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Caregiving for China’s one-child generation: a simulation study of caregiving responsibility and impact on women’s time use
Open accessAbstract
INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
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A simulated quantitative study indicates that, compared with non-only children, China's only-child caregivers bear greater caregiving challenges and stress.
“A simulated quantitative study indicates that, compared with non-only children, China’s only-child caregivers bear greater caregiving challenges and stress (19).”
From Caring alone: older adult care burdens, practices, and structural imbalances among China's one-child generation (2025) · cites this paper as [19]
The Discussion reports that women born under the one-child policy have substantially higher simulated caregiving responsibility than women born before it, partly because they have fewer siblings. This supports greater caregiving burden, but the study compares birth cohorts of women rather than only-child caregivers directly with non-only-child caregivers, and it does not establish greater psychological stress. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe caregiving role of China's only children has drawn attention in fields such as nursing and sociology.
“The caregiving role of China’s only children has drawn attention in fields such as nursing and sociology (18–21).”
From Caring alone: older adult care burdens, practices, and structural imbalances among China's one-child generation (2025) · cites this paper as [19]
The Introduction and Discussion examine caregiving responsibilities among China’s one-child generation and refer to previous studies of caregiving in China. They support that the subject has received research attention, but our copy does not establish that this attention came from nursing and sociology specifically. (LLM, conf=0.80)
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Xiang, S., Xiang, H., Ren, Q., & Deng, Q. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1694636 · Cited by 6
Metadata
- Authors
- Kwete, X., Knaul, F. M., Essue, B. M., Touchton, M., Arreola-Ornelas, H., Langer, A., Calderon-Anyosa, R., & Nargund, R. S.
- Affiliations
- University of Miami (US)
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, Florida, USA
- Harvard University (US)
- ORCID
- Venue
- BMJ Global Health
- Publisher
- BMJ
- Published
- 2024-06
- Volume
- 9
- Issue
- 6
- Pages
- e013400
- ISSN
- 2059-7908 (ISSN-L)
- PMC
- PMC11163626
- OpenAlex
- W4399384884
- Cited by
- 22
- References
- 22
- Citations by year
- 2026: 17 · 2025: 5
- FWCI
- 15.78
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMJ Global Health (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- EMD Serono (AWD-003776, AWD-006650, AWD-008501)
- Topics
- Social Sciences › Sociology and Political Science › Intergenerational Family Dynamics and Caregiving
- Social Sciences › Gender Studies › Demographic Trends and Gender Preferences
- Social Sciences › Gender Studies › Gender, Labor, and Family Dynamics
- Keywords
- one-child policy, caregiving responsibilities, women's time use, family caregiving, China, epidemiological transition, end-of-life care, palliative care, grandparents, siblings, working-age women, population simulation
- MeSH terms
- Adult, Child, Child, Preschool, China, Female, Humans, Infant, Middle Aged, Caregivers
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