first baby boom occurred from 1950 to 1958, with an average annual birth
rate of 21 million. From 1962 to 1975, the average annual number of births during the second
baby boom was 26.28 million. Since 2010, the elderly of the first baby boom have entered the
old age period, and the people of the second baby boom will also enter the old age period, which
has greatly promoted the aging of the population. After the tremendous development after the
reform and opening up, China has undergone earth-shaking changes and its economy has
developed rapidly. Since the reform and opening up, the GDP has risen from 367.87 billion yuan
in 1978 to 101.3567 billion yuan in 2020, an increase of 275 times. In the first 30 years of
reform and opening up, the average annual GDP growth rate was about 9%, which can be called
a miracle in the history of world economic development. China's per capita GDP rose from 385
yuan in 1978 to 71,828 yuan in 2020, and the birth rate dropped from 18.25 per thousand in
1978 to 8.5 per thousand in 2020. The natural population growth rate dropped from 12 per
thousand in 1978 to 1.45 per thousand in 2020. The rapid development of the economy and the
abundance of the material foundation have led to the rapid development of the aging
population. In some areas with a relatively high population aging in China, such as Shanghai,
Jiangsu and Zhejiang, they are some areas at the forefront of reform and opening up, with a high
level of economic development and a high degree of aging.
(2) The direct cause: the improvement of medical and health care level and the
improvement of security system
In the early days of the founding of New China, the average life expectancy of our
population was 39 years for males and 42 years for females. In 1981, it was 66.28 years for men
and 69.27 years for women. In 2010, the sixth census data showed that men were 72.38 years
old and women 77.37 years old. In 2020, the seventh census data showed that the average life
expectancy in China was 77 years old, 73.64 years old for males and 79.43 years old for females.
It is estimated that by 2050, China's average life expectancy will be 85 years. Therefore, the
level of medical and health care has a significant impact on the development of aging. In order
to ensure Chinese residents' rights to health care, the Chinese government has formulated a
series of policies and systems since the beginning of the last century. In recent years, the
medical insurance system has been reformed, and the medical insurance system for urban
employees and the rural cooperative medical insurance system have been established. 95.3
percent of urban residents and 98.3 percent of rural residents are covered by various types of
medical insurance. Among them, 99.9 percent of the elderly eligible for the new rural
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cooperative medical insurance system are covered by the new medical insurance system,
effectively ensuring people's safety.
(3) Indirect reason: the acceleration of urbanization process
In China, urbanization has expanded to urbanization, and the rural population has shifted
not only to cities but also to small towns, realizing the process of non-agriculture and
citizenization. The speed and scale of China's urbanization amaze the world. In 2000, the level
of urbanization was only 35%. According to the sixth census data, from 2000 to 2010, China's
urban population increased by 207 million, while the rural population decreased by 133
million, and the urbanization rate of the population increased by 13.5 percentage points. A huge
amount of rural population has been transferred to urban areas, leaving a large number of
elderly people left behind. According to the seventh census, the urban population is 901.99
million, accounting for 63.89 percent, while the rural population is 509.79 million, accounting
for 36.11 percent. Compared with the sixth census data, the urban population increased by
more than 230 million, up 14.21 percentage points. The rural population decreased by more
than 160 million. 2) In the past two decades since the beginning of the new century, the
urbanization process has been accelerating and the aging population has been increasing
simultaneously.
(4) Subjective reason: the change of fertility concept
With the improvement of education level, the fertility intention has also changed. At the
beginning of the founding of the People's Republic of China, the illiteracy rate was as high as 80
percent, and the nine-year compulsory education in the new era covered 100 percent of the
population. In 2018, the enrollment rate of senior high schools reached 88 percent, and the
gross enrollment rate of higher education rose from 2.7 percent in 1978 to 48 percent in 2018.
On the one hand, good education enables people to accept advanced and scientific ideas, give
up traditional and backward feudal ideas and ideas, and form a healthy conception of fertility.
According to relevant studies, the degree of adult education is negatively correlated with
fertility rate. Generally speaking, the higher a woman's education level is, the less affected by
the traditional "raising children for old age" and "having more children and more happiness",
and the lower her willingness to give birth. On the other hand, children's education is an
important part of the family expenditure. The extension of the time limit of education, the
improvement of talent requirements, and the cost of family education have greatly increased,
which makes the families who are willing to bear children have their will but not their ability.
At the same time, the opportunity cost of family childbearing increases, which leads to the
decrease of wage income and the increase of leisure cost. Even if the two-child policy is fully
liberalized, there are still not many families who are willing to have a second child. After the
introduction of the "single two-child" policy, there are 11 million families eligible for
childbearing, and only 1.069 million families apply for childbearing, and only 470,000 couples
actually have a second child. In addition, the mortality rate is negatively correlated with the
education rate. Science is the primary productive force, and education continues to provide
talents for science. Good education can cultivate more high-quality talents, which is more
conducive to creating social wealth, thus improving people's living environment and medical
and health conditions, prolonging people's average life expectancy and aggravating population
aging. In a word, the change of fertility intention promotes the process of population aging.
(5) Objective reason: the implementation of family planning policy
China's family planning policy has a lot to do with the decline of fertility rate. After the
founding of the People's Republic of China, the Chinese population experienced a demographic
transition, especially after the first and second baby boom. Faced with a large and rapidly
growing population, the state implemented the family planning policy to control the population
quantity and improve the quality of the population. In July 1971, The State Council approved
and passed the Report on the Work of Family Planning. Since then, the state has incorporated
population growth control into the national economic development plan. In the 1970s, it also
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put forward the strategy of "late, thin and few". In September 1980, the Chinese government
issued an Open Letter to All Communist Party Members and Members of the Communist Youth
League on the Issue of Controlling China's Population Growth, advocating a "one-child" policy
in which couples are allowed to have only one child. In 1982, family planning was established
as a basic state policy and written into the Constitution. With the vigorous promotion of the
family planning policy, the fertility rate dropped rapidly, from 18.25 per thousand in 1978 to
8.50 per thousand in 2020, and the natural population growth rate was 12 per thousand in 1978
to 1.45 per thousand in 2020. Obviously, the implementation of the family planning policy has
led to a decline in the birth rate and China has entered the ranks of countries with low fertility
rate. In 2022, China ushered in the era of negative population growth for the first time.
3.3 Impact of China's aging population on the economy
Keynes proposed that the population problem is a major economic problem. Population
aging will affect economic development in all aspects. Population aging will reverse the
consumption structure, increase the burden of economic operation, change the structure of
labor resource allocation, and affect industrial development.
(1) Reverse the consumption structure.
Expanding domestic demand and boosting consumption is a long-term economic strategy
for China's economic development. Marx once pointed out that consumption determines
production. The aging population is the consumer. With the rapid development of population
aging, consumption has increased significantly in terms of total amount. However, the income
level of the elderly population is at a medium and low level, the elderly live with diseases in
their remaining life, and the medical consumption expenditure is large. The total consumption
capacity and consumption demand of the elderly are far lower than that of the young and
middle-aged people. The demand and consumption habits of young and middle-aged people are
different from those of the elderly. Young and middle-aged people are the main force of
economic consumption, and their habits of real estate demand, tourism consumption,
education consumption and advanced consumption far exceed the consumption level of the
elderly. With the development of aging population, the decrease of children population and the
increase of elderly population will inevitably lead to the shortage of effective demand. The
young and middle-aged population with strong consumption capacity is decreasing, and the
consumption structure is changing. Even if the elderly population increases part of the
consumption, the overall demand for national consumption is difficult to maintain a continuous
upward trend.
(2) Increasing the burden on the economy
With the socialized reform of the social security system in the 1980s and 1990s,
population aging has been rapidly promoted, and the social burden of coping with population
aging has become more and more heavy. Due to the increase of the elderly population, the level
of pension expenditure will rise sharply, which will greatly increase the government's public
expenditure, which will lead to the decline of government savings. There is a phenomenon of
"empty account" running in individual pension accounts, which reached 3.1 trillion yuan in
2013. Since 2005, the proportion of pension fund expenditure in GDP has continued to increase.
In 2015, pension fund expenditure for urban workers accounted for 2 percent of GDP, and by
2018, it had accounted for 4 percent of GDP. The growth rate of China's pension fund income
has been slower than the growth rate of expenditure. We increased the burden on government
finances, with government subsidies exceeding one trillion yuan in the past decade. We will
change the structure of labor allocation. Labor resources are an important factor in production.
The aging population has led to an absolute reduction in the number of workers in the total
population, and the labor-intensive industries developed by relying on cheap labor have lost
their advantages. The competitive advantage of low cost of labor has gradually disappeared,
and enterprises have the problems of "labor shortage" and "labor difficulty". The decline of
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labor force will inevitably lead to changes in the relationship between supply and demand in
the labor market, and change the structure of labor resource allocation.
(3) It will affect industrial development
Population aging affects the primary, secondary and tertiary industries. China's primary
industry, agriculture, has not been fully modernized, and some rural areas still use traditional
farming methods. Due to the superposition of urbanization and aging, young and middle-aged
people in rural areas flow into cities and towns, and most of the remaining people are elderly
and women. The agricultural economy has become an aging economy, and rural areas mainly
rely on the elderly for agricultural production. A large number of fertile land has been
abandoned in some villages, which has little impact on the country's food reserves at present,
but is still worrying in the long run. Due to the internal aging of the labor force, the secondary
industry mainly requires young labor force, and the shortage of young labor force has a great
impact on the adjustment of economic mode and industrial upgrading. In an aging population
society, more and more elderly people need to be supported, and the pension demand has
become an important part of the economic demand, which promotes the development of the
pension industry and related services, and the silver economy will become a new economic
growth point.
Fourth, China's innovative approach to cope with the aging society in the new era
4.1 Improve the rule of law and health public policy system for the elderly
In order to comprehensively protect the legitimate rights and interests of the elderly,
China promulgated and implemented the Law of the People's Republic of China on the
Protection of the Rights and Interests of the Elderly in 1996. With the development of the
economy and society and the intensification of the aging trend, the state revised it again at the
end of 2012, revising many new contents, making it one of the most revised laws since the
founding of the People's Republic of China. In 2013, the newly revised Law of the People's
Republic of China on the Protection of the Rights and Interests of the Elderly was formally
implemented. Since then, the active response to the aging population has been incorporated
into the national law and has become the will of the state. Subsequently, it was revised again in
2015 and 2018, which is a leap forward in China's elderly security work in the process of rule
of law, and is the legal basis for China to actively respond to population aging in the new era.
The combination of medical care and elderly care is a new way of providing for the aged,
which organically combines medical care and elderly care resources. It is also named as the
integration of medical care and elderly care, which is a way of further integration and common
development of management, service and talent. China's national and local policies on the
combination of medical care and elderly care take into account both demand and supply, and
provide multi-dimensional incentives and support for the combination of medical care and
elderly care. The details are shown in Table 2.
4.2 Explore new pension models with Chinese characteristics
With the improvement of economic conditions and the change of the migration of working
areas, more and more elderly people need a large number of services such as family care and
spiritual support, which makes the original family pension mode cannot fully meet the needs.
The views and modes of pension follow the change and innovation of The Times, and various
modes are intertwined, interconnected and integrated, and develop together. Various models
are interwoven, interconnected and integrated, and developed together. New models such as
community home care, combination of medical care and health care, mutual assistance, housing
care, and smart care have been promoted.
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Table 2.
Special Policies for the Combination of Medical Care and Elderly
Care were Issued for the First Time
Topics
Policy name
Issuing agency
Time of Posting
Guidance
A guideline on promoting the
integration of medical and health
care and elderly care services
The State Council
October 18, 2015
Division of key
tasks
Notice on printing and distributing
the division of Labor plan for
integrating medical care and elderly
care
National Health and Family
Planning Commission
April 17, 2016
Service
organization
license
Notice on the licensing of medical
and nursing service institutions
Ministry of Civil Affairs,
National Health and Family
Planning Commission
April 8, 2016
Selection of
pilot units
Notice on the selection of national
pilot units combining medical care
and elderly care
Ministry of Civil Affairs and
National Health and Family
Planning Commission
May 17, 2016
Pilot units
identified
Notice on determining the first
batch of state-level pilot units for
combining medical care with elderly
care
Ministry of Civil Affairs and
National Health and Family
Planning Commission
June 16, 2016
Monitoring
efforts
Notice on monitoring the
combination of medical care and
elderly care
Ministry of Civil Affairs and
National Health Commission
2017
Institutional
approval and
registration
Notice on the Examination and
approval and registration of
institutions combining medical care
and elderly care
The National Health
Commission, the State
Administration for Market
Regulation and the National
Administration of Traditional
Chinese Medicine
May 27, 2019
"Call for
Experience
Promotion
Notice on the collection and
promotion of typical experience in
the combination of medical care and
elderly care
National Health Commission
June 25, 2019
Pushing deeper
Opinions on further promoting the
development of combining medical
care with elderly care
National Health Commission,
Ministry of Civil Affairs,
National Development and
Reform Commission, Ministry
of Finance, Ministry of
Education, etc
Oct 23, 2019
List of typical
experiences
The list of typical experiences in the
combination of medical care and
elderly care in China
National Health Commission
December 12,
2019
Institutional
Service Guide
Notice on the issuance of guidelines
on Institutional services for the
Integration of medical care and
elderly care (trial)
National Health Commission,
Ministry of Civil Affairs,
National Administration of
Traditional Chinese Medicine
December 23,
2019
epidemic
prevention and
control
Notice on further improving the
prevention and control of COVID-19
in institutions that combine medical
care with nursing care
The State Council
February 17, 2020
Pilot agencies
identified
Notice on determining the first
batch of pilot institutions for remote
collaborative services combining
health care and nursing care for the
elderly
National Health Commission
August 28, 2020
Improving
service quality
Notice on improving the service
quality of medical and elderly care
institutions
National Health Commission
and National Administration
of Traditional Chinese
Medicine
December 3, 2020
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(1) Community home care model
Community home-based care for the aged is a socialized service operation mode based on
family as the core, relying on community and professional service institutions, through
government purchase of services, social participation, and undertaking by non-governmental
organizations. The service forms mainly include door-to-door service and neighborhood
mutual assistance in the community, and the service contents include life care, medical care,
psychological comfort and so on.
In China, the community home care model has achieved rapid development since 2010.
By 2020, China had 421,000 community service stations and 28,000 community service
centers. The number of community old-age care institutions and facilities increased from
19,000 in 2014 to 291,000, and the number of community mutual aid old-age care facilities also
increased from 40,000 in 2014 to 147,000.
(2) The model of combining medical care and health care with elderly care
The mode of medical care and health care combined with pension is the combination of
medical care and pension for the elderly, and the integration of medical care with home care,
community care, institutional care and other pension modes. It is the development and
innovation of the traditional pension concept, promotes the functional upgrading of the pension
mode, realizes the comprehensive coverage of medical security and support services, and
improves the quality of residents' old age life. It promotes the realization of the goal of having
medical care for the sick and providing for the elderly. In 2016, the National Health and Family
Planning Commission and the Ministry of Civil Affairs identified the first and second batches of
90 state-level pilot units combining medical care and elderly care. Driven by the national policy
of combining medical care with elderly care, many cities have carried out the model of
combining medical care with elderly care in practice. From the actual situation of the
integration of medical care and elderly care in various cities, it can be summarized as medical
institutions to expand elderly care services, elderly care institutions to expand medical services,
and the integration mode of medical institutions, elderly care institutions and communities.
(3) The mode of mutual support for the elderly
Mutual support for the aged, that is, the elderly out of voluntary and familiar groups, or
the elderly partner for the aged, is a new exploration of community home care service. The
elderly who participate in mutual care have similar characteristics such as lifestyle, living
habits, personality and values. They live together, accompany each other and help each other,
so as to meet the needs of daily care and spiritual care. The mode of mutual assistance for the
aged usually consists of home-based neighborhood mutual assistance, mutual assistance
happiness home and other forms. Home-based neighborhood mutual aid is mainly based on
community volunteer service, and a volunteer team for the young elderly is established. The
young elderly serve the elderly, and those with strong mobility serve the weak mobility. In the
form of pair assistance, the home-based neighborhood mutual aid regularly provides doorto
door services for the elderly in need. Mutual assistance welfare home is a "group pension" way,
the collective will be idle site into a welfare home, to achieve collective construction, centralized
living, self-security form.
(4) Housing for the aged mode
Housing pension model, born in the West, is also known as reverse mortgage, refers to the
elderly use their own housing to obtain pension living expenses. Reverse mortgage refers to
that the elderly use their own houses to mortgage the property rights of the houses to financial
institutions, and these institutions make a comprehensive evaluation on the current value and
future value growth of the houses, as well as the life expectancy of the elderly. According to the
assessed price of the house owned by the elderly, excluding expected depreciation and interest
paid in advance, and calculated according to the average life expectancy, the value of the
property owned by the elderly is apportion to the expected life of the elderly, and the cash is
paid to the borrower on an annual or monthly basis until the death of the borrower. After the
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death of the elderly, the right to use the house owned by the elderly will be recovered by the
financial institution, which makes it feasible for the borrower to spend the sales money of the
house owned by the elderly in advance during his/her lifetime.
(5) Smart pension model
With the development of big data, cloud computing, artificial intelligence and other
science and technology, emerging science and technology are integrated into the pension
model, and smart pension has become a new trend of pension development. Smart pension is
based on modern science and technology, the use of information technology to use the network
and China's home, community, institution three pension methods combined, to establish a
diversified channel three-dimensional service platform, the establishment of a new social
pension service mode. In November 2017, the Ministry of Civil Affairs of China, the Ministry of
Industry and Information Technology and other departments issued the "Notice on the Pilot
Demonstration of smart health Pension application". 53 enterprises, 22 towns and 19 bases
have been used as smart health pension demonstration enterprises, demonstration streets and
towns, demonstration bases. The smart old-age care model has developed rapidly.
4.3 Improve the development mechanism of education for the elderly
Education for the elderly is a comprehensive social education that advocates lifelong
learning in practice and takes public cultural facilities and service facilities for the elderly as
the carrier. In September 2012, the National Office on Aging jointly issued the Opinions on
Further Strengthening the Construction of culture for the Elderly, proposing that "cultural and
education departments should integrate education for the elderly into lifelong education and
community education systems, strengthen leadership and unify planning." In 2015, the Law on
the Elderly will increase government investment and encourage social participation in running
universities for the elderly as one of the important revision contents. By 2022, China will have
at least one university for the elderly in a city at or above the county level, and more than 80,000
universities (schools and learning centers) for the elderly at all levels, with more than 14
million registered students. China will build 29 provincial-level open universities for the
elderly, providing offline training for 3.5 million people and online training for 80 million
people. There are 221 universities and colleges that are members of the Third-Age University
Alliance. Education and learning centers for the elderly have been set up in 216 cities
(prefectures), 689 counties (cities and districts), 4,856 townships (streets) and 26,698 villages
(communities).
At the same time, based on traditional values, Chinese society advocates the mode of
caring for the elderly, encourages people to provide convenient and flexible work opportunities
for the elderly, and gradually extends the retirement age, which provides strong support and
guarantee for the social and economic development of the aging population.
Reference:
General Report Drafting Group, & Li, Z. (2015). General Report on National Strategy for
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Li, Z. (2015). Scientific Research on Aging (11), 11.
Li, Z. (2020). Scientific Research on Aging, 8(7), 14.
Lin, B. (2021). Chinese Journal of Population Science (3), 15.
Mo, L. (2009). Quantitative Research on the Coordination between population aging and
economic development in China from 1980 to 2050. Population Studies (3), 10.
Tong, C., Wang, L. & Geng, A. (2015). The four-dimensional supply Subject and responsibility
orientation of China's old-age security system: based on the analytical framework of welfare
pluralism paradigm. Journal of Xiangtan University: Philosophy and Social Sciences Edition (3), 5.
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