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Severe Prenatal Shocks and Adolescent Health: Evidence from the Dutch Hunger Winter

Author

Listed:
  • Gabriella Conti

    (University College London)

  • Stavros Poupakis

    (University College London)

  • Peter Ekamper

    (Netherlands Interdisciplinary Demographic Institute)

  • Govert Bijwaard

    (Netherlands Interdisciplinary Demographic Institute)

  • L. H. Lumey

    (Columbia University Medical Center)

Abstract
This paper investigates impacts, mechanisms and selection effects of prenatal exposure to multiple shocks, by exploiting the unique natural experiment of the Dutch Hunger Winter. At the end of World War II, a famine occurred abruptly in the Western Netherlands (November 1944 - May 1945), pushing the previously and subsequently well-nourished Dutch population to the brink of starvation. We link high-quality military recruits data with objective health measurements for the cohorts born in the years surrounding WWII with newly digitised historical records on calories and nutrient composition of the war rations, daily temperature, and warfare deaths. Using difference-in-differences and triple differences research designs, we show that the cohorts exposed to the Dutch Hunger Winter since early gestation have a higher Body Mass Index and an increased probability of being overweight at age 18, and that this effect is partly accounted for by warfare exposure and a reduction in energy-adjusted protein intake. Moreover, we account for selective mortality using a copula-based approach and newly-digitised data on survival rates, and find evidence of both selection and scarring effects. These results emphasise the complexity of the mechanisms at play in studying the consequences of early conditions.

Suggested Citation

  • Gabriella Conti & Stavros Poupakis & Peter Ekamper & Govert Bijwaard & L. H. Lumey, 2021. "Severe Prenatal Shocks and Adolescent Health: Evidence from the Dutch Hunger Winter," Working Papers 2021-056, Human Capital and Economic Opportunity Working Group.
    • Handle: RePEc:hka:wpaper:2021-056
    Note: HI
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    References listed on IDEAS

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    Cited by:

    1. Samuel Baker & Pietro Biroli & Hans van Kippersluis & Stephanie von Hinke, 2022. "Beyond Barker: Infant Mortality at Birth and Ischaemic Heart Disease in Older Age," Working Papers 2022-015, Human Capital and Economic Opportunity Working Group.
    2. von Hinke, Stephanie & Sørensen, Emil N., 2023. "The long-term effects of early-life pollution exposure: Evidence from the London smog," Journal of Health Economics, Elsevier, vol. 92(C).
    3. Dora Costa, 2022. "Overweight Grandsons and Grandfathers' Starvation Exposure," NBER Working Papers 30599, National Bureau of Economic Research, Inc.
    4. Costa, Dora L., 2023. "Overweight grandsons and grandfathers’ starvation exposure," Journal of Health Economics, Elsevier, vol. 91(C).

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    More about this item

    Keywords

    fetal origins hypothesis; famine; prenatal exposure;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth

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