BMC Public Health. 2025 Aug 6;25(1):2677. doi: 10.1186/s12889-025-23725-w.
ABSTRACT
BACKGROUND: The decline in fertility intentions has emerged as a critical demographic and policy challenge within China, particularly in light of the introduction of the three-child policy. This situation necessitates a thorough examination of the multiple underlying factors that contribute to individuals’ decisions regarding family size. By analyzing these diverse influences, policymakers and stakeholders will be better equipped to design effective interventions aimed at addressing this urgent issue. A nuanced comprehension of the complexities surrounding low fertility intentions is essential for promoting family growth and fostering stability within the nation. Ultimately, a targeted approach informed by these insights will be vital for encouraging a cultural shift towards larger families and ensuring the long-term demographic health of China.
METHODS: In our research, we performed a cross-sectional analysis using data gathered in 2022 from the Psychology and Behavior Investigation of Chinese Residents (PBICR), which encompassed 21,916 participants aged 18 to 49 years. We assessed fertility intention scores for respondents based on their preferences for having a first, second, and third child, employing a scoring system that ranged from 0 to 100. To investigate the impact of various factors on fertility intentions, we organized the independent variables into three primary domains: socio-demographic characteristics, lifestyle and health behaviors, and family structure. We utilized domain-specific multivariate linear regression analyses, along with gender-stratified models, and examined interaction effects. The explanatory capacity of each model was evaluated by calculating R² values, which offered insights into the variance accounted for by the independent variables.
RESULTS: Our research indicated that men demonstrated significantly higher scores for fertility intention than women, with a meaningful statistical difference (β = 7.63, p < 0.001). Various factors were recognized as positive indicators of fertility intention, such as being younger, residing in rural areas, having a favorable self-evaluation of health, and marital status. Moreover, behaviors like smoking and current alcohol use showed significant associations with fertility intentions. In our examination of family-related factors, we discovered that dual-income households without children (DINK) and nuclear family setups were linked to lower fertility intentions, whereas those living with parents expressed greater intentions to parent. Importantly, the interaction effects suggested that women faced a more pronounced decline in fertility intentions as age increased. Among the factors studied, socio-demographic characteristics explained the largest proportion of variance in fertility intentions (R² = 0.086).
CONCLUSIONS: Fertility intentions in China are shaped by various factors, such as differences between genders, individual health, and family structure. To tackle the challenge of decreasing fertility rates effectively, it is essential that interventions focus on younger women and highlight the advantages of living with multiple generations. In addition, reproductive policies ought to consider health and lifestyle factors, establishing a more comprehensive strategy to encourage family expansion in urban settings. Through the adoption of these approaches, stakeholders can strive to counteract the patterns of low fertility intentions and create an environment that supports family growth.
PMID:40770308 | DOI:10.1186/s12889-025-23725-w
