GLOBAL HEALTH AGING

China’s workforce is aging. Of special relevance here, and a pressing issue for the country, is the aging of its healthcare workforce. These include China’s barefoot doctors who are rapidly aging. Barefoot doctors are farmers who receive basic and minimal medical training and work as health care providers in the rural areas of China.

Xu et al. highlights three main implications of aging barefoot doctors. The first implication is a high risk of healthcare workforce shortage in the immediate future, leaving many rural residents without basic healthcare. This will create a huge burden on China’s healthcare system, hindering any plans for health reform. The second implication is that aging barefoot doctors currently have lower education levels, are less susceptible to change and technology and lack the formal training of younger counterparts, which might deter rural residents to seek care from them. The third implication is that the very same characteristics of aging barefoot doctors can lead to poor treatment and provision of facilities, especially for non-communicable diseases. While data on urban health care providers and other types of health personnel such as nurses is scarce, the general trend toward a graying population in China tends to suggest that these types of workforce are also aging.

China has one of the highest proportion of aging population at over 9%. At the current rate, this proportion is expected to increase to 25% by 2050. The aging population is a result of population control strategies in the 1970s and 80s as the government promoted the “later, longer, fewer” lifestyle. Moreover, the government instated the controversial one-child policy which restricted families to having only one child. There are several consequences and impacts of an aging population that require a focus on chronic, non-communicable diseases. Close to two-thirds (60%) of the disease burden in China is non-communicable diseases such as cardiovascular diseases and diabetes, among those of 45 years and older.

The healthcare industry is not alone in facing an aging workforce. The increasing age of the workforce decreases productivity, while raising the average wage level. On a global level, this will make a dent in China’s manufacturing might and other labor-intensive industries, threatening the country’s economic growth rate. At the current rate, India and Indonesia are poised to overtake China in terms of economic growth by 2020. The trends are also seen in the Chinese migrant workforce, a population of about 245 million migrant workers at the end of 2013. The average age increased from 33.1 years in 2011 to 33.7 years in 2013.

However, the situation is not all bleak. An aging population provides great potential for a booming healthcare industry that needs to account for chronic diseases as well as elderly living options due to rapid urbanization and changing family dynamics. There is documented need and much scope for growth in China’s healthcare industry, particularly catering toward the elderly. However, the needs for the younger generations who may be facing lack of adequate healthcare should not be ignored.

Namratha Rao is currently pursuing her MSPH in International Health in Social and Behavioral Interventions at the Johns Hopkins University Bloomberg School of Public Health.