Abstract：
This paper investigates health impacts at the end of adolescence of prenatal exposure to multiple shocks, by exploiting the unique natural experiment of the Dutch Hunger Winter. At the end of World War II, a famine occurred abruptly in the Western Netherlands (November 1944-May 1945), pushing the previously and subsequently well-nourished Dutch population to the brink of starvation. We link high-quality military recruits data with objective health measurements for the cohorts born in the years surrounding WWII with newly digitised historical records on calories and nutrient composition of the war rations, daily temperature, and warfare deaths. Using difference-in-differences and triple differences research designs, we first show that the cohorts exposed to the Dutch Hunger Winter since early gestation have a higher Body Mass Index and an increased probability of being obese at age 18. We then find that this effect is partly moderated by warfare exposure and a reduction in energy-adjusted protein intake. Lastly, we account for selective mortality using a copula-based approach and newly-digitised data on survival rates, and find evidence of both selection and scarring effects. These results emphasise the complexity of the mechanisms at play in studying the consequences of early conditions.
摘要：
本文调查了产前暴露于多次电击对青春期结束时健康的影响，通过利用荷兰饥饿冬季的独特自然实验。在第二次世界大战结束时,荷兰西部突然发生饥荒（1944年11月至1945年5月），将以前和后来营养丰富的荷兰人口推向饥饿的边缘。我们将高质量的新兵数据与二战前后出生的队列的客观健康测量与战争口粮的卡路里和营养成分的最新数字化历史记录联系起来，每日温度,战争死亡。使用差异和三重差异研究设计，我们首先表明,从妊娠早期开始暴露于荷兰饥饿冬季的队列具有较高的身体质量指数,并且在18岁时肥胖的可能性增加.然后，我们发现这种影响部分受到战争暴露和能量调节蛋白质摄入量减少的影响。最后,我们使用基于copula的方法和新数字化的生存率数据来解释选择性死亡率，并找到选择和疤痕效应的证据。这些结果强调了研究早期条件后果的机制的复杂性。
