Aging & Longevity

Old-age Care Responsibilities in China's National Five-year Plans (2001-2025): Towards Active Ageing and Explicit Familialism.

TL;DR

Content analysis of China's Five-Year Plans from 2001-2025 indicates that OAC policy is shifting from implicit familialism towards explicit familialism, while simultaneously showing incipient de-familialism and increasing individual responsibility consistent with active ageing.

Key Findings

China's old-age care policy is shifting from implicit familialism towards explicit familialism across the five Five-Year Plans studied.

  • The study analyzed five Five-Year Plans for National Economic and Social Development (FYPs) spanning 2001 to 2025.
  • Under implicit familialism, family care obligations are assumed without direct policy support; under explicit familialism, families remain primary caregivers but receive indirect support such as tax relief.
  • The family has remained the primary provider of old-age care throughout the period studied.
  • Content analysis methodology was used to identify changes in care responsibilities across the FYPs.

The FYPs indicate a growing role for the government in old-age care through expanding care provisions, integrating technology, improving economic security, and promoting home- and community-based care.

  • Government expansion was identified across multiple dimensions: expanding care provisions, integrating technology into OAC, improving older adults' economic security, and promoting home- and community-based care.
  • These developments are framed as complements to family care rather than replacements.
  • The authors characterize these developments as indicating 'incipient de-familialism,' suggesting early-stage movement away from family-exclusive care responsibility.
  • Home- and community-based care was identified as a specific policy direction promoted across the FYPs.

Individuals are increasingly expected to assume greater personal responsibility for their own old-age care, consistent with active ageing policy directions.

  • The FYPs increasingly expect individuals to work longer, engage in personal pension arrangements, and consume OAC products and services.
  • These expectations reflect policy directions described as 'consistent with active ageing.'
  • The shift places greater financial and caregiving responsibility on individuals themselves, alongside family and government roles.
  • This individualization of responsibility represents a distinct third dimension of care responsibility alongside family and government.

Traditional family care for older adults in China has been declining due to decreasing family size and urbanisation.

  • Rapid population ageing is identified as a key challenge to China's old-age care system.
  • Decreasing family size is cited as a structural factor undermining the traditional family care role.
  • Urbanisation is identified as a second major factor contributing to the decline of traditional family-based old-age care.
  • These demographic and social changes provide the context for the policy shifts analyzed in the FYPs.

The Five-Year Plans for National Economic and Social Development serve as the general framework for the direction of old-age care policy in China.

  • The study examined FYPs covering the period 2001 to 2025, encompassing five successive plans.
  • Content analysis was the primary methodology used to examine changes across the plans.
  • The FYPs were analyzed specifically for changes in OAC responsibilities distributed among families, the government, and individuals.
  • The FYPs are described as providing 'a general framework for the direction of OAC policy' in China.

What This Means

This research examines how China's approach to caring for its elderly population has evolved over more than two decades by analyzing the country's national planning documents, known as Five-Year Plans, from 2001 to 2025. Using content analysis, the researchers tracked how responsibilities for elder care have been distributed among families, the government, and individuals across five successive plans. China, like many countries, faces the challenge of a rapidly aging population, made more difficult by smaller family sizes and urbanization, which have weakened the traditional expectation that families will handle all elder care. The study found that China is moving from a system where family care was simply assumed without much policy support, toward one where families are still expected to be the main caregivers but receive some government backing, such as tax relief. At the same time, the government is playing a larger role by expanding care services, bringing technology into elder care, strengthening financial security for older people, and promoting care delivered at home and in communities rather than only in institutions. These changes suggest the very early stages of reducing the burden placed solely on families. Additionally, individuals are increasingly expected to take personal responsibility for their own old age — by working longer, saving through personal pension plans, and purchasing care services — a trend the authors connect to the global concept of 'active ageing.' This research matters because it documents how one of the world's most populous countries is renegotiating who is responsible for caring for a growing elderly population. The findings suggest that China's policy direction involves a complex balancing act: maintaining family care as the cornerstone while gradually expanding government support and shifting more responsibility onto individuals themselves. This pattern may have relevance for other countries facing similar demographic pressures, and it raises important questions about the adequacy of support for families and older adults as these policy shifts continue.

Have a question about this study?

Citation

Yu D, Timonen V, Zechner M. (2026). Old-age Care Responsibilities in China's National Five-year Plans (2001-2025): Towards Active Ageing and Explicit Familialism.. Journal of cross-cultural gerontology. https://doi.org/10.1007/s10823-026-09594-9