Older parents enjoy better filial piety and care from daughters than sons in China.

This study analyzes the unique datasets of the Chinese Longitudinal Healthy Longevity Survey using logistic regression and controlling for various covariates. Our analyses clearly demonstrate that disabled older parents are more satisfied with care provided by daughters than sons and that older parents enjoy greater filial piety from and better relationships with daughters than sons. The daughter-advantages of enjoying greater filial piety from and better relationships with children are stronger among the oldest-old aged 80+ than the young-old aged 65-79, and surprisingly more profound in rural areas than urban areas, while son-preference is much more prevalent among rural residents. We also discuss why China's rigorous fertility policy until October-2015 and much less-developed pension system in rural areas substantially contribute to sustaining traditional son-preference and a high sex ratio at birth (SRB) when fertility is low. We recommend China take integrative public health policy actions of informing the public that having daughter(s) is beneficial for old age care, developing the rural pension system and implementing the universal two-child policy as soon as possible. We believe that these policy actions would help to reduce son-preference, bring down the high SRB, and enable more future elderly parents to enjoy better care from their children and healthier lives.