Long-term effects of malnutrition on early-life famine survivors and their offspring: New evidence from the Great Vietnam Famine 1944-45

Health Econ. 2021 Jul;30(7):1600-1627. doi: 10.1002/hec.4274. Epub 2021 Apr 20.

Abstract

We investigate the long-term effects of the 1944-45 Great Vietnam Famine on early-life survivors and their offspring using census data, household survey data and historical administrative data. Unlike previous famine studies, we measure famine severity using a unique, more direct, and "plausibly exogenous" metric of food availability: province-level excess paddy (rice) production per capita in 1944. Our study makes two novel contributions. First, we overcome several selection problems associated with the estimation of true famine effects, given the short duration and spatial variation of the Vietnamese famine. Second, we investigate the intergenerational effects of famine, focusing specifically on the occupation of the survivors' parents and the school participation of the survivors' offspring. Our preferred specification estimates generalized triple differences that allow us to control for birth-year and birth-province fixed effects and nation-wide shocks. Our findings suggest that the Vietnamese famine reduced literacy by around 3 percent, BMI by 5.6%-8.4%, arm-length by 4.5%-6.7% (1.1-1.7 cm), height by 2.2%-3.2% (3.4-5 cm), and weight by 10%-14% (4.7-6.9 kg) among the affected cohort. These detrimental famine effects also extended to economic welfare, in the form of lower household incomes and lower non-food household expenditures in adulthood. We also document a 4.9%-7.2% reduction in school participation among survivors' offspring, which has major implications for the exogenous origins of social mobility, inequality, and poverty.

Keywords: Vietnam; famine; health; human capital; intergenerational transmission.

MeSH terms

  • Adult
  • China
  • Famine
  • Humans
  • Malnutrition*
  • Starvation*
  • Survivors
  • Vietnam / epidemiology