Intended for healthcare professionals

Rapid response to:


China's one child policy

BMJ 2006; 333 doi: (Published 17 August 2006) Cite this as: BMJ 2006;333:361

Rapid Response:

Policy or a disaster?

We don’t share the same view as Prof Potts on china’s one-child
policy. Prof Potts undermined the impact of this policy on Chinese
people’s mental and social health. 1

China's one child policy was established by Chinese communist regime in
1979 to limit communist China's population growth. Although designated a
"temporary measure," it continues a quarter-century after its
establishment and China has proclaimed that it will continue this policy,
through the 2006-2010 five year planning period .2
The policy which limits couples to one child has caused a disdain for
female infants; abortion, neglect, abandonment, and even infanticide have
been known to occur to female infants .2
The effect of the policy on the sex ratio has received much attention. The
sex ratio at birth, defined as the proportion of male live births to
female live births, ranges from 1.03 to 1.07 in industrialized countries. Since the onset of the one-child policy, there has been a steady increase
in the reported sex ratio, from 1.06 in 1979, to 1.11 in 1988, to 1.17 in

The Chinese government has acknowledged the potentially disastrous social
consequences of this sex imbalance. The shortage of women may have
increased mental health problems and socially disruptive behavior among
men and has left some men unable to marry and have a family. The scarcity
of females has resulted in kidnapping and trafficking of women for
marriage and increased numbers of commercial sex workers, with a potential
resultant rise in human immunodeficiency virus infection and other
sexually transmitted diseases. There are fears that these consequences
could be a real threat to China's stability in the future.3

The other issue with this policy is the percentage of the population over
the age of 65 years was 5 percent in 1982 and now stands at 7.5 percent
but is expected to rise to more than 15 percent by 2025. Due to
inadequate pension coverage financial dependence on offspring is still
necessary for approximately 70 percent of elderly people. In China, this
problem has been named the "4:2:1" phenomenon, meaning that increasing
numbers of couples will be solely responsible for the care of one child
and four parents.3

The one-child policy does not allow families to decide how large they will
be, but imposes controls top-down. If they do not comply they can be
arrested, or the women even forced to have an abortion. This is illegal,
and inhumane. 4

We think China has to find a slightly kinder policy, which is based on
education, rather than this tough and cruel approach they have now.


(1) Potts M. China’s one child policy. BMJ 2006; 333: 361-2

(2) Designed to limit population growth (accessed
on 29th August 2006)

(3) Hesketh T, Lu L, Xing ZW. The effect of china’s one-child family
policy after 25 years. N Engl J Med 2005;353: 1171-6

(4) China’s one-child policy
(accessed on 29th August 2006)

Competing interests:
None declared

Competing interests: No competing interests

29 August 2006
Aruna Reddy Gurrala
SHO in Anaesthetics
Chandrakant Gosavi
University Hospitals of Leicester, LE1 5WW