On January 22, 2023, the Chinese calendar entered the Year of the Rabbit, in China a symbol of fertility, longevity and prosperity. The ironies, alas, are palpable: Chinese society in 2023, like many others, must cope with strikingly low fertility. The year started with the Chinese Communist Party’s acknowledgement that the country experienced fewer births than deaths in 2022, marking the first year of decline in population since the catastrophic famine of the early 1960s caused by Mao’s Great Leap Forward. And subsequent news reinforced the sense that China is being buffeted by gale-force demographic winds. China recorded the smallest number of marriages since 1986, when the country was home to some 53 million fewer people age 20-39 years.

Slow-moving Train Wreck

The vulnerability of China’s family structure seems to be a statistical blind spot for its leaders. Like other modern governments, Beijing does not bother to count cousins, nephews or widowed grandmothers in assembling demographic data. But that does not make the changes in the family now underway any less portentous.

In some ways, this out-of-sight, out-of-mind view is surprising because the family does feature prominently in national ideology. It forms a central pillar running through Confucian thought to the present day, where its official promotion is so common that it may as well be considered an unofficial 15th element of Xi Jinping Thought – the omnipresent pronouncements of China’s ruler. Indeed, the Chinese state relies on the family far more than most middle- and high-income countries.

China’s Constitution, its Marriage Law, and the 1996 “Law of the People’s Republic of China on the Protection of the Rights and Interests of the Elderly” each codify filial piety and the duty of adult children to support their aging parents. The last of these stipulates that “the elderly shall be provided for mainly by their families” – specifically, that children and children-in-law “shall pay medical expenses [and] properly arrange for the housing of the elderly,” and that, if they fail to support an elderly parent, “the latter shall have the right to ask the former for alimony.”

But these cultural norms and laws about family care embed deep assumptions about the stability of Chinese families, and these assumptions are about to be tested. Put simply, China is scarcely prepared for the scale and scope of population aging that it is about to experience.

For example, China has 29 nurses for every 10,000 people, far fewer than rapidly aging East Asian neighbors like Japan (115) and South Korea (70). Much the same can be said for investment in health care in China compared to its affluent neighbors. In 2018, per capita expenditures totaled $398 compared to $4,200 in Japan and $2,000 in South Korea. Among adults age 60 and older needing medical intervention, only 5.7 percent receive for- mal, paid care.

Hence, absent a massive scaling up of care workers, the burden of China’s rapidly growing cohort of retirees will sit precariously on the shoulders of the younger generation. The same can be said for retirement costs. In China, some privileged urban retirees do enjoy relatively generous pensions. But researchers estimate that, nationwide, personal earnings plus public benefits currently cover just three-fifths of living costs for those age 65, two-fifths for those age 75 and under a third for those 80 and older. The rest comes from the fruits of the family tree.

In a recent monograph, we traced out some of the ways China’s demographic change is colliding with its family orientation and what these might mean for the country’s economic, social and geopolitical capacities in the decades ahead. We necessarily relied on simulations grounded in reasonable assumptions, but the conclusions are as robust as they are ominous: a flood of aging Chinese is piling up behind institutional barriers that will soon lack the strength to support them.

The Family Care Dam

Consider the current and future state of Chi- na’s “family dam,” and whether it can withstand the pressure as care needs grow. Today’s China enjoys a capacious family net that covers the otherwise unmet needs of older adults. We estimate that 95 percent of those in their 70s in 2020 had at least one living child. But our models point to several likely breach points. By 2050, the number of Chinese over 65 is expected to nearly double to 395 million. Meanwhile, the number of working-age Chinese will fall sharply. And critically, the ratio of working-age to retirement-age Chinese will decline from 4.9 to just 1.9 (see figure below). Complicating matters, family support of the elderly is expected to deteriorate in a surprisingly asymmetric way. In 2050, some 94 percent of women in their 70s will have children to rely on, but just 86 percent of their male peers will enjoy equivalent generational protection.

Here’s why. Chinese now in their 60s generally have living children, though they do not necessarily have living sons who are traditionally expected to be their parents’ primary caretakers (or else provide access to a daughter-in-law who will do so). In fact, in our simulation models about a third of men and women in their 60s have no sons; daughters-in-law are even scarcer. And collapsing marriage rates among young adults will increase the gap.

Even conservative models of China’s chronic marriage market squeeze suggest that 15 percent of today’s young Chinese men will never marry because there aren’t enough women to go around – which, in turn, will lead to a daughter-in-law deficit for an even larger number of older families. Why this shortage of young women? Millions of Chinese couples, eager to have sons in the era of the one-child policy, chose to improve their odds with sex-selective abortion.

These numbers do not, however, tell the full story. In 2020, 80 percent of men and women in their 70s had two or more living children. In 2050, only 41 percent of men and 44 percent of women are projected to have as many.

Of course, elderly couples are more likely to be self-reliant than surviving spouses or men who never married. And we do expect a decline in both men and women in their 70s who lack a living spouse in 2050. But these benefits will be offset by other demographic trends. About 15 percent of Chinese men and women in their 70s today have no living siblings. We expect this figure to rise to 24 percent by 2050, removing one more potential prop for the dependent elderly.

In some ways, though, thinking in percentages obscures the enormity of the changes in store. About 4 million Chinese adults in their 70s had no children in 2020. For every- one age 60 and above, the total is 17 million. In 2050, the number without living children in their 70s will be nearly as large as the total for all people over 60 today. The total for those of any age over 60 lacking children will be a staggering 51 million. Whereas the number of adults over 65 and the ratio of retirees to workers will double over the period, the size of the elderly population unable to count on care from children will triple.

The number of 60-years-olds without spouses will rise from 78 million to 138 million over the period. Most of these will be widows – 77 million in 2050, compared to 51 million in 2020. But the really dramatic growth will be among the widowers, who will rise from 27 million in 2020 to 61 million in 2050. Roughly 36 million of those over 60 did not have siblings in 2020, but 115 million in this age range will not have them in 2050.

In one way or another, the younger generation, which buttresses the metaphoric family dam, will have to carry the load. By 2050, the overwhelming majority of middle-aged Chinese – among those in their 40s, we expect more than 90 percent – will have elderly parents, many of them likely to be dependent to various degrees. And the duration of the obligation won’t be brief. In 2050 nearly two-thirds of China’s 50-somethings and half its 60-somethings will have at least one surviving parent, and occasionally two. By comparison, just 27 percent of those in their 60s today have a living mother or father.

The deepening filial burden facing the current generation of China’s young and middle-aged will also be an increasingly lonely experience, paradoxically even as it becomes more common. Only about 13 percent of today’s 30- and 40-somethings lack a living sibling (this group was born before the one-child policy began to bite). By contrast, four out of ten of those caring for elders in China in 2050 will be without siblings.

Add to this the reality that the prospects of extended families banding together to mitigate the eldercare burden are receding be-cause extended families are shrinking. In 2020, we estimate that those in the prime caregiving ages (between ages 30 and 60) had about 75 to 100 people in their extended families (parents, children, siblings, spouses, nieces and nephews, aunts and uncles, grand- children, grandparents and cousins). By 2050, we expect this number to decline to between 40 and 50.

Protected by the State

Many readers no doubt have guessed how China arrived at this particular cul-de-sac. The standard explanation is that the suite of fertility control efforts often referred to as the country’s decades-long one-child policy is to blame. But that program – and for that matter, China’s longer-term 20th-century fertility decline (most of which took place before that odious policy) – does not explain the whole story. To understand what happened, we have to look at how the country got to where it is today, and this turns out to be both surprising and counterintuitive.

The saga of China’s demographic past, at least the one ritualized into national myths and repeated often enough abroad to be received wisdom, is that the country’s historical family landscape was overgrown by dense networks of extended kin ties. Protagonists in this story had a large cast of siblings, cousins and other relatives to rely on – or come to them for assistance. This is a story told about most of the world’s “traditional” societies, and it seems to make sense since historical birth rates were so high. But our survey of change in China’s family structure over the last seven decades or so reveals a surprise that runs shockingly counter to this story. For the present day – not the past – is the period luxuriant with kin in China.

Given high historical birth rates, as high as five or more children per woman in “traditional” China, and the country’s low and dropping birth rates since about 1970, how can the present be replete with kin while the past is comparatively sparse? The answer lies at the mortality end of the demographic pipeline. As the world over, traditional Chinese mortality, especially that of infants and children, was so high to preclude the mass formation of extended kin networks. Some 40-50 percent of newborns in traditional China did not live to see their fifth birthdays, and substantially more did not live into their 30s. This thinning of the clusters of historical kinship all but precluded dense growth.

Consider a hypothetical regime with five births per woman and 40 percent survival through childhood to the reproductive ages. In this world (which resembles pre-modern China), your maternal and paternal sets of grandparents would each bear five children and bury three. The result is that they would have produced two children that survive to ages where they can have their own children, two of whom are your own parents. This leaves one biological aunt or uncle on each side for a total of two. These biological relatives then, presumably, partner and have children of their own. Your two biological aunts and uncles and their partners would each produce two children of their own who survive into adulthood, leaving you with only four cousins – more of a patchy scraggle than a thicket of kin.

At varying points since the 18th century, mortality rates and fertility rates in nearly every human society fell from their long-run historic averages. This process is collectively known as the “demographic transition.” In this transition, mortality rates fell before fertility rates at a faster pace with remarkable regularity in context after context. What’s more, the mortality rates that fell the most and the most quickly were those of infants and children.

In a matter of decades in places that began the process early – and in a matter of just a few years among societies that began the transition sometime after World War II – parents went from burying up to half their children to burying almost none. And, at least for a time, they were still having four, five or more children, meaning that the demographic transition increased effective fertility rates temporarily. These dynamics produced the massive population growth the world has seen in the last two centuries, which is only now running out of momentum.

The story of the demographic transition’s influence on population growth is well-known. But the reality that the demographic transition also produced a kinship transition is not.

Interrupted only by Mao’s disastrous Great Leap Forward in the 1960s, China experienced an effective baby boom after World War II that was caused not by a leap in fertility rates but in the usual way – by a stunning decline in infant and child deaths from about 400 per 1,000 before age five in the 1930s all the way down to 100 in the 1970s. During this period, actual fertility rates averaged above five births per woman, then began falling precipitously in the 1970s (reaching about 2.5 by the start of programs associated with the one-child policy around 1980). Between 1950 and 1970, China ended up with an additional 50 percent more five-year-olds even though birth rates did not change.

More five-year-olds means more siblings. More siblings mean more nieces and nephews in a few decades, as well as aunts and uncles. More nieces, nephews, aunts and uncles mean more cousins. And all of these dynamics unfolded while mortality continued to fall – including the harder-to-reduce mortality of the aged – pushing up numbers of living parents, grandparents and so forth. Mortality reduction, it seems, is modernity’s fertilizer for the bushes of kinship.

We estimate that, among people in their 40s, the average number of extended kin in the categories discussed above leapt from just over 20 in the 1950s to about 80 today. The constituent kin arrangements bear this out, for 78 percent of the 40-somethings of the 1950s had no living parents, compared with only 16 percent today. Being without siblings was also much more common: About 45 percent of 40- to 49-year-olds in the 1950s had no living siblings, while today only 12 percent have none. Nieces and nephews, aunts and uncles, and cousins all tell the same story.

It is an intriguing coincidence that China’s massive economic bloom over the past half century coincided quite directly with the flourishing of its kinship networks. The bonds of blood, stronger than ever, may have trel- lised the nation’s economic potential at a propitious time. We further speculate that such kin network growth afforded novel opportunities to the Chinese government to focus its priorities elsewhere, leaving aside questions about planning the retirement and eldercare of its baby boomers. Its constitution’s promise aside, the Chinese family may, in fact, have been the one protecting the Chinese state. And the “kin explosion” may have been a major unobserved variable, both in modern China’s economic ascent, and in the broader East Asian Economic Miracle.

Such factors make the current moment all the more precarious. The massive number of older adults in China sits atop a steep hill, at just the moment when the bushes of kinship are wilting and the branches constituting the family care dam are snapping. (Mixed metaphors, but you get the point.)

At the very least, these challenges suggest a crash effort will be needed to build a massive welfare state in China if the nation’s small families are to avoid an ever-larger eldercare burden. Consider, too, that one demographic imbalance has a way of creating others. The greater eldercare burden on families may in turn reduce fertility. And diverting a substantial share of the workforce into eldercare will similarly suppress economic vitality. These demographic trends will greatly constrain the dynamism of the Chinese economy and state, perhaps even constraining its geopolitical ambitions as attention shifts to the home front.

Public Policy to the Rescue?

Communist Party officials have undertaken a suite of reforms including changes to fertility limitation policies in 2009, 2016 and 2021; new tax incentives and subsidies for large families; and a pilot initiative in 20 cities to change hearts and minds about marriage and childbearing. It is unlikely that any of these will work – no society the globe over has yet managed to reverse exceedingly low fertility of the voluntary, economics-driven variety found in China today. But, even if one could envision a future in which Beijing manages a fertility rebound, the future of family in China we describe is essentially inevitable.

It takes time to grow a family. This is as true in the world as it is in our models. In China’s coming crush of eldercare, the relevant actors for the next 30 or so years are already alive, and no amount of goading from the government can make them subdivide to fill the widening cracks.

A large increase in mortality, in particular among the elderly, would ease the burden somewhat. But such events are rare, and the scale would need to be massive – and socially disastrous. The recent Covid-19 wave in China provides some sense of the scale such events would have to take. Covid-19 killed at most 1.5 million Chinese. That is a lot of people. But an equivalent disaster that killed 1.5 million, even if all of them were elderly, would barely dent the projected growth of those over 65 (from 203 million to 395 million) expected between 2020 and 2050.

Similarly, it is almost impossible to imagine the levels of immigration that would be needed to offset the changes now taking place. China’s ratio of working-age population to re-retirees is expected to fall from 4.9 in 2023 to 1.9 in 2050. (In the same period, the ratio in the U.S. will fall far less, from 3.7 to 2.6.)

To maintain a retiree-to-worker ratio comparable to the 2.6 expected in the United States in 2050 – the most conservative estimate – China would need 246 million immigrants. This is more people than the combined population of Thailand, Vietnam and Myanmar. Now, of course, Thais, Vietnamese and Burmese can hardly be expected to move en masse to China. It’s even more improbable that the Chinese state would welcome even a small fraction of them.

Innovation, technology and the like may play a role in softening the blow, but it is difficult to square this prospect with the enormous pressures facing the Chinese family. Who will develop new technologies if a large portion of the educated workforce is locked into the service economy, primarily dedicated to nursing the old?

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The next two Years of the Rabbit in China will coincide with 2035 and 2047 on the Western calendar, roughly the midpoint and end of the interval we simulated. We can imagine the rabbit emerging from its burrow in 2035 and finding the underbrush of kinship to which it has become accustomed greatly thinned. If our bunny waits until 2047, the comfort of kinship will be truly hard to find. How all this squares with China’s ambitions to become a rich, stable global power is anyone’s guess.