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China's rapid urbanization has prompted a significant movement of young working-class adults towards cities. This rural-urban migratory phenomenon, driven by economic advancement, has resulted in millions of older adults being “left behind” in rural areas as empty nest families. This review delves into the repercussions of such migration, particularly on the well-being of these left behind older adults, against a backdrop of fading traditional filial piety practices and the complexities of hukou (household registration) status. Using a PRISMA-guided approach with PubMed as the primary database, 61 peer-reviewed articles were refined to 15 subject-related papers focused in on internal rural to urban migration processes on older adults living in China. Articles that were non-English articles, before 2013, non-rural migration, and those not focused on older adults were excluded. Findings suggest that healthcare accessibility and higher living costs, often due to hukou restrictions, influence older adults' decisions to remain in rural areas or their satisfaction with urban relocation. This migration pattern has altered family structures, labor, and care dynamics, leading to increased physical and mental health challenges among rural older adults, including loneliness, depression, and a tendency towards institutionalized care due to reduced support. The research underscores the intersection of health, socioeconomic status, and cultural expectations, noting that the physical, psychological, and social health of non-migrating older adults often deteriorates due to isolation and the erosion of traditional support structures. This paper calls for more granular, mixed-methods research to develop culturally sensitive and region-specific interventions to address these disparities effectively.
