Prediction of the Number of and Care Costs for Disabled Elderly from 2020 to 2050: A Comparison between Urban and Rural Areas in China

An aging population and an increase in the proportion of elderly people who are disabled have created an unprecedented global challenge, especially in China. This study aimed to predict the number of, and the care costs for, disabled elderly from 2020 to 2050 in China. A comparison was made between urban and rural areas, and we analyzed what must be done to maintain the sustainable development of China’s long-term care insurance (LTCI) system. An overall simulation model and a Monte Carlo simulation were used to estimate the number of disabled elderly and their related care costs, in both urban and rural areas. According to the forecast, the total disabled population will increase rapidly, rising from 43.75 million in 2020 to 91.4 million in 2050. Of that total, 69.7% are expected to be urban elderly. Starting in 2020, the growth rates of the elderly with mild, moderate, and severe disabilities will be 108%, 104%, and 120%, respectively, by 2050. Accordingly, the total care costs will increase from 538.0 billion yuan in 2020 to 8530.8 billion yuan in 2050, of which 80.2% will be required in urban areas. In addition, the per capita costs of care in urban and rural areas in 2050 will be 6 times and 11 times higher than in 2020, respectively. The predicted results show that the number of disabled elderly and the related care costs will increase sharply from 2020 to 2050, especially the growth rate of the number of severely disabled elderly. This study provides strong evidence of the need for the establishment of a unified national LTCI system in China.

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PREDICTION OF THE NUMBER OF AND CARE COSTS FOR DISABLED OLDER ADULTS FROM 2020 TO 2050 IN URBAN AND RURAL AREAS IN CHINA

Innovation in Aging ◽

10.1093/geroni/igz038.3117 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S847-S847

Author(s):

liangwen zhang ◽

Ya Fang

Keyword(s):

Older Adults ◽

Rural Areas ◽

Urban Areas ◽

Census Data ◽

The Elderly ◽

Severe Disabilities ◽

Term Care ◽

Total Care ◽

Urban And Rural Areas ◽

Care Costs

Abstract Disability for the elderly has become a crucial policy concerns in rapidly aging Asia counties, especially in China. This study aimed to predict the trend of the number of and care costs for disabled older adults from 2020 to 2050 in urban and rural areas in China. Population Administration Decision Information System was used to predict the population of China by urban and rural areas and age group from 2020 to 2050. Monte Carlo simulation and Policy Simulation Model were used to estimate the number and care costs of disabled elderly between urban and rural areas, based on the Chinese latest census data, statistical yearbook, and national survey database. The total disabled population rises rapidly from 43.75 million in 2020 to 91.4 million in 2050, of which 69.7% were urban adults. Compared with the values in 2020, the growth rates of the adults with mild, moderate and severe disabilities were 108%, 104% and 120% in 2050, respectively. The value were 167% and 39% in urban and rural areas, respectively. By 2050, the total care costs increase from 538.0 billion yuan in 2020 to 8530.8 billion yuan, of which 80.2% occurs in urban areas. The predicted results indicate that the numbers and care costs for disabled older adults increase sharply from 2020 to 2050, especially in urban areas of China. It provided a series of evidence for the establishment of the long-term care insurance system in China.

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Green and Blue Space Availability and Self-Rated Health among Seniors in China: Evidence from a National Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020545 ◽

2021 ◽

Vol 18 (2) ◽

pp. 545

Author(s):

Chensong Lin ◽

Longfeng Wu

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Empirical Studies ◽

National Level ◽

The Elderly ◽

Coverage Ratio ◽

Self Rated Health ◽

Health Promoting ◽

Major River ◽

Urban And Rural Areas

Many empirical studies have shown evidence of multiple health benefits provided by green and blue spaces. Despite the importance of these spaces, investigations are scarce in details for blue spaces rather than green. Moreover, most research has focused on developed regions. A limited number of studies on blue spaces can be found in China with a focus on the city level. Outcomes have been mixed due to varying research scales, methodologies, and definitions. This study relies on a national-level social survey to explore how the self-rated health (SRH) of senior individuals is associated with local green and blue space availability in urban and rural areas. Results indicate that the coverage ratio of overall green spaces and waterbodies around a resident’s home have marginal effects on SRH status in both urban and rural areas. In urban areas, living close to a park can is marginally beneficial for older people’s health. Regarding different types of blue spaces, the presence of a major river (within 0.3–0.5 km) or coastline (within 1 km and 1–5 km) in the vicinity of home negatively affects SRH among the elderly in urban areas. Close proximity to lakes and other types of waterbodies with a water surface larger than 6.25 ha did not significantly influence SRH. These findings not only evaluate general health impacts of green/blue space development on senior populations across the county but inform decision makers concerning the health-promoting qualities and features of different green/blue spaces to better accommodate an aging population in the era of urbanization.

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Factors Associated with Happiness among Malaysian Elderly

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073831 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3831

Author(s):

Shamsul Azhar Shah ◽

Nazarudin Safian ◽

Saharuddin Ahmad ◽

Wan Abdul Hannan Wan Ibadullah ◽

Zulkefley bin Mohammad ◽

...

Keyword(s):

Emotional Support ◽

Rural Areas ◽

Social Engagement ◽

Urban Areas ◽

Elderly Population ◽

Handgrip Strength ◽

The Elderly ◽

Evaluation Study ◽

Factors Associated ◽

Urban And Rural Areas

Happiness is an essential component to experience healthy ageing. Hence, understanding the factors that contribute to happiness is important. This study aimed to determine the factors associated with happiness among the elderly population in Malaysia. In this study, 1204 respondents were recruited from urban and rural areas in Selangor. A face-to-face interview was conducted using the Bahasa Malaysia version of the Japan Gerontological Evaluation Study questionnaire. The inclusion criteria include Malaysians who are 60-years old and above and can converse in the Malaysian language. Those who encounter less than seven scores for the Abbreviated Mental Test were excluded from the study. Among the 1204 respondents, 953 (79.2%) were happy. Sociodemographic characteristics showed that being a men, age of 60 to 74 years, and living in urban areas were significantly associated with happiness. A logistic regression model showed that locality (aOR 1.61), income category (Bottom 40% aOR 0.49; Middle-class group 40% aOR 1.40), social engagement (active aOR 1.77; less active aOR 1.25), receiving emotional support (aOR 2.11) and handgrip strength (aOR 1.02) were significantly associated with happiness. Thus, ensuring the elderly population in receiving emotional support and active social engagement among them can enhance their happiness level.

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Functional limitation on elderly people in the northeast and the feminization of eld in urban and rural areas of Brazil

Acta Scientiarum Health Sciences ◽

10.4025/actascihealthsci.v43i1.51421 ◽

2021 ◽

Vol 43 ◽

pp. e51421

Author(s):

Roberta Dayanny Soares ◽

Aíla Maropô Araújo

Keyword(s):

Activities Of Daily Living ◽

Rural Areas ◽

Urban Areas ◽

Daily Living ◽

Functional Limitation ◽

Rio Grande ◽

The Elderly ◽

Northeast Region ◽

Instrumental Activities ◽

Urban And Rural Areas

Population aging in Brazil increases on a large scale due to declining fertility and mortality. This phenomenon can be influenced by several factors (demographic, biological and social), making them determinants for the health conditions of the elderly populations residing in different geographic areas. The present study aims to identify the functional limitation in elderly residents of urban and rural areas of Brazil. This is a descriptive epidemiological study with a quantitative approach. It was evidenced that the functional limitation for activities of daily living and instrumental activities of daily living are concentrated in the northeast region, mainly in the urban area. The following states presented the highest proportions of daily life activity limitation in urban areas: Alagoas (11.60%), Rio Grande do Norte (10.95%), Pernambuco (10.36%) and Paraíba (9.62%). For activities of daily living in the rural area were found in the states of Paraíba (12.19%), Maranhão (8.93%), Piauí (8.85%) and then Pernambuco (7.24%). Data from the functional limitation for instrumental activities of daily living again highlighted the Northeast region, with the states of Rio Grande do Norte (26.01%), Paraíba (25.96%), Maranhão (25.72%) and Alagoas (24.57%). Lastly, it was verified that the elderly woman exhibits greater proportions of functional limitation in relation to the elderly of the masculine sex, standing out again the northeastern region of the country.

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Utilisation willingness for institutional care by the elderly: a comparative study of empty nesters and non-empty nesters in Shandong, China

BMJ Open ◽

10.1136/bmjopen-2018-022324 ◽

2018 ◽

Vol 8 (8) ◽

pp. e022324 ◽

Cited By ~ 4

Author(s):

Yangyang Qian ◽

Wen Qin ◽

Chengchao Zhou ◽

Dandan Ge ◽

Li Zhang ◽

...

Keyword(s):

Rural Areas ◽

Living Arrangements ◽

Urban Areas ◽

Institutional Care ◽

Binary Logistic Regression ◽

The Elderly ◽

Empty Nest ◽

Care Needs ◽

Term Care ◽

The Government

IntroductionInstitutional care has been strongly promoted in China to meet seniors’ long-term care needs. Empty-nest elderly, in comparison with their counterparts, have less social support and fewer caring networks. This study aimed to compare the utilisation willingness for institutional care and its predictors between empty-nest and non-empty-nest seniors.MethodsA total of 3923 seniors were included in the analysis. Binary logistic regression models were used to understand the association between the living arrangements of the elderly households and willingness for institutional care and to identify the predictors of the utilisation willingness for institutional care among empty nesters and non-empty nesters.ResultsOur study found that approximately 8.5% of the seniors had a willingness for institutional care in Shandong, China. Empty-nest singles (OR 5.301; 95% CI 2.838 to 9.904) and empty-nest couples (OR 1.547; 95% CI 1.135 to 2.107) were found to be more willing to receive institutional care. Our results also showed that residence was a key determinant for institutionalisation willingness in empty-nest and non-empty-nest elderly. Among empty-nest singles, psychological stress was a positive determinant for institutional care. Factors, including education attainment, relationship with adult children, household income and per capita living space, were determinants for empty-nest couple willingness for institutionalisation. Age, number of children and self-reported health status were found to be associated factors for willingness among non-empty nesters.ConclusionsThe government should pay more attention to institutional care in rural areas where there is still a gap in elder care compared with that in urban areas. Targeted policies should be made for different types of seniors to offer appropriate institutional care.

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Prediction the Contribution Rate of Long-Term Care Insurance for the Aged in China Based on the Balance of Supply and Demand

Sustainability ◽

10.3390/su12083144 ◽

2020 ◽

Vol 12 (8) ◽

pp. 3144 ◽

Cited By ~ 2

Author(s):

Liangwen Zhang ◽

Sijia Fu ◽

Ya Fang

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Long Term Care ◽

Population Census ◽

Contribution Rate ◽

Term Care ◽

Disabled Elderly ◽

Long Term Care Insurance ◽

Per Capita

There are a large number of disabled elderly people in China, which results in huge care and financial burdens to their families and society. However, China has not yet launched a unified long-term care insurance (LTCI) system. This study aims to predict the contribution rate of LTCI in China from 2020 to 2050 based on the long-term care (LTC) cost of the disabled elderly, aged 65 and over, in order to provide strong evidence for the establishment of a unified and sustainable national LTCI system in China. The simulations are based on data from the population census data, the Chinese statistical yearbook, and the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database. Based on the International Labor Organization (ILO) financing model from the perspective of fund balance, an overall simulation model and a Monte Carlo simulation are used to estimate the contribution rate of LTCI for disabled elderly from 2020 to 2050 in China. The total financial demands will increase sharply from 538.0 billion yuan in 2020 to 8530.8 billion yuan in 2050. Of that total, 80.2% will be required in urban areas. In addition, the per capita financial demands of care in urban and rural areas in 2050 will be approximately six times and 11 times higher than in 2020, respectively. The predicted results show that the overall contribution rate of LTCI in China will increase sharply from 1.46% in 2020 to 5.14% in 2050, an increase of about 3.5 times. By comparison, the contribution rate in 2020 will be close to 1.33% in Japan in 2015 and 1.40% in Germany in 2010. According to the 1:1 payment proportion between employer and employee, each side bears 0.68% of the insurance premium. From 2020 to 2050, the financial demands of long-term care for disabled elderly in China will increase, especially in urban areas, and the burden of per capita financial demands in rural areas will increase significantly. The overall contribution rate of LTCI will increase linearly and the payment burden of policyholders will increase year by year. This study provides evidence of the need for the establishment of a sustainable financing mechanism for multiple financial supplies.

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Estimating Long-Term Care Costs among Thai Elderly: A Phichit Province Case Study

Journal of Aging Research ◽

10.1155/2018/4180565 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Pattaraporn Khongboon ◽

Sathirakorn Pongpanich

Keyword(s):

Informal Care ◽

Rural Areas ◽

Urban Areas ◽

Socioeconomic Development ◽

Long Term Care ◽

The Elderly ◽

Term Care ◽

Rural And Urban Areas ◽

Rural And Urban

Background. Rural-urban inequality in long-term care (LTC) services has been increasing alongside rapid socioeconomic development. This study estimates the average spending on LTC services and identifies the factors that influence the use and cost of LTC for the elderly living in urban and rural areas of Thailand. Methods. The sample comprised 837 elderly aged 60 years drawn from rural and urban areas in Phichit Province. Costs were assessed over a 1-month period. Direct costs of caregiving and indirect costs (opportunity cost method) were analyzed. Binary logistic regression was performed to determine which factors affected LTC costs. Results. The total annual LTC spending for rural and urban residents was on average USD 7,285 and USD 7,280.6, respectively. Formal care and informal care comprise the largest share of payments. There was a significant association between rural residents and costs for informal care, day/night care, and home renovation. Conclusions. Even though total LTC expenditures do not seem to vary significantly across rural and urban areas, the fundamental differences between areas need to be recognized. Reorganizing country delivery systems and finding a balance between formal and informal care are alternative solutions.

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PERBEDAAN TINGKAT DEPRESI ANTARA LANSIA DI PEDESAAN DAN PERKOTAAN

KOSALA : Jurnal Ilmu Kesehatan ◽

10.37831/jik.v4i2.96 ◽

2016 ◽

Vol 4 (2) ◽

Author(s):

Tunjung Sri Yulianti ◽

Anggit Ike Prascika

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Geriatric Depression Scale ◽

Depression Scale ◽

The Elderly ◽

Economic Changes ◽

Rural And Urban ◽

Significant Difference ◽

Urban And Rural Areas ◽

The Village

AbstractElderly will fail maintaining a balance of physiological conditions, thereby increasingvulnerability to depression. Factors that influence is the socio-economic changes, socialvalues, awareness among individuals and others. More urban environment isindividualistic and socioeconomic pressures are higher, while rural areas have theeducational background lower. The results showed not a few elderly people who returnedto the village because they felt pressured by the situation in the city, the elderly should bealone in the house and no neighbors who could be invited to communicate, so it isdifficult to be happy. But there are also elderly who live in the village reveal feelingdepressed and showed signs of depression. Purpose of the study to determine the levelof depression in the elderly in urban, rural and differences in the level of depressionamong the elderly who live in rural and urban areas.Subjects were elderly who live in the village of Palur Sukoharjo and Kampung SewuSurakarta. Methods of analytical study comparative research design. Measuringinstrument used is the Geriatric Depression Scale. Test data normality using theKolmogorov-Smirnov Test. Statistical test with independent t test.The results of the study obtained significancy value of t-test (two-tailed) 0.001.Conclusion of research is significant difference in rates of depression among the elderlyin urban and rural areas, the elderly in urban areas have higher levels of depression thanelderly people in rural areasKeywords: Elderly Depression Level, Rural, Urban

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INVESTIGATING URBAN GROWTH BOUNDARY AS MECHANISM TO PLAN FOR SUSTAINABLE URBAN DEVELOPMENT

PLANNING MALAYSIA JOURNAL ◽

10.21837/pm.v19i18.1050 ◽

2021 ◽

Vol 19 ◽

Author(s):

Narimah Samat ◽

Mohd Amirul Mahamud ◽

Mohammad Javad Maghsoodi Tilaki ◽

Mohd Azmeer Abu Bakar ◽

Leong Tan Mou ◽

...

Keyword(s):

Sustainable Development ◽

Urban Development ◽

Urban Growth ◽

Rural Areas ◽

Urban Areas ◽

Online Survey ◽

Sustainable Urban Development ◽

Urban Growth Boundary ◽

The Sustainable Development ◽

Urban And Rural Areas

Urban encroachment into the peri-urban areas has blurred the borders between urban and rural areas. Thus, the urban growth boundary (UGB) has been used to encourage the sustainable development of cities and improve long-term planning efficiency. Studying the understanding of the UGB concept in ensuring sustainable development in Malaysia would be beneficial. This study aimed to investigate the perception and understanding of the UGB concept and function to achieve sustainable urban development. An online survey was conducted involving 82 experts, which comprised planners from PLANMalaysia and academicians in the field of urban planning. Results indicated that the perception of the UGB score was significantly greater by 1.16 than the normal score of 3, which indicated that the experts agreed that UGB could improve the urban development. The findings also indicated that the existing planning policy and inclusion of UGB had protected agricultural and natural land; however, stricter and tighter borderless development should be conducted.

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Urban–Rural Differences in Long-Term Care Service Status and Needs Among Home-Based Elderly People in China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17051701 ◽

2020 ◽

Vol 17 (5) ◽

pp. 1701

Author(s):

Liangwen Zhang ◽

Yanbing Zeng ◽

Lixia Wang ◽

Ya Fang

Keyword(s):

Low Income ◽

Rural Areas ◽

Urban Areas ◽

The Elderly ◽

Influential Factors ◽

Term Care ◽

Home Based ◽

Urban Rural ◽

Young Old

Background: Long-term care (LTC) needs for the elderly have become increasingly crucial policy concerns in rapidly aging Asia, especially in China, the most populous nation. However, very few studies have examined the cohort differences in terms of their existing and expected utilization of LTC services, above all urban–rural differences. This study aims to evaluate the differences of LTC current status and needs between urban–rural areas and age groups, and to identify influencing factors causing the different LTC needs. Methods: The data come from the Chinese Longitudinal Health Longevity Survey in 2014. A total of 7192 home-based elderly aged ≥65 years by multistage sampling were enrolled. The Andersen Model was applied to categorize the influential factors into three components including predisposing, enabling and needs. Multivariate logistic regression analysis was used to analyze the influential factors of the three levels of LTC needs. Results: A total of 6909 valid sample sizes were included in this study. The overall LTC needs of the elderly showed a rapidly increasing trend among which older people had the highest needs for bathing (27.29%) and toileting (15.8%). It was also demonstrated the aged cohort between urban and rural exerted an impact on all aspects of LTC status and needs to varying degrees (p < 0.05). Compared with urban areas, the LTC needs for the elderly in rural areas was more vigorous, but the supply was seriously inadequate. The elderly who were older, living in rural areas, unmarried, non-farming, with low income, in poor health and having less autonomy had higher anticipated needs for LTC services (OR > 1, p < 0.01). Compared with the young-old in rural areas, the young-old in urban areas were prone to live alone (OR = 1.61, p < 0.01). The elderly who were older, living in rural areas, farming, with low income, lonely and depressed had higher anticipated needs for community-based services (1 < OR < 1.69, p < 0.05). Conclusions: The aged cohort in urban–rural distinction were facing an increasing need for immediate care due to the inadequate support being provided, especially among rural elderly. The oldest elderly in rural areas had higher LTC needs, and different levels of needs were affected by age, economic level, family support, health status and other related effects. This study provides evidence-based recommendation for further improving the construction and development of the LTC system in China.

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