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. 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. Using difference-in-differences and triple differences designs, we show that the cohorts exposed to the Dutch Hunger Winter since early gestation have a higher probability of being obese at age 18. We then find that this effect is partly accounted for by warfare exposure and a reduction in energy-adjusted protein intake. Lastly, we account for selective mortality using a copula-based approach, 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.

Keywords: health, fetal origins hypothesis, Famine, Prenatal Exposure