Who Will Care for Middle Aged and Elderly Parents in Rural China?

• Published date: 01 March 2021
• Author: Menghua Li,Yun Zhou,Xinjie Shi
• Date: 01 March 2021
• DOI: http://doi.org/10.1111/cwe.12373

©2021 Institute of World Economics and Politics, Chinese Academy of Social Sciences

China & World Economy / 123–150, Vol. 29, No. 2, 2021 123

Who Will Care for Middle Aged and Elderly Parents

in Rural China?

Menghua Li, Yun Zhou, Xinjie Shi*

Abstract

Using data from the 2015 China Health and Retirement Longitudinal Study, this paper

analyzes how the health of parents is causally linked to the gender of their children.

We find that, compared with parents with no daughters, those with one daughter are

healthier by 0.155 more activities of daily living. This effect is mainly channeled through

the provision of emotional comfort and fi nancial support, and not through living with

parents. We also confirm that daughters are an important source of financial and

emotional support for elderly parents, regardless of whether the parents have pension

insurance. This study has important policy implications for China as it focuses on the

support from daughters, who historically have not been considered to be as reliable as

sons in supporting their parents.

Key words: family pension, gender of children, health of parents

JEL codes: J130, J140, J150, J160

I. Introduction

Recent studies have drawn increased attention to the effect of children’s behavior on the

health and long-term care of parents (Horowitz, 1985; Cai et al., 2006; Antman, 2010;

Giuntella, 2018). Some of the studies have examined the mechanisms of this effect,

including financial support and emotional care (Pezzin and Schone, 1999; Souza and

Grundy, 2007). However, little is known about whether and how children’s demographic

*Menghua Li, PhD Candidate, China Academy for Rural Development, School of Public Affairs, Zhejiang

University, China. Email: 11722015@zju.edu.cn; Yun Zhou (corresponding author), PhD Candidate, China

Academy for Rural Development, School of Public Affairs, Zhejiang University, China. Email: zysimone@zju.

edu.cn; Xinjie Shi (joint corresponding author), Assistant Professor, China Academy for Rural Development,

School of Public Affairs, Zhejiang University, China. Email: xjshi1990@zju.edu.cn. The authors contributed

equally to this work. This research was supported financially by the National Natural Science Foundation

of China (No. 72003170), Zhejiang University-International Food Policy Research Institute Center for

International Development Studies (No. 126000-541902/006), and Zhejiang Federation of Humanities and

Social Sciences (No. 21NDQN219YB).

Menghua Li et al. / 123–150, Vol. 29, No. 2, 2021

©2021 Institute of World Economics and Politics, Chinese Academy of Social Sciences

124

characteristics affect their parents’ health status. In this article, we study one additional

correlate of parents’ health – children’s gender – and investigate the mechanisms

underlying this relationship. Gender preference and sex imbalance are well documented

in China (as described below), so it is crucial to understand how the gender of children

affects the health status of their parents when designing policies to address health-care

issues for elderly people in China.

Since the 1980s, many parents have been affected by China’s one-child policy.

Although the one-child limit was enforced among urban residents, mothers with only a

daughter-child in many rural provinces were allowed to have a single additional birth (the

“1.5-child policy”) and families in remote areas were allowed to have a second or third

child. Under the one-child policy, parents in China who exceed their fertility limit are

forced to pay a fi ne and are subject to a variety of other monetary punishments, including

the seizure of property and forced dismissal from government employment (Gu et al.,

2007).

The one-child policy has become one of the most important factors in the fertility

decline in China (National Population Development Strategy Research Group, 2007;

Wang and Mason, 2008). The average household size in China has been shrinking,

which has further changed the dependency ratio. National Bureau of Statistics data

from 2019 show that situation has been worsened by the strong population aging

trend: nearly 4 out of every 10 people in China, on average, have entered middle age.

Vulnerable parents generally choose one of two forms of pension – the social pension or

the family pension. Of these, family pensions are the most prevalent because of the poor

development of the pension system in rural China. Another major challenge resulting

from the one-child policy, together with Chinese parents’ preference for a son, is gender

imbalance. The gender ratio at birth in China has deviated from the normal range and

reached 102 to 107, which means for every 100 girls, 102 to 107 boys are born. Several

explanations have been proposed, including adoption (Johansson and Nygren, 1991),

differential mortality rates (Coale and Banister, 1994), gender-selective abortion (Chen,

2001; Gupta, 2005), and the increased prevalence of male births. This “discriminatory

gender preference” reduces the “chosen fertility space” and greatly affects people’s

fertility-related choices.

Combined with the one-child policy, Confucian culture also has a deep influence,

as indicated by old sayings such as “raising sons to prepare for older age.” Under this

infl uence, parents rely on their children to support them and prefer boys to girls, which

accounts for the gender difference in the responsibility for family pensions (Wei and

Zhang, 2011a; Chen, 2017). This is also partly because boys have more utility to parents

than girls in traditional agricultural societies. In a society with a long tradition of both an