“Thirty years from now, it will be rare to see children walking along the streets of Taiwan,” says Chen Kuan-jeng (陳寬政), a research fellow in the Institute of Sociology at Academia Sinica. “Instead, the streets will be full of elderly people.” Chen's prediction may sound a bit drastic, but he voices a growing concern among sociologists over the dramatic shift under way in Taiwan society toward a graying population. As in many developed countries, island families are having fewer children, while at the same time the average life span is increasing to create a larger and larger pool of senior citizens.
Between 1953 and 1993, the annual birthrate declined from about forty-five births per thousand persons to less than sixteen. During the same period, the average number of children per Taiwan couple declined by more than two-thirds, from about 7 to 1.7. The current average is below that of the United States (2 children per couple), Mainland China (1.9), and Britain or France (both 1.8). The Taiwan figure also means that since 1984 the birthrate has dropped below the “replacement level.” Sociologists predict that within forty years, the total population will be declining.
Another trend is also changing the face of Taiwan's population: the average life span is steadily rising, leading to a growing proportion of elderly people. In 1951, local men lived an average of 53 years, and women lived 56 years. Today, men average 72 years and women 77. Because the trend toward fewer children and more senior citizens is expected to continue, sociologists predict that the elderly proportion of the population will increase steadily. While persons aged over 65 made up just over 7 percent of the population in 1994, they are expected to account for 22 percent by the year 2036—a figure that could mean more than five million senior citizens.
The result is an overall “graying” of society and a new set of social welfare needs that must be met---nursing homes rather than nursery schools, daycare programs for the elderly rather than for preschoolers. Social scientists predict that these demands will be hard to fulfill. “In the future, there won't be enough young people to support the older people,” says Chen. Sociologists are particularly concerned that expanding health care costs for senior citizens will mean a large financial burden for taxpayers. Another concern is that a dwindling population of working-age adults will slow economic growth.
Patterns in Taiwan's population growth looked far different just a generation ago. During the 1950s, the island's population zoomed from 7.6 million to a 1960 figure of 10.8 million. The centuries-old belief that more children bring luck to a family was strong among local residents. Another long-held tradition---the preference for male children---also boosted family size. Because sons traditionally carry on the family name and care for their parents in old age while daughters “join” another family after marriage, couples have long faced strong pressure to produce male heirs. In the past, women simply continued having children until they had given birth to the desired number of sons.
But as the decade came to a close, the rapid population increase began to alarm sociologists. One of the most outspoken advocates of population control was Chiang Meng-lin (蔣夢麟), then chairman of the Joint Commission for Rural Reconstruction. In 1959, he gained recognition with attention-grabbing statements such as the claim that each year the island's high birthrate cost taxpayers more than the NT$4.8 billion [US$180 million] Shihmen Reservoir, then under construction. Chiang began promoting use of contraceptives, despite strong opposition from the public and from some government officials anxious to see Taiwan increase its population in order to build military strength.
Opposition notwithstanding, the government launched a pre-pregnancy health campaign in 1959, which included teaching birth control methods through public hospitals and health stations (community out-patient clinics) and later by visiting married women door to door in rural areas. Two years later, health stations began supplying the IUD (intrauterine device), but the initial use-rate was quite low. The provincial government also established two agencies devoted to family planning, the Taiwan Population Studies Center, to conduct research, and the Provincial Government's Health Department's Committee on Family Planning, to administer official population-control campaigns. In 1964, the committee launched a five-year project in which a team of three hundred field workers visited villages throughout the island, going door to door to educate women on the use of contraceptives. They also helped publicize the official family planning policy. This comprised several easy-to-remember elements, designed to protect the health of mother and child. Couples should have their first baby only after they had been married for three years. They should wait another three years before having a second. And they should limit the number of children to three, all born before the mother turned thirty-three years old.
In the mid-1960s, the government launched an even more restrictive family planning campaign with the slogan, “Two children is just right; girls and boys are equally good.” In addition, the government began promoting birth control methods which were newly available on the island, including birth control pills, condoms, and tubal ligation.
Public sentiment toward birth control gradually changed. While less than 2 percent of married women aged fifteen to forty-four practiced birth control in 1964, more than 18 percent did so in 1970. By the mid-1980s, approximately 80 percent of married couples used contraceptives.
Still, Taiwan's population grew from 14.7 million to 17.8 million during the 1970s, and social scientists continued to urge further population control measures. In 1985, the government promulgated the Genetic Health Law that liberalized abortion regulations. The new law approved abortion within a broad set of circumstances, including cases of rape, incest, fetal deformity or risk of hereditary disease, or when the birth of the child would “adversely affect family life.”
The 1980s marked a turning point in population control. After three decades of steady increase, the growth rate began tapering off. The population doubled between 1950 and 1970, and rose by more than one-third between 1970 and 1990 (see graph). By the mid-1980s, the average number of children per couple was below two, near the rate of most developed countries. Sociologists now predict that total population figures will remain flat over the next few decades and will likely begin declining after the year 2030.
In addition to official family planning campaigns, a number of social factors have led to the declining birthrate. For example, couples are marrying later, and a growing number of young people are opting to stay single. Ministry of Interior data show that between 1971 and 1994 the average age for first marriages increased from twenty-two to twenty-eight for women, and from twenty-eight to thirty-one for men. And among people who do marry, a growing proportion are choosing not to have children.
Chien Tai-lang---”Over the next few years we will promote a reasonable growth rate.” Priorities include increasing the birthrate and raising the percentage of healthy babies born.
Hu Yu-hui (胡幼慧), an associate professor at the Institute of Health and Welfare Policy, National Yang Ming University, says a number of social problems are leading people to choose to stay single or to become “DINKs” (double income, no kids). She lists several factors that induce people not to have children. These include the escalating cost of raising a child and the lack of daycare services, and social concerns such as increasing environmental pollution, dissatisfaction with the highly competitive education system, and worsening social order.
Hu believes more women than men are deciding against marriage and children. “Women are more affected by these social problems because they are more influenced by marriage,” she says. Hu explains that wives and mothers are still the primary caretakers of parents-in-law and youngsters, at least in most families, and so it is they who most often sacrifice personal interests and careers when they marry or have children. She adds that the desire for economic independence, and dissatisfaction with traditional family dynamics—the unequal status of men and women, for example, and the often strained relationship between mothers- and daughters-in-law—are also discouraging some women from marriage and motherhood.
For these reasons, Taiwan's population explosion has long since been offset. In both 1987 and 1992, the island was named the most successful in population control among ninety-five developing countries or areas by the U.S. Population Crisis Committee.
But sociologists worry that population control measures may have gone too far. The government is now reversing its official stance on family planning. “While in past decades we controlled the population, over the next few years we will promote a reasonable growth rate,” says Chien Tai-lang (簡太郎), director of the Department of Population, Ministry of the Interior. He says the goal of the new campaign is to increase the birthrate to two children per couple, to help infertile couples have children, and to increase the percentage of healthy births.
The government launched its latest family planning campaign in May, this one urging people to marry earlier and to have at least two children. “Based on medical and social considerations, and ROC law [which sets the minimum marrying age at 20], we think twenty-two to thirty is the optimal age range for marriage,” Chien says. The new policy is being promoted by TV, radio, and the print media. Regulations on marriage and birth subsidies have also been revised. In the past, among civil servants, men under the age of twenty-five and women under twenty-two were not allowed to apply for the marriage and birth bonuses, each equivalent to one month's salary. In 1993, the government reduced the minimum age to twenty for both men and women.
Chen Kuan-jeng---"Thirty years from now, it will be rare to see children walking along the streets of Taiwan. The streets will be full of elderly people."
The flip side of Taiwan's declining birthrate is the growing proportion of elderly persons. Currently, there are ten adults of working age for every person over sixty-five, but the ratio is expected to plunge to three working adults per senior citizen during the next forty years. This trend has sparked concern among sociologists. In traditional Chinese families, the younger generations provide financial and social support for elderly relatives. But the shrinking population of working adults is expected to strain such arrangements. The dramatic nature of this structural population change is reflected in a projection by the Council for Economic Planning and Development (CEPD): in 2031, persons over eighty will comprise more than 4 percent of the population, compared with a 1991 figure of less than 2 percent. Indeed, by then every age group will be represented with a startling degree of uniformity.
Economists are looking to the government to shoulder the burden of providing services that families can no longer afford. One goal is to expand pension programs. At present, only civil servants receive government retirement benefits. (In the past, government employees did not pay into the pension system. But beginning this year, they must pay a percentage of their salaries into their personal retirement fund.) Some social scientists and legislators are pushing the government to create a pension system for all people over sixty-five, even though this would dramatically increase welfare expenditures. “The government should establish a good national pension system now, when Taiwan is just beginning to encounter the problems of an aging population,” says Academia Sinica researcher Chen Kuan-jeng. “We can't wait any longer.”
By 2036, Taiwan may have more than five million citizens over sixty-five. With fewer children being born, who is going to support the gray generation?
Another goal is to increase the number of nursing homes, daycare centers for the elderly, and in-home caretakers. There are currently forty-two registered daycare centers for the elderly and thirteen nursing homes providing medical staff. Besides increasing the number of such facilities, the government will also have to improve their quality. In addition to the registered elderly care centers, hundreds of unlicensed facilities have opened up around the island in recent years, but the quality of their services varies widely. According to a survey by the Research, Development, and Evaluation Commission of the Executive Yuan, daycare centers currently operate at 70 percent of capacity. Why? The report concluded that public dissatisfaction with the facilities and a lack of understanding of the services offered are the main reasons.
Ensuring the mental and emotional health of an aging population poses another challenge. Wang Chien-min (王建民), a psychiatrist at Taipei Municipal Chunghsiao Hospital and director of the hospital's Geriatric Daycare Center, explains that many of his patients suffer from depression, boredom, and frustration. He believes that daycare centers can provide a more satisfying environment for many older people than the traditional arrangement of living with family. He points out that such centers not only provide basic health care services, they offer opportunities for socializing with peers and arranging activities and outings.
Hu Yu-hui of National Yang Ming University suggests extending the retirement age beyond the age of sixty-five or encouraging elderly persons to re-enter the work force. She also stresses that senior citizens should be encouraged to develop a social life beyond that of their extended families.
Many seniors suffer from boredom, depression, and frustration. Daycare centers are one answer, but many unlicensed facilities offer only patchy quality.
Economists also worry that the graying of the population could result in a shortage of working-age adults, which would slow the development of Taiwan's economy. To cope with an expected scarcity of younger workers, the island may have to rely more heavily on its foreign work force. Already, a shortage of blue-collar workers has led the government to liberalize regulations to allow more than 180,000 foreign workers to work on the island.
The answer, according to many sociologists and health care professionals, is to begin planning for the coming changes now. “The aging of Taiwan is an inevitable trend,” says Chen Kuan-jeng of Academia Sinica. “Only if the authorities set up a good social welfare system for the elderly, will aging not become a problem.”