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

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.

Eating habits, food consumption, and health: The role of early life experiences

“…22 We also include regional dummies, y r to account for the differential effect of WWII across regions. 23 These also capture systematic differences in eating habits, for instance, due to the culinary traditions of each region. Given that the dependent variable is binary, we estimate a linear probability model.…”

“…We accordingly control for individuals' educational attainment and occupation in a robustness exercise. The results do not, however, depend on the inclusion/exclusion of these controls (See Section 4.2) 23. The regional dummies absorb ∆(livestock) in the estimation 24.…”

Insuring Against Hunger? Long-Term Political Consequences of Exposure to the Dutch Famine

“…An abundant literature documents that individuals exposed to famine in-utero are more likely to be overweight (Barker, 1990;Conti et al, 2019;Ravelli et al, 1976), shorter (Van den Berg et al, 2015;Portrait et al, 2017), have a lower life expectancy (Lindeboom et al, 2010) and suffer from coronary heart disease, disturbed blood coagulation, and diabetes (Barker, 1990;Roseboom et al, 2006), as well as mental health problems (Susser et al, 1998;Brown et al, 1995;Neugebauer et al, 1999). 2 Lower levels of health capital not only intensify the risk of ill health in adulthood, but also affect employment and labor market outcomes.…”