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Ole Bruun

After 30 years of unbridled economic growth China is now facing tremendous challenges from urban air pollution, toxic emissions from industry and power plants, pollution of waterways and compromised foodstuff safety. Those aspects of environmental degradation most directly impacting human welfare have seen the strongest outcry from the public, resulting in both organised civil society activity and endless spontaneous protests. Today, environmental and food safety may constitute the most important threats to political stability. This chapter will outline relevant data on welfare issues relating to climate and environment in the broadest sense, and discuss State and media responses, new legislation, public opinion and the role of civil society organising. The chapter argues that China has come to an important juncture in its striving towards sustainable development, and that real change in environmental practices is questionable without simultaneous political change and a greater space for non-State actors. However, State–society relations remain ambiguous, hampering those ‘social forces’ that may contribute efficiently to reaching an environmental turning point, as well as hampering general public mobilisation for substantial improvements in environmental welfare. Finally, the chapter frames China’s present environmental health issues in a broader historical perspective, contending that the country is currently in a transitional state between inherent and modern perspectives on the environment, and that we must look beyond the shifting politico-economic arrangements in the contemporary era to appreciate the long-term processes in State–society–environment relations.

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Karen R. Fisher, Xiaoyuan Shang and Megan Blaxland

This chapter examines people’s experiences of welfare policy intended to address the rights of people with disabilities as citizens of China. It applies a conceptual framework of disability and welfare from human rights. In a rights framework, meeting people’s support needs is required to fulfil their rights as citizens. Nationally, China adopts a rights framework in disability law. It is a signatory to the UN Convention on the Rights of Persons with Disabilities 2008. Yet, like other countries, research on disability in China indicates gaps between government commitment, experience of policies and consequent support required to fulfil their rights. In light of increased international and Chinese concerns about disability policy, it is timely to investigate experiences of support to inform welfare reform. Seeking socially inclusive policy for people with disabilities is directly related to rights, an issue high on the international political agenda. The chapter draws on fieldwork and secondary data analysis about the experience of people with disabilities within the family context (children, young people and older people) or in State care if family members are unknown. The policy implications of the findings focus on the ways State policy can strengthen family networks rather than exclude families from the disability policy process. In this, it takes a broad approach to policy implementation by acknowledging the role of the State, non-government agencies, communities and citizens.

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Elaine Jeffreys

This chapter looks at the growth of charitable foundations funded by newly rich private entrepreneurs and commercial entertainment and sports celebrities in the People’s Republic of China (PRC). Foundations provide the basis for elite philanthropy in developed countries such as the United States, but are a new phenomenon in the PRC. The chapter first outlines the recent history of elite philanthropy, and philanthropy more generally in the PRC. It then examines a sample group of non-public foundations established by some of the most ‘rich and famous’ people in China, focusing on the nature of their missions and their founders’ interactions with government, elite politics and the media. It finds that conventional western critiques of elite philanthropy lack explanatory power in the PRC. It is neither the case that government is simply outsourcing welfare provision to ‘unaccountable’ business–celebrity elites nor that elite-funded foundations simply work independently to fill gaps in the government’s provision of public services. Elite philanthropists in the PRC typically operate hand in glove with the government on core social welfare and humanitarian initiatives while mobilizing more limited financial resources and their elite political connections to pursue peripheral independent interests.

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Sarah Cook and Xiao-yuan Dong

This chapter examines welfare changes in reform era China through the lens of care – that is, the daily and generational work of reproduction essential for the functioning of society and the economy. During the Mao era, care roles and responsibilities were largely socialized, enabling women to enter the labour force in vast numbers while also contributing to rapid improvements in a range of welfare indicators. The reform era has seen the work of care largely returned to the domestic sphere, with households providing care with unpaid (predominantly female) labour, or accessing care services through the market. These changes have significant implications for women’s choices around work, family and fertility, as well as for the welfare of care recipients. Market reforms and the commodification of care services affect the provision and quality of care services, the nature of care work and the status of its providers. The chapter sheds light on the gendered nature of welfare systems, and the wide-ranging implications of how care is delivered and financed: on the welfare and opportunities of women as carers; and on the wellbeing of those in need of care, as well as on broader economic, social and demographic outcomes.

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Ye Liu

This chapter explores the changing role of the State in the provision of educational opportunities, with a specific focus on geographical differences since the market reform in China. Drawing on evidence from national data on enrolment, progression rates and educational spending, it highlights widening inequality in access and participation in education between the eastern, central and western areas during the first stage of the reform (1980s–1990s), as the consequence of the Party-State’s gradual development strategy. Furthermore, from the 2000s a new initiative to improve educational provision in rural and western areas was coincident with the Party-State’s strategy of promoting social cohesion. However, the State’s selective strategy towards educational provision by prioritising funding to realise universal access to compulsory education and to support elite universities has further divided regions in opportunity structures. The chapter argues that the State’s educational provision, while consistent with its overall development objectives, allowed eastern provinces to increase their advantage in educational spending and access to higher education. The same institutional structures punished students from poor western and central provinces, who were relatively disadvantaged in their opportunities to achieve upward social mobility through higher education.

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Edited by Beatriz Carrillo, Johanna Hood and Paul Kadetz

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Zhongwei Zhao, Hongbo Jia and Jiaying Zhao

Great disparities in health, morbidity and chances of survival exist widely across different populations. These disparities are closely related to and often caused by inequalities in levels of income, standards of living and accessibility to high-quality health services and care. Health disparities can also increase the gap in income and living conditions that already exist in a population. As important strategies, social medical insurance and financial assistance have been developed to address such health inequities and their negative externalities on vulnerable social groups. Through an analysis of health and demographic data collected and published by the Chinese government, national censuses and surveys, and a review of the existing literature and official documents, this chapter aims to provide a systematic introduction to the development of China’s health insurance and medical financial assistance programmes, and their contributions to the improvement of social welfare in its urban and rural areas.

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Bingqin Li

Housing continues to be one of the three most pressing concerns among all social policy areas, inciting strong public outcry. High housing prices are considered to be an important cause of the low life satisfaction among urban residents, in particular among new university graduates and migrant workers. The strong discontent over housing affordability, to a great extent, reflects the inability of the Chinese housing policy to address pressing urban housing needs. Using secondary sources and primary research carried out by the author, this chapter provides an historical review tracing the different stages of China’s housing reform. It argues that despite the radical changes in the housing market, the logic behind Chinese housing policies at different stages of the reform is in essence similar to that during the Central Planning period (1953–1977), even in the context of recent reforms, which claim to be people oriented. The seemingly improved inclusiveness of the new housing welfare system in China is a response to labour market changes rather than an effort to satisfy the housing needs of urban citizens.

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Yi Zeng and Therese Hesketh

In October 2015, China’s ‘one-child policy’ was replaced by a universal two-child policy. The impacts of the new policy are inevitably speculative, but predictions can be made based on recent trends. The population increase will be relatively small, peaking at 1.45 billion in 2029 (compared with a peak of 1.4 billion in 2023 if the one-child policy continued). The new policy will allow almost all Chinese people to have their preferred number of children. The benefits of the new policy include virtual elimination of abortions of unapproved pregnancies and problems of unregistered children and a lower sex ratio at birth – all of which should improve health outcomes. Impacts of the new policy on the shrinking workforce and rapid population ageing will not be evident for two decades. In the meantime more sound policy actions need to be taken to meet the social, health and care needs of the quickly growing elderly population. About 45 per cent of China’s population currently live in rural areas, where the potential is great for fertility increase to enrich the future workforce and cumulate pension premium funds from young farmers (who previously have not participated in old-age insurance programmes). China’s current low retirement age and cultural tradition of familial care for the elderly could provide useful potential opportunities to address ageing problems. In conclusion, we believe that if (and only if) the universal two-child policy is thoroughly and quickly implemented and other needed policy actions are taken, China should be able to face the serious challenges of population ageing.

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Beatriz Carrillo, Johanna Hood and Paul Kadetz