The 4-2-1 of China's Aging Problem...

Sombit Mishra

One Child Policy has resulted in the 4:2:1 problem in caregiving - image courtesy of's an excellent post from Haihong Sun, a close friend of the QMedic team based in China. Haihong is a design expert who, along with her team of MIT and Harvard alums, is reinventing retirement communities in Jiangsu Province, China. 

While it's long been clear that aging is a global challenge, Haihong's post underscores that aging dynamics are very different by country.  In China, for example, the one-child policy—enacted in 1978—has put the majority of Chinese families in a precarious caregiving situation, commonly referred to as 4:2:1 (i.e. 1 couple taking care of 4 grandparents and 1 child).

Whereas in the United States the economic and social burden of caregiving tends to be distributed across multiple adult children and the healthcare system, this is rarely the case in China. China does not have the pension and insurance system of the United States, which leaves working families to bear almost the full burden of care for their parents.

35 years after its enactment, the one-child policy will soon be phased out, but its consequences on economic growth in China have already taken root and are likely to have destabilizing effects for years to come.

The good news is that aging innovation is going global. We're excited to see more from Haihong and her team!


Interested in reading more posts from QMedic - Read our last post "Wild Honey at TEDMED's the "Hive"".