Skip to main content
Log in

Population aging and the need for long term care: A comparison of the United States and the People's Republic of China

  • Published:
Journal of Cross-Cultural Gerontology Aims and scope Submit manuscript

Abstract

Both developing and major developed countries of theworld are facing the global aging of their citizenry.The United States and the People's Republic ofChina each share in this phenomenon. Therapid growth of their aging populations comes as bothcountries are experiencing a sustained period ofeconomic stability with an accompanying drop infertility rates (Coale & Watkins 1986; Dyson &Murphy 1985). Together with longer expected lifespans in both countries, these factors have caused ashift in the population structure which will result inincreasingly large portions of the population who willpotentially require assistance with ADL's and/or longterm care (Olson 1990; Kennedy, LaPlante & Kaye1997). The careful assessment and interpretation ofavailable data to define the actual extent of needshould be part of a process to help guide each countryas they prepare for the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • American Association of Retired Persons (1997). Out-of-pocket spending by Medicare beneficiaries age 65 and older: 1997 projections (pp. 18–28). AARP Public Policy Institute.

  • Armstrong, P. W. (1993). Medical advances in the treatment of congestive heart failure, Circulation 88: 2941–2952.

    Google Scholar 

  • Arnsberger Webber, P., Fox, P. & Burnette, D. (1994). Living alone with Alzheimer's disease: Effects on health and social service utilization patterns, The Gerontologist 34: 8–15.

    Google Scholar 

  • Banister, J. (1988). The aging of China's population, Problems of Communism 37: 62–67.

    Google Scholar 

  • Beck, C. & Chumber, N. (1997). Planning for the future of long term care: Consumers providers and purchasers, Journal of Gerontological Nursing, 6–12.

  • Bulatao, R. & Lee, R. (1983). Determinants of fertility in developing countries, Vol. 2. New York: Academic Press.

    Google Scholar 

  • Caldwell, J. (1982). Theory of fertility decline. London: Academic Press.

    Google Scholar 

  • Cao, G. (1991). Development of social security. In X. Lu & P. Li (eds.), Report of the social development of China. Shen Yang: Liaoning People's Press.

    Google Scholar 

  • China Research Center on Aging (1994). Data compilation of the survey on China's support for the elderly. Bejing, China: Huling Press.

    Google Scholar 

  • Chow, N. (1988). Caregiving in Developing East and Southeast Asian Countries, unpublished paper. Tampa, FL: International Exchange Center on Gerontology, University of South Florida.

    Google Scholar 

  • Coale, A. & Watkins, S. (1986). The decline of fertility in Europe. Princeton, NJ: Princeton University Press.

    Google Scholar 

  • Crews, D. E. (1997). Aging and gerontology: A paradigm of transdisciplinary research, Collegium Antropologicum 21(1): 83–92.

    Google Scholar 

  • Cruse, J. M. (1999). History of medicine: The metamorphosis of scientific medicine in the ever-present past, American Journal of the Medical Sciences 318: 171–180.

    Google Scholar 

  • Dyson, T. & Murphy, M. (1985). The onset of fertility transition, Population and Development Review 11: 399–440.

    Google Scholar 

  • Fairchild, T., Knebl, J. & Burgos, D. (1995). The complex long term care service system. In Z. Harel & R. E. W. Dunkel (eds.), Matching people and services in long term care (pp. 73–88). New York: Springer.

    Google Scholar 

  • Fox, P. (1989). From senility to Alzheimer's disease: The rise of the Alzheimer's disease movement, The Milbank Quarterly 67: 58–71.

    Google Scholar 

  • Fox, P., Maslow, K. & Zhang, X. (1999). Long-term care eligibility criteria for people with Alzheimer's disease, Health Care Financing Review 20: 67–85.

    Google Scholar 

  • Freedman, R. (1995). Asia fertility decline and prospects of future demographic change: Asia Pacific Population Research reports. East West Center Program of Population 1: 1–27.

    Google Scholar 

  • Greene, V. L. & Ondrich, J. I. (1990). Risk factors for nursing home admissions and exits: A discrete-time hazard function approach, Journal of Gerontology 45(6): s250–258.

    Google Scholar 

  • Gui, S., Likui, L., Ning, S. Z., Xin, D. I., Zhong G. Q., Ming, C. Y. & Fang, Q. (1987). Status and needs of the elderly in urban Shanghai: Analysis of some preliminary statistics, Journal of Cross Cultural Gerontology 2: 171–186.

    Google Scholar 

  • Gui, S. (1993). Old age care in the process of China's modernization policies. Paper prepared for Conference on China's Modernization Taiwan Foundation.

  • Gui, S. (1994). A pattern study: China's Family of the elderly and community care in the future. Paper prepared for the International Conference on Family and Community Studies April 18–21.

  • Gui, S. (1998). The pressure and countermeasures of old age insurance in China, Journal of East China Normal University Social Science 4: 56–61.

    Google Scholar 

  • Hao, C. (1990). Population policy of China and its impact on family size and structure, The Journal of Family Welfare 36: 7–21.

    Google Scholar 

  • Health Care Financing Administration (1992). Medicare Current Beneficiary Survey: Access to Care, Inter-University Consortium for Political and Social Research, Study No. 6332.

  • JARC, Japan Aging Research Center (1997). Statistical Abstracts of Aging in Japan. Tokyo, Japan.

  • Johnson, S. W., Sambamoorthi, U. & Crystal, S. (1999). Gender differences in pension wealth, The Gerontologist 39: 320–333.

    Google Scholar 

  • Johnson, R. J. & Wolinsky, F. D. (1993). The structure of health status among older adults: disease, disability, functional limitation and perceived health, Journal of Health and Social Behavior 34: 105–121.

    Google Scholar 

  • Jow Ching Tu, E., Liang, J. & Li, S. (1989). Mortality decline and the Chinese family structure: Implications for old age support, Journal of Gerontology Social Sciences 44: S157-S167.

    Google Scholar 

  • Kane, R. A. & Kane, R. L. (1982). Long term care: A field in search of values, in Kane & Kane, Values and Long Term Care (p. 4). Lexington, MA: Heath.

    Google Scholar 

  • Kasper, J. (1990). Cognitive impairment among functionally limited elderly people in the community: Future considerations for long term care policy, The Milbank Quarterly 68: 81–110.

    Google Scholar 

  • Katz, S. & Akpom, C. (1976). A measure of primary socio-biological functions, International Journal of Health services 6: 493–507.

    Google Scholar 

  • Kennedy, J., LaPlante, M. & Kaye, S. (1997). Need for Assistance in Activities of Daily Living Disability Statistics, Abstract 18, US Department of Education National Institute on Disability and Rehabilitation Research.

  • Lei J. Q. & Yang, S. (eds). (1994). The change in marriage and the family in the Chinese countryside since the change in the economic system. Beijing: Peking University Press.

    Google Scholar 

  • Leutz, W. R. Abrahams, C. & Capitman, J. (1993). The administration of eligibility for long term care, The Gerontologist 331: 92–104.

    Google Scholar 

  • Li, J. & Tao, C. (1998). On the support mode in the countryside. Proceedings of the 1998 Shanghai International Conference on Aging (pp. 502–510). Shanghai: Science and Technology Publishing House.

    Google Scholar 

  • Li, T. & Xu, L. (1998). On community support. Proceedings of the 1998 Shanghai International Conference on Aging (pp. 457–471). Shanghai: Science and Technology Publishing House.

    Google Scholar 

  • Liu, K., Coughlin, T. & McBride, T. (1991). Predicting nursing-home admission and length of stay, Medical Care 29: 125–141.

    Google Scholar 

  • Manton, K. G., Corder, L. & Stallard, E. (1997). Chronic disability trends in elderly United States populations: 1982–1994, Proceedings of the National Academy of Sciences of the United States of America 94: 2593–2598.

    Google Scholar 

  • Manton, K. G., Stallard, E. & Corder, L. S. (1998). The dynamics of dimensions of age-related disability 1982 to 1994 in the US elderly population, Journals of Gerontology. Biological Sciences & Medical Sciences 53: B59–70.

    Google Scholar 

  • Martin, L. G. (1991). Population aging policies in East Asia and the United States, Science 251: 527–531.

    Google Scholar 

  • Martin, L. G. (1990). Changing Intergenerational Family Relations in East Asia, Annals of the American Psychological Society 510: 102–114.

    Google Scholar 

  • Max, W., Webber, P. & Fox, P. (1995) Alzheimer's disease: The unpaid burden of caring, Journal of Aging and Health 7: 179–200.

    Google Scholar 

  • Moen, P. & Forest, K. B. (1995). Family policies for an aging society: Moving to the twenty-first century, The Gerontologist 35: 825–830.

    Google Scholar 

  • Moon, M. (1996). What medicare has meant to older Americans, Health Care Financing Review 18: 49–59.

    Google Scholar 

  • MMWR, Morbidity and Mortality Weekly Report (1999a). Healthier mothers and babies. 48: 849–858.

    Google Scholar 

  • MMWR, Morbidity and Mortality Weekly Report (1999b). Ten great public health achievements-United States, 1900–1999. 48: 241–243.

    Google Scholar 

  • National Center for Health Statistics (1995). Current Estimates from the National Health Interview Survey. Vital and Health Statistics, Series 10 #193. Washington, DC: US Government Printing Office.

    Google Scholar 

  • Newman, S. J., Struyk, R., Wright, P. & Rice, M. (1990). Overwhelming odds: Caregiving and the risk of institutionalization, Journal of Gerontology 45: s173–183.

    Google Scholar 

  • Ni, J. (1986). The past, present and future of the life expectancy in China, Journal of Statistical Studies 2: 21–27.

    Google Scholar 

  • Olson, P. (1990). The elderly in the People's Republic of China. In J. Sokolovsy (ed.), The Cultural Context of Aging: Worldwide Perspectives (pp. 143–161). New York: Bergin and Garvey.

    Google Scholar 

  • Pearlman, D. N. & Crown, W. H. (1992). Alternative sources of social support and their impact on institutional risk, The Gerontologist 32: 527–535.

    Google Scholar 

  • Peng, X., Liang, H., Huang, J. & Guo, Y. (1998). Characteristics and needs of the aging in Pudong New Area Shanghai. Proceedings of the 1998 Shanghai International Conference on Aging (pp. 282–297). Shanghai: Science and Technology Publishing House.

    Google Scholar 

  • People's Republic of China (1982). One per thousand fertility survey.

  • Phillips, B. R., Stephens, S. A. & Cerf, J. J. (1986). The evaluation of the national long term care demonstration: Survey data collection design and procedures. Princeton, NJ: Mathematica Policy Research.

    Google Scholar 

  • Rice, D., Fox, P., Hauck, W., Max, W., Webber, P., Lindeman, D. & Segura, E. (1993). The economic burden of Alzheimer's Disease, Health Affairs: 164–176.

  • Rice, D. (1996). Medicare beneficiary profile: Yesterday, today and tomorrow, Health Care Financing Review 18: 23–45.

    Google Scholar 

  • Robinson, K. M. (1999). Family caregiving who provides the care and what cost?, Nursing Economics 15: 243–247.

    Google Scholar 

  • Rowland, D. & Lyons, B. (1996). Medicare, Medicaid and the elderly poor, Health Care Financing Review 18: 61–85.

    Google Scholar 

  • Shen, C. (1991). Development of population. In X. Lu & P. Li (eds.), Reports of China's Social Development (pp. 259–298). Shenyang: Liao Ning People's Press.

    Google Scholar 

  • Sheng, X. (1992). Population aging and the traditional patterns of supporting the aged. Proceedings of the Asia Pacific Regional Conference on the Future of the Family (pp. 66–71). Beijing: Social Science Documentation Publishing House.

    Google Scholar 

  • Shi, L. (1994). Elderly support in rural and suburban villages: Implications for future support systems in China, Social Science and Medicine 39: 265–277.

    Google Scholar 

  • Shulian, X. & Zhiping,W. (1988). The situation of the elderly in Beijing, International Health 16: 51–66.

    Google Scholar 

  • Stone, R., Cafferata, G. & Sangl, J. (1987). Caregivers of the frail elderly: A national profile, The Gerontologist 27: 616–626.

    Google Scholar 

  • Sung, K-T. (1990). A new look at filial piety: Ideals and practices of family-centered parent care in Korea, The Gerontologist 30: 610–617.

    Google Scholar 

  • Tian, X. (1991a). Economics of the Chinese aging population. Beijing: Chinese Economic Press.

    Google Scholar 

  • Tian, X. (1991b). Chinese aging society: A national survey of the elderly. Beijing: China Economic Press.

    Google Scholar 

  • US Bureau of the Census (1992). An Aging World II. International Population Reports, P-25, 92–93. Washington, DC: US Government Printing Office.

    Google Scholar 

  • US Bureau of the Census (1995). Current Population Reports Series P–23–128 and P–25–10116. Statistical Abstracts of the United States. Washington, DC: US Government Printing Office.

    Google Scholar 

  • US Government Accounting Office (1998). Alzheimer's Disease Estimates of Prevalence in the United States, United States Government Accounting Office, DHHS Publication No. 98–16.

  • Weissert, W. G., Matthews, C., McCready, C. M. & Pawelak, J. E. (1988). The past and future of home and community-based long-term care, The Milbank Quarterly 66: 309–388.

    Google Scholar 

  • Williams J., Lyons, B. & Rowland, D. (1997). Unmet long term care needs of elderly people in the community: A review of the literature, Home Health Services Quarterly 16: 93–1190.

    Google Scholar 

  • Wolinsky, F. R. & Johnson, R. J. (1992). Widowhood, health status, and the use of health.

  • Wu, C. P. & Du, P. (1996). The elderly in the process of population aging in China. Shanghai: East china Normal University Press.

    Google Scholar 

  • Yang, S. (1991). Family development report. In X. Liu & P. Li (eds.), Report of the Social Development of China (pp. 299–334). Shen Yang: Liaoning People's Press.

    Google Scholar 

Download references

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Arnsberger, P., Fox, P., Zhang, X. et al. Population aging and the need for long term care: A comparison of the United States and the People's Republic of China. Journal of Cross-Cultural Gerontology 15, 207–227 (2000). https://doi.org/10.1023/A:1006745324079

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1006745324079

Navigation