China Economic Update - June 2024 Acknowledgements The June 2024 issue of the China Economic Update was prepared by a team comprising Yusha Li (Task Team Leader), Kevin Chua (co-Task Team Leader), Jun Ge, Maria Ana Lugo, Elitza Mileva, Sailesh Tiwari, Dewen Wang, Samuel Christopher Hill, Shichao Zhou, Veronica Montalva Talledo, Katherine Anne Stapleton, Marius Vismantas, Fang Yang, Yang Huang, Kate Mandeville, Liping Xiao, Salman Asim, Marcin Piatkowski, Wenting Wei, Danxu Cheng, Hongyi He, Jia Liu, and Zhang Zhang. Guidance and thoughtful comments from Mara Warwick, Lalita M. Moorty, Aaditya Mattoo, Sebastian Eckardt, Zafer Mustafaoglu, Rinku Murgai, Cristian Aedo, Philip O’Keefe, John Giles, Elena Glinskaya, and Ergys Islamaj are gratefully acknowledged. The team would like to thank Tianshu Chen, Ying Yu, Luoyi Zhou, Xiaoting Li, Mingjie Li, and Yu Shang for support in the production and dissemination of this report. The team would also like to thank Xiaoyan Lei, Junni Zhang, Bo Zhao, Wei Huang, Qingyuan Li and Chunfeng Zhang from the National School of Development at Peking University for the discussion on the economic impact of population aging in China. The findings, interpretations, and conclusions expressed in this report do not necessarily reflect the views of the Executive Directors of the World Bank or the Chinese government. Questions and feedback can be addressed to Tianshu Chen (tchen@worldbank.org). China Economic Update - June 2024 Table of Contents Executive Summary ...................................................................................................................................... 1 I. Recent Economic Developments ...................................................................................................... 6 Favorable external demand drove China’s growth performance in early 2024 ........................................... 6 Trade activity and capital flows improved in early 2024 .............................................................................. 7 The property sector continues to undergo an adjustment .......................................................................... 9 Demand and supply imbalances in some sectors have exerted downward pressure on prices ................ 10 Carbon emissions increased moderately despite rapid scale-up of renewable energy ............................. 13 Announced fiscal measures will provide some support to domestic demand ........................................... 14 Credit growth continues to moderate ........................................................................................................ 16 The banking sector remains well capitalized, though profitability has fallen ............................................ 17 II. Outlook, Risks, and Policy Implications ......................................................................................... 19 Outlook ....................................................................................................................................................... 19 Risks ......................................................................................................................................................... 21 Policy implications ...................................................................................................................................... 21 III. Special Focus: Aging China—Implications for Growth and Inequality .......................................... 24 China has become an aged society ............................................................................................................. 24 Will population aging dampen long term growth?..................................................................................... 26 Will aging exacerbate inequality? ............................................................................................................... 32 Looking ahead – policy directions............................................................................................................... 37 Figures Figure 1. Firmer external demand drove up China’s growth in early 2024 .................................................. 7 Figure 2. Trade activity and capital flows improved in early 2024 ............................................................... 9 Figure 3. Home sales and prices continued to drop amid a necessary sectoral adjustment ..................... 10 Figure 4. Demand and supply imbalances in some sectors have exerted downward pressure on prices . 11 Figure 5. Performance diverged within manufacturing sectors ................................................................. 12 Figure 6. Emissions driven by the power and residential sectors, while the utilization rates of renewable energy fell ................................................................................................................................................... 14 Figure 7. Faster bond issuance will provide some fiscal support ............................................................... 15 Figure 8. The pace of monetary easing slowed in Q1 ................................................................................. 16 Figure 9. Banking sector capitalization increased despite declining profitability ...................................... 18 Figure 10. Poverty reduction will continue, albeit slower than in previous years ..................................... 20 Figure 11. China is an aged society, where the demographic window has closed ..................................... 25 Figure 12. Aging impacts China’s growth trajectory through various channels ......................................... 27 Figure 13. The working age population share has been declining for over a decade ................................ 27 Figure 14. In China, older cohorts save but less compared with middle-aged cohorts ............................. 29 Figure 15. Income, old-age dependency, and social security are significant determinants of household savings rates................................................................................................................................................ 29 Figure 16. Rising old age dependency is linked to a decline in total factor productivity, … ...................... 30 Figure 17. … but China has been leveraging innovation and technology to facilitate productivity growth30 Figure 18. The share of healthcare to total expenditures rises across age cohorts ................................... 31 Figure 19. Fiscal subsidy to the pension schemes and medical insurance is already high in China, … ...... 31 Figure 20. … significantly supporting the social security fund .................................................................... 31 Figure 21. Income inequality is higher among old households than young households … ........................ 33 Figure 22. …which is largely driven by location of birth and education attained ...................................... 33 China Economic Update - June 2024 Figure 23. Lower income households are more likely to receive lower pension benefits ......................... 34 Figure 24. Over half of current workers contribute to the RURS ............................................................... 34 Figure 25. The burden on health spending is larger for old households than for young households ........ 35 Figure 26. Enrolment in the basic medical insurance has declined in recent years ................................... 35 Figure 27. Care needs to rise rapidly with age............................................................................................ 37 Figure 28. Women and less educated people are more likely to have depressive symptoms .................. 37 Table Table 1. China selected economic indicators, 2021-2026 .......................................................................... 19 Box Box 1. Emerging supply and demand imbalances in some industries ........................................................ 12 Box 2. Guidance on the Silver Economy from China’s Government........................................................... 32 Box 3. Fertility policies – the international experience .............................................................................. 38 China Economic Update - June 2024 List of Abbreviations CCB City Commercial Banks CFPS China Family Panel Survey CHARLS China Health and Retirement Longitudinal Study CHN, CN China COVID-19, COVID Coronavirus Disease 2019 CO2 Carbon Dioxide CPI Consumer Price Index EAP East Asia Pacific ECB The European Central Bank EU European Union EV Electric Vehicles FAI Fixed Asset Investment FDI Foreign Direct Investment FRED Federal Reserve Economic Data GDP Gross Domestic Product GW Gigawatt HH Household IMF International Monetary Fund ILO International Labor Organization JSB Joint-Stock Banks LGFV Local Government Financing Vehicle LHS Left Hand Side LPR Loan Prime Rate LSB Large State Banks LUR Land-Use Right MLF Medium-term Lending Facility MOF Ministry of Finance m/m Month-on-Month NAFR National Administration of Financial Regulation NBS China National Bureau of Statistics NPL Non-performing Loan OADR Old-Age Dependency Ratio OECD Organization for Economic Co-operation and Development OLS Ordinary Least Square PBC People’s Bank of China PMI Purchasing Manager Index POE Private-Owned Enterprise PPI Producer Price Index PPP Purchasing Power Parity PWT Penn World Table q/q Quarter-on-Quarter China Economic Update - June 2024 Q1 First Quarter Q2 Second Quarter Q3 Third Quarter Q4 Fourth Quarter RCB Rural Commercial Banks R&D Research and Development RHS Right Hand Side RMB Renminbi ROA Return on Assets ROE Return on Equity RRR Required Reserve Ratio RURS Rural-Urban Resident Scheme sa Seasonally Adjusted SAFE State Administration of Foreign Exchange SOE State-Owned Enterprise TFP Total Factor Productivity UN United Nations US United States USD US Dollar VAT Value-Added Tax WBG World Bank Group WDI World Development Indicators y/y Year-on-Year ytd Year-to-Date 4mma Four-month Moving Average China Economic Update - June 2024 Executive Summary Economic activity picked up in China in early 2024. Real GDP growth accelerated to 5.3 percent y/y in the first quarter of 2024 buoyed by stronger exports amid firmer global demand. At the same time, domestic demand growth moderated. While growth in manufacturing and infrastructure investment, as well as consumer spending on services, remained robust, the property market correction continued, weighing on investment. In response to subdued domestic demand, the government has provided additional support to the property sector and budgeted higher fiscal spending. GDP growth is projected at 4.8 percent in 2024, an upward revision of 0.3 percentage points from our December 2023 China Economic Update. The revision reflects stronger-than-expected exports and the impact of recent policy measures. Looking ahead, growth momentum is projected to taper, due to normalization of demand for services after the post-pandemic rebound, continued adjustment in the property sector, and headwinds to manufacturing investment from soft demand and deflationary pressures. China Economic Outlook 2021 2022 2023e 2024f 2025f 2026f Real GDP growth (%) 8.4 3.0 5.2 4.8 4.1 4.0 Consumer Price Index (% change, average) 0.9 2.0 0.2 0.9 1.5 2.0 Current account balance (% of GDP) 2.0 2.2 1.5 1.0 0.5 0.2 Consolidated fiscal balance (% of GDP) * -4.0 -6.3 -5.8 -6.4 -4.4 -4.1 Source: World Bank. Note: f = forecast (baseline). * World Bank staff estimates. Risks to the growth outlook are broadly balanced. On the upside, larger and more effective policy support to the property sector, alongside more active restructuring of property developer debt, could stabilize the property sector earlier than expected and boost household confidence. Higher-than-expected fiscal spending, possibly financed at the central level, could lift public investment above baseline expectations. Substantial progress on structural reforms, including of the enabling environment for the private sector, could boost short-term confidence and long-run productivity growth. Downside risks include a delay in the property sector recovery beyond 2024, persistent deflationary pressures, slower-than-expected global growth, and increased trade tensions. Macroeconomic policies could support near-term growth if downside risks materialize, whereas deeper structural reforms are needed to address long-term economic challenges. Additional moderate monetary easing and more fiscal support could be provided, should the economy lose growth momentum. Subdued household confidence and under-execution of liquidity support 1 China Economic Update - June 2024 measures in the property sector underscore the need to expedite the restructuring of struggling developers. While market adjustment to supply-demand imbalances has been observed in some industrial sectors, reforms to strengthen the corporate insolvency framework could facilitate the exit of non-viable firms and the rescue of viable firms experiencing liquidity problems. Policies to accelerate the green transition could not only help China to progress toward its dual carbon targets—achieving peak carbon emissions before 2030 and carbon neutrality by 2060—but also absorb the growing supply of green technology products. A more sustained increase in household consumption requires reforms that go beyond short-term stimulus, such as improvements in social protection. Special Focus: Aging China – Implications for Growth and Inequality This edition's special topic section provides initial analysis of the impact of population aging on growth and inequality. Driven by China’s rapid economic development and improved public health outcomes, life expectancy rose from 60.2 years in 1974 to 78.2 years in 2021.This is a major achievement. Yet, along with declining fertility, it has contributed to rapid population aging. China has now joined the ranks of aged societies, where individuals over the age of 65 years constitute 15-20 percent of the population. Over the next 20 years, the share is expected to rise to about 28.0 percent of the population, while China’s total population is expected to fall to 1.35 billion by 2045. Population aging will have an impact on China’s economic growth through labor supply and productivity channels. With a declining working age population, the labor force is likely to decline. Unless labor participation increases, estimates suggest that the average labor force growth could fall from 0.3 percent in 2000-20 to the range of -1.1 to -1.4 percent in 2025-45. Preliminary empirical analysis also shows that rising old age dependency could be associated with a decline in factor productivity growth in China, as also observed in other countries based on existing studies. This underscores the need for policies to boost productivity growth including through technology and innovation. The demographic transition may also present a challenge to common prosperity. Rapid aging could contribute to inequality in incomes, expenditure needs and, more broadly, well-being. Income inequality among households with old members is higher than among those without, driven largely by pension disparity. The expansion of pension system coverage has improved old- age income support for previously uncovered rural residents, self-employed and migrant workers. Today’s pension coverage in China is among the highest in the developing world. Despite recent increases, the benefits for the above groups of people are, on average, less than 6 percent of those received by urban employees and less than 4 percent of those received by 2 China Economic Update - June 2024 public sector workers. Household expenditures on health and aged care also increase with age. While medical insurance is near universal, low-income people remain less financially protected to face rising health costs, given differences in effective coverage across medical insurance systems. Finally, the differing lifestyle choices of young adults today will impact the health gaps of future older population. Smoking and depression are more prevalent among the less educated, potentially leading to increased costs and less healthy aging. The good news is that demographics are not destiny. The economic challenges posed by population aging can be managed with the right policy and behavioral adjustments. Beyond efforts to increase fertility, which may have limited impact in the short term, policies such as those aimed at promoting affordable childcare and family-friendly policies to support work-life balance, reducing gender-based hiring biases, and supporting women’s entrepreneurship can increase female labor force participation and thus mitigate the negative impacts of aging. Additionally, raising the retirement age and increasing human capital through skills upgrading and lifelong learning will extend productive working lives. Promoting market competition to draw in private sector participation can support innovation and the emerging silver economy. Finally, closing gaps in services – particularly healthcare, old-age pension insurance, and long-term care – and addressing early-life inequalities like educational disparities across the country will help safeguard common prosperity. 3 China Economic Update - June 2024 The China Economic Update at a glance Economic activity picked up in China in early 2024, buoyed Domestically consumer spending on services remains by stronger net exports robust while goods demand lags A. GDP demand components B. Retail sales growth Final consumption Gross capital formation 8 Net exports Real GDP growth Service Catering Percentage points, contribution to y/y 6 Consumer goods Recreational goods 4 Telecom appliance growth Household appliance Furniture 2 Clothing Daily use goods 0 Automobile Decoration material -2 0 5 10 15 Mar-22 Sep-22 Mar-23 Sep-23 Mar-24 Percent y/y , January - April Manufacturing and infrastructure investment remain … with home price declining and sales and investment resilient, while the property sector continues to undergo contraction deepening an adjustment … C. Fixed asset investment by sector D. Home sales, starts, and investment Manufacturing Real estate Infrastructure 100 100 20 80 80 Index, July 2021 = 100, 12mma 10 Percent y/y, 3mma 60 60 0 40 40 New home sales (value) -10 20 New home sales (floor space) 20 Property investment Housing new starts -20 0 0 Apr-22 Oct-22 Apr-23 Oct-23 Apr-24 Aug-21 Apr-22 Dec-22 Aug-23 Apr-24 The strength in manufacturing investment is partly However, demand and supply imbalances in some bolstered by credit support for prioritized sectors sectors have exerted downward pressure on prices … E. Change in bank loan stock F. Change in PPI and capacity utilization 10 Coal Mining Real estate Industry Green Inclusive 40 Percent, change in producer prices since 30 8 Non Ferrous Oil and Gases Metals 20 6 2019Q4 All Industries 10 RMB trillion Chemical Fibers Foods 4 0 Automobiles Computer & 2 -10 Nonmetal Electronics Minerals -20 0 -30 60 70 80 90 100 -2 Capacity utilization rate, 2023 Mar-12 Mar-14 Mar-16 Mar-18 Mar-20 Mar-22 Mar-24 4 China Economic Update - June 2024 … which has eroded industrial profit margins Carbon emissions increased moderately despite rapid scale-up of renewable energy G. Profit margins H. Utilization rate of wind and solar power General equipment Special equipment Solar installed capacity (RHS) Wind installed capacity (RHS) Automobile Electric machine Wind utilization rate Solar utilization rate 100 1200 Computer & electronics 130 99 1000 120 98 800 Index, 2019 =100 Percent, 3mma 110 97 GW 600 100 96 400 90 95 80 94 200 70 93 0 2019 2020 2021 2022 2023 2024 Jul-21 Dec-21 May-22 Oct-22 Mar-23 Aug-23 Jan-24 Rising longevity and declining fertility contribute to … which impacts the country’s growth trajectory population aging in China, … I. Population share of individuals 65 years and above J. Real GDP growth and contributions China Japan Capital stock Labor Human capital TFP Republic of Korea Hong Kong, China 14 EU 40 12 Percentage points, contribution to y/y 35 Percent, population 65 and above 10 30 Super-aged society 8 25 growth 6 20 4 Aged society 15 2 10 Aging society 0 5 0 1974 1980 1986 1992 1998 2004 2010 2016 2022 Population aging is also expected to increase spending on … and could contribute to inequality in the absence of health and social security, … mitigating measures K. Social Security Fund balance L. Gini and concentration indices Expenditure 10 Revenue, net of fiscal subsidy 59.2 Balance, net of fiscal subsidy 8 46.2 45.7 41.6 43.6 39.8 Percent of GDP 6 Index 4 2 0 -2 Total Income Pensions Total Income Pensions income from work income from work -4 Young households Old households 2015 2016 2017 2018 2019 2020 2021 2022 2023 Source: NBS, PBC, National Renewable Energy Absorption Monitoring and Early Warning Centre, National Energy Administration, UN, WDI, PWT, ILO, Barro-Lee dataset website, Hanewald, Jia and Liu (2021), China Health and Nutrition Survey, World Bank staff estimates. 5 China Economic Update - June 2024 I. Recent Economic Developments Favorable external demand drove China’s growth performance in early 2024 Global economic activity has recently firmed, supported by an uptick in manufacturing and resilient growth in the United States. Global trade, which was largely stagnant last year— recording its worst outcome in the past 50 years outside global recessions—also showed signs of improvement. In early 2024, global goods trade increased for the first time in almost a year and leading indicators point to further near-term strengthening. Both the manufacturing and services components of the global new export orders PMIs have shown improvements in recent months (Figure 1A). Against the backdrop of firmer external demand, economic growth in China picked up in the first quarter, buoyed by strong net exports despite softer domestic demand. On a seasonally adjusted annualized basis, growth accelerated to 6.6 percent in the first quarter of 2024, from 4.9 percent in the fourth quarter last year. In year-on-year terms, GDP growth rose to 5.3 percent from 5.2 percent during the same period. Firmer external demand drove growth in the first quarter, with net exports expanding 12.7 percent y/y and contributing 0.8 percentage points to overall growth (Figure 1B). At the same time, domestic demand growth moderated from the post-pandemic rebound, and performance remains uneven across sectors. Domestically, consumer spending on services remained robust, while growth in demand for goods stayed below the pre-pandemic trend. Goods retail sales expanded by 3.5 percent in the first four months of 2024, lower than the 7.9 percent growth in 2019, with the deceleration largely attributed to subdued sales in durable goods (Figure 1C). The reluctance of consumers to make significant big-ticket purchases partly reflects their weak confidence, which is yet to recover due to the negative wealth effect from the property sector correction and uncertainty in income prospects. While surveyed unemployment declined to 5.0 percent in April from 5.2 percent in January, nominal household income increased by 6.8 percent y/y in the first quarter, still below the 8.0 percent average of the pre-pandemic years. Capital spending in manufacturing and infrastructure remained resilient, even as real estate investment contracted. Manufacturing investment was lifted by policy measures on equipment upgrades and other support to priority sectors, while infrastructure investment benefited from the remaining balance of RMB 500 billion in disaster recovery and resilience stimulus announced last year. Real estate investment declined by 7.9 percent y/y in the first quarter of the year. In contrast, manufacturing and infrastructure investments remained resilient, increasing by 9.9 and 8.8 percent y/y, respectively, during the same period (Figure 1D). 6 China Economic Update - June 2024 Domestic demand has shown signs of moderation since April. Retail sales increased by 2.3 percent y/y in April, moderating from 4.7 percent in the first quarter. Meanwhile, fixed asset investment growth slowed to 3.6 percent in April from 4.5 percent in the first quarter, with the real estate contraction deepening and infrastructure investment moderating. Figure 1. Firmer external demand drove up China’s growth in early 2024 A. Global PMI new export orders B. Contribution to real GDP growth 56 Final consumption Gross capital formation Manufacturing Services 8 Net exports Real GDP growth Percentage points, contribution to y/y growth 54 6 52 4 Index 50 2 48 0 46 44 -2 Apr-22 Oct-22 Apr-23 Oct-23 Apr-24 Mar-22 Sep-22 Mar-23 Sep-23 Mar-24 C. Retail sales growth D. Fixed asset investment by sector Service Manufacturing Real estate Infrastructure Catering 20 Consumer goods Recreational goods 10 Percent y/y, 3mma Telecom appliance Household appliance 0 Furniture Clothing Daily use goods -10 Automobile Decoration material 0 2 4 6 8 10 12 14 16 -20 Percent y/y , January - April Apr-22 Oct-22 Apr-23 Oct-23 Apr-24 Source: FRED, ECB, NBS, World Bank staff estimates. Note: Figure D. The infrastructure sector includes transport, storage and postal service, water conservancy, environment and utility management, and electricity, gas and water production and supply. Trade activity and capital flows improved in early 2024 Merchandise exports have gained some momentum, benefiting from near-term strength in external demand, especially from emerging markets. After a 4.7 percent contraction in goods exports in 2023, exports grew by 1.5 percent y/y in the first four months of this year, propelled 7 China Economic Update - June 2024 by stronger demand from developed markets and Asian economies. Export volumes have rebounded, in part due to declining export prices and real effective exchange rate depreciation (Figure 2A). By product, the uptick in exports was broad-based, with low-tech consumer goods, medium-tech machinery, and high-tech IT products all experiencing higher growth. While exports of green-tech products continue to outperform, they represent a small fraction of total exports and thus contribute modestly to overall export growth. Robust export demand and higher global energy prices lifted imports in early 2024. Goods imports expanded by 3.2 percent y/y in the first four months of the year, after a contraction of 5.5 percent in 2023. Higher global energy prices have contributed to the increase, while goods import volumes rose by an average of 3.6 percent y/y in the first quarter of 2024 (Figure 2B). Solid industrial activity and stronger exports underpinned import demand, while the domestic property sector continues to weigh on imports. Trade in services improved due to a recovery in inbound and outbound tourism. Services exports increased by 6.4 percent y/y in the first quarter of 2024, as inbound tourism started to recover and transport services stabilized in line with higher goods exports and rising shipping costs. Concurrently, services imports saw an increase of 14.5 percent y/y, driven by the recovery in outbound tourism.1 This helped narrow the current account surplus to 0.9 percent of GDP in the first quarter of 2024, compared with 1.8 percent of GDP in the same period last year, signaling a continued return to pre-pandemic levels (Figure 2C). Capital inflows resumed in the first quarter of 2024, alleviating exchange rate depreciation pressures. After experiencing two years of net capital outflows, due to differences in economic conditions and interest rates between China and other major economies, and a general retreat of capital from emerging markets, China’s financial and capital account shifted to a modest surplus in the first quarter of 2024. Foreign direct investment (FDI) inflows remained subdued (Figure 2D), with foreign firms cautious in the face of economic uncertainty and geopolitical risks. Conversely, China’s outbound direct investments demonstrated resilience. Portfolio outflows, which were significant in 2023 amid wide interest rate differentials with major economies, eased in the first quarter of 2024. Accordingly, the Renminbi depreciated by 1.8 percent against the US dollar in the first four months of 2024. 1 However, the post-pandemic tourism recovery has been gradual, and tourism spending has not yet returned to pre-pandemic levels. 8 China Economic Update - June 2024 Figure 2. Trade activity and capital flows improved in early 2024 A. Contribution to goods export growth B. Contribution to goods import growth FX change Price change in RMB FX change Price change in RMB Volume change Export change Volume change Import change 60 50 50 40 40 30 Percent y/y, 4mma Percent y/y, 4mma 30 20 20 10 10 0 0 -10 -10 -20 -20 -30 -30 Apr-18 Apr-20 Apr-22 Apr-24 Apr-18 Apr-20 Apr-22 Apr-24 C. Balance of payments D. Foreign direct investment flows Current account Financial and capital account FDI outflows FDI inflows Net FDI flows 5 Net error and omisssions Reserve accumulation 5 4 4 3 3 Percent of GDP Percent of GDP 2 2 1 1 0 0 -1 -1 -2 -2 -3 -3 2010-14 2015-19 2020-23 2023Q1 2024Q1 2003 2006 2009 2012 2015 2018 2021 2024Q1 Source: China Customs, SAFE, World Bank staff estimates. Note: Figure D shows the annual data from 2003 to 2023 and the quarterly data for 2024. The property sector continues to undergo an adjustment Weak housing demand and high debt of property developers continue to dampen activity in the property sector. The difficulty in stabilizing the market underscores the challenge of propping up housing demand due to household concerns about timely housing delivery and uncertain income prospects. Weak demand has contributed to a decline of new home sales by 47.2 percent in value and 46.8 percent in volume terms by April 2024, compared to their peak levels in July 2021 (Figure 3A). New home prices for 70 cities had decreased by 8.0 percent from their peak levels by April 2024, while second-hand home prices, which better reflect market conditions, contracted by a steeper 14.0 percent (Figure 3B). Real estate investment continues to contract, as many property developers are constrained by high debt. On the supply side, the continued weakness in housing sales prompted further pull back from new projects, resulting in 24.6 9 China Economic Update - June 2024 percent y/y decline on housing starts in January-April 2024. Housing completion slowed, falling by 20.4 percent y/y in January-April 2024. The government has unveiled new measures to support the ailing property sector. Recently, the authorities have announced new demand-side easing measures, including lowering the minimum down payment ratios and interest rates on housing provident fund loans and eliminating the residential mortgage rate floor.2 They also adopted measures to reduce housing inventories and provide liquidity to developers, including an RMB 300 billion (US$42 billion) relending facility for local SOEs to purchase completed but unsold properties and a buyback of unused residential land. The size of the new facility accounts for about 13.3 percent of the inventories of completed homes.3 Figure 3. Home sales and prices continued to drop amid a necessary sectoral adjustment A. Home sales, starts, and investment B. Home prices 100 100 100 80 80 Index, July 2021 = 100 12mma Index, Sep 2021=100 80 60 60 40 40 60 New home sales (value) 20 20 Second-hand home prices New home sales (floor space) Property investment New home prices Housing new starts 0 0 40 Aug-21 Apr-22 Dec-22 Aug-23 Apr-24 Apr-15 Apr-18 Apr-21 Apr-24 Source: NBS, PBC, World Bank staff estimates. Demand and supply imbalances in some sectors have exerted downward pressure on prices Deflationary pressure in producer prices has persisted into early 2024, reflecting imbalances between demand and supply in some industrial sectors. Producer prices fell by 2.6 percent y/y during the first four months of 2024, following a 3.0 percent drop in 2023 (Figure 4A). Aside from volatile commodity prices, the decline in producer prices has been partly driven by industries with imbalances between supply and demand, as evidenced by their lower industrial capacity utilization rates (Box 1). These industries include non-metal minerals, ferrous metals, and electric appliance manufacturing, all of which are connected to the sluggish property sector (Figure 4B). 2 The minimum downpayment ratio has been reduced to 15 percent for first homebuyers, and to 25 percent for second home purchases. 3 World Bank staff estimates. 10 China Economic Update - June 2024 In addition, lower factory-gate prices for electronics that have been experiencing post-pandemic normalization in demand and automobiles that have faced intense domestic price competition also contributed to deflationary pressure. Lower food prices and subdued consumer demand for goods contributed to very low consumer inflation during the first four months of 2024. Headline CPI inflation stagnated at 0.1 percent y/y in January-April 2024, compared to a modest inflation of 0.2 percent in 2023. Although recent fluctuations in headline inflation were primarily attributed to volatile food and energy prices, core inflation, lingering at around 0.7 percent y/y, has consistently stayed below the pre- pandemic average of 1.5 percent (Figure 4C). The domestic automobile sector faced price pressure from intense competition for customers (Figure 4D). In services, flat rental prices were offset by stronger travel-related services inflation. Figure 4. Demand and supply imbalances in some sectors have exerted downward pressure on prices A. Producer price index B. Change in PPI and capacity utilization 16 Coal Mining PPI Non-commodity PPI 40 Percent, change in producer prices since 14 12 30 Non Ferrous Oil and Gases 10 Metals 20 8 All Industries 2019Q4 Percent y/y 6 10 Chemical Fibers Foods 4 0 2 Automobiles -10 Computer & 0 Nonmetal Electronics -2 Minerals -20 -4 -6 -30 -8 60 70 80 90 100 Apr-16 Apr-18 Apr-20 Apr-22 Apr-24 Capacity utilization rate, 2023 C. Consumer price index D. Consumer price index in selected sectors Food Energy Core: services Rent Household appliance 6 Core: goods CPI Vehicles Telecom appliance 8 5 6 4 4 3 Percent y/y 2 Percent y/y 2 0 1 -2 0 -4 -1 -6 -2 -8 Apr-16 Apr-18 Apr-20 Apr-22 Apr-24 Apr-16 Apr-18 Apr-20 Apr-22 Apr-24 Source: NBS, World Bank staff estimates. 11 China Economic Update - June 2024 Box 1. Emerging supply and demand imbalances in some industries The decline in China’s industrial capacity utilization rates mainly reflects imbalances between demand and supply in a few specific sectors. The industrial capacity utilization rate has decreased to an average of 74.9 percent over the past four quarters, falling below the pre-pandemic average of 76.7 percent from 2017 to 2019. This decline has been concentrated in a few sectors, particularly those linked to the property sector (Figure 5A). These include non-metal minerals such as cement and glass, ferrous metals (steel), and electrical machinery (household appliances) in which supply capacity resulting from years of high property investment now exceeds diminished demand. Meanwhile, rapid production capacity expansion during the pandemic, along with the post-pandemic global demand normalization, has led to reduced capacity utilization in the electronics sector. This could partly reverse this year with the improvement in global trade. A structural shift in demand toward electric vehicles could be contributing to the decline in capacity utilization in the internal combustion engine (ICE) automobile sector. In 2023, the number of ICE passenger car sales in China stagnated at 0.1 percent growth, while the growth of EV sales jumped to 38.2 percent y/y. Figure 5. Performance diverged within manufacturing sectors A. Capacity utilization rate by sector B. Capacity utilization and deflation Nonmetal mineral Automobile Coefficient (LHS var = ppi inflation) 1.0 Food Capacity Utilization Computer & electronics 0.8 2017-2019 average Textile Pharmaceutical Capacity Utilization 0.6 Electric machine in 2023 0.4 All industries Special equipment 0.2 Chemical Electricity, water & gas 0.0 Ferrous metal Non ferrous metal -0.2 Chemical fiber -0.4 General equipment Oil and gas -0.6 Coal mining Idle capacity PPI Inflation Lagged PPI inflation 60 70 Percent 80 90 expectation C. Profit margins in key manufacturing sectors D. Fixed asset investment by key sectors General equipment Special equipment General equipment Special equipment Automobile Electric machine Automobile Electric machine Computer & electronics Computer & electronics 130 50 120 40 Index, 2019 =100 Percent, ytd 110 30 20 100 10 90 0 80 -10 70 -20 2019 2020 2021 2022 2023 2024 2019 2020 2021 2022 2023 2024 Source: NBS, World Bank staff estimates. 12 China Economic Update - June 2024 Note: Figure B: Idle capacity = 100-capacity utilization rate; PPI inflation expectation = 10-year average of PPI inflation before the pandemic. The regression analysis explores the relationship between China’s PPI inflation (dependent variable) and idle capacity utilization, inflation expectation and lagged PPI inflation (independent variables), controlling for year and industry fixed effects, with standard errors clustered at industry level, using quarterly data from 2016Q1 to 2024Q1. Lower capacity utilization rates in these sectors have contributed to producer price deflation, which has eroded industrial profit margins. Idle capacity, measured by the gap between the capacity utilization rate and full capacity utilization, is associated with lower producer prices (Figure 5B). Lower PPI inflation expectations, coupled with the persistence of inflation over time, have also contributed to weak PPI inflation in China. These negative price pressures have eroded profit margins in the sectors with lower capacity utilization rates (Figure 5C). Investment growth in these sectors could slow, as firms hold back on expanding or upgrading facilities until demand catches up with supply. Automobile and electrical machinery manufacturing are already witnessing investment retrenchment, suggesting ongoing market adjustment to demand changes (Figure 5D). The other sectors with declining profits could experience a similar decline in investment in the coming quarters. Carbon emissions increased moderately despite rapid scale-up of renewable energy Carbon emissions increased at a rate below the rate of GDP growth for the third consecutive quarter, reflecting subdued growth of transport and property-related industrial emissions. China’s carbon dioxide (CO2) emissions are estimated to have risen by 2.2 percent y/y in the first quarter of 2024, slower than GDP growth, signaling continued relative decoupling of economic growth from emissions (Figure 6A). The power sector and residential emissions continue to drive emission growth, while transport emissions remained stable and industrial emissions contracted (Figure 6B). Lower transport emissions likely reflect increasing electrification in the sector, as evidenced by the 34.5 percent surge in the number of electric vehicles (EVs) sold in domestic market in the first quarter. The reduction in industrial emissions was attributed to the diminished output from the steel and cement industries, the two highest industrial emitters, amid the deepening property sector slowdown. Power generation from fossil fuels continued to grow to meet rising electricity demand, despite rapid scale-up of renewable capacity. Total electricity generation grew by 8.8 percent y/y in the first quarter, with thermal sources contributing the most (Figure 6C). Although solar and wind electricity generation grew to meet more than 40 percent of the additional electricity demand in the first quarter, utilization rates—the ratio of consumption by end-users to generation— declined (Figure 6D). Even though China increased investment in the power grid by 14.7 percent y/y and in electricity storage capacity by 210 percent y/y in the first quarter of 2024, the reduction 13 China Economic Update - June 2024 in solar and wind utilization rates could signal possible constraints to the integration of rapidly growing renewable energy in the power grid in recent quarters. Figure 6. Emissions driven by the power and residential sectors, while the utilization rates of renewable energy fell A. Carbon emissions growth and GDP growth B. Contribution to carbon growth by sector 25 Carbon emission growth GDP growth 6 Power Industry Transport Residential Total 20 5 4 15 3 Percentage points Percent y/y 10 2 5 1 0 0 -1 -5 -2 -10 -3 2020Q1 2021Q1 2022Q1 2023Q1 2024Q1 2020 2021 2022 2023 2024Q1 C. Electricity generation growth in the first quarter D. Utilization rate of wind and solar power Solar installed capacity (RHS) Wind installed capacity (RHS) Wind utilization rate Solar utilization rate 100 1200 99 1000 98 800 Percent, 3mma 97 GW 600 96 400 95 94 200 93 0 Jul-21 Dec-21 May-22 Oct-22 Mar-23 Aug-23 Jan-24 Source: Carbon monitor, Ember, National Renewable Energy Absorption Monitoring and Early Warning Centre, National Energy Administration, World Bank staff estimates. Announced fiscal measures will provide some support to domestic demand Subdued domestic demand and property sector woes weighed on fiscal revenues in the first four months of 2024, constraining spending. China’s consolidated fiscal revenue fell by 3.4 percent y/y in the January-April (Figure 7A). A drop in tax receipts was mainly driven by declines in domestic VAT, reflecting soft domestic demand, particularly for big-ticket items. Meanwhile, the persistent downturn in the property sector led to a 10.4 percent y/y decrease in land lease revenues. On the spending side, the consolidated fiscal expenditures declined by 2.3 percent y/y. This was mainly due to weak local government spending, reflecting normalization in health 14 China Economic Update - June 2024 spending from the high level during the COVID-19 exit wave early last year and local financial constraints in some cases. Meanwhile, the government spending on trade-in program and equipment upgrades, including RMB 11.2 billion (US$ 1.6 billion) allocated for car trade-ins, will provide some support for domestic demand. Overall, the consolidated fiscal deficit stood at 1.4 percent of GDP at the end of April, only marginally larger from the same period last year. This could indicate a risk of budget under-execution. The issuance of a new special Treasury bond will help support local government expenditures. The pace of government bond issuance was slow during the first four months of this year (Figure 7B). Increased scrutiny of local debt could have contributed to delayed approvals of local projects eligible for bond funding. Central agencies issued revised guidance on funding for submitted local government projects in mid-April.4 The issuance of special ultra-long Treasury bonds worth a total of RMB 1 trillion (US$ 141 billion) started in May. The transfer of some of these funds to local governments is expected to alleviate some of the financing constraints for the rest of the year. Figure 7. Faster bond issuance will provide some fiscal support A. Government revenue and expenditure B. Net government bond issuance Fiscal expenditure growth Fiscal revenue growth 2.0 Treasury bond 60 Land sale revenue Local government general bond 1.6 Local government special bond 40 1.2 Percent of GDP Percent y/y ytd 20 0.8 0 0.4 -20 0.0 -0.4 -40 Jan-23 May-23 Sep-23 Jan-24 May-24 Apr-21 Oct-21 Apr-22 Oct-22 Apr-23 Oct-23 Apr-24 Source: MOF, NBS, Wind, World Bank staff estimates. Note: China’s budget system consists of (i) the General Public Budget which includes tax and non-tax revenues, current expenditures, and a portion of capital expenditures; (ii) the Government Fund Budget which reflects mainly land-lease revenues of local governments and expenditures for specific infrastructure and social projects; (iii) the Social Security Fund Budget which records social insurance contributions and disbursements; and (iv) the SOE Fund Budget which is the state-owned assets operation budget. The consolidated budget balance refers to the sum of (i), (ii), (iii), and (iv) minus net withdrawals from the government’s stabilization fund. Data on (iii) and (iv) are only reported at annual frequency. In the General Public Budget, local government revenues exclude transfers from the central budget, and central government expenditures exclude transfers to local governments. 4 The State Council Information Office Press Conference on Macroeconomics Situation and Policies, April 18th, 2024. Available at: https://www.gov.cn/lianbo/fabu/202404/content_6946244.htm. 15 China Economic Update - June 2024 Credit growth continues to moderate Monetary policy has been eased, although the size of the response has been constrained by a risk of exchange rate depreciation and capital outflows. Following last year’s rate cuts, the 5- year loan prime rate (LPR) – the benchmark rate for mortgages – was lowered by another 25 basis points (bps) in February (Figure 8A). The People’s Bank of China (PBC) lowered banks’ costs of holding reserves at the central bank by reducing the required reserve ratio (RRR) in February, but it withdrew RMB 0.8 trillion (0.6 percent of GDP) of liquidity from the banking system in net terms mainly through open market operations in the first quarter (more than offsetting the liquidity effect of the RRR cut) (Figure 8B). These actions reflect the PBC’s efforts to balance between providing policy support to the economy with mitigating risks of exchange rate depreciation and capital outflows, given wide interest rate differentials with other major economies. Figure 8. The pace of monetary easing slowed in Q1 A. Policy rates B. Net liquidity injection MLF: 1Y LPR: 1Y Open market operations Lending facilities 6 LPR: 5Y Reverse repo rate: 7D RRR change Structural instruments Net liquidity provision 5 4 4 Percent of GDP 2 Percent 3 2 0 1 0 -2 Apr-21 Apr-22 Apr-23 Apr-24 2019 2020 2021 2022 2023 2024Q1 C. Credit to the non-financial sector D. Change in bank loan stock Others 10 Real estate Industry Green Inclusive Corporate bonds Government bonds Contribution to growth, percentage points Shadow banking 8 14 Bank loan 12 Aggregate financing (minus equity) 6 10 RMB trillion 8 4 6 2 4 2 0 0 -2 -2 Apr-21 Apr-22 Apr-23 Apr-24 2012 2014 2016 2018 2020 2022 2024 Source: NBS, PBC, National Interbank Funding Center, World Bank staff estimates. Note: Figure D: Green loans support environmental initiatives and address climate change by financing projects in energy conservation, clean production, clean energy, ecological protection, green infrastructure upgrades, and 16 China Economic Update - June 2024 related services. Inclusive loans refer to loans to small and micro enterprises with a single credit limit of up to RMB 10 million. Credit growth has continued to slow, with the PBC increasingly resorting to structural tools to support prioritized sectors. China’s non-financial sector credit growth slowed to 8.2 percent y/y in April, primarily due to slower government bond issuance in early 2024 but also to a high base last year when credit was substantially front-loaded (Figure 8C). To support credit growth, the PBC has provided funds at low interest rates to priority sectors through structural lending facilities. This has contributed to a surge in green loans and “inclusive” loans to micro and small enterprises, with the combined outstanding amount tripling from 2019 to RMB 67.2 trillion in the first quarter of 2024, while bank loans to the property sector decreased (Figure 8D). More recently, a new relending facility with a quota of RMB 500 billion has been implemented to facilitate equipment upgrades in the manufacturing sector. Regarding the property sector, the PBC has provided targeted financing to China’s policy banks and other low -cost credit support initiatives.5 However, fiscal pressures at the local level and risk aversion among banks may have affected the effectiveness of these policy measures. The banking sector remains well capitalized, though profitability has fallen Aggregate net profit of the banking system grew at a somewhat slower pace, but adequate capitalization levels have been maintained. Lower retained earnings were offset by equity and rights offerings to replenish capital. Banks’ return on assets (ROA) declined by 6 bps in 2023, driven by an ROA decline in large state banks and joint-stock banks (Figure 9A). On the asset side, a few factors contributed to the decline of banks’ net income: reductions in the benchmark LPR, lower interest rates on existing mortgages, a decrease in long-term bond yields, and market competition for assets. On the liability side, depositors shifted to fixed-term deposits which commanded higher interest rates. Estimates based on data for publicly listed commercial banks show that fixed-term deposits grew at an annual rate of around 20 percent over the past two years in some banks. Despite banks lowering deposit rates in 2023, the reduction was insufficient to halt the decline in net interest margins from an average of 1.9 percent at the end of 2022 to 1.7 percent at the end of 2023. The sector’s capital adequacy ratio improved by 20 bps, reaching 15.1 percent in 2023 (Figure 9B). This improvement was supported by equity and rights offerings and bond issuance. While asset quality of commercial banks continues to face pressure from exposure to the property sector, reported system-wide NPLs remain manageable. The outstanding non- performing loans (NPL) of commercial banks grew by 8.1 percent y/y in 2023, reaching RMB 3.2 5 Measures include a RMB 200 billion credit support quota to guarantee home deliveries and a RMB 100 billion quota to purchase existing housing inventory for rental purposes, etc. 17 China Economic Update - June 2024 trillion which translates to an NPL ratio of 1.6 percent, broadly unchanged from 2022. The sector- wide loan loss provision ratio remained high at 205.1 percent of NPL. Asset quality varies across banks, with some city and rural commercial banks more exposed to asset quality risks due to their geographically concentrated loan portfolios and lower risk management capacity. The NPL ratio of rural commercial banks remained relatively elevated at 3.3 percent at the end of 2023, while the loan loss provision ratio decreased by 8.9 percentage points to 134.4 percent, still above the regulatory requirement. Estimates based on data for publicly listed commercial banks indicate that the property sector NPL ratio of banks increased to 3.8 percent at the end of 2023, while the mortgage NPLs remained around 0.6 percent6. Due to the prolonged contraction in the property sector, banks’ property sector NPLs continued to increase. As of the end of the first quarter of 2024, the outstanding loans of property developers amounted to RMB 13.8 trillion (5.6 percent of total loans) and mortgage loans amounted to RMB 38.2 trillion (5.5 percent of total loans). The NPL ratio of total property (developer loans and mortgages) exposures is estimated to be 0.3 percent of total loans outstanding. Figure 9. Banking sector capitalization increased despite declining profitability A. Return on assets of banks B. Capital adequacy ratio Overall CCB Overall LSB JSB CCB RCB 20 RCB LSB 1.2 JSB Regulatory requirement 18 1.0 0.8 16 Percent Percent 0.6 14 0.4 12 0.2 0.0 10 Dec-18 Dec-19 Dec-20 Dec-21 Dec-22 Dec-23 Dec-18 Dec-19 Dec-20 Dec-21 Dec-22 Dec-23 Source: NAFR, World Bank staff estimates. Note: LSB – large state banks, JSB – joint-stock banks, CCB – city commercial banks, RCB – rural commercial banks. 6 Measured as a ratio of NPLs for the segment against total loans for the segment. 18 China Economic Update - June 2024 II. Outlook, Risks, and Policy Implications Outlook The outlook for global growth this year remains tepid, and a modest pick-up is expected next year. Global growth is set to remain below the pre-pandemic average amid the effects of tight monetary policy and elevated geopolitical uncertainty (World Bank 2024a). Global trade growth is projected to pick up this year, supported by expanding goods trade, but is also anticipated to remain below the pre-pandemic average. Interest rates are expected to remain elevated for some time, as inflation returns to target only gradually. Assuming no escalation of ongoing conflicts, overall commodity prices are forecast to decline only slightly in 2024 and 2025, and to remain well above pre-pandemic levels (World Bank 2024b). GDP growth is projected at 4.8 percent in 2024, an upward revision of 0.3 percentage points from our December 2023 China Economic Update (Table 1). The revision reflects stronger-than- expected exports and the impact of policy measures such as additional support the property sector and higher fiscal spending. Consumer price inflation is projected to rise to 0.9 percent in 2024, as the drag from falling food prices fades. However, inflation will likely remain below the policy target of 3 percent, given that demand is yet to catch up with the rapid expansion of supply. Table 1. China selected economic indicators, 2021-2026 Annual percent change unless indicated otherwise 2021 2022 2023 2024 2025 2026 Real GDP growth, at constant market prices 8.4 3.0 5.2 4.8 4.1 4.0 Private Consumption 11.7 0.5 10.1 6.5 5.6 5.4 Government Consumption 3.3 4.8 2.9 3.4 2.9 2.8 Gross Fixed Capital Formation 3.1 3.3 3.7 3.9 3.7 3.6 Exports, Goods and Services 18.4 -2.3 -0.1 3.1 2.0 2.0 Imports, Goods and Services 10.3 -6.0 3.6 2.9 2.7 2.7 Real GDP growth, at constant factor prices 8.4 3.0 5.3 4.8 4.1 4.0 Agriculture 7.1 4.2 4.1 3.0 3.0 3.0 Industry 8.7 2.6 4.7 4.9 3.5 3.2 Services 8.5 3.0 5.8 4.9 4.7 4.6 Inflation (Consumer price index) 0.9 2.0 0.2 0.9 1.5 2.0 Current account balance (% of GDP) 2.0 2.2 1.5 1.0 0.5 0.2 Net foreign direct investment, Inflow (% of GDP) 0.9 0.2 -0.9 -0.6 -0.3 0.1 Consolidated fiscal balance (% of GDP)* -4.0 -6.3 -5.8 -6.4 -4.4 -4.1 Government debt (% of GDP) 46.9 50.4 54.2 57.4 58.6 55.5 Primary balance (% of GDP) -3.0 -5.2 -4.7 -5.4 -3.4 -3.2 Source: World Bank. Note: f = forecast (baseline). * World Bank staff estimates. 19 China Economic Update - June 2024 Despite the uptick in early 2024, growth momentum is projected to taper. The pent-up demand for services is expected to normalize, while goods consumption could remain subdued. However, this trend is likely to be mitigated by the government’s trade-in policy aimed at boosting the consumption of durable goods. While recent fiscal measures will provide some support to domestic demand, the adjustment in the property sector continues. Soft demand and deflationary pressures are anticipated to slow corporate revenue and profit growth, weighing on manufacturing investment in some sectors. On the external side, exports are poised to improve on the back of a recovery of global trade and strong demand for green technology. Over the medium term, slowing productivity growth, high debt levels, and an aging population are expected to weigh on GDP growth. GDP growth is projected to moderate to an average of 4.1 percent in 2025-26. Contributing to this deceleration are slower productivity gains, reduced efficiency of investment, and increasing public and private debt (non-financial sector debt reached 309 percent of GDP in March 2024). With a rising old-age dependency ratio and a low and declining fertility rate, demographic headwinds are set to intensify, further diminishing potential growth (See Special Focus for details). Figure 10. Poverty reduction will continue, albeit slower than in previous years A. Poverty rate ($6.85 per person per day) B. Number of poor ($6.85 per person per day) 45 National Urban Rural 450 National Urban Rural Millions of people, $6.85 per person per 40 400 Percent, $6.85 per person per day 35 350 30 300 25 250 day 20 200 15 150 10 100 5 50 0 0 2018 2019 2020 2021 2022 2023 2024 2025 2026 2018 2019 2020 2021 2022 2023 2024 2025 2026 Source: World Bank staff estimates using tabulated data from NBS and World Bank’s GDP growth projections. Note: Last grouped data available to calculate poverty is for 2020. Projections based on per capita GDP growth estimates, using a neutral distribution assumption with pass-through 0.85 to per capita household consumption. The pace of poverty reduction, evaluated at the World Bank’s upper middle income poverty line of US$6.85/day per person (2017 PPP), rose in 2023 but is expected to moderate. Rural extreme poverty, following the national definition (US$ 2.3/day per person in 2017 purchasing power parity (PPP)), has effectively been eliminated. About 17 percent of the population (243 million people) is estimated to have consumption levels below US$ 6.85/day per person, a higher 20 China Economic Update - June 2024 living standard benchmark used as a reference by the World Bank to compare progress across countries (Figure 10A). Based on this higher benchmark, 30 million people were lifted out of poverty in 2023, compared with 21 million in 2022 (Figure 10B). The pace of poverty reduction at this line is expected to slightly decelerate to 28 million in 2024, due largely to the slower economic growth projected for these years. Risks Risks to China’s growth outlook are broadly balanced. On the upside, increased magnitude and effective implementation of existing measures, along with decisive policy action to restructure the property sector, could help boost household confidence and stabilize the property sector earlier than expected. Higher-than-expected fiscal spending, possibly financed at the central level, has the potential to lift public investment above baseline expectations. Further substantial progress in structural reforms, particularly for the private sector, would boost investor sentiment, productivity growth and China’s growth potential (see below). On the downside, a further delay in the property sector recovery beyond 2024 could weigh on investment and place considerable financial strain on developers, their creditors, and suppliers. Financial stress in the property sector could spill over into the broader financial sector. This would also further squeeze local government revenue, dampening public investment. The negative household wealth effect from a longer-than-expected housing price decline, combined with a worse-than-expected labor market, could lead to a more persistent weakness in confidence and spending. While recovering exports have provided near-term support, the economy remains vulnerable to slower global growth, tighter-for-longer financial conditions, and increased trade tensions. Monetary easing in advanced economies could be further delayed if progress toward returning inflation to targets slows. This could lead to slower-than-expected global growth and weigh on the demand for China’s exports in turn dampening investment and employment in export- oriented sectors. Rising trade protectionism presents an additional risk, particularly if it constrains China’s imports of critical technology, slows the transfer of productivity-enhancing innovations, and leads to a decoupling of high-tech supply chains. In contrast, stronger-than- expected external demand, especially faster-than-expected growth in the United States, could push China’s near-term growth higher than in the baseline. Policy implications The government could increase macroeconomic policy support if downside risks materialize. Monetary policy could be further eased, should the economy lose growth momentum. On the fiscal side, given financial constraints at the local level, shifting a larger share of borrowing to the central government could help mitigate risks of under-execution of the budget. The recent 21 China Economic Update - June 2024 issuance of ultra-long special Treasury bonds and the transfer of some of these funds to local governments is a welcome move in this regard. Managing the slowdown of the property sector and restoring household confidence warrant structural measures beyond short-term regulatory easing and liquidity support. While the government has taken demand-side measures—including relaxation of housing purchase restrictions and reduction of downpayment ratios and mortgage rates—the property sector downturn has persisted. The whitelist scheme and other liquidity support measures have provided some financing support for viable developers. Recently announced measures to support inventory destocking will increase affordable housing and aid in rebalancing supply and demand in the property sector. However, subdued household confidence and under-execution of some liquidity support measures underscore the need to implement supply-side initiatives such as expediting the restructuring of distressed developers to reallocate resources to more productive uses, greater price flexibility to stimulate housing demand, and strengthening the regulation of the housing pre-sale system to boost home-buyer confidence. Market-oriented reforms remain important for redirecting resources to more productive uses and reducing the risk of imbalances between supply and demand in some sectors. The rapid increase in investment creates risks of emerging imbalances in industrial sectors where demand fails to catch up with supply expansion. While market adjustment to demand changes has been observed in sectors such as automobile and electrical machinery manufacturing, more active use of the corporate insolvency framework could enable the exit of non-viable firms and rescue of viable but distressed firms. 7 Measures such as improving legal and institutional frameworks, streamlining reorganization procedures, and enhancing capacity for insolvency practitioners could improve insolvency procedures, thereby contributing to more efficient resource allocation. Policies to accelerate the transition towards carbon neutrality could boost demand for green technologies. Through a scale-up of renewable energy investments and other low-carbon technologies, China could not only progress toward its dual carbon targets—achieving peak carbon emissions before 2030 and carbon neutrality by 2060—but also boost domestic demand and absorb its growing supply of green technology products. Energy market reforms to facilitate the integration of renewables in the energy mix, energy efficiency mandates, and green government procurement could support these efforts (World Bank 2022). 7 Well-functioning insolvency frameworks have been found to: (i) lower the cost of and increase the availability of credit; (ii) increase returns to creditors; (iii) promote job preservation through efficient restructuring tools; and (iv) encourage entrepreneurship (World Bank, 2014). 22 China Economic Update - June 2024 A more sustained increase in household consumption requires reforms that go beyond short- term stimulus, such as improvements in social protection. The government’s trade-in programs for vehicles and household appliances could provide some support to consumption in the near term. However, short-term stimulus measures may not be adequate to increase China’s structurally low consumption level. Reforms in areas such as broadening the coverage and raising the benefits of social security programs, adopting a more progressive tax system, redirecting fiscal spending from infrastructure to human capital, and lessening inequalities in access to quality healthcare and education could diminish households’ inclination for precautionary savings and drive a more sustained and balanced growth path in the longer term (World Bank 2023). 23 China Economic Update - June 2024 III. Special Focus: Aging China—Implications for Growth and Inequality This focus note presents an initial exploration into the impact of population aging on two selected issues—long-term growth and inequality. The following section examines the potential impacts of the demographic shift by analyzing its effect on the main sources of growth. The next section explores the effects of demographics on different dimensions of well-being and inequality, as they matter to achieving China’s common prosperity goal. The final section presents some considerations for future policy directions. China has become an aged society Rising longevity and declining fertility have contributed to population aging in China. Life expectancy in China has risen from 60.2 years in 1974 to 78.2 years in 2021. This is a major achievement. Yet, along with declining fertility, it has contributed to rapid population aging. The fertility ratio has declined from 4.2 children per woman in 1974 to 1.1 in 2022. Measures have been introduced to reverse the declining fertility, including a transition from a one-child to a three-child policy in 2021 and financial incentives for families to have more children, but the desired outcomes have not been achieved yet. In 2023, China became an aged society, defined as one in which individuals over the age of 65 years constitute 15-20 percent of the population (Figure 11A). Over the next 20 years, the share of people over 65 will rise to about 28 percent of the population, while the total population is expected to fall to 1.35 billion. China’s demographic transition is unfolding at a relatively rapid pace, compared with other aged economies at higher levels of development. Family planning policy and improvements in female education led to a fall in fertility in the 1970s, from 6.5 in 1968 to 2.7 in 1980. Since the implementation of the one-child policy in 1980, as well as the increase in overall incomes and continued improvements in education (particularly for women), China’s fertility ratio has continued its fall, decreasing by 1.6 children per woman between 1980 and 2022, faster than the decline of 0.6 in Japan’s fertility ratio, but slower than the decline of 2.0 in the Republic of Korea’s. Both Japan and the Republic of Korea aged at a stage when their societies had already reached high-income levels and have had resources to service the needs of their aged population since then. China remains an upper middle-income country on the cusp of becoming a high-income country, but already with a fertility ratio that is lower than that of Japan (Figure 11B). In China, the rising costs of raising a child have been arguably a key driver of declining fertility. Estimates suggest that the cost of raising a child could be as high as seven times per capita GDP, second only to Korea (Liang et al. 2024). In addition to the direct financial cost of childbearing and rearing, families also face the time cost of maternity leave, childcare, school pick-up, after- 24 China Economic Update - June 2024 school tutoring, household chores, and others and opportunity costs such as the “motherhood career penalty”—a decline in work skills, missing promotion opportunities, and lower wage rates. The demographic landscape varies across China’s regi ons. Richer provinces and cities such as Jiangsu and Shanghai are seeing high rates of old age dependency (Figure 11C). However, some other wealthier provinces such as Guangdong and Fujian have younger populations due to the presence of migrant workers from other provinces (Glinskaya et al. 2022). While poorer provinces tend to have younger populations, given shorter life expectancy and higher fertility rates, some of the poorest provinces such as Gansu and Sichuan have a high share of older adults as well, due to outmigration of the working-age population. In terms of geography, the Northeast provinces of Liaoning, Jilin, and Heilongjiang are among the most aged, while Xinjiang Uygur Autonomous Region and Qinghai are among the youngest. The steadily increasing old age dependency has raised the overall dependency ratio. China’s dependency ratio declined from 79 in 1974 to around 37 in the mid-2000s, tracking the decline in the youth dependency ratio as fertility decreased (Figure 11D). However, while the youth dependency ratio has continued to decline into the 2020s, the overall dependency ratio has started to rise reaching nearly 45 in 2022, pulled by rising old age dependency that steadily rose to 19.9 in 2022. As a result of these dynamics, the demographic window—the window of opportunity during which a country maximizes its work force due to a high work-ready population and a low dependent population—has run its course after roughly 15 years.8 Figure 11. China is an aged society, where the demographic window has closed A. Rising longevity and declining fertility contribute to B. … with a fertility ratio falling faster than in other population aging in China, … aged countries at higher stages of development China Japan 2.2 China Republic of Korea Hong Kong, China Japan 40 2.0 Republic of Korea Percent, population 65 and above 35 1.8 30 Super-aged society Fertility rates Japan (1986) 25 1.6 Republic of Korea(1996) 20 Aged society 1.4 15 10 1.2 Aging society Republic of… 5 China (2022) 1.0 0 3000 8000 13000 1974 1980 1986 1992 1998 2004 2010 2016 2022 GNI per capita (Atlas method) 8 Dependency ratios were computed based on the UN population data. The demographic window follows the UN definition: the window is open when “the share of children and youth under 15 years falls below 30 percent of the population, and the share of people 65 years and older is still below 15 percent” (United Nations 2004). 25 China Economic Update - June 2024 C. Regional experiences have varied, but even some D. Steadily increasing old-age dependency has poorer provinces have already aged raised overall dependency ratios 35 Demographic window 100 Young-age dependency ratio Liaoning 30 Sichuan Old-age dependency ratio Shanghai Percent, old-age dependency rate Dependency ratio 80 25 Jilin Gansu 20 Beijing 60 Percent Zhejiang 15 40 10 Guangdong 5 20 0 0 10 10.2 10.4 10.6 10.8 11 11.2 11.4 Log (per capita Income) 1974 1993 2012 2031 2050 Source: UN, WDI, NBS, World Bank staff estimates. Will population aging dampen long term growth? China succeeded in capturing the demographic dividend. Past changes in the demographic structure, particularly the decline in the overall dependency ratio and the expansion of working- age population, contributed to a demographic dividend, boosting economic growth. Estimates of the dividend vary but range between 15 and 25 percent of GDP growth across different periods (Cai and Wang 2005; Feng and Mason 2008; Wei and Hao 2010). 9 Recent analysis, however, shows that the fall of labor force participation from the 1980s to the early 2010s reduced the demographic dividend (Meng 2023). As China deals with an aged population, the question of its impact on long-term economic growth becomes important. Without mitigation measures, population aging could contribute to a deceleration in potential growth. China’s economic growth slowed from an average of 10.5 percent in 2003-12 to 6.2 percent in 2013-22. Physical and human capital accumulation, labor, and total factor productivity, which were all drivers of past growth, have contributed less to growth in recent years (Figure 12). Population aging will impact growth through these same labor, human capital, physical capital, and productivity channels. Without mitigating policy and behavioral adjustments, aging could further shrink the size of the labor force, lower household savings that may reduce resources available for investment and support economic rebalancing, put pressure on the government’s finances, and adversely affect productivity. 9 In several Asian countries, the demographic dividend contributed up to a third of economic growth between 1960s and 1990s (Bloom, Caning and Finlay 2010; Bloom and Williamson 1998). 26 China Economic Update - June 2024 Figure 12. Aging impacts China’s growth Figure 13. The working age population share has trajectory through various channels been declining for over a decade Capital stock Labor Human capital TFP China (men: 15-59; women: 15-54) 14 China (15-64) Percentage points, contribution to y/y Hong Kong, China 12 85 Japan Percent, the working age population Singapore 10 80 Republic of Korea European Union 27 8 growth 75 6 70 4 2 65 0 60 55 1991 1997 2003 2009 2015 2021 Source: NBS, PWT, WDI, ILO, Barro-Lee dataset website, Source: WDI, ILO, World Bank staff estimates. World Bank staff estimates. A lower working-age population share and labor force participation rate could reduce labor supply. Previously, the growth of the working-age population in China ensured a labor cost advantage, aided by rural-urban migration since the 1980s, which released surplus labor from the countryside to cities. However, most of the cost advantage has already been exhausted, as rural surplus labor has largely been absorbed (Li et al. 2012). With a declining working age population, the labor force is likely to decline. Unless labor participation increases, estimates suggest that the average labor force growth could fall from 0.3 percent in 2000-20 to the range of -1.1 to -1.4 percent in 2025-45. Falling female labor force participation has compounded the effect of aging. The share of women active in the workforce fell from 73 percent in 1991 to 61 percent in 2023.10 Population aging also changes the workforce composition from younger to older individuals. Some studies suggest that older workers are less productive and less engaged in entrepreneurial activity than their younger counterparts. A rise in the proportion of older workers could consequently lead to a decline in overall labor productivity and further reduce growth, if the accumulation of experience does not make up for the depreciation of knowledge and the loss in the physical and mental capabilities of older workers (IMF 2019). However, in China this effect has been in part offset by increases in human capital. The continued expansion of education in the past decades has meant that young generations are more educated than the older ones 10 Part of this decline can be associated with the process of structural transformation, with industrialization favoring male employment, and rising incomes allowing for women to stop working for subsistence purposed. Yet, despite continued rapid economic growth and a shift to a service-based economy (where women have a revealed comparative advantage), gender gaps in terms of employment and wages continued to diverge (Brussevich and Dabla-Norris 2021). 27 China Economic Update - June 2024 exiting the labor force (Cao et al. 2020). The contribution of human capital to growth was larger in 2018-22 than in earlier decades. China’s retirement age—low compared to global standards—compounds the negative impact of aging on the size of the workforce. Set in 1951, China’s statutory retirement ages for men at 60 years and women at 55 (white collar) and 50 (blue-collar) that apply to mostly urban residents are low by international comparison (Giles et al. 2023). Across OECD countries, the retirement age averages 64.4 years for men and 63.6 for women.11 The low age for retirement means that the share of the effective working-age population is lower in China than in other East Asian countries such as the Republic of Korea and Singapore (Figure 13). Besides the impact on labor, aging affects growth through household savings and, hence, the capital channel. Competing theories explain the impact of aging on household savings. On the one hand, aging in economies at the late stage of demographic transition, such as China, could lead to lower aggregate savings in line with the life cycle hypothesis where people save during their working years and dissave in retirement to smooth lifetime consumption (the compositional effect).12 On the other hand, aging could also lead to higher savings over the course of life in anticipation of longer lives (the behavioral effect) and also due to altruism and bequest motives of households for the next generation. Household data for 2014, 2018, and 2022 show that older cohorts in China do still save (that is, at least the group aged 70+ does not dissave as expected under the life-cycle hypothesis), but less so compared with their middle-aged counterparts, who are at the prime of their working careers (Figure 14). On this basis, it is unclear whether the composition or the behavioral effect would dominate in the aggregate as the country continues to age. The saving pattern observed across provinces suggests that household savings may decline with the rise in old-age dependency. Panel regressions using provincial data reveal that household income, the old-age dependency ratio, and pension and medical insurance are significant determinants of the household savings rate (Figure 15). Higher-income households tend to have greater propensity to save, explaining the higher savings rate with rising income levels. Rising old-age dependency is associated with a decrease in aggregate household savings. 11 Based on OECD website. Note that the restrictions in China do not apply to rural and informal workers who tend to work considerably longer, implying that potentially less productive parts of the old aged population work longer. 12 Countries in the late stage of demographic transition are those countries where the working age population is about to decline or are already declining. Countries under the advanced stage demographic transition include those where the demographic dividend has ended or will end very soon. Countries under the early-stage demographic transition include those where fertility rates are declining but remain relatively high with the share of the working age population expected to peak in the coming decades (IMF 2019). Households at the early stage of the transition will likely experience increased savings. 28 China Economic Update - June 2024 Controlling for population size, the higher the number of contributors to the urban employee pension system and to medical insurance, the lower the household savings rate. This suggests that social protection programs contribute to lower precautionary saving by households. Figure 14. In China, older cohorts save but less Figure 15. Income, old-age dependency, and compared with middle-aged cohorts social security are significant determinants of household savings rates 0.8 35 2014 2018 2020 Estimated impact on household saving 0.6 Percent, savings rate as a share of 0.229 30 0.4 (0.000)*** 0.083 (0.488) disposable income 0.2 25 0 rate -0.2 -0.030 -0.039 20 (0.736) (0.000)*** -0.4 15 -0.388 -0.6 (0.000)*** -0.588 10 -0.8 (0.000)*** -1 Income Youth Old-age Pension Pension Medical 5 dependency dependency contributors contributors insurance 18-29 30-39 40-49 50-59 60-69 70+ ratio ratio (resident (employee contributors Household head age system) system) Source: Tiwari et al. (2024) forthcoming, analysis based Source: NBS, UN, World Bank staff estimates. on various years of the CFPS. Note: P-values in parentheses. Panel regression using provincial level data. Pension and medical insurance are denoted as contributors (in billions) to the systems. Regression also includes population, provincial and time dummies as control variables. Lower household savings may reduce the resources available for investment and support economic rebalancing. Capital investments in the infrastructure and property sectors are yielding diminishing returns, due to already high capital stocks (World Bank 2023). A reasonable decline in China’s investment rate would thus be consistent with reduced macroeconomic imbalances and improved efficiency. While rebalancing the economy from an investment- and export-led model to a consumption-led model may not necessarily lead to more rapid GDP growth than observed in pre-pandemic years, it will lead to more sustainable growth and reduce financial risk. Rising old-age dependency is also linked to a decline in total factor productivity (TFP) growth. The reasons discussed in the literature include the tendency of old people to be less entrepreneurial, have less appetite for risk and fewer incentives to invest in training, as they have a shorter time horizon to reap the benefits of such investments (IMF 2019; Yao et al. 2017). Dou (2019) found a negative relation between population aging and the number of patent applications in China which is a strong indicator of innovation. An inverted U-shaped productivity pattern emerges among age groups, with those aged 50-59, known to have accumulated 29 China Economic Update - June 2024 experience and expertise and usually in leadership and mentorship roles within organizations, being the most productive in China (Figure 16).13 One way to offset the negative productivity effect of population aging is to leverage innovation and technology. Using U.S. data, Acemoglu and Restrepo (2022) show that aging is associated with greater use and development of industrial robots. Deng et al. (2018) find a similar effect using Chinese provincial panel data. China has already leveraged technology to facilitate productivity growth. China installed more than half of industrial robots globally in 2022 (Figure 17). Figure 16. Rising old age dependency is linked to Figure 17. … but China has been leveraging a decline in total factor productivity, … innovation and technology to facilitate productivity growth Share of 20-29Share of 30-39Share of 40-49Share of 60-69 OADR Annual installation of industrial robots Rest of the (2022) Age-related factors affecting TFP (first World 16% Germany difference) 5% -0.008 -0.008 (0.009)*** (0.007)*** -0.009 South Korea (0.072)* 6% -0.011 China (0.031)** 56% United States (290,300) 7% Japan -0.019 10% (0.064)* Source: World Bank staff estimates building on Liu and Source: International Federation of Robotics. Westelius (2016), Aiyar et al. (2016) and Feyrer (2007). Note: P-values in parentheses. OADR: old-age dependency ratio. The 50-59 cohort is the reference age group. A constant term is found significant. Individual preferences and needs evolve with aging, leading to shifts in demand across various industries and a structural transformation of the economy. Data show that the share of healthcare in household expenditures in China rises from 3.3 percent for the young cohort to 15.1 percent for the elderly cohort, while allocations for education, transport, and communication drop significantly (Figure 18). Consequently, an aging population fosters a market environment that increasingly favors products and services geared toward health and comfort, encompassing healthcare provisions, retirement planning, and leisure pursuits, and specialized 13 The inverted U-shaped pattern is similar to results found by Feyrer (2007) for 87 non-oil countries, and Liu and Westelius (2016) for Japan, but with the age group 40-49 found to be the most productive. 30 China Economic Update - June 2024 products like mobility aids and dietary Figure 18. The share of healthcare to total supplements. This demographic transition expenditures rises across age cohorts also has broader implications for the housing Transport & telecom Education & entertainment Healthcare 30 market, transportation, and leisure facilities Percent, share of total household to suit the needs of an aging population. 25 These evolving demands drive the emergence 20 expenditure of new "silver economy" industries (Box 2). 15 Aging can also put pressure on fiscal 10 expenditures. The fiscal subsidy to both the 5 resident pension system and the urban 0 employees and public sector scheme, as well <=33 33-43 43-54 54-73 >73 as to medical insurance, is already high. In Source: World Bank Development Data Hub. 2023, 22.3 percent of the social security fund budget came from fiscal subsidies of RMB 2.5 trillion, equivalent to 9.1 percent of expenditures in the public finance budget and 2.0 percent of GDP (Figure 19 and Figure 20). These expenditures are expected to increase with population aging. In the absence of fiscal support, the social security fund would have run constant deficits. If social security spending per person for each age group remained at current levels, population aging would put the sustainability of the social security fund at risk in the long term. Pension payments alone are projected to increase from 5.0 percent of GDP in 2017 to between 13.5 percent and 17.0 percent in 2050, depending on how much Chinese benefit levels converge toward OECD levels (Cai et al. 2018; Glinskaya et al. 2022). The Chinese Academy of Social Sciences has warned that, on the current trend, the funds would be depleted by 2035 (Zheng 2019). Figure 19. Fiscal subsidy to the pension schemes Figure 20. … significantly supporting the social and medical insurance is already high in China, … security fund Share of fiscal subsidy on SSF revenue Expenditure 30 10 Revenue, net of fiscal subsidy Share of fiscal subsidy on PFB expenditure Balance, net of fiscal subsidy 8 25 6 20 Percent of GDP 4 Percent 15 2 10 0 5 -2 0 -4 2015 2016 2017 2018 2019 2020 2021 2022 2023 2015 2016 2017 2018 2019 2020 2021 2022 2023 Source: NBS, World Bank staff estimates. Source: NBS, World Bank staff estimates. 31 China Economic Update - June 2024 Box 2. Guidance on the Silver Economy from China’s Government On 11 January 2024, the General Office of the State Council issued Opinions on Developing the Silver Economy to Improve the Well-Being of the Elderly. This policy initiative defines the concept of a silver economy as the aggregation of a range of economic activities that produce products or services that serve the elderly. It aims to address the challenges of aging with a national strategy and calls for collaboration between the government, industries, and civil society in four areas: • Accessibility for the elderly: Policy measures include strengthening and expanding meal assistance, home- and community-based care, institutional care, coordinated health and long- term care, rural elderly services, and cultural and sports services. • Silver economy industrial clusters: The government plans to build 10 silver economy industrial parks nationwide and use free trade zones, e-commerce platforms, and shopping festivals to promote the elderly’s consumption, brand development, and standardized service delivery. • Technology and innovation: Measures aim to support the development and use of information technologies, mobile devices, wearable devices, nursing and home service robots, anti-aging products, biotechnologies to alleviate age-related illnesses and facilitate a barrier-free environment. • Silver economy business ecosystem: Policies include financial support for research and investment, land and facilities for elder care services and industries, favorable credit terms, talent development, data for motoring and evaluation, and combating fraud targeting the elderly. The Silver Economy policy initiative aims to support the welfare and quality of life of China’s elderly while leveraging their economic potential. One recent study projects that the consumption of the elderly population could amount to RMB 12.0-15.5 trillion by 2030 (Dang et al. 2021). Another study estimated that the size of China’s silver economy was about RMB 7.0 trillion (6 percent of GDP) in 2023 and would rise to RMB 30 trillion (10 percent of GDP) by 2035 (Ageing Research Institute 2024). Will aging exacerbate inequality? Beyond its impact on growth, China’s aging may increase inequality in incomes, consumption and, more broadly, well-being. Income inequality in China is relatively high for its level of development. According to the most recent official statistics, the income-based Gini index in 2022 was 47.6, slightly higher than the average of the upper-middle income countries and several points above that found in high-income economies. Evidence from China suggests that rapid aging could raise income inequality in the absence of other changes. The empirical literature suggests that income distribution within cohorts becomes more unequal as they age because of accumulated socioeconomic disadvantages 32 China Economic Update - June 2024 during the life cycle, which is consistent with the permanent income hypothesis.14 In the case of China, income inequality is higher among the old than those of working age (Figure 21). Hanewald et al. (2021) find that old age income inequality is driven by inequality in education (largely determined by the place of birth) and urban-rural gaps that determine wages during the working age and pensions after retirement, the two main components of the income of households with at least one person aged 60 and above (Figure 22). Similarly, using an overlapping generations model for China, Chen et al. (2018) find that aging worsens inequality of income and consumption. 15 Figure 21. Income inequality is higher among old Figure 22. …which is largely driven by location of households than young households … birth and education attained Demographics Urban Province Education 59.2 100 46.2 45.7 41.6 43.6 80 39.8 Index 60 40 20 Total Income Pensions Total Income Pensions 0 income from work income from work Education inequality Income inequality Young households Old households Among old households Source: Hanewald, Jia and Liu (2021). Analysis based on data from the China Health and Nutrition Survey for the period 1991-2015. Note: Bars in figure 22 represent the Gini and concentration indices of different sources of income, and proportion of the Gini index explained by different sociodemographic factors. ‘Old households’ are defined as those with at least one household member aged 60 or more. ‘Young households’ have no members aged 60 or more. Other components of households’ income not included in figure 22 but incorporated in the authors’ calculations include capital income, private transfers, and subsidies – together, they represent less than 10 percent of total household income. The variation in benefits between pension schemes contributes to overall income inequality (Li et al. 2020; Hanewald, Jia and Liu 2021). 55 percent of China’s pensioners, disproportionally in the lower income deciles, receive pension benefits from the largely subsidized Rural-Urban Resident Scheme (RURS) (Figure 23). The RURS covers rural residents and three fifths of China’s 14 For the United States and the United Kingdom, see Deaton and Paxton (1994), for Germany see Bonke, Shrode and Schulte (2010). 15 A fuller assessment of the impact of aging on overall inequality will need to consider the effect of demographic change on wages (and its inequality) as well as the inequality between the working population and the old. Chen et al. (2022) consider some of these aspects from a macroeconomic perspective. A microdata-based analysis could be done to confirm these results. 33 China Economic Update - June 2024 300 million rural migrants employed in cities (Wang et al. 2022). RURS benefits are, on average, less than 6 percent of the average pension benefit from the Urban Employee Pension Scheme and less than 4 percent of the average pension for public sector employees, China’s two contributive pension schemes for formal workers (Figure 24).16 Compared to other countries in the region, China’s social pension coverage is among the highest, but benefit levels are among the lowest relative to GDP per capita (Chomik et al. 2024; Asian Development Bank 2024).17 Gaps in average pension benefits are widening between formal and informal sector workers and between public and non-public sector workers under the Urban Employee Pension Scheme, after controlling for observable characteristics (Glinskaya et al. 2022; Wang et al. 2022; Wang and Huang 2023; Wang et al. 2023). In the future, without further expansion of the Urban Employee Pension Scheme to cover migrants, the existing social security system would worsen accumulated inequalities. Figure 23. Lower income households are more Figure 24. Over half of current workers likely to receive lower pension benefits contribute to the RURS Residents' pension Employee pension Employee contributors Resident contributors 800 Residents average benefit Employee average benefit 700 Number of Enrollment, million 70 10000 Percent, share of households 60 600 8000 50 500 RMB, average 40 6000 400 30 4000 300 20 2000 200 10 100 0 0 1 2 3 4 5 6 7 8 9 10 0 Deciles of per capita consumption 2010201120122013201420152016201720182019202020212022 Source: World Bank staff estimates based on 2018 China Source: NBS. Family Panel Survey. Aging may also put pressure on household budgets due to higher health expenditures. Based on medical insurance data for Beijing, healthcare expenditure among those aged 64 and above is almost twice as large as that among people aged 25-59 (Li et al. 2020). Out-of-pocket expenditure is higher on average among old-age households and represents a particularly high share of overall spending among households at the bottom of the distribution (Figure 25). 16 2022 MOHRSS Statistical Bulletin. Urban Employee Pension and Public Sector Pension schemes is structured around a pay-as-you-go first tier for basic pension financed by employers, a second mandatory tier of a notional individual account financed by employee contributions. A third tier in the Urban Employee Scheme is a private voluntary pillar, introduced in 2022. 17 China’s social pension system is a hybrid with modest individual contributions and predominantly budget financing, unlike most other countries where social pensions are largely non-contributory. 34 China Economic Update - June 2024 Lower-income families are less financially protected to face healthcare costs that rise with old age. The massive expansion of medical insurance since 2003 has allowed low-income families access to financial protection against health risks. But the depth of coverage varies by insurance scheme, city, and occupation. Generally, the public sector and urban employee medical insurance schemes offer more generous benefits than those provided under the residents’ medical insurance scheme.18 The annual medical insurance premium is 8 times higher for urban formal employees and retirees than for those in the residents’ medical insurance, and the average reimbursement rate is 85.2 percent for the former compared to 70 percent for the latter (Zhang et al. 2023). Furthermore, the resident insurance scheme covers only primary care, outpatient services, basic hospitalization, and essential medications, whereas the urban employee insurance covers a broader range of medical services. 19 In recent years, enrollment in the resident insurance system has declined (Figure 26). The fall may reflect low willingness to pay insurance premiums among low-income groups in a context of rising premiums. A recent study found that migrant workers are willing to pay an average of RMB 136 for the medical premium, equivalent to about one third of the resident insurance premium expected for 2024 (Wang and Han 2022). Figure 25. The burden on health spending is Figure 26. Enrolment in the basic medical larger for old households than for young insurance has declined in recent years households Employee medical insurance Residents medical insurance Young household Old household 35 1600 Percent, share of total expenditure in out- 1345 1354 1361 1363 1346 1334 30 1400 1177 of-pocket health spending 1200 25 Person, million 1000 20 744 800 666 597 15 600 10 400 5 200 0 0 1 2 3 4 5 6 7 8 9 10 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Source: World Bank staff estimates based on 2018 Source: National Health Security Administration. China Family Panel Survey. The lack of adequate financial protection against health shocks could exacerbate disparities in health outcomes among low-income populations as the country ages. Individuals with less 18 In 2016, the Resident medical insurance scheme emerged as the integration of the New Cooperative Medical Scheme for rural residents, and the Urban Resident Basic Medical Insurance. It covers urban and rural residents that are not employed or informally employed, elderly that did not contribute to the Employee medical insurance, children and students. 19 National Human Resources and Social Security Services, Social Security Online Service Platform Q&A Guide. Available at: https://m12333.cn/ 35 China Economic Update - June 2024 generous medical insurance are more likely to suffer from reduced access to essential health services and delayed treatment, leading to a widening gap in health outcomes across different socio-economic groups.20 Economic pressure is the primary factor restricting access to medical services for the elderly, while the distance to healthcare facilities also affects the availability of services from the supply side (Qiu and Ran 2019). Accessibility of basic medical services has a greater effect on the health of low-income and geographically distant old aged individuals. In 2018, 24 percent of households had out-of-pocket health spending above 10 percent of total household spending, and 7 percent of households had health spending share of over 25 percent, the two Sustainable Development Goal indicators used to measure catastrophic health spending. With inadequate medical insurance, poorer families often must choose between healthcare and other essentials such as food, housing, and education. In addition, the demand for long-term care is expected to increase with aging. The prevalence of older people with functional limitations and disability rises with age, particularly for women (Figure 27). China’s improvements in healthcare access, age-friendly environment, and educational attainment have lowered the share of people who self-reported needing care from 2.9 percent of the population in 2010 to 2.3 percent in 2020, as reported in the Population Census. But household survey data suggest that old-age disability may be more prevalent and start earlier than self-reported. In 2020, the share of people that required help with daily activities was higher among less educated rural residents: 49 percent of illiterate older adults (more likely to be low-income) were functionally dependent, compared to 13 percent for high- school graduates (Chen et al. 2022). A recent study projects that by 2048 over a third of people aged 60 and above will be functionally dependent for at least one activity of daily living,21 with the share significantly higher for rural and less educated adults (Jiang and Li 2024). Care for older adults in China is typically done by family members (spouse, children, or in-laws) who may forego labor income to fulfill this duty. The rapid rise in life expectancy and the gradual increase in the gap between healthy and total life expectancy could increase pressure on families, especially women, to provide care. Despite increasing access to long-term care, significant unmet care needs remain, particularly for poorer rural residents. Since 2011, China has started to build a multi-tiered long-term care system comprising home- and community-based care, institutional care, and coordinated and integrated social and health care for the elderly. The number of aged-care facilities has more than doubled, and the number of direct beneficiaries of public long-term care programs, including 20 Foregone care for physical examinations was found to be much higher (59 percent) than that of foregone outpatient and inpatient care among middle-aged and elderly people (10 and 7 percent, respectively) (Li et al. 2018). 21 Activities of daily living include dressing, bathing and showering, eating, getting in and out of bed, using the toilet, and controlling urination and defecation. 36 China Economic Update - June 2024 senior allowance for people aged 70 and older, nursing care and elderly care for the elderly people who have functional limitations, and comprehensive subsidies to provide income and in- kind support for people aged 65 and above, rose from 26.8 million (11.6 percent of the population aged 60 and above) in 2016 to 41.4 million (14.8 percent) in 2022.22 However, long-term care provision is still primarily dominated by informal care (NBS Population Census 2020), particularly for rural residents (Zhu and Osterle 2017; Hu et al. 2020; Zhang et al. 2022). Finally, other aspects of a dignified life may deteriorate more for women and lower-income, less-educated households, as the country ages. Unhealthy lifestyles of young adults today will impact their health when they age. China has one of the highest male smoking rates worldwide, and the rate is higher among the less educated (Chen et al. 2022). On the other hand, more educated adults are more likely to drink and lead a sedentary life. By 2030, the cardiovascular age-adjusted mortality rate is expected to be the highest in the lagging western region, nearly double that in the eastern region (Yang et al. 2022). Depression is higher among less educated, rural residents and is particularly high among rural women, 47 percent of whom had depressive symptoms in 2018 (Chen et al. 2022) (Figure 28). Figure 27. Care needs to rise rapidly with age Figure 28. Women and less educated people are more likely to have depressive symptoms 35 Men Women 60 All Rural Urban Percent, population that had depressive 30 Percentage of Unhealthy, not able 50 25 40 selfcaare 20 symptoms 30 15 10 20 5 10 0 0 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 100+ Women Men Illiterate High-school graduates Source: NBS, Population Census 2020. Source: Chen et al. (2022), based on 2018 CHARLS. Looking ahead – policy directions The economic and social challenges posed by population aging can be managed with the right policy and behavioral adjustments. Policy directions can be grouped into three areas. First, policies could aim to expand the labor force both in the short and long term, and thus mitigate the potential impact on the country’s growth potential. A second set of measures could increase productivity and promote private sector participation to support innovation and the silver 22 Ministry of Civil Affairs, Statistical Bulletins. 37 China Economic Update - June 2024 economy as additional sources of growth. Finally, several measures can be considered to close gaps in services and reduce the impact that aging can have on inequality. 1- Expanding the labor force There are several ways to mitigate the shrinking size of the workforce and its impact on growth. Policies could aim to increase the future size of the labor force through fertility-related policies, to raise female labor force participation among the existing population and extend the productive working lives of workers. Policies to increase the birth rate, if successful, can only partly offset the otherwise expected decline in the labor force. The government has introduced measures to improve pre- and post- natal medical services and child benefits and tax breaks in some localities, with no success so far in limiting the decline in fertility. Evidence from other countries suggest that additional measures to further lower the cost associated with childbearing could help (Box 3). These include higher subsidies and better childcare service provision in the first few years after birth, equitable leave policies, flexible work arrangements, and gender-equal labor conditions to reduce the motherhood career penalty. Regional and global experience suggests that gender norms are associated with low fertility rates, especially in other parts of East Asia where the relative female burden of child rearing and unpaid domestic work is very pronounced. And yet, even successful experiences have not seen an increase in fertility to the replacement rate. Box 3. Fertility policies – the international experience Many countries have implemented policy measures to slow the decline in fertility rates. These include policies that aim to lower the financial costs of having children (e.g. child allowances, childcare provision and education discounts, and tax support for families with children), lower the motherhood career penalty through gender-equal labor conditions (e.g. incentives for shared parental leave, lower workplace gender discrimination and benefits systems that support working parents), improve work- life balance (e.g. regulations on overtime, expanded leave policies, flexible working), and improve gender equality outside of work (e.g. by promoting equal sharing of childcare and housework between partners). Across countries, there is a strong positive correlation between spending on family policies as a share of GDP and fertility rates (Sabotka, Matysiak and Brzozowska 2019). A country’s fertility also often goes up when family policies become more generous (Buttner and Lutz 1990; McDonald 2006). Empirical evidence shows that accessible, affordable, high-quality childcare services across childhood, aligned with working hours have a strong positive effect on fertility (Goldstein et al. 2017; Luci-Greulich and Thévenon 2013; Rindfuss et al. 2010). Financial transfers typically have a small impact, possibly because transfers tend to cover only a small proportion of the costs of raising children and have greater impact 38 China Economic Update - June 2024 on lower-income households, who tend to already have higher fertility. One offs “baby bonuses” appear as largely ineffective, hence were abandoned in countries such as Australia, Spain and Canada. Longer well-designed paid parental leave also has a positive impact on fertility, although effects also depend on leave type and context. Large parental leave reforms in Central Europe had significant and substantial effects on fertility (Lalive and Zweimüller 2009). The “use it or lose it” parental leave schemes in the mid-1990s pioneered in Nordic countries, substantially increased in leave uptake among men, and increased the likelihood of having a second child (Duvander et al. 2010). Sweden has managed to maintain a relatively high fertility rate, in part due to its heavily subsidized daycare and generous parental leave shared by both parents, though at 1.7 it is still way below replacement (Mörk et al. 2009). Policies that improve the flexibility of working conditions have also been shown to have a strong effect. In Germany, for example, Billari et al. (2019) have shown that the roll out of broadband raised the fertility of highly educated women. Likewise, remote work has also been shown to raise fertility (Ozimek and Carlson 2023). Few countries have succeeded at reversing declining fertility, with the exception being some Nordic and Eastern and Central European countries, where a combination of policies that support dual- earner families were implemented. Czech Republic and Romania have managed to maintain relatively high and steady fertility rates -around 1.8 births/woman - through a combination of childcare allowances and housing subsidies for families. Still, even the successful experiences have not been able to return to replacement rate. Other countries such as Republic of Korea and Japan had more limited success of the initial set of policies and have now expanded the tool toward a more comprehensive approach, though evidence of their effects is still unclear. Since 2006, the government of Korea has tried a range of policies including tax incentives, expanded childcare, housing benefits, and improved parental leave policies. Measuring the causal impact of these policies poses a range of challenges, but most evidence suggests these policies have had only a muted effect (Sabotka, Matysiak and Brzozowska 2019). Since 2021 the government has changed approach to focus instead on improving working hours, promoting a more equitable distribution of housework and care duties and creating gender-equal labor conditions, such as by lowering workplace discrimination against pregnant women. Similarly, Japan started implementing policies to boost fertility in the 1990s, with limited success. In 2016, it launched a new “Plan for Dynamic Engagement of All Citizens”, focused on “work style reforms” to improve work conditions of temporary workers and to limit work hours of employees, measures to expand childcare provision and to provide childcare and higher education free of charge and reforms to increase mothers’ employment and men’s involvement in childcare. Evidence is still limited but suggests some small positive impacts on fertility (Jones 2024). Measures to promote women’s labor force participation can increas e the active labor force. Despite the expansion of the service sector where women tend to have a revealed comparative 39 China Economic Update - June 2024 advantage, female labor participation has continued to decline in the past two decades. In part, barriers associated with labor market regulations, discrimination, and affordable child and elderly care have been found at play (Brussevich and Dabla-Norris 2021; Wang and Klugman 2020; Zhang and Huang 2020). Policies to remove the women’s productivity wedge, reduce gender bias, and increase service sector productivity can help boost female labor market participation. Affordable childcare and other family-friendly policies to support a work-life balance could serve a dual purpose—boosting fertility rates and encouraging women’s labor force participation. Several supply- and demand-side interventions can support the extension of productive lives. Increasing healthy life expectancy can improve people's ability and incentives to remain in the labor force longer. This is especially true for urban workers with formal employment who are generally better educated but retire upon reaching retirement age, while rural workers often work longer informally to support themselves. Recent evidence shows that there is indeed a large untapped work capacity in the older urban population in China, especially for women (Chen and Park 2024) and without crowding out youth employment (Boheim and Nice 2019; Zhang and Zhang 2012). Progressively increasing the retirement age, especially for women, and offering flexible work arrangements can boost productive aging. The change of the retirement age could be complemented with reforms to create incentive-compatible social insurance and labor taxation, provide affordable care to free up older workers from informal care, and address aged- related barriers to finance (De Silva and Huang 2024). On the labor demand side, policies may include providing incentives to employers to retain or hire mature workers (e.g., offering performance-based wages instead of seniority wages), adapting working conditions to increase older people’s productivity and willingness to work, 23 and investing in workers’ productivity throughout their working life so that their skills remain relevant even in older age. 2- Increasing productivity A second set of policies could be directed at raising productivity to counterbalance the negative impact of a shrinking labor force on growth. Human capital investment through skills upgrading, flexible education system, and lifelong learning will enhance labor productivity and raise workers’ capability to meet the demands of current and future jobs. Promoting market competition to crowd in private sector participation will support innovation and the development of the silver economy. This will not only cater to the needs of an aging society but also support emerging growth areas in China. Investing in younger generations and the current workforce will support a shift toward a more productive labor force. There is evidence of skills mismatch in the labor market. For instance, 23 A low-cost, simple modification to work environment organization at BMW resulted in a remarkable surge in productivity. See EU-OSHA (2016) for more details. 40 China Economic Update - June 2024 half of job seekers on online platforms have been shown to be overeducated, resulting in a wage penalty (Zheng et al. 2021). Adult education or lifelong learning, traditionally delivered through open universities and vocational colleges, can shift from traditional academic-oriented programs to more flexible and demand-driven provisions, with stronger collaboration between educational institutions, industry, and technology providers to develop curricula that reflect current and future skill demands. Promoting market competition to crowd in private sector participation will not only support innovation and productivity, but also the development of the silver economy. The private sector, with its market know-how, finances, and networks, is a natural partner in nurturing technology and innovation and developing the silver economy. China has made progress in improving the business environment over the past decade, including by using digital technologies for easier business registration and lower business compliance costs (Wei and Sanchez Ortega 2020). However, there continues to be significant regional divergence in the quality of the business environment between the first-tier cities and the rest, as well as between types of firm ownership. 3- Safeguarding common prosperity The evidence reviewed suggests that some aspects of well-being may become more unequal as the demographic transition advances further. The following policy directions focus on closing existing gaps in human capital, social protection, and critical public services that contribute to inequality in incomes, consumption needs, and other aspects of wellbeing for a dignified life.24 Closing educational gaps will help narrow inequality later in life. As shown, a significant part of inequality in older ages is determined by the place of birth, which impacts the person’s education outcomes and employment prospects. Providing equal opportunities to access to similar quality education will not only help enhance equity but also increase future chances of economic mobility. China has made impressive improvements in universalizing access to compulsory education (grades 1-9). Yet, up to 45 percent of rural infants in China are at risk of experiencing cognitive delays due to low-quality early childhood education and development services, particularly among left-behind children (Emmers et al. 2021). Upper secondary enrollment and completion rates are substantially below universal levels, and large gaps persist across regions. At the same time, the demographic shift implies a rapidly declining student body, more acutely in some provinces where fertility is fast declining and outmigration accelerates. Thus, there is a 24 A fuller assessment of the impact of demographics alone on income inequality -and its respective policy implications- will require also understanding the effect of the shrinking labor force on inequality within the working age population (particularly, of wages), and between the working age and the elderly. While crucial, this is beyond the scope of this analysis. 41 China Economic Update - June 2024 need to reassess the allocation of resources and school mapping plan at the local level, to be able to adjust management and resources to improve quality, while maintaining transfer programs from central and provincial governments targeting disadvantaged groups. Active and systematic involvement of families and communities is also crucial for successfully bridging the developmental gaps observed in early childhood. Expanding the urban employee pension scheme coverage and further improving adequacy of the resident pension scheme can contribute to reducing overall household income inequalities . Reducing wage inequality alone may be one of the most powerful measures to lower pension benefits inequality (and overall household inequality directly). But there are additional measures related to the pension systems that would also contribute to this agenda. Expanding the urban employee pension scheme to cover rural migrant workers would require strengthening and enforcing the labor contract and social insurance laws and reforming the existing urban employee pension scheme, to consider new forms of employment (i.e. gig and platform workers). Equalizing key pension parameters such as contribution base, contribution rate and benefit factors could help reduce pension inequality across and within each scheme. The current residents’ pension scheme contains some elements of social pension in nature and relies on voluntary annual contributions (from RMB 200 to RMB 2000), while local authorities co-match RMB 30 to RMB 60 to individual accounts as incentives (the current government subsidy to the residents’ pension is 21 percent of overall government subsidies to pension systems, and represents 62 percent of residents pension scheme revenues). Increasing residents’ pension benefits to reach levels equivalent to those observed in other countries’ social pension would require encouraging higher voluntary contributions from residents and for more years (currently, the minimum is set to 15 years), while also increasing public financial inputs from the central and local governments where subsidies are still relatively low compared to subsidies to the other systems in China.25 The inequality in access to health care and disparity of health outcomes are likely to be further exacerbated by population aging. To address the challenges, comprehensive healthcare reforms are needed to prioritize resource allocation toward underserved regions and communities with limited access to healthcare facilities and services. This could involve targeted investments in infrastructure, workforce training, and telemedicine technologies to bridge the gap between age groups, and urban and rural areas. Policies focused on reducing financial barriers to healthcare by implementing insurance subsidy programs for low-income groups can be key. Additionally, 25 There have been concerns that higher social pension would disincentive savings or work at older ages, but several papers founds no or weak evidence of such effect, particularly rural resident’s pension (Zhang et al. 2014, Giles et al. 2023). 42 China Economic Update - June 2024 supply-side reforms government can incentivize healthcare providers to establish outreach programs and mobile clinics to increase elderly people’s access to primary care, screenings, and non-communicable disease management services. Finally, an integrated health-care system that emphasizes preventive care and promotes healthy lifestyles through demand-side incentives for physical activity, access to nutritious foods, and alcohol, sugary-sweetened beverages and tobacco control measures (including higher taxation) can mitigate the impact of growing incidence of non-communicable disease, improve population health outcomes, and ensure sustainable healthcare for its aging population. Finally, deepening the long-term care policy reform agenda will help fill the gaps in unmet care for the elderly, prioritizing target population groups and lagging regions. Built on the national list of basic elderly care services, further long-term care policy reform should extend the existing programs to cover the near poor and low-income elderly who needs care services and assistance, promote coverage expansion in the rural areas and lagging regions where the coverage is very low, improve the scope and quality of care services with a focus on home- and community-based services to support aging in place, and strengthen professional nursing services for the elderly who are disabled and/or have cognitive impairments. To do so, a robust financing mechanism will be crucial to help finance coverage expansion and ensure financial sustainability. China has been piloting long-term care insurance in 49 cities. With lessons learned from those pilots and international experiences (such as Japan, Republic of Korea, and Germany) China could introduce a national framework to scale up the long-term care insurance. In the meantime, policy reform should shift the subsidy structure from the past subsidies of “bricks” and “beds” to more supplementing “people” and “services,” and foster private sector participation, to deliver better care services. Finally, strengthening policy coordination between social and health sectors can build effective mechanisms and promote an integrated long-term care system, which can help allocate scare resources to fill unmet care gaps, enhance the quality of care, and meet increasing care needs when China becomes super-aged. 43 China Economic Update - June 2024 References Acemoglu, D. and P. Restrepo. 2022. “Demographics and Automation.” The Review of Economic Studies, vol. 89(1) pp. 1-44, January. Ageing Research Institute of Fudan University. 2024. China’s Silver Economy Development Research Report. http://www.news.cn/sikepro/20240131/9f2a4498d1914b8fb2ef3522ebfae344/c.html. Asian Development Bank (2024). Aging Well in Asia. Aiyar, S., C. Ebeke and X. Shao. 2016. “The Impact of Workforce Aging on European Productivity.” IMF Working Paper 2016/238. Washington DC: IMF. Billari, F.C., Giuntella, O. and Stella, L., 2019. Does broadband Internet affect fertility?. Population studies, 73(3), pp.297-316. Bloom, D. and J. Williamson. 1998. “Demographic Transitions and Economic Miracles in Emerging Asia.” T he World Bank Economic Review, 12(3), pp. 419-55. Bloom, D., D. Canning and J. Finlay. 2010. “Population Aging and Economic Growth in Asia.” In: I. Takatoshi and A. Rose, editors, The Economic Consequences of Demographic Change in East Asia . Chicago: University of Chicago Press, pp. 61-89. Böheim, R. and T. Nice. 2019. “The effect of early retirement schemes on youth employment. ” IZA World of Labor 2019: 70v2. Buttner, Thomas, and Wolfgang Lutz. 1990. “Estimating Fertility Responses to Policy Measures in the German Democratic Republic.” Population and Development Review 16(3): 539–555. Brussevich, M. and E. Dabla-Norris, 2021. “China’s Rebalancing and Gender Inequality,” IMF Working Papers 2021/138, International Monetary Fund. Cai, F. and D. Wang. 2005. “China’s demographic transition: implications for growth.” In: Garnaut, Ross, Song, Lina (Eds.), The China Boom and Its Discontents. Asia Pacific Press, Canberra. Brussevich, M. and E. Dabla-Norris, 2021. “China’s Rebalancing and Gender Inequality,” IMF Working Papers 2021/138, International Monetary Fund. Cai, Y., W. Feng, and K. Shen. 2018. “Fiscal Implications of Population Aging and Social Sector Expenditure in China.” Population and Development Review, vol. 44(4), pp. 811-831. Cao, J., Ho, M. S., Hu, W., and Jorgenson, D. 2020. “Effective labor supply and growth outlook in China.” China Economic Review, 61, 101398. Chen X, Huang B, and S. Li. 2018. “Population ageing and inequality: Evidence from China. ” World Economy. 41: 1976–2000. Chen, Z. and A. Park. 2024. “Understanding the Health Capacity to Work among Older Persons in Rural and Urban Areas in the People’s Republic of China,” Asian Development Review (ADR), World Scientific Publishing Co. Pte. Ltd., vol. 41(01), pages 39-67, March. Chen Q, Chi Q, Chen Y, Lyulyov O, Pimonenko T. 2022. Does Population Aging Impact China’s Economic Growth? International Journal of Environmental Research and Public Health: 19, 12171. Chen X, Giles J, Yao Y, Yip W, Meng Q, Berkman L, Chen H, Chen X, Feng J, Feng Z, Glinskaya E, Gong J, Hu P, Kan H, Lei X, Liu X, Steptoe A, Wang G, Wang H, Wang H, Wang X, Wang Y, Yang L, Zhang L, Zhang Q, Wu J, Wu Z, Strauss J, Smith J, Zhao Y. 2022. “The Path to Healthy Ageing in China: A Peking University-Lancet Commission,” The Lancet 400 (10367) (December 2022): p1967-2006. Chomik, R., P. O’Keefe, and J. Piggott. 2024. Pensions in Ageing Asia: Policy insights and priorities. ARC Centre of Excellence for Population Ageing Research (CEPAR). Dang, Junwu, Lily Wang, Xiaoqi Yang, and Yanyan Wei. 2021. Research on the Development and Indicators System of China’s Ageing Industries. Social Science Literature Press. 44 China Economic Update - June 2024 Deng, X., W. Zhang and W. Wang. 2018. “Does Population Aging induce Automation?” Modern Economic Analysis, vol. 12, pp. 17-24. De Silva, J. and Y. Huang. 2024. “Productive Longevity: What Can the World Bank Do to Foster Longer and More Productive Working Lives?” World Bank. Dou, J. 2019. “The Effect of Aging on Innovation: Mechanism and its Implications to China.” Population and Economics. Vol. 236 (5): 78-93. (In Chinese). Duvander, A.-Z., Lappegård, T. and Andersson, G. 2010. Family policy and fertility: fathers' and mothers' use of parental leave and continued childbearing in Norway and Sweden. Journal of European Social Policy, 20(1), 45-57. Emmers D, Jiang Q, Xue H, Zhang Y, Zhang Y, Zhao Y, Liu B, Dill SE, Qian Y, Warrinnier N, Johnstone H, Cai J, Wang X, Wang L, Luo R, Li G, Xu J, Liu M, Huang Y, Shan W, Li Z, Zhang Y, Sylvia S, Ma Y, Medina A, Rozelle S. 2021. “Early childhood development and parental training interventions in rural China: a systematic review and meta-analysis.” BMJ Glob Health. 6(8). EU-OSHA. 2016. Healthy Workplaces for All Ages: Promoting a sustainable working life. Feng, W. and A. Mason. 2008. “The Demographic Factor in China’s Transition.” In: Brandt, Loren, Rawski, Thomas G. (Eds.), China’s Great Economic Transformation. Cambridge Univ. Press, pp. 136–166. Feyrer, J. 2007. “Demographics and Productivity.” The Review of Economics and Statistics, vol 89(1), pp. 100–109. Giles, J., X. Lei, G. Wang, Y. Wang and Y. Zhao. 2023. “One Country, Two Systems: Evidence on Retirement Patterns in China,” Journal of Pension Economics and Finance, 22(2) (April 2023): 188 -210. Glinskaya, E., B. Hofman, L. Johnston, T. Haepp, and D. Wang. 2022. “China and Population Aging: What are the Implications and what do we know? Key Economic Aspects of Aging in China: Literature Review.” World Bank. Goldstein, J. R., Koulovatianos, C., Li, J. and Schröder, C. 2017. Evaluating how child allowances and daycare subsidies affect fertility. Centre for Financial Studies, CFS Working Paper Series 568. Hanewald, K., R. Jia, Z. Liu. 2021. “Why is inequality higher among the old? Evidence from China ?” China Economic Review 66. Hu, H., Y. Si, and B. Li, 2020. “Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective.” International Journal of Environmental Research and Public Health. 17:2599. IMF. 2019. Macroeconomics of Aging and Policy Implications. Washington DC: IMF. Jiang, Y. and L. Li. 2024. “Projections of functional dependence among the late middle‑aged and older population from 2018‑2048 in China: a dynamic microsimulation.” Global Health Research and Policy. 9:15. Jones, R.S., 2024. Addressing demographic headwinds in Japan: A long-term perspective. Lalive, R. and Zweimueller, J. 2009. How does parental leave affect fertility and return to work? Evidence from two natural experiments. The Quarterly Journal of Economics, 124(3), 1363-1402. Li, H., L. Li, B. Wu and Y. Xiong. 2012. “The End of Cheap Chinese Labor.” Jou rnal of Economic Perspectives, 26(4): 57-74. Li, L., Du, T., & Hu, Y. 2020. “The Effect of Population Aging on Healthcare Expenditure from a Healthcare Demand Perspective Among Different Age Groups: Evidence from Beijing City in the People's Republic of China.” Risk management and healthcare policy, 13: 1403–1412. Li X, Chen M, Wang Z, et al. 2018. « Forgone care among middle aged and elderly with chronic diseases in China: evidence from the China Health and Retirement Longitudinal Study Baseline Survey.” BMJ Open; 8: e019901. Li, Wang, Xu and Yuan 2020. “The role of public pensions in income inequality among elderly households in China 1988-2013.” China Economic Review, vol. 61 (2020) 101422. Liang J., Z. Ren, W. Huang and Y. He. 2024. “China’s Childbirth Cost Report 2022 Edition”. Yuwa Population Research Liu, Y. and N. Westelius. 2016. “The Impact of Demographics on Productivity and Inflation in Japan.” IMF Working Paper 16/237. Washington DC: IMF. 45 China Economic Update - June 2024 Lu, J. 2016. Impacts of Demographic Transition on Future Economic Growth: China Case Study. Paper presented at the conference, China and the West 1950-2050: Economic Growth, Demographic Transition and Pensions. University of Zurich. Luci-Greulich, A. and Thévenon, O. 2013. The impact of family policies on fertility trends in developed countries. European Journal of Population, 29(4), 387-416. Lugo, M., Lustig, N., Montalva, M., Tiwari, and Wan g, Y. 2024. “How Redistributive is Fiscal Policy in China? New Evidence on Distributional Impact of Taxes and Spending.” World Bank. McDonald, Peter. 2006. “Low Fertility and the State: The Efficacy of Policy.” Population and Development Review 32(3): 485–510. Medvedev, D., 2020. Promoting Innovation in China: Lessons from International Good Practice, World Bank Group. United States of America. Meng, X., 2023. China’s Forty Years Demographic Dividend and Labor Supply: The Quantity Myth. IZA DP No. 16207, June. Mörk, E., Sjögren, A., and Svaleryd, H. 2009. Cheaper child care, more children. IZA Discussion Paper No. 3942. Ozimek, A. and Carlson, E., 2023. Remote Work and Household Formation. Working paper, Economic Innovation Group. Qiu Yu-lin, Ran Xiao-xing. Impact of medical service accessibility on the health of the elderly: Analysis based on Chinese Longitudinal Healthy Longevity Survey (CLHLS) data. Chinese Journal of Health Policy, 2019, 12(7): 1-10. Rindfuss, R.R., Guilkey, D.K., Morgan, S.P. and Kravdal, Ø. 2010. Childcare availability and fertility in Norway. Population and Development Review, 36(4), 725-748. Sobotka, T., Matysiak, A. and Brzozowska, Z., 2019. Policy responses to low fertility: How effective are they. United Nations Population Fund, 98. Tiwari, S., E. Skoufias, K. Vinha, and V. Montalva. 2024. [Forthcoming]. Household Saving and Health Shocks in China. World Bank. United Nations. 2004. “World Population to 2300.” United Nations, Department of Economic and Social Affairs, Population Division, New York. Wang, H. and J. Huang. 2023. “How can China’s Recent Pension Reform Reduce Pension Inequality?” Journal of Aging and Social Policy, 35:1, 37-51. Wang, X.Y. and Y. J. Han. 2022. “Research on the medical insurance choices of migrant workers - Analysis based on China’s rural-urban population flow survey data” (in Chinese). Wang, L., and J. Klugman. 2020. “How women have fared in the labour market with China's rise as a global economic power," Asia & the Pacific Policy Studies, 7(1): 43-64. Wang, D., M. Dorfman, and J. Feng. 2022. China’s Pension Reform: Progress, Challenges, and Prospects. World Bank. Wang, W., H. Shi, Q. Li. 2023. “Pension gap between the Chinese public and nonpublic sectors: Evidence in the context of the integration of dual-track pension schemes.” International Review of Economics and Finance 85 (2023) 664–688. Wei, Z. and R. Hao. 2010. “Demographic Structure and Economic Growth: Evidence from China.” Journal of Comparative Economics. Vol. 38, pp. 472–491. Wei, W. and Sanchez Ortega, L. 2022. Business Registration Reforms in China: A Case Study. Equitable Growth, Finance & Institutions Insight. World Bank, Washington, DC. World Bank. 2014. Debt Resolution and Business Exit: Insolvency Reform for Credit, Entrepreneurship and Growth, Public Policy for the Private Sector note no. 343, Washington DC: World Bank. World Bank. 2022. China Country Climate and Development Report. World Bank, Washington, DC. World Bank. 2023. China Economic Update, December. “Which Way Forward? Navigating China's Post-Pandemic Growth Path.” World Bank, Washington, DC. World Bank. 2024a. Global Economic Prospects. January. World Bank, Washington, DC. 46 China Economic Update - June 2024 World Bank. 2024b. Commodity Markets Outlook. April. World Bank, Washington, DC. Yang Cui Hong, Chen Ya Li, LI Ning, WANG Zi Xing, HAN Wei, XUE Fang, WU Peng, GU Wen Tao, DU Jin, JIANG Jing Mei. Noncommunicable Disease Mortality with Population Aging in Eastern, Central, and Western Regions of China: Current Status and Projection to 2030. Biomedical and Environmental Sciences, 2022, 35(10): 976-980. Yao, D. J. Ning and S. Wei. 2017. “How does the Population Aging Affect Technology Innovation?” World Economy, vol. 4, pp. 105-128. Zhang, C., J. Giles and Y. Zhao. 2014. “A Policy Evaluation of China’s New Rural Pension Program: Income, Poverty, Expenditure, Subjective Well-Being and Labor Supply” (in Chinese). China Economic Quarterly 14(1) (October 2014): 203-230. Zhang, E., and T. Huang. 2020. “Gender discrimination at work is dragging China's growth," Discussion paper, Peterson Institute for International Economics. Zhang, L., R. Chen, and Y. Fang. 2023. “Effects of Urban and Rural Resident Basic Medical Insurance on Healthcare Utilization Inequality in China,” International Journal of Public Health 68. Zhang, T., C. Liu, B. Lu, and X. Wang. 2022. “Changes of Inequality in Functional Disability of Older Populations in China from 2008 to 2018: a Decomposition Analysis.” BMC Geriatrics 22:308. Zheng, B. 2019. China Pension Actuarial Projection Report (2019-2050). China Labor and Social Security Publishing Press. Zheng, Y., X. Zhang, and Y. Zhu. 2021. “Overeducation, major mismatch, and return to higher education tiers: Evidence from novel data source of a major online recruitment platform in China.” Ch ina Economic Review. 66. 101584. Zhu, Y. and A. Osterle. 2017. “Rural-Urban Disparities in Unmet Long-Term Care Needs in China: The Role of the Hukou Status.” Social Science & Medicine 191: 30 -37. 47 China Economic Update - June 2024 48