How the one-child policy reshaped rural elderly care: evidence from a fuzzy regression discontinuity design

Using 2018 CHARLS data, this study employs a fuzzy regression discontinuity design to examine the effects of the one-child policy on the accessibility of community home-based elderly care service in rural communities. The findings reveal that the one-child policy has weakened the traditional family-based care system through mechanisms such as promoting non-multigenerational living arrangements and reducing the likelihood of male offspring. Consequently, elderly parents in rural one-child families increasingly rely on social elderly care services, particularly health-oriented services. Further analysis demonstrates that the New Rural Social Pension Insurance serves as an ‘economic supplement’ by alleviating financial burdens, while mutual care provides emotional and daily life support through community networks, functioning as a ‘life replacement’. The study concludes by recommending measures to enhance the provision of health services in rural communities, foster integration between family and social elderly care systems, and optimize the synergistic development of the New Rural Insurance Scheme and mutual care frameworks. These findings offer policy insights for building a diversified and sustainable rural elderly care system.