GLOBAL HEALTH AGING

One Child: The Story of China’s Most Radical Experiment by Mei Fong presents a compelling analysis of the impact of China’s “One-Child Policy” on older adults. The one-child policy, a compelling story of population control for economic growth, has long term implications that are only now apparent. Fong describes the challenges of a rapidly aging population as she focuses on families who are struggling to care for older adults, and those who have no children to care for them in old age.

One of the book’s most gripping stories is of parents during the 2008 Sichun earthquake. According to official reports, “eight thousand families lost their only children in the disaster.” (p.3) These parents, and other parents who have lost their only children, face barriers in accessing nursing homes, health care, and burial plots. Fong notes, “they are also more financially vulnerable than ordinary retirees, and more prone to depression, studies show.” (p. 41) While these challenges are tangible, the emotional challenges of losing support systems in old age is also a prominent problem. Fong addresses the growth of China’s hospice industry, stating that many older adults without family feel unable to contribute to society. (p.151)

The book also digs into the cultural complexities in aging and filial obligation. In one notable story, that received national acclaim in china, Liu Ting brought his mother with him to college, when she was too ill to care for herself. His mother suffered from kidney disease and uremia. Although Ting received fame and attention, his job opportunities after college were limited at the expense and time required to properly care for his mother. (p. 92)

While Fong discusses other implications of China’s one-child policy such as rise in adoptions, increase in bride prices to compensate for the greater number of men than women, and the further consequences of sex-selective abortions, the primary implications of the policy relate to the care and treatment of older adults. With only one child per two aging parents, the traditional way of caring for Chinese parents will cause economic slow down, and place burdens on the younger generation.

Fong is at the forefront of a wave of journalism that will detail the challenges of aging in China. She acknowledged that it could be difficult to find many children who were burdened by caring for aging parents, as more parents of children from this time period are in their 50’s and 60’s (p. 86) However, her book is at the forefront of a problem that will only become more prominent in the coming decades.

Grace Mandel is pursuing a Master of Public Health in Health Systems and Policy at the Johns Hopkins University Bloomberg School of Public Health.