Great Chinese Famine Research Articles

In utero and childhood exposure to the great Chinese famine and risk of aging in adulthood

Background Early-life exposure to famine may influence the occurrence of chronic diseases and aging in midlife among those exposed. This study aims to explore the relationship between exposure to the Chinese Great Famine and aging in middle-aged individuals. Methods Participants born in 1963–1965 (unexposed), 1959–1961 (in utero exposure), and 1955–1957 (childhood exposure) from the Kailuan Study were included. Their biological age at 2010, 2014, and 2018 was investigated, and age acceleration (biological age minus actual age) was calculated to assess aging. Logistic regression analysis was employed to describe the relationship between famine exposure and the aging risk. Subgroup and sensitivity analysis were conducted to explore differences and stability in this relationship among different groups. Results A total of 17,543 participants were included in this study. Among them, 12,762 (72.7%) were male, and 4,781 (27.3%) were female, with 2,543 participants experiencing aging events. Compared to unexposed participants, those exposed during childhood and in utero exhibited a 1.69-fold (OR = 1.69, 95%CI: 1.53–1.87) and 1.22-fold (OR = 1.22, 95%CI: 1.08–1.37) increased risk of aging. Subgroup analysis revealed an interaction with income (P for interaction = 0.008), and additional interaction analysis suggested that increasing income could partially mitigate the detrimental effects of early-life famine exposure. Furthermore, experiencing famine in severely affected regions exacerbated the risk of aging (OR = 1.41, 95%CI: 1.21–1.63). Conclusion Exposure to famine in utero or during childhood may elevate the risk of midlife aging among exposed individuals, and these relationships are influenced by the severity of famine exposure. Increasing income may also help mitigate these effects.Trial registration: Kailuan study, ChiCTRTNRC11001489. Registered July 19, 2015 Retrospectively registered, https//www.chictr.org.cn/showprojEN.html?proj=8050&u_atoken=af46a0dee8d73f320bb5459ab7bbcfa9&u_asig=1a0c381017255295896468605e00cf .

Early-life famine exposure may modify the association between long-term temperature variability and cardio-cerebrovascular diseases: a nationwide study

Abstract Background We aimed to evaluate whether the association between long-term temperature variability (TV) and CCVDs was affected by famine exposure in different age stages. 
Methods We used data from the fourth national Urban and Rural Elderly Population survey (2015). Participants were categorized into six groups based on their age at famine exposure (famine exposure under age 5, between ages 5 and 18, and during adulthood) and the severity (severely affected areas versus mildly affected areas) of the Great Chinese Famine (1959-1961) in their province of residence. Mixed-effects logistic regression model was used to quantify the association between long-term TV and the prevalence of CCVDs across six famine-exposed groups.
Findings A total of 222,179 participants were included. In severely affected areas, the odds ratio (OR) of CCVDs associated with per 1°C increase in 5-year average TV were 1.07 (95% confidence interval [CI]: 1.02, 1.13) for those exposed to famine during adulthood, 1.28 (95% CI: 1.17, 1.40) under the age of 5 years. Urban residence, higher education, increased household income, and more frequent physical activity could mitigate the association between TV and CCVDs, particularly among those exposed to severe famine before the age of 5.
Conclusion Individuals exposed to famine before the age of 5 are more susceptible to TV-related CCVDs compared to those exposed during adulthood. Our findings highlight the importance of early-life nutrition in lowering susceptibility to CCVDs later in life.

Does childhood adversity affect household portfolio decisions? Evidence from the Chinese Great Famine

We employ the 1959–1961 Chinese Great Famine as a quasi-natural experiment to examine the relationship between experiencing adversity in childhood and financial decisions in adulthood. Using data from the 2017 China Household Finance Survey and the intensity of excess deaths during the Great Famine, results from our preferred two-part fractional regression model suggest that, for an additional excess death per thousand people during the Famine, cohorts who were in their infancy and early childhood during the Famine are 0.2–0.3 percentage points less likely to hold risky financial assets than other cohorts. We also find that, conditional on the decision to hold risky assets, those who experienced an additional excess death per thousand people during the Famine in their middle to late childhood hold 1.1 percentage points higher share of risky assets in their household financial portfolios than those who did not experience the Famine. We explore several potential mechanisms and find that financial literacy, risk-taking preferences and locus of control are channels through which childhood adversity in the famine years affects household portfolio decisions. Our findings are robust to a series of sensitivity checks.

Consequences of Exposure to Famine Exposure on the Later Life eGFR Decline Among Survivors of the Great Chinese Famine: A Retrospective Study

Background and ObjectivesChronic kidney disease (CKD) significantly contributes to the socio-economic burden both in China and worldwide. Previous research has shown that experiencing childhood famine is linked to various chronic conditions like diabetes, hypertension, and proteinuria. However, the long-term effects of early life famine exposure on adult kidney function remain unclear. This study investigates whether exposure to the Chinese Great Famine (1959-1962) is associated with a decline in glomerular filtration rate (GFR) later in life. Materials and MethodsCHARLS is a population-based observational study. We analyzed data from 8,828 participants in the 2011-2012 baseline survey, updated in 2014. Participants were categorized based on their birth year into fetal-exposed (1959-1962), childhood-exposed (1949-1958), adolescence/adult-exposed (1912–1948), and non-exposed (1963–1989) groups. The estimated GFR (eGFR) was calculated using the CKD-EPI-Cr-Cys equation (2021), with CKD defined as an eGFR below 60 mL/min/1.73 m2. ResultsAverage eGFR values were 103.0, 96.8, 91.2, and 76.3 mL/min/1.73 m2 for the fetal-exposed, childhood-exposed, adolescence/adult-exposed, and non-exposed groups, respectively. The eGFR in the exposed groups was significantly lower compared to the non-exposed group. Specifically, famine exposure correlated with a lower eGFR (CE -9.14, 95%CI -9.46, -8.82), with the strongest association observed in the adolescence/adult-exposed group (CE -26.74, 95%CI -27.75, -25.74). Adjusting for variables such as demographics, physical and laboratory tests, complications, and personal habits like smoking and drinking did not qualitatively alter this association (CE -1.38, 95%CI -1.72, -1.04). Further stratification by sex, body mass index (BMI), alcohol consumption history, hypertension, diabetes, CESD score, and education level showed that the association remained consistent. ConclusionsExposure to famine during different life stages can have enduring effects on GFR decline in humans.

CEO's early‐life famine experience and tunneling: Evidence from China

AbstractThe Great Chinese Famine is considered one of the most traumatic events recorded in human history and has a long‐lasting influence on the survivors' behaviors. Previous studies have linked the CEOs' early‐life experiences to corporate decisions and managerial behaviors, but does experience affect corporate governance? We investigate the impact of the CEO's early‐life famine experience on tunneling using a data set consisting of 11,573 firm‐year observations from the Chinese manufacturing companies publishing A‐shares on the main board from 2006 to 2016. We find that companies run by CEOs who experienced the Great Chinese Famine (1959–1961) in their early life are less likely to collude with controlling shareholders to expropriate minority shareholders than those who did not suffer the hardships of famine. We further make mediation tests to confirm two channels: risk aversion and empathy for poverty. The overall findings align with the view of imprinting theory: CEOs' experiences of adverse events in their early life have a lasting impact on their later‐life behaviors.

In Utero and Early-Childhood Exposure to the Great Chinese Famine and Adult Arterial Stiffness: A Cross-Sectional Study.

In Utero and Early-Childhood Exposure to the Great Chinese Famine and Adult Arterial Stiffness: A Cross-Sectional Study.

Gestational exposure to the great Chinese famine: early life undernutrition impact on prostatic hyperplasia in adulthood.

Benign prostatic hyperplasia (BPH) is a frequent illness in aged men that impacts their quality of life; early childhood exposure to famines may have long-term effects on the chance of developing BPH. The aim of this study is to investigate the relationship between early-life famine exposure and benign prostatic hyperplasia (BPH) risk in Chinese men born during 1959-1961. We used medical records from a large, comprehensive hospital to screen people born in China during the years of famine (1959-1961). Birthplaces were identified as indicators of famine exposure status. In the time window between 2017 and 2022, people born during the famine years who had prostatic ultrasonic examinations were selected, and their medical records were retrieved from the database. Univariate and multivariate logistic regression analyses investigated the relationship between famine exposure and BPH risk. A total of 3,009 subjects were included in this study. Patients with heavy famine exposure had older age, shorter height, lighter weight, lower cholesterol, lower uric acid (UA), lower aspartate aminotransferase (ALT), and a higher incidence of BPH than those with light famine exposure (all p < 0.05). Univariate logistic regression showed that BPH was positively related to famine exposure, age, height, weight, and body mass index (BMI) but negatively related to UA (all p < 0.05). Multivariate logistic regression showed that age and famine exposure were still independent risk factors (p < 0.05), while UA was an independent protective factor for BPH (p < 0.05). Heavy famine exposure increased the risk of BPH (adjusted OR = 1.214, 95% CI = 1.05-1.467, p = 0.045). Famine and malnutrition exposure during early life may be independent risk factors for BPH in Chinese adults. This relationship provides additional evidence to support the fetal origins of adult diseases and offers clues for the pathological mechanisms of BPH.

Early Life Exposure to the Great Chinese Famine (1959-1961) and the Health of Older Adults in China: A Meta-Analysis (2008-2023)

Early Life Exposure to the Great Chinese Famine (1959-1961) and the Health of Older Adults in China: A Meta-Analysis (2008-2023)

Politician’s childhood experience and government policies: Evidence from the Chinese Great Famine

We analyze the impact of a politician’s childhood experience on their policy choices. By exploiting exogenous variations in exposure to China’s Great Famine, we find that a provincial leader’s childhood experience of the famine significantly increases the share of government expenditure allocated to health care during his term. This effect is observed only for those who were aged under five during the famine and is not found among older cohorts. The impact is substantial: our back-of-the-envelope calculation indicates that an increase of one standard deviation in exposure to the famine can lead to an increase of roughly 7.84 billion RMB (equivalent to about 1.19 billion US Dollars) in annual provincial health care expenditure for a province with average government spending in 2017. We provide evidence suggesting that this effect may be driven by a politician’s personal experience of negative health outcomes due to the famine. Furthermore, we observe that China’s political promotion system, which favors economic growth, incentivizes provincial leaders to counterbalance increased health care spending by reducing funding for less visible public services, particularly cultural activities. Such strategic allocations ensure the continuity of other policy areas that are more influential in their political career.

How does early-life famine experience influence household energy transition?

The transition of households towards cleaner energy is crucial for achieving sustainable development goals. However, the impacts and associated mechanisms of early-life experiences on household energy transition have not been considered. Based on data from the 2015 Chinese General Social Survey, this study aimed to investigate whether people experiencing China's Great Famine (1959–1961) in their early life promoted household energy transition in adulthood. The varying severity of the Great Famine in different provinces was characterised as a quasi-natural experiment and was used to perform difference-in-differences (DID) estimation analysis for birth cohorts. The results showed that the transitions from firewood, agricultural waste, and animal waste to liquefied petroleum gas and electricity were significant in households with the Great Famine experiences. Specifically, the long-term energy transition effect of the famine was exhibited mostly in those who experienced the famine during childhood (4–11 years old) and adolescence (12–17 years old). Besides, early-life famine experiences led to poor physical health, and more modern forms of energy, such as electricity, were consumed to avoid further deteriorating health. Early-life famine experience also brought psychological trauma to people at that time, which led them to increase Internet use to gain emotional support, and the increased Internet use provided better access to information about the energy transition. Moreover, the household energy transition influenced by early-life famine experience occurred more in female-headed, rural, more educated, and low-income households. Our results illustrated the role of early-life famine experience in household energy transition and provided new insights into developing effective energy policies.

CEO Early-Life Disaster Experience and Tax Avoidance: Chinese Evidence

Synopsis The research problem This study examines the impact of chief executive officers (CEOs)’ early-life disaster experiences on corporate tax-avoidance behaviors and explores the mechanisms through which these experiences influence these behaviors. We use the Great Chinese Famine of 1959–1961 (hereafter the Great Famine) as an indicator of early-life disaster experience. Motivation or theoretical reasoning Our study is motivated by the following reasons. First, like many major economies worldwide, corporate income tax is an important source of tax revenue in China. The financial impact of corporate income tax on a country’s economy is enormous. Second, the Great Famine was one of the most destructive natural disasters in human history, which is likely to have a lifelong influence on CEOs who lived through the disaster as children and teenagers. Third, corporate tax strategy is a significant accounting, financing, and managerial behavior of firms that is influenced by multiple internal and external factors. However, there are limited findings on the impact of CEOs’ early-life disaster experience on corporate tax decisions. The consequences of this impact remain unclear. The test hypotheses We hypothesize that CEOs’ early-life famine experience mitigates corporate tax aggressiveness. We also consider the alternative hypothesis that CEOs’ early-life famine experience increases corporate tax aggressiveness. Target population Our sample includes Chinese listed firms from 2013 to 2020 led by CEOs who have or who do not have early-life disaster experiences. Adopted methodology We employed ordinary least square regressions in our analyses. Analyses Since the Great Famine occurred between 1959 and 1961, we considered CEOs to have experienced famine if they were born prior to or in the year 1961, in a province affected by the Great Famine (e.g., Hu et al. , 2020 ; Zhang , 2017 ). We identified a province as significantly affected by famine if its abnormal death rate was greater than the median abnormal death ratio of all Chinese provinces during the period of famine. Following Dyreng et al. ( 2010 ), Hoi et al. ( 2013 ), Koester et al. ( 2017 ), and Rego &amp; Wilson ( 2012 ), we used effective tax rate as the first proxy of tax avoidance for a firm. Additionally, in line with Desai &amp; Dharmapala ( 2006 ) and Hoi et al. ( 2013 ), we used the discretionary book-tax differences of firms as an alternative proxy to measure corporate tax avoidance. Findings The findings indicate that CEOs who experienced the Great Famine at a young age significantly reduced their firms’ tax-avoidance efforts. Furthermore, the negative association between CEOs’ early-life famine experiences and corporate tax-avoidance behaviors is more pronounced for companies with higher independent director ratios. These negative associations appear more obvious for firms with CEOs who experienced famine early in life and for females. The economic mechanism of the findings demonstrate that CEOs’ famine experiences make them more conservative in investing in innovative projects; they are more likely to fulfill corporate social responsibility and work in state-owned enterprises. Furthermore, firms with lower innovation expenditure, effective corporate social performance, and government ownership are less likely to display tax-avoidance behaviors.

Early-life exposure to the Great Chinese Famine and gut microbiome disruption across adulthood for type 2 diabetes: three population-based cohort studies

BackgroundThe early life stage is critical for the gut microbiota establishment and development. We aimed to investigate the lifelong impact of famine exposure during early life on the adult gut microbial ecosystem and examine the association of famine-induced disturbance in gut microbiota with type 2 diabetes.MethodsWe profiled the gut microbial composition among 11,513 adults (18–97 years) from three independent cohorts and examined the association of famine exposure during early life with alterations of adult gut microbial diversity and composition. We performed co-abundance network analyses to identify keystone taxa in the three cohorts and constructed an index with the shared keystone taxa across the three cohorts. Among each cohort, we used linear regression to examine the association of famine exposure during early life with the keystone taxa index and assessed the correlation between the keystone taxa index and type 2 diabetes using logistic regression adjusted for potential confounders. We combined the effect estimates from the three cohorts using random-effects meta-analysis.ResultsCompared with the no-exposed control group (born during 1962–1964), participants who were exposed to the famine during the first 1000 days of life (born in 1959) had consistently lower gut microbial alpha diversity and alterations in the gut microbial community during adulthood across the three cohorts. Compared with the no-exposed control group, participants who were exposed to famine during the first 1000 days of life were associated with consistently lower levels of keystone taxa index in the three cohorts (pooled beta − 0.29, 95% CI − 0.43, − 0.15). Per 1-standard deviation increment in the keystone taxa index was associated with a 13% lower risk of type 2 diabetes (pooled odds ratio 0.87, 95% CI 0.80, 0.93), with consistent results across three individual cohorts.ConclusionsThese findings reveal a potential role of the gut microbiota in the developmental origins of health and disease (DOHaD) hypothesis, deepening our understanding about the etiology of type 2 diabetes.

A Link between Prenatal Stage of Life during the Great Chinese Famine and Subsequent Depressive Symptoms among Middle-Aged and Older Adults

Prenatal malnutrition may increase the risk of depressive symptoms in adulthood. This study investigated the association between prenatal exposure to malnutrition with risk of depressive symptoms in middle-aged and older adults using the Chinese Great Famine of 1959–1961 as a natural experiment. Data were obtained from the China Health and Retirement Longitudinal Study baseline survey (2011). A total of 5391 individuals born from 1956 to 1965 were included in the study. Depressive symptoms were ascertained via the Center for Epidemiological Studies Depression Scale short form. Famine severity was measured using the cohort size shrinkage index. Difference-in-differences models were used to explore the association between prenatal famine exposure and later-life depressive symptoms. Compared with the post-famine cohort (1963–1965), famine cohorts (1959–1962) were 4.74 times (95% CI = 1.28–8.20) as likely to develop depressive symptoms. The stratified analysis found that prenatal exposure to famine was associated with depressive symptoms in rural residents but not those living in urban areas. In rural females, prenatal malnutrition was associated with a higher risk of depressive symptoms. However, there was no significant association between prenatal malnutrition and depressive symptoms in rural males. Our results indicated that prenatal malnutrition may contribute to a higher risk for depressive symptoms in later life among female rural residents.

CEOs’ early-life famine experience and corporate donations: Evidence from the great Chinese famine

Do traumatic disaster experiences shape people's prosocial attitudes? Some literature suggests that great resource scarcity experience predicts an increase in prosocial allocations, whereas others suggest a decrease. We find CEOs exposed to the Great Chinese Famine tend to drive corporate donations, which is termed the famine effect. CEOs who have experienced more severe famines, were born in poor and food-deficient areas, or currently work in less developed regions, drive more corporate donations. Regarding board characteristics, the famine effect intensifies in older and more famine-affected directors, but decreases as female directors and board diversity increase. Finally, by examining the effect of CEOs' famine experience on different dimensions of CSR, we intriguingly find CEOs' prosocial attitudes are not oriented toward everyone but are specific to those who suffer from resource scarcity. Overall, CEOs' famine experiences substantially affect corporate donations and can result in recipient-dependent prosocial behaviors.

Associations of famine exposure in early life with height in two consecutive generations in China

Abstract Background Poor nutrition early in life is associated with short stature, which is known to be associated with increased risk of cardiovascular disease and mortality in later life. Less evidence is available about whether early life nutrition affects height growth in the subsequent generation. Objective We aimed to investigate associations of famine exposure in utero and early-childhood with height across two generations. Methods We used the China Health and Nutrition Survey data and included 5,401 participants (F1) born in 1955-66 (the calendar year around the Chinese Great Famine in1959-61) and their 3,930 biological offspring (F2). We classified F1 participants into subgroups by famine exposure status (unexposed/exposed) and timing (fetal-/childhood-exposed) according to their birth year, and grouped F2 by their parents’ exposure. Linear regression models were conducted to evaluate the associations of famine exposure with adult height of F1 and F2. Linear mixed effect models with fractional polynomial functions were performed to estimate the difference in height between exposure groups of F2 during childhood. Results Participants (F1) exposed to famine in utero or childhood were shorter than those unexposed by 0.41 cm (95% CI: 0.03, 0.80) and 1.12 cm (0.75, 1.48), respectively. Offspring (F2) of exposed fathers were also shorter than those of unexposed parents by 1.07 cm (0.28, 1.86) during childhood (&amp;lt;18 years) and by 1.25 cm (0.07, 2.43) in adulthood (≥18 years), and those with exposed parents had a reduced height during childhood by 1.29 cm (0.68, 1.89). The associations were more pronounced among child offspring of highly-educated F1, particularly for paternal exposure and among female offspring (all p for interaction &amp;lt; 0.05). Conclusions The findings support the intergenerational effect of famine exposure in early life on height in Chinese populations, and indicate public health significance to improve nutritional status of mothers and children in the long run. Key messages • Exposure to famine in uteri or early-childhood were associated with a shorter height during adulthood and in their offspring. • The adverse impact of famine exposure was more pronounced among child offspring of highly-educated F1, particularly for paternal exposure and among female offspring.

Long-term mental health cost of the Great Chinese Famine.

The Great Chinese Famine (1959-1961) claimed tens of millions of lives. This study aims to causally examine the long-term mental health cost it imposed on those who survived. To estimate the nationwide total mental health cost, we use a novel dataset to measure the famine intensity of every prefecture-level region, match it to a nationally representative survey, and then identify the long-term effects of the famine on the depression of rural residents then in the early years of their lives. Difference-in-differences estimates reveal that a one-standard-deviation rise in the experienced famine intensity increased a standard measure of depression by about 0.039 and 0.064 if the individual experienced the famine at ages 0-2 and 3-5, respectively. This translates into roughly 7.99million cases of severe depressive symptoms caused by the famine, which is likely an undercount. Examining the mechanisms behind the large effects, we find that important roles were played by starvation experience and childhood maltreatment, as well as the primary mediators including other health outcomes, economic status, and social relationship. Our findings shed light on how large-scale food security failures impact the mental well-being of the survivors.

The intergenerational legacy of the 1959–1961 Great Chinese Famine on children’s cognitive development

We investigate the effect of early exposure to malnutrition on the cognitive abilities of the offspring of survivors in the context of a natural experiment; i.e., the Great Chinese Famine (GCF) of 1959–61. We employ a novel dataset – the China Family Panel Studies (CFPS) – to do so. The paper finds that the cognitive abilities of children whose fathers were born in rural areas during the famine years (1959–1961) were impaired by exposure to the GCF and the negative effect was greater for girls than boys, whereas children whose mothers were born in rural areas during the famine years were not affected. The uncovered gender-specific effect is almost entirely attributable to son preference exhibited in families with male famine survivors.

Do chairmen with China's Great Famine experience in early‐life affect firm tax avoidance activities?

AbstractThis article investigates whether and how chairmen with China's Great Famine experience affect firm tax avoidance activities. We find that the chairmen who experienced China's Great Famine in early‐life engage in fewer tax avoidance activities than other chairmen. This effect is stronger for firms in regions with a weak gambling culture and provinces with higher political uncertainty, nonstate‐owned firms, and chairmen with higher education. We show that a lower‐level risk appetite among chairmen is the primary mechanism driving lower tax avoidance in their firms. Our article provides new insights into the differences in tax avoidance between firms based on whether managers experienced the Great Famine.

Secular trend of non-communicable chronic disease prevalence throughout the life span who endured Chinese Great Famine (1959–1961)

BackgroundFamine is a risk factor for non-communicable chronic diseases (NCDs), which account for over 80% of deaths in China. The effect of famine on the prevalence of NCDs in terms of various age groups, time periods and cohorts is currently poorly understood.ObjectiveThis study aims to explore long-term trends in the impact of China’s Great Famine (1959–1961) on NCDs in China.MethodsThis study used data from the 2010–2020 China Family Panel Longitudinal Survey across 25 provinces in China. The subjects were aged 18–85 years, and the total number of subjects was 174,894. The prevalence of NCDs was derived from the China Family Panel Studies database (CFPS). An age-period-cohort (APC) model was used to estimate the age, period and cohort effects of NCDs in 2010–2020 and the effect of famine on the risk of NCDs in terms of cohort effects.ResultsThe prevalence of NCDs increased with age. Additionally, the prevalence did not clearly decrease over the survey period. Regarding the cohort effect, people born in the years adjacent to the famine period had a higher risk of NCDs; additionally, females, those born in rural areas, and those who lived in provinces with severe famine and post-famine had a higher likelihood of NCDs.ConclusionsExperiencing famine at an early age or the experience of famine in a close relative’s generation (births after the onset of famine) are associated with an increased risk of NCDs. Additionally, more severe famine is associated with a higher risk of NCDs.

Does CEO early-life famine experience affect corporate tax avoidance? Evidence from China

Based on the imprinting theory, this study investigates the effect of CEO early-life famine experience on corporate tax avoidance (CTA). The empirical results show that firms led by CEOs who experienced the Great Chinese Famine (1959–1961) in early life tend to engage in CTA at a lower level. Both CEO duality and higher educational attainment weaken the negative effect of CEO early-life famine experience on CTA. Corporate social responsibility and risk-taking have partial mediating effects between CEO early-life famine experience and CTA. Moreover, heterogeneous analysis indicates that the negative relationship is more pronounced and the moderating effects are both significant in a more munificent and dynamic environment.