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Commentary: Aging in China: Challenges and Opportunities

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通讯作者: 陈斌, bchen63@163.com
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    沈阳化工大学材料科学与工程学院 沈阳 110142

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Aging in China: Challenges and Opportunities

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  • 1. Health Science Center, Peking University, Beijing, China
  • 2. Chinese Center of Disease Control and Prevention, Beijing, China
  • Corresponding author:

    Hongman Wang, pkuwhm2006@163.com

    Online Date: July 08 2022
    Issue Date: July 08 2022
    doi: 10.46234/ccdcw2022.130
  • According to China’s seventh national census (1) of 2020, the number of people 60 years and above was 264.02 million (18.70% of the total population), and the number of people 65 years and above was 190.64 million (13.50%). The proportion of elderly people in the seventh census is greater than that in the sixth national census. China will therefore face substantial pressure for balanced population development in the long term. In 2016, The Lancet published an editorial — Ageing in China: A ticking bomb (2). As the country with the largest number of elderly people in the world, how can China meet the challenges brought by a rapidly aging population? Will China’s demographic “ticking bomb” explode?

    With the first 100-year goal of the nation achieved in 2021, China has become a moderately prosperous society, with abject poverty eradicated and a life expectancy that has increased from 70.1 years in 1996 to 77.3 years in 2019. More people living longer requires planning for health and social systems that support people to be happy and healthy as they grow old — especially when population aging coincides with an increasing burden of noncommunicable diseases (NCDs). As China is rapidly moving toward an aging society with a large population, we must act today to address the challenges of tomorrow. To meet such challenges, the “Active National Initiative for Population Aging: Theory and Practice at Present and in Future” was launched in China. The following efforts have been made to address the challenges from theoretical and practice perspectives.

    • A “senior” in China is recommended to be defined as an individual 65 years or older. Although the Law of the People's Republic of China on the Protection of the Rights and Interests of the Elderly, promulgated in 1996, defines a senior as 60 years and above, the Principles and Recommendations for a Vital Statistics System, issued by the United Nations in 2015, defines a senior as 65 years or above. An adjustment from 60 years to 65 years would reduce the number of elderly people by nearly 73.38 million in China.

    • Happy, healthy, and successful aging is more than merely the absence (or management) of NCDs. Rather, healthy aging is making the most of the opportunities from population aging — for example, promoting older people’s social participation and contributions to the community — and requires health and social support systems that are designed for people as they age, including effective management of NCDs along the continuum of care and throughout the life course. Measurement of healthy aging is discussed as well. Experts on aging suggest that healthy aging should not only be measured by the absence of disease, but also with the consideration of activities of daily living (ADL) or instrumental activities of daily living (IADL).

      For technical guidance and review, the Criteria and Methods for Accreditation of Blue Zones (3) (in Chinese, English, and Russian) has been published by an aging research team in Peking University led by Dr. Hongman Wang for “Theoretical and Empirical Research on Healthy China.” This document emphasizes that we should pay attention to healthy longevity, rather than longevity by itself.

      However, to realize healthy aging, it is necessary to put the strategy of “healthy aging” in the entire human life cycle as a priority strategy for China and actively respond to the challenges of an aging population. “Active aging and healthy aging” is a trend of the times and ranks highly among community aims of health for all.

      This year, the theme of the symposium Health Care & Social Care of the Elderly in China is “Active National Initiative for Population Aging: Theory and Practice at Present and in the Future.” Population aging brings not only challenges, but also opportunities.

      A lesson learned from countries that have already experienced their demographic transition is to plan ahead — the earlier, the better. Collective efforts are needed, including community engagement, civil society involvement, and primary health care platform development — along with political commitment and academic and industrial community collaborations — to transform societies successfully and meet healthy aging targets.

      Proactive policies have been taken and implemented at central and local government levels (4). China advocates that “Every person should take care of their own health” in its Healthy China 2030 Action Plan. We see older adults and their families striving for the good health of the elderly and enterprises that have been playing active roles in healthy aging (5). Some nursing homes are employing the younger elderly to care for the older elderly. China’s response and actions on population aging are positive. We believe that by adhering to the concept of healthy aging and summing up the experience in a timely manner, China will be able to turn challenges into opportunities with a virtuous circle of population development. China is taking action for healthy aging, and its population aging will be healthier and more productive, providing reference for development of a “positive outlook on aging and healthy aging” policy around the world. This is Chinese wisdom and a program that China contributes for a shared future of health for all, healthy aging of mankind, and a healthy China and a healthy world.

      A report of the “Theoretical and Empirical Research on Healthy China” research group shows that after China’s entry as an aging population, the Party and the government have attached great importance and actively responded to the research by systematically issuing relevant policies and regulations on aging. The elderly have become a valuable wealth, and the industry for the elderly has become a sunrise industry. Aging not only has no negative impact, rather, it reflects positive energy. It is a fact that the Chinese elderly are becoming healthier and better educated year by year, especially those born in the 1950s and 1960s. They love their country, family, work, and study. The elderly in the new era are not the elderly who “lie flat” and don't care. They are the elders who keep pace with the times, glow with youth, love to work, and contribute to society and family. The elderly are creating value in special ways. In cities, people in their 80s or 90s, if healthy enough, still send and pick up their grandchildren from school and contribute to the housework. In rural areas, the elderly not only manage their families, but also take good care of their grandchildren’s life and study and work in the farmland; they enjoy these activities and refuse to be regarded as old. Many older people with cultural, artistic, or traditional skills have become masters, set up cooperatives, or engage in handicraft making. Their products go to the market and even abroad, bringing considerable income. As a Chinese saying goes, having an elder person at home is better than having a treasure at home. The elderly have become the backbone of the family. With China’s good aging policies and comprehensive poverty alleviation measures, the elderly have become an indispensable force for China’s economic and social development. Most older people in the new era are educated and possess certain skills. They refuse to accept aging, are willing to contribute to society, are living full lives, and are making great contributions to China’s socialist construction.

      At the advent of the Chinese top policy-making bodies’ release of China’s national efforts to respond actively to population aging, we feel it is appropriate to share the Chinese political commitment and active effort by leadership and academia with the world. We hope this short communication can contribute to a better world for the elderly and for people of all ages to live in a world with universal health for all.

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