LONG-TERM AND INTERGENERATIONAL EFFECTS OF EARLY-LIFE EXPOSURE TO THE 1959–1961 CHINESE FAMINE ON HEALTH

Undernutrition in early life is associated with increased risk of poor health and mortality in later life. Less is known if the health effects of early-life undernutrition transmit across generations. This study examined the associations between early-life famine exposure and self-rated health in the first generation (F1) and the subsequent generation (F2). We used data from the China Health and Retirement Longitudinal Study (2011-2020, 11,000 participants). We classified F1 participants by famine exposure (exposed/unexposed) and timing at famine exposure (exposed in utero, infancy, pre-school, primary school, or adolescence); we classified F2 offspring by their parents’ famine exposure status. We performed growth curve models to investigate the associations between early-life famine exposure and self-rated health in F1 and F2. The first generation (F1) exposed to famine in utero, infancy, pre-school, primary school, or adolescence had poorer self-rated health than those unexposed (IRR=1.06, 95% CI [1.04 – 1.07], p <.001). The offspring generation (F2) whose parents were exposed to famine also had poorer self-rated health than those of unexposed parents (IRR=1.05, 95% CI [1.01 – 1.10], p <.05). Findings of this study show the long-term and intergenerational effects of early-life famine exposure on health, indicating cumulative advantage and disadvantage over the life course and across generations. Our study highlights the need to prevent and treat child/adolescent undernutrition to improve health in the long run.