The long-term effects of the 1958--1962 famine on adult mortality in China.

摘要

Fetal origins hypothesis proposes that fetal undernutrition triggers fetal programming, which can permanently change the fetus' structure, physiology, and metabolism, and consequently increases the offspring's susceptibility to chronic disease in later life (Barker, 1998). This study investigated the long-term effects of the in utero famine exposure on adult mortality for the Chinese cohorts born during a great famine in 1958-62.;Using mortality data from China's Censuses and the Chinese Disease Surveillance Points System in the 1990s, cohort analyses were conducted to estimate the average mortality deviation for the 1958-62 cohorts on both national and provincial level and by causes-of-death. Results show that on the nation level, the 1958-62 Chinese cohorts had not experienced increased mortality up to their early 40s in 2000. In several provinces with most severe exposure to famine, such as Sichuan, it is found that males of the famine cohorts experienced elevated adult mortality in 2000. Furthermore, the association between the famine exposure and the mortality deviation for the famine cohorts is found positive and statistically significant across provinces for males, particularly for rural males. By causes-of-death, the detrimental effects of the famine exposure in utero are found to be related with cardiovascular disease.;The findings suggest the long-term detrimental effects of the famine exposure in utero can be significant for adults who had severe fetal undernutrition, particularly for males. Future research is needed to further study the trajectory of health and mortality for the people exposed to famine in utero and differentials between sexes to fully reveal the long-term effects of the great famine in China.