Aging of China
is aging faster than almost all other countries in modern history. In 2050, the proportion of Chinese over retirement age will become 39 percent of the total population according to projections. China is rapidly aging at an earlier stage of its development than other countries. Current demographic trends could hinder economic growth and create challenging social issues in China.
In 1979, the Government of China established a controversial one-child policy aimed at curbing the high fertility rate. With economic development, the provision of social services, and improved welfare conditions, life expectancy in China has also increased. These two factors have directly contributed to China's aging population, which has significant ramifications on China's society, politics, and economy. In October 2015, a two-child policy was introduced in an attempt to deal with the aging problem. In May 2021, the Chinese government introduced the three-child policy in a further attempt to address the issue. In July 2021, all family size limits as well as penalties for exceeding them were removed.
Since 2022, deaths have outstripped births in the country. In 2025, China had 323 million people over age 60, or 23 percent of the population.
Overview
From 1950 to 2020, the total fertility rate in China dropped from 6.11 to 1.3 births per woman. The mortality rate also decreased, from 22.2 to 7.1 per 1,000 people. Life expectancy rose from 44.6 to 77.47 years from 1950 to 2020, and is expected to reach about 80 years in 2050.In 2018, 249.49 million people over 60 years old constituted 17.9 percent of the total population. Chinese state media reported the country's total fertility rate dropped to 1.09 in 2022.
Causes
China's aging population is caused by a low birth rate together with prolonged human life expectancy.Low fertility rates
One-child policy
In order to suppress excessive population growth, the one-child policy was introduced in 1979. The enforcement methods include financial penalties, widespread use of various contraceptive methods, as well as more severe forced abortion and sterilization. As a result, birth rates and population growth rates have drastically decreased. Previously, the fine is so-called "social maintenance fee" and it is the punishment for the families who have more than one child. According to the policy, the families who violate the law may bring the burden to the whole society. Therefore, the social maintenance fee will be used for the operation of the basic government.Reproductive health of couples
With economic growth and social development, increasing smoking, alcohol use, unhealthy diets, and psychological stress have an effect on lowering the fertility rates of couples. Surging pollution in China also has an impact on male sperm count, which has been declining since the 1970s. At the Chinese University of Hong Kong, a team of scientists studied the sperms from approximately 6,500 men and found a "strong correlation" between high levels of air pollution and "abnormal sperm shape".Researchers point out that many particulate matter components are associated with sperm damage in experimental studies. Exposure to air pollutants may cause free radicals to exceed body's regulation ability, adversely altering biologically relevant molecules such as DNA and triggering human diseases. These conditions may be associated with a significant number of infertile couples, lowering the fertility rate.
Cultural impact
China's sex ratio is the most skewed in the world. The country's ratio of males to females is skewed 3% to 4% higher towards males. In the traditional, patriarchal society, many Chinese people believed that men were more important than women. This mindset has continued to be prevalent in modern China, especially in rural areas, resulting in high female fetal abortion rates and even female infanticide. The imbalance in sex ratio has led to a decrease in marriage rates and birth rates in China.Extension of human life span
The improvements in social welfare and the medical system have prolonged people's life span. Since 1949, the general health of the Chinese people has greatly improved, and the life expectancy has increased by about 30 years, from 44.6 to 75.3 years from 1950 to 2015. It is expected to reach approximately 80 years in 2050. The minimum income security in rural areas has been expanded and is covering more than 50 million residents in poor areas. The Chinese government has unified the welfare systems of urban and rural migrants, and the pension system covers nearly 700 million people.Despite the improvement of China's social welfare system, there are still huge inequalities in health between urban and rural areas. Compared with urban peers, the number of medical service providers for rural residents is significantly reduced, and the utilization rate of facilities is low, resulting in their poor health. Since the late 1990s, three new medical insurance systems have been established by the government to provide more health care services. In 2009, urban and rural health insurance reforms achieved greater coverage. More advanced medical techniques have reduced the prevalence of diseases and increased survival.
Impacts
The demographic trend of aging population has social, political and economic ramifications in China. The growth of the elderly population has increased the dependency ratio and the prevalence of many chronic diseases. Aging society has also brought about changes in public policy. The weakening of the labor force has negative impacts on China's economic growth and development, which was originally driven by the labor market.Social
According to some analysts, rapid aging may create only a few challenging social problems and does not increase the risk of social instability in China.Due to the lower fertility rate and extension of the human life span, the population in China is aging faster than almost all other countries. In 2050, the proportion of Chinese over retirement age will become 39 percent of the total population. At that time, its dependency ratio will rise to 69.7%, almost twice as high as that in 2015, which was about 36.6%.
Others consider the issue more serious. The higher dependency ratio is associated with the greater pressure placed on those who are working to support the rest of the population. Even if the Chinese government provides part of the financial support for the elderly through social welfare, such as pensions and public welfare homes, there are still many elderly people in China who are unable to be taken care of. In 2015, there were, on average, 27 beds per 1,000 elderly in nursing homes in China, far fewer than those in the United States or Germany.
The aging population in China has increased the incidence and types of chronic diseases. Chronic diseases include four basic types: cardiovascular diseases, cancer, respiratory diseases, and diabetes. There are nearly 300 million chronic patients in China, half of whom are over 65 years old. During aging, many cellular and molecular events break down and eventually lead to a variety of chronic diseases, such as coronary heart diseases. The number of CHD incidents and deaths in China will increase dramatically from 2010 to 2029; among Chinese adults aged 35–84, a 64% increase in CHD occurrences is predicted between 2020 and 2029.
Political
A large number of the elderly population has increased the pressure on the Chinese government to allocate pensions and make social welfare more accessible. The lack of conventional financial infrastructure and the extent of the aging population make it difficult for China to provide a holistic solution. Even at an economic growth rate of 8 percent, pension spending is growing much faster at a rate of 15 percent per year. Pension expenditure increased by 11.6% in 2016, reaching 2.58 trillion yuan, with a shortfall of 429.1 billion yuan, requiring government subsidies.Since the establishment of the pension system, China has been paying the income of retirees with the contribution of the working population. As more people retire and fewer people enter the labor market, the gap between income and expenditure will continue to widen. China's Working Committee on Ageing suggested that the inclusion of improved care services for the elderly in the national development road-map would be a key measure for the top leadership to cope with population aging. The elderly care service market provides more opportunities for private capital and non-governmental organizations so that the elderly can have more service choices.
In 2022, Peking University and Lancet established a commission on healthy aging in China. The Commission's purpose is to re-focus the debate on aging not just on the risks but on opportunities through "unleashing the intellectual and vocational capacities of the older population and the whole of Chinese society." Also in 2022, the Fudan Institute on Aging was established as a state-level think tank aimed at developing what it describes as Chinese solutions for addressing the problems of aging and Chinese wisdom for coping with an aging society.
Neighborhood committees of the Chinese Communist Party are typically staffed by older volunteers.
Geopolitical
China's aging population could hinder economic growth, create challenging social problems, and limit its capabilities to act as a new global hegemon.Ryan Hass of the Brookings Institution said, "China is at risk of growing old before it grows rich, becoming a graying society with degrading economic fundamentals that impede growth." He went on to say, "The working-age population is already shrinking; by 2050, China will go from having eight workers per retiree now to two workers per retiree. Moreover, it has already squeezed out most of the large productivity gains that come with a population becoming more educated and urban and adopting technologies to make manufacturing more efficient."
Nicholas Eberstadt, an economist and demographic expert at the American Enterprise Institute, said that current demographic trends will overwhelm China's economy and geopolitics, making its rise much more uncertain. He said, "The age of heroic economic growth is over." Brendan O'Reilly, a guest expert at Geopolitical Intelligence Services, wrote, "A dark scenario of demographic decline sparking a negative feedback loop of economic crisis, political instability, emigration and further decreased fertility is very real for China".