October 13, 2015, by Editor
The Health of the ‘Left-behind Parents’
Written by Zhong ZHAO.
Statistics in 2012 showed that 194 million Chinese were 60 years old and over, accounting for 14.3% of the total Chinese population. Of these senior citizens, 117 million were based in rural China, making up 17% of the total rural population. Meanwhile, China had a total of 168 million rural-to-urban migrant workers in 2014, which has resulted in millions of ‘left-behind parents’ in rural areas. According to a news report by Xinhua News Agency, there were about 40 million such parents in 2011.
While children who migrate to the city to work can remit money back home, migration can also result in negative effects on the health of the left-behind parents. Migrants spend less time at home and thus have less time to take care of their parents. Such estrangement can also have a negative impact on the mental health of the parents.
Xiang Ao, Dawei Jiang and I recently conducted a study of the impact of rural-urban migration on the health of left-behind parents in China (forthcoming in China Economic Review). Our results suggest that the negative effects outweigh the positive. Having adult children who migrate to an urban area significantly increases the probability of left-behind parents suffering poor health, as measured by self-reported health status. The left behind parents of an only child are the most vulnerable group, with the child’s migration having a substantial and significantly negative health impact.
Our research focuses on a specific issue, but has important implications for a host of key policies and social phenomena in China. First, population ageing is becoming an important social issue, with tremendous challenges for old-age support systems. This challenge is especially apparent in rural areas because of the enormous rural-urban disparity, the lack of a formal support system and because of the central role of family in old-age support in rural areas. The massive scale of rural-to-urban migration has eroded the foundations of traditional family support and has therefore inevitably increased the ageing problem in rural China. The migration phenomenon has resulted in an important and urgent need to establish a formal old-age support system in rural China, to complement traditional family care.
Second, our results highlight the fact that parents with a single child are the most vulnerable group. Because of the family planning policy, the proportion of parents with one child has increased very rapidly. Indeed, from 1978 to 2013, the national household size decreased from 4.66 to 3.03, and household size in villages has decreased from 3.61 in 2004 to 3.19 in 2013. Given the many other negative implications of the one-child policy, it is imperative that the pros and cons of this 30 year old policy are urgently re-evaluated and re-considered.
Third, the Chinese government – aiming to provide basic social security and benefits for rural residents – launched a nationwide health insurance programme (the New Cooperative Medical Scheme) and a rural pension programme (the New Rural Pension Scheme) in 2003 and 2009 respectively. Though both programmes were rolled out very quickly, and now cover all of rural China, the benefits are very low. For example, the national guideline stipulates that the basic pension benefit is 55 Chinese Yuan (about 9 USD) per month, which equates to 14% of the 2008 average per capita net income in rural China. Given the almost universal coverage of the health insurance system and pension system, it is time to increase the benefit levels and to reduce the rural-urban gap in social security benefits among many other aspects.
Fourth, the fundamental institutional factor behind the rural-urban disparity and rural-urban migration is the hukou (household registration system). In the context of our study, this system hinders the assimilation of rural-urban migrants, denies the rural-urban migrants equal access to basic social benefits, and generates millions of left-behind parents and children. The hukou system is the leading cause of left-behind parents, according to the findings of our research. More broadly, this system unfairly divides Chinese people into two classes, restricts free mobility and curtails the scale economy and agglomeration effect. In doing so it curtails China’s potential.
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