Governance paradigms in healthy ageing: a systematic comparative review of residential care strategies in China and the United Kingdom

Abstract Population ageing represents the definitive demographic shift of the 21st century, necessitating a systemic transformation of residential environments to support health and independence in later life. This review presents a comparative analysis of divergent strategies adopted by the United Kingdom (UK) and China to develop healthy, age-friendly housing ecosystems. Using a mixed-methods approach, the study integrates a systematic policy review with text mining techniques to map the evolutionary trajectories of 12 UK and 81 Chinese policy documents. The analysis reveals distinct developmental paradigms: the UK model has evolved from a foundational welfare framework (1990–2000) into a complex, evidence-based system anchored by the ‘Decent Homes Standard’ and advanced data infrastructure—including Health Data Research UK (HDRUK) and English Longitudinal Study of Ageing (ELSA)—yet continues to face challenges related to market fragmentation and an ageing housing stock. In contrast, China’s state-led model has transitioned rapidly from a passive response (pre-1999) to high-level strategic integration (2019–present), exemplified by the 2023 Law on the Construction of Barrier-Free Environments. While China demonstrates exceptional capacity for large-scale infrastructure deployment—such as the “9073” three-tiered care system—it encounters persistent issues in service consistency and regional equity. The review synthesises these findings into a mutual learning framework: China could benefit from adopting the UK’s robust, data-driven evaluation mechanisms to improve service quality, whereas the UK could emulate China’s ability to implement coordinated, cross-sectoral policies to accelerate housing retrofitting. The study concludes by proposing a globally adaptable, data-informed housing policy blueprint, designed for scalability across diverse economic contexts, including middle-income nations.