Working Paper: NBER ID: w20166
Authors: Mingjen Lin; Elaine M. Liu
Abstract: This paper tests whether in utero conditions affect long-run developmental outcomes using the 1918 influenza pandemic in Taiwan as a natural experiment. Combining several historical and current datasets, we find that cohorts in utero during the pandemic are shorter as children/adolescents and less educated compared to other birth cohorts. We also find that they are more likely to have serious health problems including kidney disease, circulatory and respiratory problems, and diabetes in old age. Despite possible positive selection on health outcomes due to high infant mortality rates during this period (18 percent), our paper finds a strong negative impact of in utero exposure to influenza.
Keywords: Influenza; Fetal Origins Hypothesis; Maternal Mortality; Health Outcomes
JEL Codes: I12; I19; N35
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| in utero exposure to influenza pandemic (I12) | worse outcomes in terms of height, education, and health conditions in old age (I14) |
| 1919 birth cohort (N32) | 0.08 fewer years of education than surrounding cohorts (I24) |
| 1920 birth cohort (J11) | 0.04 fewer years of education than surrounding cohorts (I24) |
| increase in maternal mortality rates (J13) | reduction in years of schooling (I21) |
| increase in maternal mortality rates (J13) | decrease in height (I14) |
| in utero influenza exposure (J13) | increased risks of serious health problems in later life (I12) |
| in utero exposure to adverse conditions (I12) | significant long-term effects on health and education (I24) |