Yaozhi Global Health Research and Consulting, Yangzhou, China.
Institute for Advanced Study of the Americas, University of Miami, Coral Gables, Florida, USA.
BMJ Glob Health. 2024 Jun 5;9(6):e013400. doi: 10.1136/bmjgh-2023-013400.
The introduction, strict enforcement and recent exit of China's one-child policy (OCP) resulted in China's demographical changes, and, alongside its epidemiological transition, disproportionately impacted caregiving needs and demands on women. This study examines women's caregiving responsibilities in contemporary China and evaluates how the OCP affected them.
We simulated the female population aged 25-54 years in 2020 in China and their caregiving responsibilities based on epidemiological and demographic data for women, their parents and parents-in-law, and children under 10. Three different health states were simulated for children and the senior generation: (1) healthy, (2) end of life-decedents and (3) non-decedents in need of palliative care. We combine the care responsibility for senior family members and for children using an aggregate indicator-the Care Responsibility Score (CRS) -to compare the impact of the OCP across different generations of women.
Approximately 60 million working-age women are living with medium to high levels of care responsibilities (a CRS over 0.8), which is equivalent to caring for a senior family member with palliative care needs without any assistance from siblings. This includes more than one-third of the 156 million women born after the OCP and only 5% of women born before the OCP.
For women born under the OCP, the additional responsibility generated by a lack of siblings outweighs the benefit of having four dedicated grandparents to support them in raising children.
中国独生子女政策（OCP）的引入、严格执行和最近的退出导致了中国人口结构的变化，再加上其流行病学转变，不成比例地影响了照顾需求和对女性的需求。本研究考察了当代中国女性的照顾责任，并评估了 OCP 对她们的影响。
我们根据女性及其父母和公婆、10 岁以下子女的流行病学和人口数据，模拟了 2020 年中国 25-54 岁女性人口及其照顾责任。我们为儿童和老年一代模拟了三种不同的健康状况：（1）健康，（2）临终死亡者，（3）需要姑息治疗的非死亡者。我们使用综合指标——照顾责任评分（CRS）——将老年家庭成员和儿童的照顾责任结合起来，比较不同代际女性的 OCP 影响。
大约 6000 万处于工作年龄的女性承担着中高水平的照顾责任（CRS 超过 0.8），这相当于在没有兄弟姐妹任何帮助的情况下照顾需要姑息治疗的老年家庭成员。这包括超过三分之一的 1.56 亿在 OCP 之后出生的女性，而在 OCP 之前出生的女性只有 5%。
对于在 OCP 下出生的女性来说，由于缺乏兄弟姐妹而产生的额外责任超过了有四个专门的祖父母支持她们抚养孩子的好处。
