Old-Age Disability in China: Implications for Long-Term Care Policies in the Coming Decades

China's population is aging rapidly. The increase in the elderly population, along with the rising prevalence of major chronic diseases and greater longevity among those afflicted with many of these diseases, will lead to a growing number of functionally disabled elders who may need long-term care (LTC). Elders in China have traditionally relied on their families as the main source of LTC. This situation is changing as fewer family members are available to provide care, due to shrinking family size caused by continuously low fertility, combined with increased female workforce participation. Without a well designed LTC system to address the growing care need, it is increasingly obvious that the current LTC situation in China will not be sustainable in the coming decades.;Old-age disability and LTC have not yet been well studied in China. Using logistic regressions and a prevalence ratio projection model, and considering international practices, this dissertation addresses three research questions: 1) What are the key risk factors for old-age disability in China? 2) What are the projected numbers of older adults with disabilities in China in future decades through 2050? 3) How can China develop a feasible and sustainable LTC delivery and financing system to address projected growth in LTC needs of this population over the next four decades?;Findings indicate that old age, being female, single, and in poor health (e.g., presence of a chronic condition and poor self-rated health) are the key risk factors associated with functional disability among older adults in China. Although urban older adults are more likely to be severely disabled, the overall disability risk is higher among rural older adults. No matter whether disability rates remain constant, increase or decline in the future, the sheer number of disabled older adults and the ratio of disabled elders to potential caregivers (however defined) will increase rapidly, especially in rural areas. I describe how my findings, combined with an understanding of common features of existing LTC systems and international guidelines can inform strategies policymakers can use to develop a feasible and sustainable LTC system to prepare for its growing care needs in the future.