The Rapid Graying of China

The hit play this season is about a community of retirees who struggle to adjust to the loneliness and alienation of old age in a high-rise apartment. “Candied Haw Apple”--featuring a cast in their 60s and 70s--has hit a nerve in a society that long has taken pride in its veneration of age and care of the elderly.

In one scene, a bewildered father confronts cellular-telephone-afflicted offspring who worry more about business deals than about him. In another, a lonely widower places a personal ad seeking a mate. “Are you still walking alone on the road of life?” he asks.

By the turn of the century, China will have 130 million people older than 60, an elderly population exceeding by far that of any other nation. By 2020, one-fourth of the world’s aged will live in this country.

The prolonging of life spans is one of the main successes of the Communist era. Advances in health care have boosted life expectancy from 52 years in 1950 to almost 70.

But the rapid graying of China also contributes to its immense problem of overpopulation and negates many gains made through a rigorous, controversial birth-control program. The overall population growth rate stands at 1.19%. But in 1995, the growth rate of the 60-and-older population was nearly three times higher at 3.37%.

“Since 1949,” said Zhang Wenfan, director of the National Committee on Aging, “China has evolved from a high-birthrate and high-mortality country to a low-birthrate, low-mortality country.” Moreover, said Zhang, because the majority of the country’s aging population is in its 60s, “China’s old people are younger than those in the rest of the world.”

Much international attention has been given to the graying population of Japan, which remains one of the most rapidly aging societies in the world. But there is a huge difference in scale between the countries. By 2020, when Japan is expected to have 33 million people older than 65, China will have 179 million--more than Japan’s entire population. And Japan, with a per capita income 20 times greater than China’s, is in a much better position to care for its seniors.

Until now, the phenomenon of lowered birthrates and prolonged life spans generally was limited to developed countries with per capita annual incomes of more than $10,000. But when China reaches the status of a “graying country”--when more than 10% of the population is older than 65, as is expected in 2000--its per capita income is expected to be about $1,000.

“Our aging,” said Zhang, who is in charge of coordinating China’s programs for the elderly, “is taking place while our economy is relatively backward. Most countries get rich before they get old. In China, we are not rich yet, but we are already getting old. So the economic foundation we have for taking care of our old people is still fairly weak.”

The principal responsibility for caring for the elderly, of course, has rested with Chinese families. But demographic changes are affecting even this source of support. The nation’s ability to deal with this new wave of the old is further complicated by the breakdown in its social welfare systems--based on work units--that once provided cradle-to-grave protection. Older state industries now sometimes have more retirees than active workers on their payrolls, severely limiting their ability to compete.

Consider No. 3 Iron & Steel Factory in Shanghai, founded in 1913 and one of the first of its kind established in China’s largest city. It has 15,000 active workers and 9,000 retirees living on its grounds. More than a quarter of the factory’s fund for salaries is paid to retirees; they also receive half the factory’s $5 million in annual medical benefits.

In contrast, Shanghai’s most successful steel plant--Bao Shan Iron & Steel, founded in 1979--has relatively modest retiree costs. It has 31,600 active workers and 2,937 retirees. Last year, it paid $400,000 in retiree health benefits.

The difference highlights what Zeng Yi, a distinguished Chinese demographer and director of the Institute of Population Research at Beijing University, describes as “the urgent need to establish a universal old-age insurance system and other social and family support services for the elderly in both rural and urban areas.”

The task of establishing China’s first universal social security system, he said, is a challenge equal in difficulty to building “a new Great Wall.”

Legacy of Mao

Even with its policies restricting the number of children families may have, China’s population experts say the main contributor to its unwieldy population continues to be births. Every year, the population increases by 12 million or so. There are about 300 million women of childbearing age, and, according to current projections, that number will not decrease for a decade.

To a great extent, this aspect of the population problem is a legacy of the policies of Mao Tse-tung. The late leader ignored the advice of many senior Communists--including his eventual successor, Deng Xiaoping--and encouraged the Chinese to have as many children as they wanted, telling them it was their patriotic duty.

“Every stomach has two hands to feed it,” Mao said, employing a famous aphorism.

By the 1970s, however, most senior officials had concluded that Mao’s population policy--much like his botched economic formula known as “the Great Leap Forward”--was a colossal error with devastating results.

“Today we are tasting the bitter fruit of this wrong decision,” said Chen Xianhuai, professor with the Population Institute of Fudan University in Shanghai.

By Chen’s estimate, if Mao had followed the advice he got in the 1950s and called on Chinese couples to have only two children, China would have 120 million fewer mouths to feed and the demographics would not be nearly so bleak.

In 1980, when the government finally got around to dealing with the population explosion, it was forced to implement its widely despised “one-child policy.” Even with its late start, that rule already has sharply lowered the birthrate. But it also has produced a growing imbalance between old and young that threatens to disrupt ancient cultural patterns.

In Shanghai, for example, the birthrate is one of the lowest in China--1.2 children for every woman. The city also has one of the highest life expectancy rates--74 years for men and 78 for women.

The low birthrate and high life expectancy have made Shanghai this nation’s first “gray” city, with more than 2.25 million seniors, who make up more than 15% of its population. As a result, Shanghai officials recently have considered breaking with national policy and allowing two children per couple to correct the growing imbalance.

Some largely unforeseen consequences of the one-child policy include a growing trend in which the focus of attention in the family has shifted from its oldest members to its youngest, creating a class of spoiled “little emperors.”

And there now are fewer young to care for aging parents and grandparents. Population experts speak of a “4-2-1 formula,” in which one child is responsible for two parents and four grandparents.

“The proportion of those caring for, and those being cared for, is changing very dramatically,” said Zhang, 54, of the national aging committee. He and his wife live in a four-bedroom apartment in Beijing with his 88-year-old mother and 87-year-old father, Zhang’s two children, ages 26 and 25, and their spouses.

Solitary Years

But in a culture where “three generations in one household” has long been held up as an ideal, increasingly China’s elderly live alone. In a recent study, Zeng, of Beijing University, found that about 30% of China’s 65-and-older population live alone or with a spouse, compared with about 68% who live with children or relatives. Fewer than 1% have gone into the handful of social welfare institutions.

Zeng predicts that those percentages steadily will shift until, by the middle of the next century, more than 60% of the elderly will live alone or with a spouse.

This change promises to have an enormous impact on the country’s historic treatment of its old people, as is seen in “Candied Haw Apple,” the wildly popular Beijing Children’s Theater production. Besides the fact that 12 of 15 of its main actors are 60 or older--veterans of the revolutionary and pre-revolutionary theater--the play is the first to highlight the problems faced by the first generation of elderly living mostly on their own.

“I wanted to give a chance to some of these actors to make a final curtain call,” said director Chen Yong, 67, who has been in the theater for 50 years. “It has been an emotional experience. Many people came to see actors they hadn’t seen perform in years. Some members of the audience were in their 90s. But I also wanted to make a point about this social phenomenon facing old people.”

The play--whose title refers to a sweet for children and evokes bittersweet memories for older Chinese--opened in June and has since sparked television discussion shows and university seminars about the plight of the elderly. At the end of this month, it will begin a national tour that will last until September and include most of China’s major cities.

Perhaps the drama’s most poignant moment occurs when an aging Communist cadre, played by 72-year-old Zheng Rong, struggles in his loneliness to recall whether he participated in the liberation of Taiyuan, capital of Shanxi province, during the 1944-49 civil war between Communist and Nationalist armies.

Finally, he resorts to telephoning an old comrade.

“Was it me who planted the red flag at Taiyuan?” he asks pathetically. Hearing the response, he says triumphantly: “I knew it! It was me who planted the red flag at Taiyuan!”

Alarmed by the gray wave, China’s government recently upgraded the status of the National Committee on Aging, increasing its budget and responsibilities. Under director Zhang, the agency has submitted a draft to the National People’s Congress of a “Law for the Protection of the Rights and Interests of Old People.” A regionally based pension pool to replace the work-unit system is also under development.

Meanwhile, China’s overburdened hospitals and limited nursing homes already are inadequate to house the growing number of elderly who lack relatives capable of caring for them until death.

In Beijing and other cities, private hospices have been created to care for the terminally ill.

At the Song Tang Hospice in Beijing, director Li Wei, 47, is a secular Mother Teresa who sometimes resorts to gentle lies to comfort his charges in their last days.

As a Times reporter toured the 80-bed facility on a freeway island near the Temple of Heaven, Li cheerfully, albeit falsely, announced to a dying woman: “Look, your overseas relatives have sent an American to visit you.”

Li Maojun, 83, a plump, round-faced Beijing woman who lived in a small apartment with two daughters and two grandchildren, recently came to the hospice after she slipped and injured her leg while preparing a meal for the family. She blamed her fall on the instability caused by her tiny feet, deformed in her childhood by parents who had them bound to make her a more attractive marriage prospect. (Foot-binding was outlawed by the Communists after their victory in 1949.)

Rolling down a thin cotton sock, she revealed a foot in which the arch had been broken and the toes, pressed by a heavy rock, forced under the sole.

Immobile, no longer able to do the family cooking, Li asked to be taken to the hospice. Wearing a T-shirt with a “China Electronic News” logo, she said she had been happy in her new home under the kind attentions of Dr. Li but that lately she had been troubled by a recurring bad dream.

“In the dream,” she said, managing a smile, “people have been asking me to come with them to the crematory. So far, I’ve been able to avoid them. But one of these days, they will take me with them.”

Dying Alone

Hundreds of thousands of Chinese face with varying degrees of equanimity the prospect of dying alone, outside the protection of family.

Yuan Rongsun, 94, was the first son of the first son of one of the most powerful men in Chinese history. His grandfather Yuan Shikai was a famous military commander who served from 1912 to 1916 as the provisional president of China.

“My fondest memories,” recalled Yuan Rongsun, “are living with my grandfather and my family in Zhongnanhai on the grounds of the Imperial Palace.”

But with all of his children, grandchildren and great-grandchildren in the United States, Canada and Australia, white-whiskered Yuan is prepared to die alone in the Evergreen Township Nursing Home in the western suburbs of Beijing.

“The United States and China have two different ways of taking care of the elderly,” Yuan said philosophically in flawless English as he bent forward in a wheelchair. “In the States, old couples don’t live with their families. In China, we are only starting to divide up the older people from the couples. Gradually the old ways will disappear.”

Yuan said one of his sons begged him to come live out his years in America.

“But I told him I would rather die here. I was born a Chinaman in China. I will die a Chinaman in China.”