Gender, Health, and Aging

in China

Prepared by:
MARY HAZEL P. CUAYZON
 China’s Population
• Overall population
– Mid 2008 1,324,708,000
– Mid 2025 (projected) 1,476,000,000
– Mid 2050 (projected) 1,437,000,000

• Decline in fertility and mortality

– Birth Rate 12/1000 (16,029,000 per year)
– TFR 1.6
– Death Rate 7/1000 (9,180,000 per year)
– Natural Increase 0.5% (6,849,000 per year)

(Population Reference Bureau 2008)

 An Aging Population
• More than 10% of population is now age 60 or older
– Age <15 256,993,000 (19%)
– Age 15-64 967,036,840 (73%)
– Age 65+ 107,301,000 (8%)

• Life Expectancy at Birth

– Both Sexes 73 years
– Males 71 years
– Females 75 years

(Population Reference Bureau 2008)

 Rural/Urban Divide
• Rural dwellers ages 50+ 30% higher death rate than urban

– Lower wages
– Fewer amenities, e.g., communication and transportation
– Fewer short term health care facilities
– Fewer long term care options – e.g., community care,
assisted living, nursing home
– Despite recent expansion of coverage, at least half of rural
health care expenses still out of pocket
– Little disposable income to pay for non-kin based care
– Mass migration of rural youth to urban areas
– Fewer kin available to provide care

(www.prb.org/Articles/2008/olderchinese.aspx)
Fieldsites

Urban and rural

communities in
Beijing Municipality,
China
 Chinese Women’s Views
Positive perspective end of menstruation
-end of mess, bother, expense
-not have to worry about birth control

NOT focused on:

-hormonal decline
-loss of physical attractiveness,
reproductive ability, empty nest, etc.
 Chinese Women’s Experiences

In accounting for midlife symptoms and suffering,

they tend to focus on:
-experience of social history
-suffering and loss of opportunity due to
“feudalism,” Japanese occupation, civil war, anti-
Rightist campaign, GLF, Cultural Revolution
-mother-in-law/daughter-in-law issues
-not prepared for change to market economy
 Chinese Media Advocating
Romance, Sex, and (Re)marriage
In Later Life

• Doctors, psychologists, cadres, and educators

• Clinical/popular education
• Books, booklets, magazines, newspapers
• Some television shows, videos, posters
 Campaign against

traditional views

“feudal superstition”

Confucian conservatism

Daoist alchemy
 Campaign for

modern perspectives

communist ethics

scientific knowledge

cosmopolitan views
 Media Representations

• Tradition and the Chinese past

• Chinese people in later life

• Middle-aged and old women

– Prime victims
– Prime perpetrators
Enlightenment View of Knowledge

• Educate the public on what is normal, natural,

healthy, and socially respectable,

• And thus modernize behavior of older Chinese

and promote their well-being.

Superstition  Unhealthy Constraint

Enlightenment  Liberation of Behavior
Women’s Views and Behaviors
 Not so “feudal”

• 75% of 399 women age 40-65 sexually active

• Sexual attitudes not as conservative as media depicts

• Urban women - expressed more liberal views on sex

• Rural women - higher incidence of sexual activity

• Sexual attitudes and behavior often not consistent

 Sexual Attitudes

• Only 20.6% agreed that women should abstain

from sex after menopause.
– Rural 22.5%, Urban 18.6%
– Low ed. 30%, Mod ed. 22.1%, High ed. 14.1%
• Although 80%/86% felt that husbands’/wive’s
interest in sex declined some by middle age
 Attitudes/Behavior

• Best to stop sex after menopause

– Disagree: 76.6% sexually active
– Agree: 56.1% sexually active
• Agree and postmenopausal: 32% sexually active
• Midlife decline in sexual interest in women
and/or in men
– Over 75% of sexually active women agreed
 Ideology/Practice

• General ideals distinguished from own situation

• Practicality emphasized more than ideology

– His/her health
– Basic subsistence
– Spatial convenience
– Quality of relationship – equality, respect, trust
• Second honeymoon vs. Release from duty
 Women vs. Campaign

• Few women wish to remarry

• But mostly unrelated to conservative views
• Instead: Different view of liberation/burden
– Many see husbands as wet leaves
– Flatbread story about helpless husbands
– Some had difficult marriage, disrespectful husbands
– Differential costs and benefits of remarriage
• Household division of labor for these cohorts
• Gendered age differentials, mate choice, and caretaking
 Caregiving Burden for Older Women

• Survey data from my 1994 Beijing survey, Chinese women,

ages 40-65 (N=399)

• Although only half were formally employed, most did a great

deal of informal domestic labor

• Interview and participant observation with Beijing women from

1992-2008 showed large amount of domestic labor among
many women into their late seventies

• Informal domestic labor of older women often not accounted for

in standard demographic representations of population ageing
 Housework
• Average about 28 hours of housework per week.

• The older women spent more time doing housework than the
younger ones (women in their forties 23.5 hours per week,
women in their fifties and sixties 33 hours per week).

• While two thirds said their housework load had decreased over
time, over a third said it had increased or stayed the same.
Decreases mainly due to increases in appliances, ready-made
items, and other conveniences and money to spend on them.

• A fifth of the women said they got no help whatsoever with the
housework from other members of the household, and four out
of five women said that they did most of the housework. In that
half were still employed, this translates into a large volume of
labor on their shoulders.
 Elder Care
• About three in ten of the women spent some time taking care of
elderly family members, most of whom were parents-in-law or
parents, but some of whom were elderly husbands.

• Overall, women in their forties spent more time doing eldercare

than women in their fifties or sixties.

• Of the 111 women who did some elder care, they averaged 11
hours per week.

• The 247 women with living parents-in-law or parents did an

average of 5 hours per week of elder care.

• Time spent taking care of elders increased or stayed the same

for two out of every ten woman surveyed, with this figure
nearing a third for the women in their forties.