Windows of Vulnerability: Consequences of Exposure Timing during the Dutch Hunger Winter

Prior research on early-life exposures to famine has established in utero development as a critical period of vulnerability to malnutrition. Yet, previous research tends to focus narrowly on this stage, at the expense of a more comprehensive examination of childhood. As a result, the literature has yet to compare the severity of the consequences of exposure to malnutrition across developmentally salient periods. Such comparison is crucial not only in the magnitude of effects but also in the nature of outcomes. Using a restricted population registry-linked health survey, this study examines the Dutch Hunger Winter to provide a comprehensive examination of the long-term consequences of in utero, infant, childhood, and adolescent exposure to famine. The results show malnutrition leads to heterogeneous effects depending on when the exposure occurs. In utero exposure to malnutrition leads to deleterious conditions in physical health and lower socioeconomic attainment. For older cohorts, results suggest a resilience to the effects of malnutrition on physical health in late life, but a higher vulnerability to socioeconomic stunting. Furthermore, the results suggest important gender differences in the long-term impact of malnutrition. Males consistently show stronger negative consequences across a wider array of conditions.

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Work Title Windows of Vulnerability: Consequences of Exposure Timing during the Dutch Hunger Winter
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Open Access
Creators
  1. Daniel Ramirez
  2. Steven Haas
License CC BY-NC 4.0 (Attribution-NonCommercial)
Work Type Article
Publisher
  1. Population and Development Review
Publication Date September 14, 2022
Publisher Identifier (DOI)
  1. https://doi.org/10.1111/padr.12513
Deposited January 23, 2024

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  • Added Ramirez_Haas_PDR_2022-1.pdf
  • Added Creator Daniel Ramirez
  • Added Creator Steven Haas
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    Work Title
    • Windows of Vulnerability: Heterogeneous Late life Consequences Contingent on the Timing of Exposure to Malnutrition Throughout Early Life
    • Windows of Vulnerability: Consequences of Exposure Timing during the Dutch Hunger Winter
    Description
    • Prior research on early-life exposures to famine and its consequences on late-life health and socioeconomic status has established in-utero development as a critical period of vulnerability to malnutrition. Yet, previous research tends to focus narrowly on this stage, at the expense of a more comprehensive examination of childhood. As a result, the literature has yet to compare the severity of the consequences of exposure to malnutrition across developmentally salient periods. Such comparison is crucial not only in magnitude of effects, but also in the nature of outcomes. Using a unique combination of population registries and detailed health surveys to study the Dutch Hunger Winter, this study provides a comprehensive examination of the long-term consequences for in-utero, infant, childhood, and adolescent exposure to famine. The results show malnutrition leads to heterogeneous effects depending on when the exposure occurs. Exposure to malnutrition during in-utero stages leads to deleterious conditions in physical health and lower position in socioeconomic hirearchies. For older cohorts, results suggest a resilience to the effects of malnutrition on physical health in late life, but a higher vulnerability to cognitive abilities and socioeconomic indicators. Furthermore, the results suggest important gender differences in the long-term impact of malnutrition. Male babies exposed while in-utero show stronger negative consequences and a wider array of conditions. Ultimately, this study contributes to the notion that there are multiple critical periods of exposure to malnutrition and these vary in vulnerability and nature of outcomes.
    • Prior research on early-life exposures to famine has established in utero development as a critical period of vulnerability to malnutrition. Yet, previous research tends to focus narrowly on this stage, at the expense of a more comprehensive examination of childhood. As a result, the literature has yet to compare the severity of the consequences of exposure to malnutrition across developmentally salient periods. Such comparison is crucial not only in the magnitude of effects but also in the nature of outcomes. Using a restricted population registry-linked health survey, this study examines the Dutch Hunger Winter to provide a comprehensive examination of the long-term consequences of in utero, infant, childhood, and adolescent exposure to famine. The results show malnutrition leads to heterogeneous effects depending on when the exposure occurs. In utero exposure to malnutrition leads to deleterious conditions in physical health and lower socioeconomic attainment. For older cohorts, results suggest a resilience to the effects of malnutrition on physical health in late life, but a higher vulnerability to socioeconomic stunting. Furthermore, the results suggest important gender differences in the long-term impact of malnutrition. Males consistently show stronger negative consequences across a wider array of conditions.
  • Updated