Impact of Famine Exposure in Utero on Labor Market Behavior and Health Later in Life

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In this paper, we study the long-term causal effects of the DutchFamine on labor market and healthbehavior later in life (55-70). To acknowledge the dynamic nature oflabor market changes we focus onthe impact of the famine on the timing of becoming disabled or retired.To acknowledge the dynamicnature of health behavior, medication use and health expenditures, we focus on the impact of thefamine on the changes over time of medication use and health expenditures, both categorized. In allanalyses we use a non-linear Difference-in-difference approach to identify the the causal impact offamine exposure in utero on later life outcomes.We account for selective fertility, by restricting our analysis to those conceived before the famine,and for selective survival using either an inverse propensity weighting method or a Copula approach.For the empirical analysis we used data of military recruits born around the Dutch famine (1944-1947) linked to the Dutch mortality register (deaths trough 2014)and linked to individual adminis-trative data on the monthly labor market status (1999-2013), onthe annual income (2003-2013), onannual prescribed medications (2006-2013), and, on annual insured health costs (2009-2013).We find that famine exposure in the first trimester of gestation accelerates the timing of disabil-ity, decreases labor income and increases the expenditures for mental health. Exposure in the secondtrimester decreases expenditure for medications. Exposure in the third trimester increases medicationuse for mental diseases.
Original languageEnglish
Publication statusPublished - Apr 2019


  • Famine
  • Health


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