The long-term health consequence of the 1958-61 Great Leap Forward and famine in China: Life-stage exposure and later-life frailty

This paper examines the long-term health consequences of exposure to the 1958-61 Great Leap Forward movement and famine in China among individuals born between 1910-68 (n=19,426). We used a cross-sectional Difference-in-Differences approach to compare cohorts exposed to the GLF at different life stages, while accounting for several types of selection bias. The results show that compared with unexposed individuals, exposure to the GLF at ages 0-3 and 4-11 was associated with a 0.021 and 0.042, respectively, increase in later-life frailty. In contrast, no significant adverse effects were observed among individuals exposed during adolescence or adulthood. The results further revealed that only significant adverse effects were observed among men. These findings highlight the importance of the early-life experience of extreme external events in shaping long-term health outcomes.