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The demographics of China are changing rapidly, straining long-standing values about aging, family, and caregiving. By 2025, it is likely that Chinese people will represent one-quarter of the world’s population over age 60 years. At present, the Chinese government lacks the structure and capacity to care for the elderly.1 The rapid expansion of China’s cities and the nation’s focus on economic prosperity has also made it more difficult for younger people to care for their aging parents.1 Exacerbated by the One Child Policy, which was active from 1980 to 2015 and restricted family size to 1 child per couple, issues of aging have become seemingly insurmountable. As a delegate for the Chicago Sister Cities International’s Chicago-Shanghai Social Services Exchange Program in 2015, I witnessed firsthand the unintended consequences of the One Child policy and the 4:2:1 paradigm that has become shorthand for 1 child providing care for 4 grandparents and 2 parents. The unintended consequences include caregiver burden and elder abuse and neglect. According to XinHua, the Chinese State’s new agency, approximately 185 million people over the age of 60 years do not live with their children because many children move away to pursue economic opportunities.1
Dong X. Elder Rights in ChinaCare for Your Parents or Suffer Public Shaming and Desecrate Your Credit Scores. JAMA Intern Med. 2016;176(10):1429–1430. doi:10.1001/jamainternmed.2016.5011
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