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Economic and demographic transition pose major challenges for countries worldwide, particularly in large developing countries like China; however, strengthening social welfare programs can offset negative effects and help promote a sustainable future, according to Karen Eggleston, a scholar of Asia health policy at Stanford University.

“Unprecedented economic growth in China spanning the last three decades has lifted hundreds of millions out of poverty and restored China to the prominence in the world economy that it once enjoyed centuries ago,” said Eggleston, who is a Center Fellow at the Walter H. Shorenstein Asia-Pacific Research Center.

“Demographic change not only shapes the trajectory of [its] development, but interacts with macroeconomic and microeconomic forces” in numerous ways.

Eggleston, who presented “China’s Demographic Change in Comparative Perspective: Implications for Labor Markets and Sustainable Development” at the Jackson Hole 2014 Economic Symposium “Re-evaluating Labor Market Dynamics,” says a combination of societal changes makes China distinctive, and that the country can offer insights in comparative perspective. She joined two other experts for a panel discussion on demographics during the three-day conference led by the Federal Reserve Bank of Kansas City, which draws dozens of central bankers, policymakers, academics, and economists from around the world.

The research stems from a project that Eggleston heads on policy responses to demographic change in Asia. The initiative, which is a part of the Asia Health Policy Program, grew out of a 2009 conference cosponsored by the Global Aging Program at the Stanford Center on Longevity. Its outcomes have included the publication, Aging Asia, a special issue of the Journal of the Economics of Aging focused on China and India co-edited with David Bloom of Harvard University, and two forthcoming books on urbanization and demographic change in Asia.

China in flux

China is the most populous country in the world with more than 1.3 billion people. Its sheer size alone creates heavy demands as demographics change, and the economy continues its shift from a centrally-planned system to a market-based system.

China’s population age 60 and older is projected to increase from one-tenth of the population in year 2000 to a staggering one-third by year 2060. Simultaneously, the population age 14 and under is projected to decrease by one-third between years 2010­ and 2055 (Figure 2).

Eggleston, and others who closely watch the situation, say these demographic changes will bring a myriad of challenges to the labor market and to cultural norms related to intergenerational support, work and retirement.

China’s low birth rates have largely been influenced by family planning campaigns that begun in the early 1970s, and later, the “one child policy,” a population control policy that allowed for the birth of only a single child in many families. Recently, the government has relaxed that policy, and analysts believe the change will eventually help to balance the population age structure and infuse the workforce with new employees, filling the void caused by retiring workers in the coming years.

In the meantime, preparing support structures for the older generations’ departure from the labor market is essential. Social welfare programs, including health insurance and retirement and childcare services, will see significant demand, and require restructuring to handle the influx.

China’s aging population experience is similar to other countries in Asia. Japan, South Korea and India are also projected to see significant increase in median age over the next 30 years (Figure 1). 

Eggleston says China has made positive steps toward restructuring its institutions, including establishing government-subsidized health insurance programs and reforming pension systems. Most notably since 2002, China took a large step towards universal health care by implementing the New Rural Cooperative Medical Scheme for rural residents. Now, nearly all citizens have access to basic medical care, which can support healthy aging as well as mitigate large “precautionary savings” and help those struck by medical conditions requiring significant services.

A pension system for people in China’s rural areas, developed by the government in 2009, also set up a supportive system by providing increased transfers for seniors, and, interestingly, supporting labor markets by easing the worries of adult children who migrate to urban areas for work.

China has been forward thinking with its related public policies, but it certainly can do more, Eggleston says. Integrating technology into its health systems, and making its services more fiscally responsible could improve efficiency, and expand access to care.

The full paper and handout from Eggleston’s presentation at the conference are available on the Federal Reserve of Kansas City website.

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About the topic: PSI is a global social marketing NGO that approaches clients as consumers in 60 developing countries.  What do the private sector and marketing have to teach us about saving and improving the lives of the most vulnerable?  A lot, it turns out.  

 

About the speaker: Karl Hofmann is the President and CEO of PSI (Population Services International), a non-profit global health organization based in Washington, D.C. PSI operates in 60 countries worldwide, with programs in family planning and reproductive health, malaria, child survival, HIV, maternal and child health, and non-communicable diseases.  Prior to joining PSI, Mr. Hofmann was a career American diplomat.  He served as U.S. Ambassador to the Republic of Togo, and Executive Secretary of the Department of State.

 

Cosponsors: Stanford School of Medicine, Stanford Center for Innovation in Global Health, Stanford Center for International Development

Karl Hofmann President and CEO PSI
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Speaker:  Robert Chang - Assistant Professor of Ophthalmology at Stanford University Medical Center

 

More patients are living longer and developing chronic diseases, often managed with increasingly expensive technology.  Both healthcare providers and hospital systems are struggling to keep up.  Modern smartphones can be converted into powerful, inexpensive portable medical devices to improve the delivery of healthcare, particularly in low- and middle-income countries.

Professor Chang will talk about his experience in developing a simple adapter to turn an iPhone into an “Eye-Phone” Camera. Chang is an ophthalmologist with a special interest in healthcare startups and online medical education. His clinical research focus revolves around understanding the association between high myopia and glaucoma. He is currently co-developing “EyeGo,” an iPhone imaging adapter system for remote eye care triage.

Stanford Center at Peking University
The Lee Jung Sen Building
Peking University
No.5 Yiheyuan Road Haidian District
Beijing, P.R.China 100871

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This symposium will highlight the public health threat posed by China’s non-­‐ communicable disease (NCD) epidemic, and focus on the role of research in developing an effective response. Prevalent NCDs (stroke, diabetes, heart disease, and cancer) share common origins linked to lifestyle changes and increasing disease risk factors spurred in part by successful economic development. These conditions and their complications, however, place a high burden on health care resources and reduce social capital growth. An effective response is possible, but will require a novel approach focusing on maintaining human function and wellness, strategies that impact multiple NCDs, new models of health care delivery, and greater integration of public health and clinical care.

Featured speakers include Prof. Linhong WANG (China Center for Disease Control), Prof. Lixin JIANG (National Centre for Cardiovascular Diseases), Prof. Yangfeng WU (Peking University Clinical Research Institute) Prof. Randall S. STAFFORD (Stanford Prevention Research Center), Prof. Sanjay BASU (Stanford Prevention Research Center).

Stanford Center at Peking University

Randall S. STAFFORD Professor Moderator Stanford Prevention Research Center
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Abstract:  How does teamwork increase productivity? Considering teamwork as joint monitoring and management, I investigate this question by studying the same emergency physicians working in two organizational systems differing in the team-management of work: Physicians are assigned patients in a "nurse-managed" system but divide patients between themselves in a "self-managed" system. The self-managed system increases throughput productivity by reducing a "foot-dragging" moral hazard, in which physicians prolong patient stays with expected future work. I find evidence that physicians in the same location have better information about each other and that, in the self-managed system, they use this information to assign patients. 

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