Healthy aging in China

China has aged rapidly and the rate is accelerating in decades to come. We review positive and negative forces for healthy aging in China now and in the future. The most positive force is the spectacular growth in education over time especially for Chinese women, which should improve all dimensions of cognitive and physical health and eliminate vast gender disparities in healthy aging that currently exist. Other positive forces include increasing detection and treatment of disease and the availability of health insurance and health services so that diseases like hypertension and diabetes do not remain silent killers in China. Transparency is eased on the research level by publicly available data such as CHARLS, a sharp departure from prior scientific norm in China. Negative forces center on disturbing trends in personal health behaviors such as growing rates of smoking (among men) and obesity (for both genders), and pollution-, especially in urban centers. Public health campaigns and incentives are needed on all these fronts so that predictable long-term consequences of these behaviors on older age disease are not realized. There will not be a simple demographic fix to healthy aging in China as fertility rates are unlikely to rise much, while migration will likely continue to rise leaving growing numbers of elderly parents geographically separated from their adult children. Government policy will have to allow migration of elderly parents to live with their adult children while reducing the rigid connection of policy (health insurance and health services) with place of residence. (C) 2014 Elsevier B.V. All rights reserved.