Aging and disability in China: cultural issues in measurement and interpretation

Aging is no longer an issue of concern only to industrialized countries. Recent estimates project that by the year 2000 there will be 590 million people aged 60 or older worldwide. Of these 590 million approximately 61% will be living in lesser developed countries. Thus, these countries will shortly face critical decisions concerning the impact of these aging populations on state plans for economic development. China, the country with the largest anticipated number of elderly in the world, provides an instructive case of how one developing country is attempting to balance the needs of the elderly with those of the nation as a whole. In particular the rapid aging of the Chinese population has prompted official concern about the financial implications of providing health care to increasing numbers of disabled or frail elderly. This paper reports the efforts of one study to determine the extent of disability and frailty among the urban elderly and the strategies they and their family members have developed to cope with it. The research was conducted between June 1987 and January 1988 in two neighborhoods of Canton, the capital of Guangdong Province. Two hundred households, each containing at least one member 70 years of age or older, were randomly selected from household registration lists. In each household a 1-2 hr interview was conducted with the elder (or, in the case of those too disabled to participate, a proxy) on the following topics: personal background, proximity and contact with kin, household composition and organization, health and functionality, use of medical services, work history, income sources, daily activities, and attitudes regarding intergenerational relations. The paper is divided into five parts addressing the following topics: (1) China and research on aging, (2) comparative data--problematic aspects, (3) methodological issues to consider when investigating disability, (4) the findings of the study, and (5) the significance of ideological, environmental, and political factors in mediating the experience of age-associated disability in China.