Exploring Disability Among Chinese Elderly Population: Prevalence, Use of Social Service and Gender Difference

By MAN GUO

Introduction to the Topic
China has the largest disabled population in the world (Sonnanderk & Claesson, 1997). The elderly account for a significant proportion of China’s disabled population, particularly among the severely disable persons due to the high morbidity rate caused by senile diseases (Ikels, 1991; Liu & MacKellar, 2001). In the latest national survey on disabled persons, it is estimated that more than half of the disabled people in China, or a total of 45 million are older adults aged 60 and over. Older adults also account for over 75% of the newly increased disabled population from 1987 to 2007 (National Bureau of Statistics of the People's Republic of China, 2006).

Understanding late-life disability is crucial for public policy debates on pension, retirement, and future healthcare spending (Freedman, Martin, & Schoeni, 2002; Waidmann & Liu, 2000). Disabilities causing dependency and institutionalization strongly determines the medical needs of older people and have major burdens on healthcare and social support system (Ng, Niti, & Kua, 2006). Inadequate services for late-life disability also leads to productivity losses of family caregivers for disabled elders (Gibson, 2006). As the number of older persons burgeons, the issues of late-life disability will become even more pronounced in the next several years and may have major effect on China’s healthcare system and public health policy.
Whereas many population studies on late-life disability have been conducted in Western countries, few studies of Asians have been reported. The search for disability among Chinese older adults has been extremely limited in scope (Ikels, 1991; Liu & MacKellar, 2001). Herein, this study aims to explore the issue of disability among Chinese elderly population using China’s Second National Sample Survey on Disability (hereafter refers to as the Survey). Three specific questions will be addressed in the study: 1) What are the most recent prevalence rates of various late-life disabilities among Chinese older adults? 2) What are the major healthcare needs of Chinese disabled elders? 3) What are the available formal and informal social supports for Chinese disabled elders?

The Summer Fieldwork
This summer research fieldwork is a part of the larger cross-university cooperation that has developed between the Institutes of Population Research at Peking University (PKUIPR), the School of Social Work and Institute for Health Promotion & Disease Prevention Research at USC to explore the data from the Survey. The Survey, jointly conducted by 16 Ministries and agencies in China including National Bureau of Statistics, the Ministry of Civil Affairs, the Ministry of Health and China Disabled Person Federation, provides the most recent and comprehensive information on Chinese disabled population. Totally 2,526,145 persons in 771,797 households were investigated in 2006. The Survey is notable, too, for its design and expanded content, reflecting China government’s increasing interest and demand for social data to inform policy.
With the support from both USCI and PKUIPR, I spent seven weeks at Peking University to conduct secondary data analysis on disability trend, health care need and social support among Chinese disabled elders. The first two weeks of the fieldwork involved data mining, question refinement and a comprehensive review of relevant international and Chinese studies on late-life disabilities. A presentation on disability models, disability trends among older adults and refined research plans was given to the PKUIPR faculty and studies at the end of the second week. Comments were collected; the research questions and analysis plan were finalized.

The following five weeks of the fieldwork focused on the secondary data analysis. I attended weekly meetings of the PKUIPR study group on the Survey dataset. Preliminary data analysis results from different topics of the Survey were shared and discussed in the meeting. The meetings facilitated my own data analysis and broadened my horizon in the field of disability and population study. Regular teleconferences were also held with my mentor at USC to further guide my research and exchange ideas on the analysis. Data analysis was completed and final results were presented by the seventh week.
The work from the summer fieldwork has led to two publications in progress. One is an overview of the current situation of late-life disability in China. The paper describes the most recent prevalence rate of various disabilities among Chinese older adults, their major health care need and available formal and informal support. Issues related to healthcare policy are also discussed in the paper. Another paper, using multi-level analysis, examines individual- and community- level risk factors for physical and mental disability among Chinese older adults. It is our hope that these two potential publications will serve as a basis for continuing effort amongst the researchers and policy makers to understand the disability issues among Chinese older adults and to inform the possible prevention and rehabilitation programs.

Places visited, individuals consulted
The summer fieldwork has provided me a valuable opportunity to work with and learn from the leading Chinese scholars in population and aging field at PKUIPR and PKU Department of Social Work. I also attended the Third China Population Research Frontier Forum, jointly held by PKUIPR, China Population Research Association, China Disabled Person Federation and United Nation Population Funds from 6 to 8 July, 2007 at Beijing. In the Forum I met scholars and students from some of the most prestigious universities in China and those who shared similar research interest as me. This has greatly enhanced my professional network in China and developed opportunities for future cooperation. I also met delegates from China National Committee on Aging, China Disabled Person Federation and All China Women’s Federation. Conversations with them enriched my knowledge on the current situation of Chinese older adults from a national policy perspective and shed light on my future research on Chinese elders

Future study
As the PKUIPR and China Disabled Person Federation has agreed to carry out long-term monitoring and longitudinal studies on Chinese disabled persons as a follow-up of the Survey, this summer project will become the footstone for future cooperation between the two universities and relevant institutions. The knowledge and skills gained in the summer fieldwork also provide me with an intellectual and training infrastructure within which I better developed my qualifying exam paper and dissertation on aging issues in China.