Understanding Long-Term Care Provision for Community-Dwelling Older People in China through the Lens of Welfare Mix

07 JUL
3:00 PM (HK Time, UTC + 8)
Zoom Meeting ID: 960 9672 6881 (Passcode: 948879)
Division of Public Policy (PPOL)
Miss Zilin LI



In the Asian context, the applicability of some theoretical and conceptual models of social welfare from the West can be problematic because of the central role of the family, especially those related to social care. Such a particularity leads to a fundamental divergence in welfare development between the ‘West’ and the ‘East’: while the advocacy of welfare mix was a result of the welfare retrenchment in the West; in the East, it is a request from the decreasing capacity of the family sector and calls for more contribution from the state, the market, and the third sector. This research contributes to the welfare mix literature by putting the family in a more central and active position and focusing on the formal-informal boundary. Meanwhile, by examining home-and community-based care for older people in China, this thesis aims to enrich scholarly knowledge on the welfare mix in the social care sphere in an authoritarian state that Confucianism heavily influences.


The welfare mix framework is used to connect the three independent studies that explore how the four core institutions, namely the state, the market, the third sector, and the family, share the welfare responsibilities, interact with each other, and explain the challenges they encountered over the collaboration process. The first study examines how informal and formal sectors provided long-term care using panel data from the CHARLS survey, waves 2011, 2015, and 2018. Study 2 and Study 3 are designed to generate in-depth understandings of informal and formal sectors separately. Study 2 investigates the dynamics of old-age support within the family under the background of population aging. Using panel data from the CLHLS waves 2008, 2011, 2014, and 2018, this study reveals the changing practices of filial piety and the emerging needs of Chinese families. Study 3 is a case study on the public-private partnership among formal actors in providing home- and community-based elderly care services in Guangzhou. This study provides an in-depth understanding of the formal sector based on semi-structural interviews with various stakeholders.


The findings suggest that the family is the primary care provider for community-dwelling older Chinese. However, while older parents are becoming more independent from adult children, the family alone is no longer sufficient to meet community-dwelling older people’s long-term care needs. While there is a remarkable increase in formal provision under the state’s advocacy, it does not translate into a decrease in unmet needs. The lack of effective collaboration between formal and informal care results from the state’s dominant political role, creating two consensus gaps: the state’s contribution and citizens’ expectations; and the state’s ambition and non-state actors’ capacity.

Division of Public Policy (PPOL)