Ageing under the one-child policy: long-term care needs and policy choices in urban China

China contains one-fifth of the world’s ageing population. It has been estimated that a total number of 33 million older adults have suffered activities of daily living (ADL) deficits, which consists of about 19% of the total ageing population. To date, a national long-term care policy is not in place. This paper identifies and discusses key historical and contextual factors that affect long-term care policy development, including the one-child policy, cultural values toward family care, and the unbalanced development of health and social care. We show how two long-term care models developed in Beijing and Shanghai set a desirable benchmark for a balanced development of community-based and residential care. However, there is no consensus on key criteria that should be considered on needs assessment. Finally, we argue that a needs assessment including health, finances, and family aspects of needs, instead of age, should be considered in policy development.