Long-Term Care in China and Worldwide (2024-2025)


China has one of the fastest growing aging populations in the world. It is estimated that 400 million older adults (aged 60 and over) will account for 28% of its total population by 2040. This is nearly a 60% increase in the size of the older population compared to 2019. 
Older people are more likely to have non-communicable diseases and have multiple comorbidities. It is projected that about 248 million Chinese older adults will be dependent on others in their last stage of life in 2035. This is an increase from around 112 million in 2015. These numbers imply a heavy care load for families and society.

Since China became an aging society in 1999, the Chinese Government has outlined a plan for a “9064” three-tiered long-term care system, which emphasizes having home-based care as its foundation with supplementary support from community-based services and institutional care. This overarching policy principle continues to be reinforced in the 13th and 14th Five-Year Plans, Healthy China 2030 and several high-profile national policy directives. However, there are still huge gaps in unmet elder-care needs and many challenges faced by the elder-geriatric healthcare system and society.

Project Description

This project team will work to understand development in multisectoral integrated long-term care in China and worldwide. Team members will perform literature reviews and fieldwork to investigate the integration of health care and long-term care and examine the engagement and accountability of civil society organizations and the private sector in multisectoral collaborations in long-term care. 

The team will examine the status and challenges faced by formal and informal long-term care in China and worldwide. Team members will use mixed methods to assess the working conditions and care burden, discuss social recognition and migration-related issues, and examine workforce shortfalls in long-term care. Team members will perform fieldwork in China and surrounding countries to interview key informants.

In a parallel approach, the project will develop theories and interventions for long-term care improvement. Team members will synthesize existing research and propose innovative frameworks and intervention strategies for improving integrated and individualized care. Team members will use GIS and web-based technologies and tools to develop an interactive website to map long-term care facilities, achieve relevant policies and databases, list support resources and present findings.

Anticipated Outputs

Interactive resource; advocacy website; peer-reviewed manuscripts; grant proposals; event series

Student Opportunities

Ideally, this project team will include 4 graduate students and 6 undergraduate students with majors or interests in computer science, data science, sociology, public health, social work, nursing, journalism and media, public health and or economics. Please note that this is a joint Duke-DKU team that will include faculty and students from both institutions. Applicants should be excited to work collaboratively across institutions and should expect to coordinate meetings across time zones.

Team members will be split into three subteams each led by a graduate student, and graduate students will mentor undergraduates. Students will gain experience in project design, literature and systematic review, data collection and analysis, website design, data visualization, health advocacy, manuscript and grant writing, event coordination and research communication. The team will work with colleagues across campuses and will learn interdisciplinary collaboration skills.

Subteams will meet weekly to exchange ideas and discuss project progress, and the team will meet bi-weekly as a whole. 

In a required summer component, all students will participate in the first phases of data collection phases. This work will start on June 1 and will end on July 30; each student will be expected to work 10-20 hours per week.

Selected students will conduct fieldwork to collect data and learn long-term care techniques across the U.S., China and South Asia.


Summer 2024 – Summer 2025

  • Summer 2024 (required): Prepare research plan; attend student trainings; apply for IRB approval; start data collection
  • Fall 2024: Continue data collection; start data analysis and synthesis
  • Spring 2025: Continue data analysis and synthesis; develop digital visualizations and dissemination initiatives
  • Summer 2025 (optional): Finalize digital visualizations and dissemination initiatives


Academic credit available for fall and spring semesters; summer funding available

This Team in the News

Assistant Professor Awarded two Bass Connections Projects

Image: The entrance, by Susan Jane Golding, licensed under CC BY 2.0

Image: The entrance, by Susan Jane Golding, licensed under CC BY 2.0

Team Leaders

  • Meifang Chen, Duke Kunshan University
  • Truls Ostbye, School of Medicine-Family Medicine and Community Health
  • Hanzhang Xu, School of Medicine-Family Medicine and Community Health

/yfaculty/staff Team Members

  • Taufique Joarder, Global Health Institute, SingHealth Duke-NUS
  • Mengjie Zhou, Duke Kunshan University

/zcommunity Team Members

  • Chen Chen, School of Public Health, Wuhan University
  • Zhe Yan, Jacobs University Bremen