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The Jounal of Chinese Sociology

2025年6月19日，The Journal of Chinese Sociology（《中國社會學學刊》）上線文章From ageism to respectful ageism: how is the China-specific phenomenon formed?（《從年齡歧視到尊重性年齡歧視：這種中國特有的現(xiàn)象是如何形成的？》）。

作者簡介

韓羽佳，哈爾濱工業(yè)大學博士研究生。主要研究方向：政府理論與數(shù)字治理、老年社會學。

孫濤，哈爾濱工業(yè)大學（深圳）經(jīng)管學院長聘教授、博士生導(dǎo)師，現(xiàn)代治理政府學院院長。主要研究方向：政府理論與數(shù)字治理、城市管理與政策、公共服務(wù)。

Abstract

Ageism represents a significant international challenge within the field of gerontology, but the concept of respectful ageism is a phenomenon unique to China. This study explores the mechanisms through which ageism is produced and subsequently transformed into respectful ageism. It specifically focuses on the implementation of the home-based care bed policy as a case study, grounded in Merton's theory of social structure and anomie. The study revealed that grassroots policy implementers, confronted with the interplay of institutionalized means and cultural goals, adopted a behavioral strategy characterized by ritualism. This approach facilitated the production mechanism of ageism, aligning seamlessly with the theoretical framework of social structure and anomie. However, owing to the influence of cultural traditions on individual behavioral reproduction, grassroots policy implementers undergo two additional processes: cultural retrospection and individual rethinking. These processes emerge after the formation of ageism and contribute to the transformation of ageism into respectful ageism. These findings elucidate the production mechanisms of ageism and the transformative processes that characterize respectful ageism, a phenomenon specific to China. The theoretical contribution of this research is that the individual behavioral strategies derived from social structure and anomie theory, within the Chinese context, are not merely outcomes of individual choice. Rather, the individual behavioral reproduction influenced by cultural traditions gives rise to new behavioral mechanisms among grassroots policy implementers. This research enhances our understanding of the mechanisms underlying the phenomenon of respectful ageism within the Chinese context and illustrates the innovative impact of cultural traditions on the reproduction of individual behaviors.

Keywords

Ageism; Respectful ageism; Social structure and anomie; Ritualism; Cultural retrospection; Individual rethinking

Introduction

In the context of accelerating population aging, ageism has emerged as a critical social issue. As a global phenomenon, ageism manifests in various forms of prejudice and discrimination directed toward older individuals on the basis of their age. The term “ageism” was first coined by Robert Butler in 1969, who noted that societal prejudices and demeaning attitudes toward older adults negatively affect their mental and physical health, social participation, and overall quality of life (Butler 1969).

Ageism is rooted not only in individual prejudices and stereotypes but also in social structures and cultural contexts. Ageism is widely believed to be driven by the cultural construction of the roles assigned to older and younger individuals within society (Ayalon and Tesch-R?mer 2018). Thus, its essence lies in the manner in which social elements influence individuals, prompting them to develop autonomous behavioral strategies. This process culminates in the formation of ageism, whereby individual actions impact the group, subsequently affecting the broader social structure. From this perspective, Merton’s theory of social structure and anomie is particularly well suited for explaining ageism. This theory, which analyzes individual behavioral strategies shaped by social elements and their resultant impact on social structure (Merton 1938), provides a robust framework for examining the production mechanisms of ageism.

Although ageism, as a consensual phenomenon, has doctrinal origins rooted in generational bias among age groups, its production mechanisms in real-life contexts have been insufficiently explored by scholars. Furthermore, few studies have highlighted that the manifestations of ageism are geographically specific. In China, it has taken on an innovative expression known as respectful ageism (Zhang 2017).

Respectful ageism, as a phenomenon unique to China, embodies a duality of both respect and discrimination toward older individuals. On the one hand, individuals are influenced by a cultural ethos that emphasizes respect and cherishment for elders, leading to a conscious inclination to respect and assist older individuals. On the other hand, there is an underlying orientation of ageism in people’s behaviors, rendering older individuals socially vulnerable (Guo and Zhang 2011). The phenomenon of respectful ageism is embedded within the inherent mechanisms of cultural traditions that drive social reproduction. Analyzing respectful ageism can not only enrich Merton's modern perspective of social structure and anomie theory but also demonstrate, through the mechanisms behind the phenomenon, that a richer range of individual behavioral strategies emerges that are not mentioned in this theory. Thus, the study complements Merton’s social structural and anomie theory of individual behavioral mechanisms and their impact on social structure by analyzing respectful ageism as a China-specific finding.

This article employs the implementation process of China’s home-based care bed policy as a concrete research situation to analyze the production mechanism of ageism and the transformation of ageism into respectful ageism. By examining the production mechanisms of ageism in the context of China’s home-based care bed policy implementation, this study reinforces the explanatory power of Merton's theory of social structure and anomie within policy implementation scenarios. By analyzing the formation mechanisms of respectful ageism, this study posits the theoretical perspective that cultural traditions drive the reproduction of individual behaviors. It further examines two novel mechanisms arising from this process: cultural retrospection and individual rethinking. This study demonstrates that the five individual behavioral strategies proposed by Merton are not the ultimate outcomes of individual behavior, thereby complementing the social structure and anomie theory within the culturally oriented Chinese context, as well as the subsequent individual behavioral mechanisms and social development paths.

Literature review

Ageism

Ageism is stereotyping, prejudice, and discrimination directed toward older individuals based on their actual age (Iversen et al. 2009). Ageism was first noted by Professor Robert Butler, who proposed that ageism was the result of prejudice between different age groups (Butler 1969). It can manifest itself in the form of cognitive stereotyping, emotional prejudice, and behavioral discrimination, which are often intertwined with an individual's social behavior and present socially negative thoughts, emotions, and behaviors toward older adults (Levy 2001). According to the World Health Organization (WHO), ageism is a global phenomenon that is not confined to specific social or ethnic groups; rather, it can be observed across various domains and regions (Officer and de la Fuente-Nú?ez 2018).

In response to the pervasive phenomenon of ageism, researchers have examined its manifestations across diverse contexts, including the workplace, social media, AI applications, and daily life. For instance, Oteng et al. investigated ageism in workplace scenarios and found that it fosters negative biases, such as the perception that older informal workers are poor learners of new skills, thereby hindering their access to job opportunities (Oteng et al. 2024). Zhang and Liu analyzed ageism in social media contexts and reported that during the COVID-19 period, ageism on these platforms reinforced the stereotype of older adults as passive recipients of resource services (Zhang and Liu 2021). Stypinska examined ageism in AI application scenarios and found that ageism in AI application areas ignores the interests and needs of older people, resulting in older people being excluded from services or products with AI technology (Stypinska 2023). Horhota et al. examined ageism within the context of intimacy perspectives in various life scenarios. Their study demonstrated that while relationship closeness influences perceptions of ageism, the overall acceptance of negative ageism remains low (Horhota et al. 2019). However, there remains a notable gap in the analysis of the mechanisms underlying the generation of ageism within the context of policy implementation. The policy implementation scenario serves as one of the subdivided research scenarios of ageism, and there is a need for ageism research in this scenario.

Ageism in China has evolved into respectful ageism, which is a China-specific phenomenon. The traditional Chinese cultural pattern of filial piety, which emphasizes respect and reverence for elderly individuals, significantly influences the production process of ageism in China. This results in a contradictory dynamic characterized by both respect and discrimination, ultimately giving rise to the unique phenomenon of respectful ageism (Guo and Zhang 2011). The phenomenon of respectful ageism in intergenerational interactions exacerbates the self-labeling of older adults and reveals the self-play between two distinct cognitive attitudes of respect and discrimination at the individual level (Zhang 2017). However, previous studies have presented only this China-specific phenomenon and lack a specific analysis of the evolutionary mechanisms of ageism and respectful ageism phenomena, thus leaving some leeway for this study.

Therefore, this study focuses on the context of policy implementation to discuss the production process of ageism and analyze the evolutionary mechanisms that facilitate the transition from ageism to respectful ageism. The study aims to complement the research scenario of policy implementation in ageism studies and to analyze the specific mechanisms of how ageism is produced and how it evolves into respectful ageism in the Chinese context.

Home-based care bed policy

The study selects the implementation process of the home-based care bed policy as the analysis context. The policy on home-based care beds for the elders is a series of government regulations and measures instituted by the Chinese government to provide low-income disabled and semidisabled older persons with home-based elderly care services, aging-friendly renovations, and information technology equipment (Li and Han 2023). The implementation process of China's home-based care bed policy serves as both an internationally recognized category of elderly care policy and a policy implementation scenario with distinct local characteristics. This dual perspective allows for a comprehensive analysis that integrates both domestic and international policy research frameworks, creating a typical scenario for studying policy implementation.

Aging at home aligns with the overall preferences of older persons from a global perspective and offers advantages in terms of economic costs and resource allocation. The aging population prefers aging at home over residing in a nursing home or care facility (Home 2018). Moreover, there is also a trend in countries such as Finland to encourage elderly individuals to age at home, as aging at home contributes to economic cost savings (Aaltonen and Van Aerschot 2021). In addition, from the perspective of the optimal allocation of resources, home care services can optimize the deployment and application of medical resources (Iwata et al. 2020), which is beneficial to the physical and mental health of the elderly (Zai 2024), and can also reduce disparities in the geographic accessibility of healthcare services, waiting time, and other factors, thus contributing to improving the fairness of access to healthcare services for the aging population (Agnieszka et al. 2021).

China has placed particular emphasis on the significance of aging at home, with the policy of home-based care beds for the elderly holding a crucial position within its elderly care framework. On the one hand, the traditional filial piety influence of familism continues today, laying the ethical and moral foundation for aging at home (Yan 2023). On the other hand, China’s one-child policy and urbanization have undermined the traditional model of family care but have preserved the aging field of home care (Fang et al. 2015). As a result, China has prioritized the development of community-based home care to meet the preferences of older people to age at home (Feng et al. 2020). The home-based care bed policy emerged as a pivotal initiative designed to address the needs associated with aging at home in China.

Therefore, this study takes China's home-based care bed policy as the research context for policy implementation and selects Shenyang city as a representative sample. According to the China Statistical Yearbook 2023, data from the National Bureau of Statistics of China indicate that Liaoning Province ranks first in the country, with approximately 20.02% of the total population aged 65 and above. Shenyang is the capital of Liaoning Province and the only one of the first pilot cities in Liaoning Province to implement the home-based care bed policy (Li and Han 2023). Therefore, Shenyang city has representative research significance as the only pilot city in the province with the most severely aging population in the country in 2023. As a result, Shenyang city’s implementation process of the home-based care bed policy was selected as the specific research situation for the study.

Structure and anomie

Robert K. Merton’s article “Social Structure and Anomie” discusses the connection between individual behavior and social structure and argues that individuals faced with conflicting institutionalized means and cultural goals may develop different behavioral strategies, leading to behavioral anomie and thus socialization effects. Merton hypothesizes game scenarios in which institutionalized means and cultural goals coincide and diverge from each other, and he proposes five logically possible individual actions within a society or group on the basis of the individual's choice orientations toward institutionalized means or cultural goals. The five action strategies identified by Merton are conformity, innovation, ritualism, retreatism, and rebellion. Conformity occurs when individuals align with both institutionalized means and cultural goals, while the other strategies represent individual behaviors that emerge when there is a divergence between institutionalized means and cultural goals (Merton 1938).

Merton’s structure and anomie theory has been applied from various research perspectives. Scholars have employed concepts such as general strain, social capital, age stages, digital technology, and cultural factors as influencing elements to analyze their roles and how they drive changes in social structure within the framework of social structure and anomie theory. For example, Agnew proposed general strain theory as an important addition to Merton's theory (Agnew 1992). Research has shown that multiple stressors experienced by individuals drive emotional response mechanisms, which in turn influence individual behavior and create the potential for disordered behavior (Agnew and Brezina 2019). Putnam et al. proposed analyzing social structure and anomie from a social capital perspective and argued that social support and trust are effective in reducing disordered behavior (Putnam 2000). Age perspectives show significant differences between adolescents’ and older adults’ responses to social pressures, resulting in different behavioral choices (Demo and Acock 2011). From the perspective of digital technology, Binns argued that modern digital technology, as a tool for social control, not only reshapes social relations but may also lead to perceived risks and transgressive behaviors (Binns 2018). From a cultural perspective, David Matsumoto examined individual behavior as it evolves through the interplay of basic human nature, culture, and personality. He explored how the cultural context shapes individuals' choices of social roles, which in turn influences the mechanisms underlying individual behavior (Matsumoto 2007).

The conflicts between institutionalized means and cultural goals, which are central to Merton's structure and anomie theory, have also been explored in contexts such as grassroots governance and social care. Previous research has examined individuals’ moral deviations from conflicting means of implementation and ethical goals, as well as the role tension experienced when confronting conflicting institutional requirements and client needs. For example, Maynard-Moody et al. (2022) investigated how grassroots policy implementers, faced with the tension of their dual roles as citizen-agents and state-agents, must rely on autonomous moral judgment to sustain the policy implementation process. In this context, grassroots policy implementers may also employ “rule reconstruction” and “selective enforcement” to reconcile policy ideals with the realities of implementation (Lipsky 2010). Confronted with irreconcilable individual dilemmas, grassroots policy implementers strive to develop adaptive behaviors to address the conflict between policy ideals and practical requirements (Dubois 2016). However, when institutionalized means and cultural goals are difficult to reconcile, individual dilemmas can escalate into group behaviors, leading to actions that Merton describes as “ritualism,” such as symbolic participation in community organizations (Musso et al. 2007). The conflicts between institutionalized means and cultural goals have been examined within a broader institutional context and through systemic strategies in the field of social care. For example, in the practice of social workers in the UK, ethics work has been implemented to achieve consistency in “everyday ethics” (Banks 2016). The conflicts between institutionalized means and cultural goals are particularly evident in the Canadian child protection system, where social workers strive to reconcile the moral paradox between discipline and caregiving in institutional dilemmas through the “ethical trespass model” (Weinberg 2016). In addition, not all social workers are able to find appropriate strategies to navigate the contradiction between institutionalized means and cultural goals. Consequently, they may resort to ethical compromises of last resort, such as selectively ignoring the actual needs of certain families (Gupta et al. 2018). They may also be helplessly compliant with the consequences of the institutionalized means orientation, leading to the passive demise of the well-being orientation associated with cultural goals (Stevenson 2014).

Nevertheless, previous studies have expanded Merton's theory of social structure and anomie from the perspective of cotemporal social elements influencing individual behavior but have neglected the impact of longitudinal temporal cultural traditions. There are also studies that focus on conflicts between institutionalized means and cultural goals. However, they concentrate on analyzing individual strategy choices and pay less attention to new developments in Merton's theory driven by macrocultural contexts, leaving some leeway for this study. Unlike in the West, China's millennia of traditional culture possess a profound depth that continues to exert a significant influence on modern practices in the field of elderly care (Zhang 2024). Therefore, it is essential to analyze how traditional culture, as a social element, influences individual behaviors and their social consequences in modern contexts while considering the enduring characteristics of cultural traditions.

Therefore, combining the general applicability of Merton’s theory in the analysis of cotemporal elements and the relative limitations of the analysis of diachronic elements, this paper finally chooses the implementation process of home-based care bed policy in Shenyang as the research context. The study first analyzes the production process of ageism on the basis of social structure and anomie theory, in which various social elements in policy implementation influence individual behavior. Second, the study analyzes the reproduction process in which cultural traditions drive the reproduction of individual behaviors and thus the evolution of ageism to respectful ageism in the context of traditional culture as a longitudinal social element. Thus, on the one hand, this study adds evidence of the general applicability of social structure and anomie in the field of policy implementation. More importantly, on the other hand, by introducing the longitudinal social element of traditional culture, this study analyzes a richer set of individual behavioral strategies directed by individual behavioral reproduction mechanisms so that the five individual behavioral strategies proposed by Merton may not be the ultimate behavioral choices of individuals. Ageism shifted to respectful ageism as a result of individual behavioral reproduction driven by cultural traditions, where individuals produce new behavioral mechanisms that have new effects on social structural change.

Methods and data

The data presented in this article were drawn from a larger qualitative study that aimed to understand the implementation of home-based care bed policy. Thus, the original research design did not single out the respectful ageism phenomenon during the policy implementation. However, during the process of the research, the logic of respectful ageism emerged from the interview data, and it is important for understanding the characteristic respectful ageism phenomenon in Chinese elderly care services. This captured the immediate interest of the researchers, and more attention was hence given to respectful ageism research during data collection and analysis.

Qualitative methodology

The entire project was guided by a qualitative methodology, using semistructured in-depth interviews and secondary data analysis as the main methods. Qualitative methods provide us with a way to explore the underlying themes of textual data (Corbin and Strauss 2015), thus enabling us to uncover the respectful ageism underlying distributive policy implementation for older people, taking as an example the implementation of the policy on home-based care beds.

Data collection and analysis

The data were collected from March to October 2023. In total, 23 participants were interviewed in Shenyang, which is the capital city of Liaoning Province and has the highest proportion of people aged 65 and over in the total population of China, according to the China Statistical Yearbook 2023. The identities of the 23 participants include older people as recipients of the policy on home-based care beds, community workers as grassroots implementers, civil affairs workers as transmitters of the policy, and home-based elderly care workers as service providers. Nonprobability sampling methods, including convenience sampling and snowballing, were employed to recruit participants. The study used different interview methods, including telephone interviews and face-to-face interviews.

The process of conducting interviews accompanied the implementation of the home-based care bed policy. Shenyang city's home-based care bed policy comprises three key elements: home-based elderly care services, age-friendly renovations, and the installation of information technology equipment. Among them, home-based elderly care services encompass household cleaning, daily assistance, and health management for older adults. Age-friendly renovations include the installation of nursing beds, flashing and vibrating doorbells, antislip treatments, bedside guardrails, and handrails in the homes of older adults. Additionally, the installation of information technology devices involves data gateway equipment, voice or video interconnection devices, and emergency call devices in these homes. To gain a more accurate understanding of the actual implementation of these components, the researchers observed six complete elderly care processes and interviewed civil affairs workers, home-based elderly care workers, community workers, and older adults about their experiences and perceptions regarding the implementation process and specific aspects of home-based care bed policies. Furthermore, the researchers gathered insights into their experiences, feelings, and perceptions concerning the implementation of these specific policies and their content (Table 1).

Interview guides were used to facilitate and guide the interview process. Different types of participants were asked to comment on various topics related to their experiences and feelings during the implementation of the home-based care bed policy. The older people were asked about their policy attitudes, their policy participation experiences, their subjective feelings about the policy process, and their quality of life. The community workers were asked about their policy implementation experiences, policy comments, and subjective feelings about policy implementation. The civil affairs workers were asked about their policy participation experiences, policy perceptions, policy comments, and policy attitudes. The home-based elderly care workers were asked about their experiences with home-based elderly care services, policy perceptions, and subjective feelings about the policy process. All the participants were asked in general terms about the content and feelings of their interactions with other participants. In addition, the researcher employed the triangulation method to supplement and test the field research by combining the policy text content with the researcher’s disciplinary knowledge, thus enriching the research materials and ensuring authenticity and reliability.

The study used thematic analysis to segment, categorize, summarize, and reconstruct the interview data. Following both deductive and inductive approaches, all the interview transcripts were coded, and analytical categories were identified as they emerged from the data.

Twenty-three participants shared their experiences with the home-based care bed policy, detailing their subjective feelings, evaluations of the policy, and its impact on their lives. Among them, older people and community workers have a more pronounced sense of respectful ageism, and their remarks more frequently address the relevance of the policy to respectful ageism. Therefore, given that the main purpose of this study is to explore the generation mechanism of respectful ageism, the analysis focuses mainly on interviews with older people and community workers. During the analysis, emphasis was placed on the words, actions, feelings, and thoughts of community workers and older people regarding respectful ageism during the policy implementation. For example, attention was given to community workers' views of older people as policy objects, as well as older people’s understanding of the benefits brought about by the policy.

Participant profile

The 23 participants included 10 older people, 6 community workers, 2 civil affairs workers, and 5 home-based elderly care workers. Among them, the residences of older people and the workplace of community workers are distributed in 11 communities within Shenyang city. On the basis of the principle of informed voluntariness and considering the respondents' ease of travel and heterogeneous preferences, the researcher conducted telephone interviews with 4 elderly people who had difficulty traveling and were unwilling to socialize offline and face-to-face interviews with the remaining 19 people. The older people were aged between 67 and 93 years (for details, see Table 2).

These samples were obtained from 11 communities in Shenyang city through convenient sampling and snowball sampling. The wide range and randomness of sample selection provide an important basis for studying respectful ageism in the policy implementation process. Among them, civil affairs workers and home-based elderly care workers do not have community affiliations because they work with all the communities in Shenyang. Among all the participants, community workers and older people are the groups that have the most direct perceptions of respectful ageism because community workers are at the end of home-based care bed policy implementation and older people constitute the target group of the policy. In the interviews with community workers and older individuals, the transformation of ageism into respectful ageism becomes increasingly evident, creating a coherent narrative. Therefore, the findings and arguments mainly rely on verbatim quotes from community workers and older people.

Patterns emerged from the interview data with respect to the mechanism of respectful ageism and its three related logics. The findings section of the article is structured around three themes—policy implementation exacerbates ageism, modern influences on traditional culture, and respectful ageism resulting from the conflict between policy implementation and traditional culture.

Findings

Policy implementation

exacerbates ageism

In implementing the home-based care bed policy, grassroots policy implementers primarily face pressures related to policy execution. These pressures arise from the vertical transmission of administrative pressure within the framework of Isomorphic Responsibility in the Chinese administrative system. Faced with administrative pressure, community workers adopt instrumental rationality centered on implementation efficiency. On the basis of the theory of street-level bureaucracy, grassroots policy implementers tend to ignore the needs of customers and dissolve the concept of service in the face of administrative pressure (Hill and Hupe 2002:53). This administrative pressure manifests in the home-based care bed policy, where community workers consistently face time-sensitive demands from civil services for the swift execution of tasks. One of the community workers, Mr. Li (32, HP), stated, “We received a notice from the higher authorities at that time, informing us that the aging equipment installers would be arriving soon. The installers came and completed the installation in one visit, and they were well-stocked with supplies. We had to keep up with this by going door-to-door to ensure the equipment was installed.” This emphasizes the time pressure that community workers face in implementing policies, driven by the focus on timely completion. Additionally, this pressure is intensified by the need to cooperate in completing policy elements, such as equipment installation, while remaining mobile to accommodate unexpected work schedules from the civil affairs department. In the face of the higher authorities’ requirements for policy implementation and timeliness, community workers blindly pursue implementation efficiency, treating the policy as a purely administrative process and implementation procedure and demonstrating an orientation of instrumental rationality.

For example, Mr. Li (32, HP) stated, “We are sometimes too busy with too much work. When workers come to install equipment, we also need to accompany them to install equipment, and there is too much work to handle.” Faced with the busy work situation and the realistic requirements of policy implementation, community workers have made their own choices, which are to pursue efficient implementation in the direction of instrumental rationality. As evidenced in Mrs. Lu's (53, MLZC) comment: “At that time, there were two policy recipients in the community under my jurisdiction. The workers who installed the equipment came to this community, then I took them to the site to install the equipment. After the equipment is installed, my work process is over. The supporting management and services that were supposed to be there after the equipment was installed are not there now.”

Community workers operate based on instrumental rationality and ignore the self-worth and individual intentions of older people, resulting in a mentality of disrespect, disinterest, and perceived ignorance of older people as policy subjects. In the implementation of the home-based care bed policy, community workers show an orientation of instrumental rationality, ignoring the subjective will and autonomous thoughts of older people. This phenomenon is sometimes associated with objective factors, such as miscommunication due to declining hearing levels in older people. As Mrs. Du (41, KZ) noted, “Installing those devices (referring to age-adapted devices, etc.) for the elders, it is difficult to communicate with them. We can't communicate with the elders, and they may have hearing problems, so just install the equipment without caring about their thoughts.” However, sometimes, community workers are direct in their subjective and negative assumptions, asserting that older people lack a sense of engagement with the policy and a willingness to pursue personal development. Mrs. Li (46, JC) described how she viewed older people's policy engagement: “That older people don't have any ideas for policy improvement, we're talking about a vulnerable group and asking them to change it, but they don’t have any thoughts.” Another community worker, Mr. Li (32, HP), expressed his opinion that “Now this policy is geared toward the elderly who feel that they can live one day at a time and earn one day at a time, and they don't have any plans or prospects for future of their life, nothing.”

As a result, ageism is exacerbated by the denial and neglectful behavior of community workers in policy implementation. Some community workers frankly exhibit prejudice exacerbated by age attribution. Mrs. Liu (39, JK) said, “In fact, older people are more timid the older they get. We work to guide the elderly to cooperate with this policy, but they don't trust us too much.” Another community worker, Mr. Zhao (52, WG), faced a similar situation: “Older individuals may sometimes struggle to comprehend the policy due to its novelty, as adapting to new concepts can be challenging for them.” Meanwhile, older people were able to discern the ageism exhibited by community workers, leading them to adopt avoidance behaviors that reduced their social interactions. Mrs. Bai (84, JQ) stated, “I rarely contact with community workers; my husband has contacted them twice. He is somewhat hard of hearing, which results in very few people wanting to engage in conversation with him. Once, when the community workers spoke to my husband, they asked him why he always came repeatedly for procedures and why he came so many times. So I said to my husband, you should stop asking, you don't know how to use your cell phone to check in for services online, and you are deaf, so you should venture out less often.” Therefore, ageism, exacerbated by community workers during policy implementation, affects older people's social interaction behaviors and exacerbates their avoidance and self-isolation tendencies.

In summary, community workers, faced with administrative pressures in policy implementation, adopted instrumental rationality centered on implementation efficiency, thereby ignoring older people’s self-worth and individual intentions. Consequently, community workers developed indifferent and uninformed attitudes toward older individuals, which further exacerbated their ageism.

Modern influences

on traditional culture

China has a long-standing culture of filial piety that emphasizes respect for and cherishment of older individuals, a tradition that continues to influence contemporary society (Zhang 2024). The traditional culture of respect and cherishment for older people has shaped the cultural goals of home-based care bed policy, which is reflected in the fact that the goal of home-based care bed policy is to promote the well-being of older persons (Li and Han 2023).

In the implementation of the policy, the traditional culture of respecting and cherishing older people is externalized as the policy’s cultural goals. The cultural goals of the home-based care bed policy for the well-being of older adults are commonly shared by community workers and promoted as such. As evidenced in Mr. Zhao's (52, WG) comment, “This policy can help the older people in need, and we will be reflecting the excellent traditional culture of respecting and cherishing the older people by doing these things.” Another community worker, Mrs. Du (41, KZ), stated, “This is a good policy direction now. The equipment installed could be really useful for the elders if they encounter unexpected events in their lives. I have also reviewed the list of items to be installed under the home-based care beds policy, and I believe it remains very beneficial for the elders.”

The traditional culture of respecting and cherishing older people not only influences policies through explicit cultural goals but also inherently and subconsciously shapes the self-perceptions of community workers, fostering individual empathy toward older individuals during policy implementation. One of the community workers, Mrs. Liu (39, JK), expressed her opinion that “the elders are old and in poor physical condition. We all must confront the inevitability of aging, so this policy is beneficial if it can install some aging-friendly equipment for older people to facilitate their daily lives. The elderly individuals here do not have any excessive demands; they feel satisfied that the government provides these services and express deep gratitude toward the government. When we engage in this work, we also feel a sense of fulfillment, taking pleasure in contributing positively to the lives of older individuals.” Mrs. Lu (53, MLZC) described how she viewed the older people who received the policy: “The older individuals benefiting from this policy resemble my parents' generation, who faced difficult circumstances in the past and endured many hardships throughout their lives. But now the policy is providing them with these home modifications, like the installed nursing beds, handrails, guardrails, configuration of wheelchairs and other amenities that are beneficial to their lives, that are providing them with benefits.”

In summary, the traditional Chinese culture of respecting and cherishing elders has been passed down to the present day and has shaped the cultural goals of the policy. Policy implementers are profoundly influenced by the traditional culture of filial piety, leading them to firmly believe in the cultural goals of the home-based care bed policy, which aims to increase the well-being of older individuals. Moreover, the culture of filial piety subconsciously shapes the perceptions of community workers, fostering an empathetic emotional connection to older individuals during policy implementation.

Respectful ageism

resulting from the conflict

between policy implementation

and traditional culture

Ageism exacerbated by policy implementation, coupled with the cultural tradition of respecting and cherishing elders, creates a dynamic interplay between institutionalized means and cultural goals, with community workers positioned at the center of this field. On the one hand, community workers follow the policy implementation process required by policy regulations, conform to institutional norms, and practice institutionalized means. On the other hand, community workers, cognizant of the policy’s cultural goals and deeply influenced by the traditional culture of respect for and cherishment of elders, are unable to completely ignore the revered status and individual intentions of elders. As a result, the ageism amplified by the implementation process of institutionalized means and the filial piety tradition of cherishing elders traced back to cultural goals are jointly manifested in the policy implementation behavior of community workers. This places community workers in a situation of tension and conflict, where they are faced with the dilemma that it is difficult to reconcile institutionalized means and cultural goals.

Robert K. Merton argues that individuals adopt different action strategies when faced with conflicts arising from institutionalized means and cultural goals. Merton argues that when an individual is unable to reconcile institutionalized means with cultural goals, a ritualistic action strategy is achieved if he or she chooses to follow institutionalized means and deviate from cultural goals. Ritualism refers to a scenario in which an individual is in conflict between institutionalized means and cultural goals, and the individual chooses to conform to institutionalized means and deviates from cultural goals (Merton 1938).

Ritualism was utilized as the action strategy by community workers in the implementation of the home-based care bed policy. This is specifically manifested in the tendency of community workers, when confronted with the pressures of policy implementation, to sever their emotional connections to older individuals. They set aside the moral imperatives of traditional culture that emphasize cherishing the elderly and instead adhere to instrumental rationality, thereby neglecting the elderly’s self-expression and individual intentions. This dynamic, in turn, exacerbates the reality of ageism.

However, the action strategy of ritualism proposed by Merton has new variations in the unique cultural context of China. Owing to the profound influence of traditional Chinese culture, the community workers’ action path during policy implementation is different from the ritualism strategy proposed by Merton, which is manifested in the emergence of the retrospection on cultural goals and individual rethinking.

The first aspect is community workers' retrieval of cultural goals. Community workers adopt ritualistic strategies in policy implementation, following institutionalized means but deviating from cultural goals, exacerbating ageism by ignoring the individual intentions of older persons. However, during policy implementation, community workers were significantly influenced by the traditional culture of filial piety, which produced retrospection on cultural goals. Specifically, the retrospection on cultural goals indicates that community workers are implicitly influenced by their long-accepted culture of filial piety. They subconsciously associate the policy goal of home-based care beds with the cultural tradition of respecting and cherishing elders, thereby promoting this connection. Community workers believe that cultural goals are designed to benefit elders in need; therefore, they should embody the traditional virtues of respecting and cherishing older individuals while also honoring their individual intentions and self-worth. After installation of the aging equipment, Mr. Zhao (52, WG) stated in an interview, “I believe it is crucial for community workers to have a personal understanding of policy and the ability to interpret it effectively. I now recognize that it is normal for older individuals to struggle with understanding the policy. It will require us to patiently explain the policy details to them continuously, offering our sympathy so that they can undergo a conceptual change in their understanding.” Another community worker, Mrs. Li (46, JC), stated, “We should assist vulnerable elders by implementing policies that also demonstrate respect for and reverence toward older individuals.”

Second, through individual rethinking, community workers attribute their deviation from cultural goals to the limitations of institutionalized means. Individual rethinking is the process by which community workers review their own behavior during policy implementation. They argue that their actions, which are based on instrumental rationality and deviate from cultural goals, stem from the limitations of institutionalized means. This situation represents a tragedy caused by the presence of formalism and flawed policies. Mr. Zhao (52, WG), one of the community workers, stated, “I believe that formalism persists, and it would be irresponsible for me and others to impose material provisions or concepts on the elders without considering their actual needs.” Mrs. Lu (53, MLZC), on the other hand, was more frank in pointing out the policy flaws of institutionalized means: “This policy should have allowed the elders to independently choose which equipment to install, and should have detailed information on the equipment contents, and explained how these products could be applied so that the residents could independently choose according to their needs. Currently, it is we install forty things at once for the elders. Elders often find themselves unable to raise questions, as much of the equipment lacks practical utility.”

As a result, community workers in the Chinese scene have engaged in cultural retrospection and individual rethinking based on the action strategy of ritualism, leading to the emergence of the new phenomenon of respectful ageism (for details, see Table 3). Respectful ageism, in which policy implementers perpetuate the filial piety culture of respecting and cherishing the elderly, believe in cultural goals aimed at promoting the well-being of the elderly, and adhere to institutionalized means of policy implementation in their actions, nevertheless exacerbates ageism. Respectful ageism is characterized by four features: first, a policy scenario aimed at enhancing the well-being of older people; second, the subjective will of the policy implementers to respect and cherish the elderly; third, implementation of the policy according to the norms of institutionalized means; and fourth, policy outcomes that exacerbate ageism.

Discussion and conclusions

Respectful ageism, as a China-specific phenomenon, cannot be simplistically interpreted in terms of traditional sociological theories. In this study, we take China’s elderly care policy implementation context as the field of analysis to explore the mechanism of respectful ageism. Research has indicated that community workers' policy implementation process exacerbates ageism but is significantly influenced by traditional filial culture. Community workers, through their adoption of the action strategy of ritualism, have generated two new behavioral mechanisms, cultural retrospection and individual rethinking, which lead to the new phenomenon of respectful ageism.

In the policy implementation context, grassroots policy implementers’ behavior deviates from their perceptions, demonstrating the results of amplifying ageism and the modern influence of filial piety culture, as well as generating a game of institutionalized means and cultural goals. Merton's theory of “social structure and anomie” describes the different types of individual action strategies in this game situation.

However, Merton's theory, which focuses on the singularized coping strategies produced by individuals in groups or societies, can explain the process of amplifying ageism but cannot serve as an intrinsic mechanism for deciphering the China-specific phenomenon of respectful ageism. This is because Merton's theory places the individual in groups or societies and assumes that the individual either plays a social role properly or disengages from the social role, thus creating anomie or social deviance. However, the influence of traditional Chinese culture is too far-reaching and long-lasting, so it leads to a unique cultural influence in China that produces a different reality from Merton's theoretical assumption, where the individual has experienced a new change in groups and society. Specifically, individuals will produce culturally traceable self-perceptions that are separate from their social role perceptions while playing their social roles well. This suggests that while individuals follow institutionalized means, even though they are not able to successfully achieve cultural goals with their social roles, they still retain their individual perceived cultural identity and thus add their own perceived cultural feelings to their actions in addition to their social roles.

During the policy implementation of the home-based care bed policy in this study, after adopting the ritualism action strategy, community workers detached themselves from their professional role as community workers and examined their policy implementation behaviors from an individual cognitive perspective, generating self-criticism and autonomously emphasizing the cultural tradition of filial piety in respecting and cherishing the elderly. They reflect on their actions in their social roles from a perspective outside of their professional roles, based on individually perceived cultural feelings, and try to incorporate the results of their self-reflections into the process of working in their professional roles, leading to self-criticism and attempts to optimize their actions in their social roles. This process involves the cultural retrospection and individual rethinking of community workers. In this process, community workers reinforce their individual role of passing on the culture of filial piety, reflect on the ageism of their behavioral orientation in their professional roles, and reintegrate the individual knowledge of respecting and cherishing the elderly into their professional roles. As a result, community workers have realized the transformation from ageism to respectful ageism through two mechanisms: cultural retrospection and individual rethinking.

The transformation of ageism into respectful ageism involves not only a shift in the individual strategies of grassroots policy implementers during policy execution but also a reevaluation of their self-perception in response to administrative pressures and cultural traditions. Initially, grassroots policy implementers face administrative pressures conveyed through vertical intergovernmental relations during the policy implementation process. At this stage, they prioritize administrative demands over cultural traditions. Their focus on instrumental rationality to expedite policy implementation undermines the value rationality of individual cognition, resulting in behaviors that reflect ageism. These behavioral processes, which adhere to institutionalized means while diverging from cultural goals, exemplify the individual behavioral strategies that Merton refers to as “ritualism”. The administrative pressures on grassroots policy implementers were subsequently alleviated as the degree of policy implementation completion increased. They briefly step back from their professional roles to focus on their individual perceptions. At this stage, the influence of culture on individual behavior becomes predominant, prompting grassroots policy implementers to realign their perceptions toward a policy orientation centered on the well-being of elderly individuals. This shift connects the cultural goals of the policy with the filial piety tradition of respecting and cherishing elders. As cultural traditions drive individual behavior, administrative pressures diminish while the influence of culture intensifies. During this cognitive return to cultural traditions, grassroots policy implementers experience significant behavioral changes. Rather than adhering solely to ritualistic action strategies, they begin to explore whether policies can embody filial values and examine their own implementation practices. The former represents a process of cultural retrospection, prompting grassroots policy implementers to reconnect with the filial culture of respecting and cherishing the elderly. They incorporate their role orientation into the transmission of this culture, believing that this integration will enhance their performance during the policy implementation process. The latter signifies a process of individual rethinking, enabling grassroots policy implementers to reflect more deeply and meticulously on their own behaviors. They recognize that the limitations of their ageist behaviors arise from both policy inadequacies and formalistic inertia. The interplay between cultural retrospection and individual rethinking has facilitated the transition of grassroots policy implementers toward respectful ageism.

Although ageism has evolved into a form of respectful ageism, related issues can still be addressed from a macro perspective at the policy design level to enhance the well-being of older people. Policy-makers should establish clear, phased implementation goals and systematically communicate these goals to grassroots implementers. By enabling these implementers to execute the phased plans established by policy-makers on schedule, a more comprehensive and coherent policy implementation framework can be achieved. This approach helps to avoid the dilemma of choosing between speed and quality of execution. Additionally, policy-makers should establish feedback requirements for grassroots implementers. By collecting execution reports and feedback at each stage, they can flexibly adjust the timeline for policy completion and refine the policy content on the basis of the actual needs of older people. Furthermore, policy-makers should integrate satisfaction surveys from older people into the policy design process. The home-based care bed initiative, which aims to increase the well-being of older people, ultimately aims to improve their quality of life. By designing reliable questionnaires to assess quality of life and having grassroots implementers conduct regular surveys, policy-makers can effectively monitor changes in the quality of life of older people resulting from the policy and promptly revise the policy content. The major contribution of our study is the analysis of the mechanism of respectful ageism, which is a China-specific phenomenon. Although previous studies have proposed respectful ageism as a China-specific finding (Zhang 2017), analyses of the formation mechanism of respectful ageism are lacking. This study complements the niche of ageism research by analyzing the specific mechanisms of how grassroots policy implementers generate ageism and evolve respectful ageism, using the example of the home-based care bed policy. In addition, the study shows that in the policy context influenced by traditional Chinese culture, the strategies proposed by Merton's theory of social structure and anomie are not the final results of individuals' strategic choices, and individuals will also employ new behavioral mechanisms, which will lead to new phenomena. The new behavioral mechanisms in the implementation of the home-based care bed policy are cultural retrospection and individual rethinking, and the new phenomenon is respectful ageism. This complements Merton’s theory of social structure and anomie by proposing the research assumption that cultural traditions drive the reproduction of individual behavior, addressing the resulting behavioral mechanisms of cultural retrospection and individual rethinking and their consequences.

Like most other qualitative research, the present study has certain limitations that must be considered. The findings are generated from interviews with 23 participants, representing four policy participant groups in certain social contexts. Although the study chose typical cities of the home-based care bed policy for the research to enhance the external validity and adopted the triangulation method to ensure the internal validity of the study, owing to the limited number of samples, the findings and arguments from their interview data may not be generalizable to all the pilot cities of the policy in China. Additionally, the study does not examine the evolution of ageism across different countries. While it discusses the mechanism of respectful ageism through an analysis of China, it does not explore why other countries have failed to establish an internal mechanism of respectful ageism by examining the historical development of ageism in various nations. Even so, respectful ageism is a China-specific finding generally agreed upon by academics. This paper provides more insights into the analysis of the production mechanism of respectful ageism and discusses the strategic evolutionary path of the cultural tradition-driven reproduction of individual behaviors, which is neglected by Merton's theory of social structure and anomie.

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引用本文

Han, Y., Sun, T. From ageism to respectful ageism: how is the China-specific phenomenon formed?. J. Chin. Sociol. 12, 9 (2025). https://doi.org/10.1186/s40711-025-00237-z

https://journalofchinesesociology.springeropen.com/articles/10.1186/s40711-025-00237-z

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