A Survey on the Sustainability of China’s Smoke-free Community Elderly Care Service Models from the Perspective of Welfare Pluralism

Abstract

Studies show that the harm of smoking is much higher in the elderly than in the young and middle-aged. Therefore, smoke-free communities are more suitable for the elderly. China's ministry of civil affairs pointed out that, the development of community elderly care services conforms to the wishes of over 90% of the elderly in China, which is the focus of the construction of China’s elderly care service system. Meanwhile, China’s existing smoke-free community elderly care service models are diverse, service efficiency and sustainability remains uneven. Methods: This study constructed a conceptual framework for smoke-free community elderly care service based on the theory of welfare pluralism. To find the sustainability of smoking control in smoke-free communities and the efficiency of elderly care service supply under different supply modes. According to the geographical location, 9somke-free communities in Beijing, Nanjing and Xi'an were selected for investigation. Results: Three supply modes of community-based elderly care services are summarized, including Multiactor Participation Model (MPM), Government and Social organization Cooperation Model (GSCM), and Government-led Participation Model (GPM). The case analysis method is used to analyze the characteristics of the supply actors, supply content, and supply methods of these three models. Conclusion: Three supply modes of community-based elderly care services are summarized, including Multiactor Participation Model (MPM), Government and Social organization Cooperation Model (GSCM), and Government-led Participation Model (GPM). The MPM for smoke-free community elderly care, which includes the participation of multiple subjects and is more diversified in terms of supply content and methods, is found to have better smoking control efficiency and higher sustainability.