As China Grows Older

As China “grows old before it grows rich,” the question of who will care for its burgeoning elderly population looms large for young families and for the church.

China’s birth rates have been brought under control during the past three decades. As a result, the number of working-age people as a percentage of the total population has begun to plateau and will decrease steadily over the next decade. Meanwhile, the proportion of China’s elderly has begun to mushroom. The pyramid-shaped demographic profile that characterized China up through the 1970s, with a large pool of children and youth at the bottom and a comparatively, smaller, elderly population at the top, is rapidly being replaced by a barrel-shaped contour featuring a large, middle-aged population that is steadily moving into the ranks of the elderly.

Today, there are more than 200 million senior citizens in China. Of these, some 30 million are considered disabled. As of 2012, there were only 3.9 million nursing home beds available in all of China. By 2050, the elderly population is estimated to reach 400 million, accounting for a third of the country’s total population.^[1] Given the traditional expectation that the young are to take care of their older relatives, as well as the lack of a suitable social safety net to meet the needs of China’s burgeoning older population, the burden that this demographic reality places upon the urban infrastructure is formidable.

As China’s elderly population mushrooms and its working-age population shrinks, families find themselves caught in the middle of this demographic divide. Cultural expectations and legal requirements put the onus on them to care for older family members, but neither the government nor society at large are currently prepared to provide the resources needed to support this effort.

Furthermore, the Bible is clear that taking care of one’s own family is a primary responsibility of believers: “But if anyone does not provide for his relatives, and especially for members of his household, he has denied the faith and is worse than an unbeliever.”(1 Timothy 5:8)

For many Christian congregations in China, the immediate concern, especially in the rural areas, is caring for elderly pastors in their later years of life. TSPM-affiliated churches have the advantage of owning property that, in some cases, can be used to develop a home for the elderly that adjoins or is adjacent to the church. Several have already taken this step, and others may be expected to follow suit.

Younger urban pastors are faced with caring for parents who, in many cases, still live in the countryside or in smaller cities. Many of their congregants find themselves in a similar situation. With living space limited in the city, it may not be practical or desirable to have older relatives move in with the family. While they might want to personally offer care out of a sense of filial piety, the reality is that many will need to look for third-party solutions.

Looking further across the society, two possible large-scale responses merge, both of which provide opportunities for China’s urban Christians not only to care for the elderly in their midst but also to offer a service to the larger community, thus enhancing the church’s standing in society. Given the right mix of expertise and investment, along with a favorable regulatory environment, urban Christians could potentially play a leading role in both areas.

One response involves training home health workers to visit seniors who are still living on their own or whose family is not able to care for their needs. So far, this appears to be the government’s favored approach to eldercare as it is seen as more cost-effective.

The other response is to construct residential care facilities. Investors in this space have thus far targeted the high-end market where income from wealthy clients and their families will more than cover the cost of providing first-class services. The biggest need is among middle- and low-income clients and their families. Preferential treatment and incentives, including tax exemption and waived, or lowered administrative fees, are available for companies wanting to invest in this area.

Both approaches require training skilled and non-skilled workers. Given the overall lack of expertise nationwide in gerontology and other related fields, however, the means of training these workers is not readily available in country. China’s church, like most entities in society, is struggling as it grapples with the challenge of China’s ageing population. On the other hand, the Christian community in China is the one entity that does have access to a sizeable pool of potential personnel, both professionals whose expertise could be applied specifically to senior care, as well as unskilled workers who could be trained for support roles. With a biblical ethic of caring for others, these Christians could bring to their service a motivation that would not be found among others who see senior care as simply a business opportunity. If they were able to create a viable model, it would likely catch the attention of government officials who have been tasked with finding ways to care for the elderly and who have resources at their disposal to do so, but who are wary of committing funds without first seeing firsthand that the proposed solution is going to succeed.

Several small-scale projects are currently being undertaken by individual church congregations and by Christian entrepreneurs and healthcare professionals, some in collaboration with Christians outside China. Thus, an urgent concern facing urban Christian families in China—how to care for ageing relatives amidst widespread social change that has left traditional practices unworkable—has created an opportunity for China’s Christians to exercise their beliefs and values in practical ways. Doing so would gain the church legitimacy within society as Christians are seen caring not only for their own needs but also for the needs of their community.

This article is excerpted from China’s Urban Christians: A Light That Cannot Be Hidden by Brent Fulton, pages 14 and 65-66. Used with permission.

Image credit: 20471-RODSC_0017 by neville mars via Flickr.