Across the world, there is growing alarm over the well-being of old people living in rural areas. Poverty, lack of basic health and social services and migration of young people to cities in search of jobs are endemic in rural areas, affecting millions of senior citizens in China. While in Europe and North America, proportionately smaller number of old people live in rural communities, in China they are the majority. Almost 59 million senior citizens in China, or 67 percent of the total, are rural residents. The voices of these older people must be heard and their needs fulfilled.

Old people in rural China are at high risk of marginalization. Migration patterns of working-age people have greatly weakened the once strong family ties in villages. In some regions, less than one-third of senior citizens have an offspring living nearby. This geographic separation between the generations has reduced opportunities for old people to live with their children in what traditionally has been viewed as a stable home environment. Close-knit three-generation households are becoming history. Increasingly, old people are living alone or with their spouses, which is a threat to the longstanding pattern of family as the main source of support for old people in rural areas.

Social security policies do not cover most underdeveloped areas in China. Government support to senior citizens disproportionately favors those living in urban areas, creating the risk of treating old people on the basis of where they live.

Less than three percent of senior citizens living in rural areas receive pensions and there are few long-term care programs. In some provinces, old people are allocated land which may act as a buffer against privation if they can produce enough for their own consumption and perhaps a small surplus. For them, even a small contribution from their children can increase monetary security and emotional satisfaction. Yet there is rising concern over whether the young are willing and able to meet such support obligations to elder members of their family. Old people in rural China have little option but to rely on family support at a time when family support cannot be taken for granted.

Some old people are especially at high risk of living poor quality lives. Many live in communities that have been bypassed socially and economically and are unable to provide support to those who are left behind. Childless senior citizens have no clearly defined rights to receive family care and could become destitute without the help of benevolent extended kin.

Women are less likely to have financial resources and are especially vulnerable if they do not get support from their children. Instead of receiving support from their families, some old people in rural areas are called upon to use their meager resources to support their children or grandchildren.