A new study has uncovered significant gender and urban-rural divides in China’s elderly labor force, with men and those living in the countryside more likely to continue working while suffering from chronic health conditions.

The research was conducted by academics at Huazhong University of Science and Technology using data from a nationwide survey of nearly 24,000 people aged 50 or over. It was published in the journal Nature Medicine on Aug. 1.

According to the authors, their findings highlight the need for China to identify ways to address gender and regional inequities while reforming the pension system to cope with a rapidly aging population.

China’s leaders announced plans to gradually raise the statutory retirement age during last month’s third plenary session of the Party’s Central Committee, as they try to relieve the financial pressure on pension funds.

The proportion of China’s population aged 65 or over reached 14.9% in 2022, up from 8.9% in 2010. But the present retirement age is set at just 60 for men, and 55 or 50 for women depending on their profession.

For the authors, the proposed reforms should take into account the disparities in China’s elderly workforce. They proposed that authorities promote “inclusive initiatives aimed at targeted populations” to address the specific health and labor needs of different groups.

According to the study, the estimated time spent working while in good health from age 50 was, on average, 6.87 years in China. The average age at which people start having health problems is similar across demographic groups, around 60. But the age at which people stop working varies substantially depending on their social background, according to the study.

Men who reach 50 have a healthy working life expectancy of eight years, compared with six years for women. Men also work for longer while suffering from poor health than women, at 9.48 years on average.

The authors noted a general trend for female civil servants and enterprise employees to exit the job market “at relatively young ages despite being healthy.” This is likely a result of women in that group having a lower retirement age, facing a lack of job opportunities, or wanting to retire to care for children and elderly relatives, they said.

Rural residents, meanwhile, tend to stop working far later than city dwellers despite suffering from persistent health issues. Women in the countryside often work beyond the age of 65, while men work up to the age of 70, the study said.

Rural residents on average spend 10.63 years working while in poor health, which is 3.75 years longer than their urban counterparts. They are also far less likely to be economically inactive while in good health: Rural residents in good health spend only 2.97 years out of work on average, compared with 4.92 years for urban residents.

Agricultural workers work nearly twice as long while in poor health compared with corporate employees. Conversely, corporate employees spend nearly twice as much time in good health but not working.

This stark disparity between rural and urban areas is likely caused by differences in regional pension systems, the authors suggested. Rural residents tend to receive lower pensions and often have to continue working to support themselves.

The study also noted geographical differences in the elderly population’s healthy working life expectancy, with the figure gradually decreasing as one moves from China’s economically dynamic south to the northeastern “rust belt” provinces.

People living in South China have a healthy working life expectancy of nine years on average, while the figure is only 5.6 years for those in Northwest China, the study found. The main factors behind the discrepancy are the greater job opportunities and health support in the south, the authors said.

Chinese authorities insist that pension reforms are vital to ensure the country’s social security system remains financially sustainable. Unless action is taken, the national basic pension insurance fund for enterprise employees will go into deficit by 2029, the government estimates.

For the study’s authors, it will be important to supplement these reforms with measures to protect vulnerable citizens. “For the most vulnerable people, such as aging populations in agricultural occupations, strengthening the comprehensive pension system while providing targeted health promotion programs is essential for greater social equity,” they wrote.

(Header image: IC)