Long-Term Effects of Famine on Chronic Diseases: Evidence from China's Great Leap Forward Famine

Abstract

We estimate long-term effects of famine on chronic diseases using China’s Great Leap Forward Famine as a natural experiment. Using a unique health survey, we explore the heterogeneity of famine intensity across regions and find strong evidence supporting both the adverse and selection effects. The two offsetting effects co-exist and their magnitudes vary in different age cohorts at the onset of famine. We find that the adverse effect dominates in the puberty cohort and the selection effect dominates in the prenatal/infant cohort. The net famine effects are more salient for rural residents than for urban residents. Gender differences are also found and sensitive to smoking and drinking behaviors. Our conclusion is robust to various specifications.

Keywords: Great Leap Forward Famine, Chronic Disease, Adverse Effect, Selection Effect, Gender Difference, China

JEL Classification: C21, I18, J13