Long-Term Care in China: Unique Challenges

China has entered a period of rapid aging since 2001. The proportion of people 65 years or older is projected to reach 16.1% of the total population (164 million) in 2020. In the next twelve years between now and 2020, China's elderly population is expected to grow at five times the total population growth rate. The current system relies heavily on informal care and private-hired live-in maids for meeting long-term care needs of the elderly population. However, strict family planning policies in the 1980s and 1990s will exacerbate the shortage of family caregivers on whom the burden of care falls. There are several noted characteristics of the aging population: the magnitude is huge in both relative and absolute terms; accelerated growth is expected throughout first half of this century; substantial social and economic unbalance exit across regions and between urban-rural areas; and an enormous gap exits between population long-term care needs and economic reality. Policy strategies need to focus on the following areas: expand social security and health insurance coverage, particularly in rural areas; strengthen the family and neighborhood-based care system; expand the capacity of formal care networks through public and private investment; and support and encourage aging and long-term care research.