Country life

Why suicides are on the rise among the rural elderly

To match feature CHINA-DAMS/UNREST

Around 65% of rural senior citizens live below the poverty line

As frequent WiC readers will know, amongst the core concepts of Confucianism, perhaps none is more important than the notion of filial piety. This patriarchal paradigm was the structure upon which traditional society was built: insisting that children should be loyal to their parents (particularly sons to fathers); wives to their husbands; family to ancestors; and all subjects loyal to the emperor. In this hierarchy everyone relied upon the loyalty and support of those below them.

But in today’s rural China this traditional system of support has undergone a macabre twist. Many elderly parents face destitution having been ‘left behind’ by sons and daughters who have migrated to the cities in search of work. One rural senior tells China Youth Daily he has more faith in a non-genetic group of offspring: “We have three sons here: the Medicine Son, the Rope Son, and the Water Son. These three sons are the most reliable.” The ‘three sons’ he refers to are euphemisms for the preferred methods of suicide amongst the ‘left behind seniors’: death by poison, death by hanging, and death by drowning.

Wuhan University researcher Liu Yanwu has shown that suicide amongst elderly people in rural areas is a worsening problem, rising from 100 per 100,000 to 500 per 100,000 over the last two decades. (Conversely, the overall suicide rate in the country has declined, dropping to less than 10 per 100,000.)

This became a research topic for Liu in 2008, after a villager in Hubei told him that “no one has died a natural death” in his village.

The problem is attributed by some to the erosion of traditional values – such as filial piety – and their replacement by a more urbanised society where making money has become the guiding principle.

Liu recounts: “Some people told me about the budget they calculated for treating an older relative’s illness. If they spend Rmb30,000 ($4,800) curing the disease and the old man can survive for another 10 years, meaning he can continue to do agricultural work earning Rmb3,000 a year for a decade, then it is worth the money. If not, it is seen as a waste of money.” In cases where younger relatives refuse to pay healthcare costs, the aged and infirm often choose to commit suicide rather than continue suffering, Liu told China Youth Daily.

In the countryside, 65% of seniors live below the poverty line, compared to 11% of their urban counterparts, the BBC reports. This often means they cannot afford medical operations or medicines.

In a bid to relieve these financial strains, this year’s Number 1 Document from the State Council – the first government white paper released each lunar new year – announced that “farmers will enjoy better subsidised access to the medical insurance system, while the old-age and child care systems will be improved.”

The Number 1 Document has focused on rural development for the past 13 years. This suggests the importance attached to the issues faced by impoverished rural folk. On the other hand, it also demonstrates the government’s multi-year struggle to resolve those same problems. This year’s document does claim some positives, such as a continued rise in rural residents’ annual disposable income: increasing 8.9% in 2015 to Rmb11,422.

However, this is an average figure and likely masks a worsening situation for the more elderly members of the community. There’s another issue too: even in situations where incomes are rising, the necessary local healthcare infrastructure may be lacking.

A 2015 report on palliative care across 80 countries by The Economist found that “China has among the most severe ‘demand/supply’ gaps between need for palliative care and availability of services”.

As China faces an aging population – with more than 40% of the population predicted to be 60 or older by 2050 – the shortfalls will only become more pronounced, particularly in its poorer and more remote regions.

China Youth Daily says one beacon of hope it stumbled across was in Fujian province, where a Buddhist monastery provides free ‘end of life’ care for rural residents abandoned by their families. But the head nun admits that the reason abandonment of the elderly is now so prolific is due to a lack of “family loyalty”.

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