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UI team advises Chinese counterparts on health care for elderly

IOWA CITY, Iowa -- An expanded partnership between University of Iowa researchers and their counterparts at Fudan University in Shanghai, China, may assist the Chinese in improving the country's health care system as its population ages at a rapid rate.

Five UI representatives visited Fudan University in late May to further a developing partnership with their Chinese colleagues focused on improving health care delivery and other social services while respecting Chinese cultural values. Among specific proposals signed in China were an agreement to exchange more faculty, staff and students, and the possible creation of a training program at the UI for future managers of non-governmental health and social service organizations.

The faculty who traveled to China were Michael McNulty, associate provost for international programs; Jae-On Kim, professor and director of the UI Center for Asian and Pacific Studies; Dr. Gerald Jogerst, assistant professor of family medicine; Kathleen Buckwalter, professor in the UI College of Nursing and director of the UI Center on Aging; and Thomas Walz, professor of social work.

The Chinese government is looking for ways to reform its wide-ranging system of socialized health care as its large population ages. Currently, however, non-governmental social programs are scarce or are just getting started, Buckwalter says. The need for fundamental change was evident when she visited a Chinese nursing school where students practiced their skills on plastic dummies and used clean but outdated equipment and laboratories.

An effective system to deliver more community-based health care might be one in which caregivers are trained in elements of nursing, family medicine and social work, she adds.

The expansion of China's aging population is one unanticipated effect of the country's strict "one family, one child" policy, says Kim. In one area of Shanghai called Pudong, the Chinese government estimates that 17 percent of the 1.5 million residents are more than 60 years old. There are about 14 million people in Shanghai altogether.

The one-child policy also has contributed to the erosion of the traditional Chinese mechanism for taking care of the elderly - the family. Elderly people used to move in with male children and their families, Kim says. Now many childless people or families without male children rely on special government programs created for them. The Chinese health care system has its good points, Kim says, such as widespread access, but the government is discovering that maintaining vast social and health programs is unfeasible.

"The government realizes it cannot handle all (social) security issues and all the health issues alone," Kim says. "They need to start looking to voluntary organizations for support."

A major step forward in the partnership may come at the UI in late August, when a delegation from Fudan University and the Pudong area is expected to spend about three weeks here. Among many professional activities, they will attend a conference sponsored by the UI College of Nursing, "Vitality throughout the Adult Lifecycle: Interventions to Promote Health." The conference focuses on current issues in health promotion and disease prevention in older populations and has attracted expert speakers from the U.S., Canada and Denmark.

"We hope the conference will provide them the opportunity to visit our university, view different types of facilities and participate in interdisciplinary activities," Buckwalter says. "Maybe they will observe some approaches to elder care that would be useful in China."