The 1958-61 Famine Effects on Middle-Aged Adult Mortality in China: Debilitation versus Selection

Yong Li, Johns Hopkins University

Approximate 30 million people died as a result of the 1958-61 famine in China. Its long-term effects on Chinese mortality are less known. The debilitation role of disaster-induced fetal and infancy nutritional deficiency on adult mortality has been formulated through Barker’s fetal origins hypothesis of chronic disease and supported in various degree from previous studies on Dutch 1944-45 famine and two World Wars. Equally compelling argument is the selection role famine may play. People who managed to survive the disaster were generally selected to be more robust than those who failed, especially for children and adolescents. Current adult mortality of survivors may be relatively lower compared to what would be the case under non-famine condition. Using available mortality data in China and other countries, the long-term effects of 1958-61 famine on current adult mortality are investigated. Evidence is found for both selection and debilitation mechanisms in effect in different ages.