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Does elderly care suppress women’s fertility intentions? Quasi-experimental evidence from China’s home and community-based services reform

Zhiying Li et al.

Health Economics, Policy and Law2026https://doi.org/10.1017/s1744133126100449article
ABDC B
Weight
0.50

What the paper says

China's recent expansion of Home- and Community-Based Services (HCBS) may influence fertility intentions among women of childbearing age. Using data from the China Labor-force Dynamics Survey (CLDS, 2014-2018) and a multi-period difference-in-differences (DID) design, we examine the effect of HCBS reforms on women's fertility expectations and explore the channels through which these reforms operate. Our results show that HCBS expansion significantly reduces fertility intentions, with an average decline of approximately 0.12 children per woman. The effect is stronger among women with siblings, those who already have children, rural residents, and women in their prime childbearing years (aged 25-34 years). Mechanism analysis indicates that this reduction is mediated by increased perceived community safety, greater participation in pension insurance, and higher economic satisfaction. These findings suggest that elderly care policies can shape reproductive decisions, highlighting the need for integrated strategies that address both ageing and fertility concerns in China.

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https://doi.org/https://doi.org/10.1017/s1744133126100449

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@article{zhiying2026,
  title        = {{Does elderly care suppress women’s fertility intentions? Quasi-experimental evidence from China’s home and community-based services reform}},
  author       = {Zhiying Li et al.},
  journal      = {Health Economics, Policy and Law},
  year         = {2026},
  doi          = {https://doi.org/https://doi.org/10.1017/s1744133126100449},
}

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Does elderly care suppress women’s fertility intentions? Quasi-experimental evidence from China’s home and community-based services reform

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Evidence weight

0.50

Balanced mode · F 0.40 / M 0.15 / V 0.05 / R 0.40

F · citation impact0.50 × 0.4 = 0.20
M · momentum0.50 × 0.15 = 0.07
V · venue signal0.50 × 0.05 = 0.03
R · text relevance †0.50 × 0.4 = 0.20

† Text relevance is estimated at 0.50 on the detail page — for your query’s actual relevance score, open this paper from a search result.