The effect of the universal two-child policy on medical insurance funds with a rapidly ageing population: evidence from China’s urban and rural residents’ medical insurance

Zhang, Xinjie; Huang, Jingru; Luo, Ying

doi:10.1186/s12889-021-11367-7

Cited by 12 publications

(6 citation statements)

References 18 publications

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“…The decline in fertility and changes in population structure can facilitate the adjustment of national fertility policies ( 25 ). The new policies not only provide support and resources for couples, but also provide financial help in terms of medical insurance ( 26 ). On August 20, 2021, the implementation of China's three-child policy legally stipulates that couples can have three children and enjoy these supporting measures ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Fertility Intention and Related Factors for Having a Second or Third Child Among Childbearing Couples in Shanghai, China

Zhu

Wang

et al. 2022

Front. Public Health

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Background and PurposeAs the global fertility rate declines, China has issued two and three-child policies in the past 10 years. Therefore, this study serves to evaluate fertility intention rates and related factors in couples intending to have a second child and third child.MethodsA cross-sectional survey was conducted in mainland China from July to August 2021. Couples with one or two children were invited to participate in our study in order to collect information about more than one child fertility intention and the possibly related factors. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated and adjusted for potential confounding factors.ResultsData was collected from a total of 1,026 couples. Among couples with one child, 130 (16.2%) couples had the intention to have a second child. Additionally, only 9.4% of couples with two children desired to have third child. The study revealed large differences in socioeconomic and personal factors between the two groups. For couples with intentions for a second-child, a female age >35 years (adjusted odds ratio, aOR 1.92), a first child's age range from 3 to 6 (aOR 3.12), annual child spending as a percentage of household income >30% (aOR 2.62), and children's educational barriers (aOR 1.55) were associated with lack of intent to have a second child. Similarly, among couples with two children, parents with family financial constraints (aOR 6.18) and children's educational barriers (aOR 4.93) are more likely to have lack of intent to have a third child. Here, we report that government policies encouraging fertility (aOR 0.04) can effectly promote couples to pursue a second or third child.ConclusionOverall, couples with one or two children in Shanghai had a low intention to give birth to a second or third child. In order to increase the birth rates, it is necessary to implement policies to reduce the burden of raising children and provide relief to parent's pressure of rearing a child with increased free time.

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Section: Discussionmentioning

confidence: 99%

Fertility Intention and Related Factors for Having a Second or Third Child Among Childbearing Couples in Shanghai, China

Zhu

Wang

et al. 2022

Front. Public Health

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“…However, accidental death caused by self-harm and suicide represent the third leading cause of death for all adolescents, with approximately 67,000 adolescents dying every year (4,5). China has 247 million people aged 0-14, accounting for 12.57% of the global population aged 0-14 and ranking second in the world (6). The overall pooled prevalence of total mental disorders among children and adolescents aged 6-18 was estimated at 15.6% in China (7).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Contributing Factors of Childhood Trauma, Anxiety, and Depression Among Adolescents From Two-Child Families in China

et al. 2022

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The two-child policy has been implemented in China since 2016 and has attracted the attention of the world. Adolescents may face huge psychological challenges in the process of changing family structures and relationships. To date, no mental health survey of adolescents from two-child families has been conducted. We investigated the prevalence and risk factors for childhood trauma, anxiety, and depression in two-child families in a statistically representative sample of Chinese senior high school students from Shanghai. A total of 426 participants were randomly selected from 1,059 students of four senior high schools in different districts of Shanghai. The childhood trauma questionnaire-short form (CTQ-SF), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used as the screening tools. We found that the overall prevalence of childhood trauma, anxiety, and depression among senior high school students in two-child families was 46.70% (95% CI, 39.93–53.47%), 22.17% (95% CI, 16.53–27.81%), and 35.85% (95% CI, 29.34–42.36%), respectively. The two-child families was an important factor associated childhood trauma, emotional neglect, and physical neglect (χ2 = 5.984, p = 0.014; χ2 = 4.071, p = 0.044; χ2 = 4.202, p = 0.040). Ranking in two-child families was a risk factor for childhood trauma (β = −0.135, p = 0.048). Parental preference was a significantly correlated with physical abuse, physical neglect, anxiety, and depression (β = −1.581 to 0.088, p < 0.05). Meanwhile, emotional abuse, physical abuse, emotional neglect, and physical neglect of participants in the two groups were positively correlated with anxiety and depression (r = 0.195–0.478, p < 0.05). There was a significant relationship between sexual abuse and anxiety symptoms in the one-child family group (r = 0.161, p < 0.05). The findings suggest that the overall prevalence of childhood trauma, anxiety and depression among adolescents from two-child families in China was high. The two-child families and family ranking are important factors associated childhood trauma, while parental preference is related to anxiety and depression. These results highlight an urgent need to be addressed by adolescents' mental health service providers and policy-makers.

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“…Qian et al (24) proposed to encourage appropriate fiscal decentralization to help maintain the sustainability of the social security fund. Zhang et al (25) found that the implementation of China's two-child policy helped to improve the process of population aging, delayed the onset of the urban residents' basic medical insurance fund deficit and improved the sustainability of the basic medical insurance fund. Ren and Yang (26) suggested that China should implement outpatient mutual-aid guarantee mechanism as soon as possible to improve the solvency of the medical insurance fund for urban employees and establish an independent long-term care insurance system to ensure the stability and sustainability of the long-term care insurance fund and the medical insurance fund.…”

Section: Literature Reviewmentioning

confidence: 99%

A study on the sustainability assessment of China’s basic medical insurance fund under the background of population aging–evidence from Shanghai

Chen

et al. 2023

Front. Public Health

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ObjectiveAs China’s population aging process accelerates, the expenditure of China’s basic medical insurance fund for employees may increase significantly, which may threaten the sustainability of China’s basic medical insurance fund for employees. This paper aims to forecast the future development of China’s basic medical insurance fund for employees in the context of the increasingly severe aging of the population.MethodsThis paper taking an empirical study from Shanghai as an example, constructs an actuarial model to analyze the impact of changes in the growth rate of per capita medical expenses due to non-demographic factors and in the population structure on the sustainability of the basic medical insurance fund for employees.ResultsShanghai basic medical insurance fund for employees can achieve the goal of sustainable operation in 2021-2035, with a cumulative balance of 402.150–817.751 billion yuan in 2035. The lower the growth rate of per capita medical expenses brought about by non-demographic factors, the better the sustainable operation of the fund.ConclusionShanghai basic medical insurance fund for employees can operate sustainably in the next 15 years, which can further reduce the contribution burden of enterprises, which lays the foundation for improving the basic medical insurance treatment for employees.

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The effect of the universal two-child policy on medical insurance funds with a rapidly ageing population: evidence from China’s urban and rural residents’ medical insurance

Cited by 12 publications

References 18 publications

Fertility Intention and Related Factors for Having a Second or Third Child Among Childbearing Couples in Shanghai, China

Fertility Intention and Related Factors for Having a Second or Third Child Among Childbearing Couples in Shanghai, China

Prevalence and Contributing Factors of Childhood Trauma, Anxiety, and Depression Among Adolescents From Two-Child Families in China

A study on the sustainability assessment of China’s basic medical insurance fund under the background of population aging–evidence from Shanghai

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