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Cited by 701Demographic Trends and Gender PreferencesReproductive Health and ContraceptionChina's Socioeconomic Reforms and Governance

The DOI matches its Crossref record; 61 of the 61 references it cites were found in a registry or an index; none of the 78 sources its claims cite is checked for support yet.

The effects of China’s universal two-child policy

Open access
Zeng, Yi, Hesketh, Therese·2016·The Lancet
DOI 10.1016/s0140-6736(16)31405-2PMC PMC5944611
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Abstract

In October, 2015, China’s one-child policy was replaced by a universal two-child policy. The effects of the new policy are inevitably speculative, but predictions can be made based on recent trends. The population increase will be relatively small, peaking at 1·45 billion in 2029 (compared with a peak of 1·4 billion in 2023 if the one-child policy continued). The new policy will allow almost all Chinese people to have their preferred number of children. The benefits of the new policy include: a large reduction in abortions of unapproved pregnancies, virtual elimination of the problem of unregistered children, and a more normal sex ratio. All of these effects should improve health outcomes. Effects of the new policy on the shrinking workforce and rapid population ageing will not be evident for two decades. In the meantime, more sound policy actions are needed to meet the social, health, and care needs of the elderly population.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This Review predicts that China’s 2015 universal two-child policy will produce only a moderate fertility increase, with population peaking at about 1.45 billion in 2029 versus 1.40 billion in 2023 under the one-child policy. It argues the policy will reduce abortions of unapproved pregnancies, eliminate unregistered children, improve the sex ratio, and eventually enlarge the workforce, while population ageing will still require additional policy action.

Key findings

  • The universal two-child policy is projected to lead to a peak population of around 1.45 billion in 2029, compared with a peak of around 1.40 billion in 2023 if the one-child policy continued; the overall population increase is about 3% higher at peak.
  • Assumed total fertility rates rise from 2.01 in rural areas and 1.24 in urban areas to 2.15 and 1.67, respectively, in the next decade, with a combined rural–urban total fertility rate of 1.88 in 2017 and 1.81 in 2030.
  • The policy is expected to reduce or eliminate abortions of out-of-quota second pregnancies, sex-selective abortions, and the problem of unregistered “blacklisted” children, and to help lower the sex ratio at birth, though normalisation is unlikely for many years.
  • The workforce will not be affected in the short term, but beyond 2030 the universal two-child policy would produce a workforce larger by 30 million in 2040 and 60 million in 2050 compared with an unchanged one-child policy; the percentage of over-65s is expected to reach 18% in 2030.

Methods

  • This is a Review and policy analysis, not a primary empirical study; it synthesizes demographic research, surveys, censuses, and prior studies to project effects of the universal two-child policy.
  • It compares population projections under the universal two-child policy with a scenario in which the one-child policy remains in place, using assumed total fertility rates and the same background demographic parameters such as medium mortality and rural–urban migration.
  • The projections draw on prior demographic analyses, including assumed fertility increases in rural and urban areas, and on evidence from surveys of fertility preference, census data, and longitudinal healthy ageing surveys.

Limitations

  • The paper states that the effects of the new policy are “inevitably speculative” and that future fertility cannot be accurately forecast because of various uncertain determinants.
  • The projections depend on assumed total fertility rates and background demographic parameters; the paper notes that the low uptake of the 2013 selective two-child policy—only 1.45 million (13.2%) of 11 million eligible couples applied—suggests the new policy’s effects may be less than expected.
  • The text makes evident that this is a Review rather than an original causal analysis, so findings rely on prior studies and modelling assumptions rather than new primary data or experimental identification.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/s0140-6736(16)31405-2

Cites

61 of 61 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 78 cited sources checked · 0 supported · 0 flagged

  • Findingcitation

    There are more than 5 million administrative bureaucrats and fieldworkers in China's family planning workforce.

    “There are more than 5 million administrative bureaucrats and fieldworkers.6”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] Greenhalgh, 2008
  • Findingreasoning

    In China, per-person arable land in 2011 was 36% lower than in 1979.

    “Second, it is true that in 2011, water and land resources per person in China were reduced by 30% and 36%, respectively, compared with 1979, attributable to population growth.”
    Quote in the paperNot a substantial claim
  • Findingnone given

    Under the universal two-child policy, China's total population will peak at about 3% higher than under the one-child policy.

    “First, the overall increase in population will be modest, with a peak of approximately 3% higher total population than would occur under the one-child policy.”
    Quote in the paperSubstantial claim
  • Findingnone given

    The declines in per-person water and arable land resources in China levelled off after 2000.

    “But the declines levelled off after 2000.”
    Quote in the paperNot a substantial claim
  • Findingcitation

    Under the universal two-child policy, China's average water resource per person will reach its lowest value around 2029, about 2% lower than in 2011.

    “Under the universal two-child policy, the Chinese average water resource per person and average arable land per person would reach the lowest value around 2029 (reduced by about 2% and 6%, respectively, compared with 2011), and then start to gradually increase as the total population size decreases after 2029.7”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] Zeng, 2014, A policy analysis on challenges and opportunities of population/household aging in China, J Popul Aging source
  • Probably not a substantial claim. 24
  • It may state two separate claims as one. 39

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Interpretationnone given

    The new policy will produce a more normal sex ratio.

    “a more normal sex ratio”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Interpretationnone given

    The new policy will allow nearly all Chinese people to have the number of children they prefer.

    “The new policy will allow almost all Chinese people to have their preferred number of children.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation

    By the late 1990s, China's total fertility rate had fallen to between 1.5 and 1.7 and has remained at that level.

    “by the late 1990s the total fertility rate had fallen to between 1·5 and 1·7, and it has remained at this level since (figure 1).4,5”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [4] Zhang, 2006, Re-examining China's fertility puzzle: data collection and quality over the last two decades, Popul Dev Rev source
    • cites [5] Zeng, 2007, Options of fertility policy transition in China, Popul Dev Rev source

  • It may state two separate claims as one.

    Premisecitation

    The sex ratio at birth began rising after the one-child policy started, and the rise accelerated after diagnostic ultrasound for sex determination became available in the late 1980s.

    “The sex ratio at birth, defined as the number of male births for every 100 female births, started to rise after the onset of the one-child policy, but this trend accelerated further after diagnostic ultrasound for sex determination became available from the late 1980s.19”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Zeng, 1993, Causes and implications of the recent increase in the reported sex ratio at birth in China, Popul Dev Rev source

  • It may state two separate claims as one.

    Interpretationnone given

    Under the new policy, population growth will be relatively small, peaking at about 1.45 billion in 2029, compared with a peak of about 1.4 billion in 2023 if the one-child policy had continued.

    “The population increase will be relatively small, peaking at 1·45 billion in 2029 (compared with a peak of 1·4 billion in 2023 if the one-child policy continued).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Interpretationnone given

    The new policy will virtually eliminate the problem of unregistered children.

    “virtual elimination of the problem of unregistered children”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim.

    Premisenone given

    In October 2015, China replaced its one-child policy with a universal two-child policy.

    “In October, 2015, China’s one-child policy was replaced by a universal two-child policy.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisecitation

    Women benefited from fewer pregnancies and births, which contributed to a fall in maternal mortality over the past three decades.

    “Women have benefited from fewer pregnancies and births, which has contributed to a fall in the maternal mortality rate over the past three decades.12”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12]

  • It may state two separate claims as one.

    Interpretationreasoning

    The reductions in abortions, unregistered children, and abnormal sex ratio should improve health outcomes.

    “All of these effects should improve health outcomes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisenone given

    The one-child rule was strictly enforced for urban residents, who made up about 20% of the population in 1980 and nearly half by 2010.

    “The one-child rule was strictly enforced for urban residents, who in 1980 accounted for about 20% of the population, but nearly half by 2010.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    The one-child policy was introduced in 1979 by the Chinese Government, which saw population containment as essential to lifting China out of severe poverty caused by decades of economic mismanagement.

    “The one-child policy was introduced in 1979 by the Chinese Government who considered population containment as essential to lifting China out of severe poverty caused by decades of economic mismanagement.1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] Hesketh, 1997, The one child family policy: the good, the bad, and the ugly, BMJ source

  • It may state two separate claims as one.

    Premisecitation

    Surveys over the past two decades show that China has become a low-fertility culture, and such surveys are generally thought to somewhat overestimate actual fertility.

    “Surveys of fertility preference59–61 undertaken over the past two decades show that China has indeed become a low fertility culture, and such surveys are generally thought to somewhat overestimate actual fertility.62,63”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [59] Qu, 2006, Family size, fertility preferences, and sex ratio in China in the era of the one child family policy: results from national family planning and reproductive health survey, BMJ source
    • cites [60] Retherford, 2005, How far has fertility in China really declined?, Popul Dev Rev source
    • cites [61] Zheng, 2016, Socio-economic status and fertility intentions among Chinese women with one child, Hum Fertil (Camb) source
    • cites [62] Bongaarts, 2001, Fertility and reproductive preference in post-transitional societies, Popul Dev Rev
    • cites [63] Zhang, 2015, A research on the second childbirth expectation and the birth plan for the fertility age population of Chinese, Popul Econ

  • It may state two separate claims as one.

    Premisecitation

    Couples who applied for a second child were younger, had higher household income, had a young first child more likely to be a girl, and had parents who wanted a second grandchild.

    “The couples who applied for a second child were younger, had higher household income, a young first child more likely to be girl, and parents who wanted a second grandchild.58”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [58] Feng, 2016, Do or don't? The birth preference and influence factor analysis of city reproductive-aged population with one child, J Natl Sch Admin

  • It may state two separate claims as one.

    Premisecitation

    The sex ratio at birth peaked at 121 in 2005, fell to 116 in 2014, and reached as high as 140 in parts of rural central China.

    “The sex ratio at birth peaked at 121 in 2005, with latest estimates showing a fall to 116 in 2014, but with ratios as high as 140 in parts of rural central China.20,21”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [20] Liu, 2009, China's excess males, sex selective abortion, and one child policy: analysis of data from 2005 National Intercensus Survey, BMJ
    • cites [21] Greenhalgh, 2013, Patriarchal demographics? China's sex ratio reconsidered, Popul Dev Rev source

  • It may state two separate claims as one.

    Interpretationcitation

    The total population under a continuing one-child policy would be smaller than under the universal two-child policy, causing serious problems for ageing, pension fund deficiencies, and labour shortages.

    “The total population size under the one-child policy would be smaller than under the universal two-child policy (table), which would cause serious problems for ageing, pension fund deficiencies, and labour shortages.73,74”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [73] Peng, 2011, China's demographic history and future challenges, Science source
    • cites [74] Herrmann, 2012, Population aging and economic development: anxieties and policy responses, J Popul Aging source

  • It may state two separate claims as one.

    Premisecitation

    Most Chinese elderly people, especially in rural areas, lack full pension coverage and are largely dependent on their children for financial support.

    “most Chinese elderly people, especially those in rural areas, still lack full pension coverage, so are largely dependent on their children for financial support.7,39”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [7] Zeng, 2014, A policy analysis on challenges and opportunities of population/household aging in China, J Popul Aging source
    • cites [39] Zhang, 2006, Who will care for the elderly in China?: A review of the problems caused by China's one-child policy and their potential solutions, J Aging Stud source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Studies of young adult soldiers show that those with siblings are significantly more motivated, hard working, obedient, sociable, and mentally stable than only children.

    “a series of studies in young adult soldiers have shown that soldiers with siblings are significantly more motivated, hard working, obedient, sociable, and mentally stable than are those who are only children.33–37”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [33] Jiang, 2002, Effects of living conditions on the mental adaptation ability of the new soldiers, China Occup Med
    • cites [34] Li, 2004, Study on mental stress, coping style and social support level in the only-child new soldiers, China Occup Med
    • cites [35] Li, 2004, Analysis of mental health status and its related factors in 1077 new soldiers, Acad J Sec Mil Med Univ
    • cites [36] Liu, 2004, Survey study on the psychology health conditions of the only-child soldiers, Health Psychol J
    • cites [37] Wang, 2006, Soldiers' mental health and adaptation ability, China J Health Psychol

  • It may state two separate claims as one.

    Interpretationcitation

    The growth in the elderly population is putting serious pressure on China's health system, which is not adapted to the complex and expensive comorbidities of an ageing population.

    “The growth in the elderly population is also putting serious pressures on the health system, which is not yet adapted to deal with the complex and expensive comorbidities of an ageing population.44”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44] Teng, 2015, Health status and burden of health care costs among urban elderly in China, Asia Pac J Public Health source

  • It may state two separate claims as one.

    Premisecitation

    The 2000 census showed that areas with a 1.5-child policy had a sex ratio at birth as high as 125, compared with 109 in areas with a two-child policy, suggesting that the 1.5-child policy specifically worsened China's high sex ratio at birth.

    “The 2000 census data show that in areas with a 1·5-child policy, the sex ratio at birth was as high as 125 compared with 109 in areas with a two-child policy, which suggests that the 1·5-child policy has specifically exacerbated China’s high sex ratio at birth.79”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [79] Guo, 2007, Multi-level analysis on the sex ratio at birth in China based on the 2000 census and the regional fertility policy data, Popul Res

  • It may state two separate claims as one.

    Premisecitation

    About 90% of women report wanting one or two children, while in large cities nearly two-thirds prefer only one child.

    “around 90% of women report they want one or two children, whereas in large cities nearly two-thirds of women state a preference for only one child.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [59] Qu, 2006, Family size, fertility preferences, and sex ratio in China in the era of the one child family policy: results from national family planning and reproductive health survey, BMJ source
    • cites [60] Retherford, 2005, How far has fertility in China really declined?, Popul Dev Rev source
    • cites [61] Zheng, 2016, Socio-economic status and fertility intentions among Chinese women with one child, Hum Fertil (Camb) source

  • It may state two separate claims as one.

    Interpretationcitation

    The combined rural-urban total fertility rate is estimated to be 1.88 in 2017 and 1.81 in 2030.

    “The combined rural–urban total fertility rate is estimated to be 1·88 in 2017, and 1·81 in 2030.7”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] Zeng, 2014, A policy analysis on challenges and opportunities of population/household aging in China, J Popul Aging source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Interpretationcitation

    The number of disabled people older than 65 is predicted to rise from 8.4 million in 2010 to 19 million in 2030 and 37 million in 2050.

    “The number of disabled people aged older than 65 years is predicted to increase rapidly from 8·4 million in 2010, to 19 million in 2030, and 37 million in 2050.72”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [72] Zeng, 2015, Implications of changes in households and living arrangements for future home-based care needs and costs of disabled elders in China, J Aging Health source

  • It may state two separate claims as one.

    Premisecitation

    The government feared that lifting the one-child policy would cause a baby boom, so it responded cautiously with gradually introduced exemptions.

    “the government feared that lifting the policy would lead to a baby boom, so the government’s response has been cautious with a series of gradually introduced exemptions.”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [7] Zeng, 2014, A policy analysis on challenges and opportunities of population/household aging in China, J Popul Aging source
    • cites [51] Zeng, 2015
    • cites [52] Liang, 2012
    • cites [53] Gu, 2014
    • cites [54] Liang, 2014
    • cites [55] Qiao, 2015, Two-child for parents that one of them is from one-child family, a wrong policy, Popul Dev

  • It may state two separate claims as one.

    Interpretationown data

    The universal two-child policy is predicted to produce a peak population of about 1.45 billion in 2029 followed by gradual decline, while a continuing one-child policy would peak at about 1.40 billion in 2023 followed by rapid decline.

    “The universal two-child policy is predicted to lead to a peak population of around 1·45 billion in 2029 and then gradually decline (table). Under a continuing one-child policy scenario, the population would peak at around 1·40 billion in 2023 and then rapidly decline (table).”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisecitation

    The role of fertility policy is diminishing quickly, and fertility in contemporary China is socioeconomically determined.

    “There is now clear evidence that the role of fertility policy is diminishing fast, and that fertility in contemporary China, as elsewhere, is socioeconomically determined.8,11”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [8] Wang, 2013, Population, policy, and politics: how will history judge China's one-child policy?, Popul Dev Rev source
    • cites [11] Hirschman, 1994, The path to below replacement-level fertility in Thailand, Int Fam Plan Perspect source

  • It may state two separate claims as one.

    Interpretationcitation

    Under the universal two-child policy, the share of people older than 65 is expected to reach 18% in 2030, with the rural proportion about twice the urban proportion.

    “The percentage of over-65s under the universal two-child policy is expected to reach 18% in 2030, with the proportion about twice as high in rural areas than in urban areas.7,68”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [7] Zeng, 2014, A policy analysis on challenges and opportunities of population/household aging in China, J Popul Aging source
    • cites [68] Yi, 2010, Population aging and old-age care in China

  • It may state two separate claims as one.

    Premisecitation

    Studies that control for confounders show that only children have higher academic achievement, higher self-esteem, and greater confidence.

    “studies that control for confounders show that only children have higher academic achievement, higher self-esteem, and greater confidence,28–31”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [28] Yang, 2007, China's one-child policy and overweight children in the 1990s, Soc Sci Med source
    • cites [29] Hesketh, 2003, Health effects of family size: cross sectional survey in Chinese adolescents, Arch Dis Child source
    • cites [30] Yang, 1995, Only children and children with siblings in the People's Republic of China: levels of fear, anxiety, and depression, Child Dev source
    • cites [31] Poston, 1990, Academic performance and personality traits of Chinese children: “onlies” versus others, AJS

  • It may state two separate claims as one.

    Premisecitation

    Never-married middle-aged and older men have significantly higher depression levels, are more prone to aggression than married men, and may be more easily drawn into crime, raising concerns about social instability.

    “never-married middle-aged and older men have significantly higher levels of depression,23,24 they are more prone to aggression than married men, and may be more easily drawn into crime, leading to concerns about social instability.21,25,26”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [23] Zhou, 2013, Depression and aggression in never-married men in China: a growing problem, Soc Psychiatry Psychiatr Epidemiol source
    • cites [24] Zhou, 2013, High sex ratio as a correlate of depression in Chinese men, J Affect Disord source
    • cites [21] Greenhalgh, 2013, Patriarchal demographics? China's sex ratio reconsidered, Popul Dev Rev source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Interpretationcitation

    The low uptake was attributed to the high cost of raising children in cities, because the overwhelming majority of eligible couples were urban residents.

    “The low uptake has been attributed to the high cost of rearing children in cities, because the overwhelming majority of these eligible couples were urban residents.57”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [57] Xiang, 2015, The development trend of China's population and population policy adjustment, Western Forum

  • It may state two separate claims as one.

    Premisecitation

    Because grandparents traditionally assume childcare responsibilities, three-generation living arrangements increase workforce participation of female adult children, with financial and health benefits.

    “Since grandparents traditionally assume childcare responsibilities, such arrangements increase the workforce participation of female adult children, with consequent financial and health benefits.98”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [98] Shen, 2012, The causal effect of family structure on female labor force participation, Popul Res

  • It may state two separate claims as one.

    Premisecitation

    Elderly parents living with adult children show better cognition, self-assessed health, and satisfaction with life.

    “Older parents who live with their adult children have better cognitive function, self-rated health, and life satisfaction.97”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [97] Shen, 2011

  • It may state two separate claims as one.

    Premisecitation

    Data from the 2000 census showed that the average probability of an only child's death was 4% before the mother reached age 45, 12% before age 80, 16% before age 85, and 21% before age 90.

    “Data from the 2000 census showed that the average probability of the only-child’s death was 4% before their mother reached age 45 years, 12% before they reached 80 years, 16% before 85 years, and 21% before they reached 90 years.87”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [87] Zeng, 2015, Implementing the universal two-child policy as soon as possible is a win-win policy for both the nation and people, Popul Econ

  • It may state two separate claims as one.

    Premisecitation

    There is an acute shortage of paediatricians and paediatric nurses across China, and it has worsened over the past decade.

    “A major concern is the acute shortage of paediatricians and paediatric nurses across the country, which has worsened over the past decade.91”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [91] Hi, 2014, Shortage of paediatricians in China, Lancet source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.

    Interpretationreasoning

    The new rural pension schemes will improve elderly welfare and generate substantial funds through premiums from many millions of enrollees.

    “These new rural old age insurance programmes will not only enhance senior citizens’ welfare, but also create a huge amount of capital by collecting premiums from hundreds of millions of new programme participants.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Interpretationnone given

    The new policy will let nearly all couples have as many children as they desire.

    “In short, in the coming decades the universal two-child policy will help to address the challenge of population ageing, reduce the sex ratio at birth, remove the more oppressive elements of the one-child policy, contribute to economic growth, and allow the overwhelming majority of couples to have the number of children they want.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Interpretationreasoning

    The negative effects of the one-child policy are expected to be totally eliminated under the new policy.

    “These negative effects are expected to be totally eliminated.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The one-child policy caused social division and resentment, because rules varied and richer families could pay fines to have two children.

  • Probably not a substantial claim. It may state two separate claims as one.

    Interpretationreasoning

    A higher retirement age would ease the expected shortage of workers resulting from the long one-child policy and allow more time for the new policy's benefits to appear.

    “It will also ameliorate the predicted labour shortage, seen as a consequence of 36 years of the one-child policy, while also buying the time needed for the benefits of the universal two-child policy to be fully realised.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.

    Interpretationreasoning

    The outcomes of the new policy will help create a more harmonious society.

    “All of these outcomes will help to create a more harmonious society, an attribute highly regarded by the Chinese Government and the people.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationreasoning

    The new policy will produce a modest rise in births, not a baby boom.

    “The two-child policy will therefore not result in a baby boom, but rather a moderate increase in fertility.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: China's sweeping social and economic changes since the one-child policy began have produced a culture of low fertility.

  • It may state two separate claims as one.

    Interpretationreasoning

    Adopting the universal two-child policy will significantly reduce China's sex ratio at birth, but it is unlikely to normalise fully for many years because of long-standing son preference and continued access to sex-selective technologies.

    “adopting the universal two-child policy will make significant contributions to reducing the sex ratio at birth in China, but it is unlikely to totally normalise for many years to come, because of the long-standing preference for sons, especially in rural areas, and continued access to sex-selective technologies.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.

    Interpretationnone given

    With timely and effective policies, China can probably meet the challenges of an ageing population.

    “Overall, if sound policy actions are taken promptly and effectively, China should be able to successfully address the challenges of an ageing population.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.

    Interpretationnone given

    Most of the harmful consequences of the one-child policy will vanish, and almost all Chinese people will achieve their preferred family size.

    “But the many negative effects of the one-child policy will disappear and nearly all Chinese people will have their desired family size.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.

    Interpretationnone given

    The sex ratio at birth will decline due to a more balanced sex ratio in reproductive years, especially in rural areas, but these effects can only be gradual.

    “Finally, although the sex ratio at birth will decline with the beneficial effects of a more balanced sex ratio in the reproductive years, especially in rural areas, these effects can only be gradual.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Interpretationnone given

    The new policy will eliminate the harsher aspects of the one-child policy.

    “In short, in the coming decades the universal two-child policy will help to address the challenge of population ageing, reduce the sex ratio at birth, remove the more oppressive elements of the one-child policy, contribute to economic growth, and allow the overwhelming majority of couples to have the number of children they want.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. It may state two separate claims as one.

    Interpretationreasoning

    When older people are more financially independent, they depend less on sons and value daughters more equally.

    “Greater financial independence for the elderly will also reduce reliance on sons, resulting in a more enlightened attitude towards the relative value of sons and daughters.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisecitation

    Evidence from longitudinal healthy ageing surveys indicates that elderly people cared for by daughters and sons-in-law rather than sons and daughters-in-law have lower mortality and a lower probability of cognitive decline.

    “Evidence from longitudinal healthy ageing surveys42,90 indicates that elderly people cared for by daughters (and sons-in-law) rather than sons (and daughters-in-law) have a lower mortality and lower probability of declining cognitive capacity.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [42] Zeng, 2016, Older parents benefit more in health outcome from daughters than sons emotional care in China, J Aging Health source
    • cites [90] Pham-Kanter, 2012, Do sons reduce parental mortality?, J Epidemiol Community Health source

  • It may state two separate claims as one.

    Premisecitation

    Demographers estimated that about 1 million families were permanently childless in 2010 because of the death of an only child, and that number has been increasing by about 78,000 each year.

    “Demographers have estimated that there were about 1 million permanently childless families because of death of the only-child in 2010, and the number has been increasing by about 78 000 every year.89”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [89] Wang, 2013, “Only-child-death” family and its developing trends under the current family planning policy, Chin J Popul Sci

  • It may state two separate claims as one.

    Premisecitation

    Raising the retirement age extends the period of pension contributions, which strengthens pension finances and raises payments after retirement.

    “It prolongs pension contributions, improving the financial stability of the pension system,95 while increasing post-retirement payments.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [95] Zeng, 2011, Effects of demographic and retirement-age policies on future pension deficits, with an application to China, Popul Dev Rev source

  • It may state two separate claims as one.

    Premisecitation

    Under the one-child policy, corruption involved payments to officials for approval of additional births and irregular fining of people who violated birth control rules.

    “This corruption included bribing of officials for permission for more than one child, and the often unregulated collection of fines from birth control violators.51”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [51] Zeng, 2015

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Interpretationreasoning

    Increased capital from rural old age insurance will contribute to further economic development.

    “This increased capital will contribute to further economic development.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.

    Interpretationreasoning

    Promoting co-residence with a daughter and son-in-law would slowly alter the custom of daughters leaving their natal family, help the elderly, weaken son preference, and influence the sex ratio at birth.

    “This strategy would gradually change the tradition of daughters marrying-out of their own families, would be beneficial for older adults, and also help to reduce the preference for sons, with obvious effects on the sex ratio at birth.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim.

    Interpretationreasoning

    China has three unique opportunities to address rapid population ageing.

    “China has three unique opportunities to address the challenge of rapid population ageing.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Interpretationnone given

    In coming decades, the universal two-child policy will contribute to economic growth.

    “In short, in the coming decades the universal two-child policy will help to address the challenge of population ageing, reduce the sex ratio at birth, remove the more oppressive elements of the one-child policy, contribute to economic growth, and allow the overwhelming majority of couples to have the number of children they want.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Interpretationnone given

    Fertility will rise considerably in certain places under the new policy, particularly in rural areas and small towns.

    “First, the universal two-child policy will substantially increase fertility in some localities, especially in rural areas and small towns.”
    Quote in the paperNot a substantial claim
54 of 54

  • The paper relies on this without support.

    The one-child policy caused social division and resentment, because rules varied and richer families could pay fines to have two children.

    “A divisiveness was created by the one-child policy, with different rules applying to neighbours and friends, as well as resentment towards the wealthy who were able to afford the penalties for having two children.”

  • The paper relies on this without support.

    China adopted the universal two-child policy chiefly because of population ageing, which is among its biggest challenges this century.

    “The universal two-child policy was introduced principally to address the serious challenges of population ageing, one of the greatest challenges for China in the 21st century.”

  • The paper relies on this without support.

    China's mandatory retirement ages—55 for women and 60 for men—are unusually low globally.

    “The retirement age in China, 55 years for women and 60 years for men, is among the lowest in the world.”

  • The paper relies on this without support.

    There is a shortfall in health personnel, especially in paediatrics, in China.

    “The shortfall in health personnel, especially in paediatrics, requires short-term and long-term solutions.”

  • The paper relies on this without support.

    A large share of paediatricians' work in acute hospitals is actually primary care.

    “much of the work currently done by paediatricians in acute hospitals is primary care in nature”

  • The paper relies on this without support.

    China's sweeping social and economic changes since the one-child policy began have produced a culture of low fertility.

    “Since the onset of the one-child policy massive socioeconomic change in China has led to a low fertility culture.”
6 of 6

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The first generation of only children in China was born around 1980 and is now in their forties.

    “The first generation of only children in China was born around 1980 and is now in their forties (5).”

    From Caring alone: older adult care burdens, practices, and structural imbalances among China's one-child generation (2025) · cites this paper as [5]

    The one-child policy section says the policy began in 1979, supporting the inference that its first generation of only children was born around 1980. The paper does not state that this generation is now in its forties; published in 2016, it cannot establish the citing sentence’s present-day age claim. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • At the end of 1979, the Chinese government introduced the one-child policy.

    “At the end of 1979, the Chinese government introduced the one-child policy, which became an important factor contributing to the intensification of population aging (5).”

    From Caring alone: older adult care burdens, practices, and structural imbalances among China's one-child generation (2025) · cites this paper as [5]

    The one-child policy section says the Chinese Government introduced the policy in 1979, but it does not specify that this happened at the end of the year. The introduction of the universal two-child policy section also identifies accelerating population ageing as a negative consequence of the one-child policy. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • The one-child policy became an important factor contributing to the intensification of population aging.

    “At the end of 1979, the Chinese government introduced the one-child policy, which became an important factor contributing to the intensification of population aging (5).”

    From Caring alone: older adult care burdens, practices, and structural imbalances among China's one-child generation (2025) · cites this paper as [5]

Citations

Cites

Flagged first, then by citations

Research works printed but not linked: 25

  1. Jiang, 2002, Effects of living conditions on the mental adaptation ability of the new soldiers, China Occup Med, 29, 17
  2. Li, 2004, Study on mental stress, coping style and social support level in the only-child new soldiers, China Occup Med, 31, 7
  3. Li, 2004, Analysis of mental health status and its related factors in 1077 new soldiers, Acad J Sec Mil Med Univ, 25, 584
  4. Liu, 2004, Survey study on the psychology health conditions of the only-child soldiers, Health Psychol J, 10, 65
  5. Wang, 2006, Soldiers' mental health and adaptation ability, China J Health Psychol, 14, 481
  6. Gale, 1994, The shortcomings and options of China's rural population policy, Chinese Rural Econ, 6, 51
  7. Zeng, 2006, A soft-landing with the two-children-late-birth policy: need and feasibility, Soc Sci China, 58, 93
  8. National Health and Family Planning Commission. Press conference of National Health and Family Planning Commission on July 10th, 2015.
  9. Xiang, 2015, The development trend of China's population and population policy adjustment, Western Forum, 25, 40
  10. Feng, 2016, Do or don't? The birth preference and influence factor analysis of city reproductive-aged population with one child, J Natl Sch Admin, 1, 94
  11. Zhu, 2015, The second childbirth expectation and employment status: evidence from China Labor-force Dynamics Survey, Stud Labor Econ, 3, 110
  12. Zhang, 2016, Fertility intention for the second child under the selective and universal two-child policies: comparisons and implications, Popul Res, 1, 87
  13. Mu, 2015, Two-child policy: toward to modern population controlling, Chin Econ Rep, 12, 70
  14. Wang, 2015, The influence of fertility policy adjustment to the birth population size in China, Popul J, 2, 22
  15. Cai, 1999, The sustainment of China economic growth and its labor determinants, Econ Res J, 10, 62
  16. Guo, 2007, Multi-level analysis on the sex ratio at birth in China based on the 2000 census and the regional fertility policy data, Popul Res, 31, 20
  17. Yang, 2006, Regional diversity of fertility on child sex ratio in China, Popul Res, 30, 30
  18. Song, 2009, A micro empirical study of the effect of family planning policy on sex ratio at birth, Popul Res, 33, 44
  19. Gu, 2008, Practice and revelation of the two-child policy experimental areas, Popul Res, 32, 33
  20. Huang, 2012, The size of bereft families who lost their only child is increasing, collective demands deserving imminent attention, Ref Aging, 3
  21. Wang, 2013, “Only-child-death” family and its developing trends under the current family planning policy, Chin J Popul Sci, 1, 57
  22. Song, 2016, The pediatric demands and gaps under the universal two child policy, Chin J Health Policy, 9, 65
  23. Shen, 2012, The causal effect of family structure on female labor force participation, Popul Res, 36, 15
  24. Zeng, 2015, Implications of changes in households and living arrangements for future home-based care needs and costs for disabled elders in China, J Aging Health, 27, 519, 10.1177/0898264314552690 · DOI · Paper page
  25. Liang, 2014, China may get enlightenment from Singapore's model of family support for elderly, Going forward in the same boat, 9, 36

Cited by

Sorted by citations

Related

Metadata

Authors
Zeng, Y., & Hesketh, T.
Affiliations
  • Duke University (US)
  • University College London (GB)
Corresponding author
Hesketh, Therese
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2016-10
Volume
388
Issue
10054
Pages
1930-1938
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(16)31405-2
PMC
PMC5944611
OpenAlex
W2530848521
Semantic Scholar
7bcbe72d978f7b300809fc44d43b213b56a1c55c
Cited by
701
References
61
Citations by year
2026: 56 · 2025: 77 · 2024: 85 · 2023: 71 · 2022: 102 · 2021: 99 · 2020: 94 · 2019: 64 · 2018: 35 · 2017: 17 · 2016: 1
FWCI
10.48
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
  • National Natural Science Foundation of China
  • Economic and Social Research Council (ES/F034466/1)
  • National Institute on Aging (P30AG034424)
Topics
  • Social Sciences › Gender Studies › Demographic Trends and Gender Preferences
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
  • Social Sciences › Political Science and International Relations › China's Socioeconomic Reforms and Governance
Keywords
two-child policy, one-child policy, fertility policy, population projections, abortion, sex ratio, population aging, elderly care, China
MeSH terms
Abortion, Induced, Aging, Birth Rate, China, Coercion, Contraception, Educational Status, Employment, Ethnicity, Female, Persons with Disabilities, Health Services, Health Services Needs and Demand, Health Status, Humans, Income, Intrauterine Devices, Male, Only Child, Parents, Population Control, Population Growth, Public Policy, Punishment, Rural Population, Sex Ratio, Urban Population, Women's Health, Caregivers, Confucianism, History, 20th Century, History, 21st Century

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-10-08, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-10-08 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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