How can cities adapt to population aging?
Same answer, your way
PRC has been building a reference model in Yichang City, Hubei Province, where about a quarter of the 4 million residents are already over 60 — well above the national average. Since 2014, ADB has supported the city through technical assistance and two loans, including a $150 million project to build a three-tiered elderly care system spanning home-based, community-based, and residential care [1]. Rather than building high-end retirement villages, the program shifted toward serving low- and middle-income elderly, integrating health care and elderly care through a new city-wide ICT platform and a dedicated geriatric care hospital [2]. In June 2022, Yichang was named one of the PRC’s first “National Key Contact Cities” for its response to aging, positioning it as a demonstration model for other cities and provinces to replicate [3].
Evidence cards
Hubei Yichang Comprehensive Elderly Care Demonstration Project
A $150 million loan funding 16 community-based care centers, a dementia care center, and an ICT platform integrating elderly and health services.
View source →Upgrading Elderly Care in Yichang City, PRC
Documents the shift from high-end retirement housing to a three-tiered model serving low- and middle-income elderly.
View source →Elderly Care System Development in Yichang, PRC
East Asia Working Paper No. 67 — analyzes lessons from Yichang’s strategic plan as a model for replication.
View source →Implementation considerations
- A three-tiered system only works if community-based services are built first — Yichang prioritized local centers before scaling residential capacity.
- Integrating elderly care with the health system requires a shared data platform, not just co-located facilities.
- Shifting from high-end retirement housing to serving low- and middle-income elderly is a deliberate policy choice, not a default outcome — it has to be designed in from the start.
Where else has this worked?
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Hubei Yichang Comprehensive Elderly Care Demonstration Project
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View source →
Upgrading Elderly Care in Yichang City, PRC
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Elderly Care System Development in Yichang, PRC
Adaptation guidance for other cities
- Establish community-based care infrastructure before scaling residential facilities — coverage matters more than capacity at the start.
- Build a shared ICT platform linking health and elderly care early, rather than retrofitting integration later.
- Decide explicitly which income groups the system is designed to serve — this shapes financing, location, and partnership models from day one.