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Famine, death, and madness: Schizophrenia in early adulthood after prenatal exposure to the Chinese Great Leap Forward Famine

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  • Song, Shige
  • Wang, Wei
  • Hu, Peifeng

Abstract

Using data from large scale, nationally representative sample surveys, we tested the hypothesis that prenatal exposure to famine increases schizophrenia risk at adulthood by studying the Great Leap Forward Famine in China (1959-1961). Our results show that, in the urban population, being conceived and born during the famine increased the risk of developing schizophrenia at early adulthood as compared to both the pre-famine and post-famine cohorts. In the rural population, however, the post-famine cohort had the highest risk of developing schizophrenia, and there was virtually no difference in schizophrenia risk between the pre-famine and the famine cohort. This finding contrasts sharply with previous studies on the Dutch Hunger Winter as well as with smaller scale local studies in China based on hospital records. We offer an explanation for the urban-rural difference in the schizophrenia-famine relationship based on population selection by differential excess mortality and provide supportive evidence through province- and cohort-level ecological analysis

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  • Song, Shige & Wang, Wei & Hu, Peifeng, 2009. "Famine, death, and madness: Schizophrenia in early adulthood after prenatal exposure to the Chinese Great Leap Forward Famine," Social Science & Medicine, Elsevier, vol. 68(7), pages 1315-1321, April.
    • Handle: RePEc:eee:socmed:v:68:y:2009:i:7:p:1315-1321
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    References listed on IDEAS

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    1. Kim, Seonghoon & Deng, Quheng & Fleisher, Belton M. & Li, Shi, 2014. "The Lasting Impact of Parental Early Life Malnutrition on Their Offspring: Evidence from the China Great Leap Forward Famine," World Development, Elsevier, vol. 54(C), pages 232-242.
    2. Chen, Xi, 2022. "Early Life Circumstances and the Health of Older Adults: A Research Note," IZA Discussion Papers 15511, IZA Network @ LISER.
    3. Mu, Ren & Zhang, Xiaobo, 2011. "Why does the Great Chinese Famine affect the male and female survivors differently? Mortality selection versus son preference," Economics & Human Biology, Elsevier, vol. 9(1), pages 92-105, January.
    4. Huang, Wei & Zhou, Yi, 2013. "Effects of education on cognition at older ages: Evidence from China's Great Famine," Social Science & Medicine, Elsevier, vol. 98(C), pages 54-62.
    5. Ana Maria Oviedo & Harry Moroz, 2013. "A Review of the Ex Post and Ex Ante Impacts of Risk," World Bank Publications - Reports 16333, The World Bank Group.
    6. Fang, Feifan & Zhao, Yinyu & Xi, Zemiao & Han, Xinru & Zhu, Yuchun, 2023. "The impact of famine experience on middle-aged and elderly individuals’ food consumption: Evidence from China," The Journal of the Economics of Ageing, Elsevier, vol. 26(C).
    7. Ó Gráda, Cormac & Lee, Chihua & Lumey, L. H., 2023. "How Much Schizophrenia Do Famines Cause?," MPRA Paper 119448, University Library of Munich, Germany.
    8. Xu, Hongwei & Li, Lydia & Zhang, Zhenmei & Liu, Jinyu, 2016. "Is natural experiment a cure? Re-examining the long-term health effects of China's 1959–1961 famine," Social Science & Medicine, Elsevier, vol. 148(C), pages 110-122.
    9. Ko, Pei-Chun & Yeung, Wei-Jun Jean, 2019. "Childhood conditions and productive aging in China," Social Science & Medicine, Elsevier, vol. 229(C), pages 60-69.
    10. Mokhtari, MohammadAli, 2023. "Opioids ease my pain: Early-life malnutrition and elderly outcomes," Social Science & Medicine, Elsevier, vol. 327(C).
    11. Chen, Siyuan & Bracke, Piet & Delaruelle, Katrijn, 2025. "Walking to the same winter: Urban-rural disparities in pain among middle-aged and older Chinese," Social Science & Medicine, Elsevier, vol. 366(C).
    12. He, Ping & Luo, Yanan & Ding, Ruoxi & Zheng, Xiaoying, 2022. "Is it just a cure? Re-evaluating the effects of prenatal exposure to the Great Chinese Famine on the risk of infectious diseases in adulthood," Social Science & Medicine, Elsevier, vol. 314(C).
    13. Song, Shige, 2013. "Identifying the intergenerational effects of the 1959–1961 Chinese Great Leap Forward Famine on infant mortality," Economics & Human Biology, Elsevier, vol. 11(4), pages 474-487.
    14. Chen, Qihui & Deng, Tinghe & Pei, Chunchen & Wang, Chengcheng, "undated". "Memory of Famine – Does Childhood Experience of Severe Food Shortage Affect Food Choice in Old Age?," 2018 Annual Meeting, August 5-7, Washington, D.C. 273897, Agricultural and Applied Economics Association.
    15. Huang, Cheng & Phillips, Michael R. & Zhang, Yali & Zhang, Jingxuan & Shi, Qichang & Song, Zhiqiang & Ding, Zhijie & Pang, Shutao & Martorell, Reynaldo, 2013. "Malnutrition in early life and adult mental health: Evidence from a natural experiment," Social Science & Medicine, Elsevier, vol. 97(C), pages 259-266.
    16. Shige Song, 2013. "Prenatal malnutrition and subsequent foetal loss risk: Evidence from the 1959-1961 Chinese famine," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 29(26), pages 707-728.
    17. Song, Shige, 2014. "Evidence of adaptive intergenerational sex ratio adjustment in contemporary human populations," Theoretical Population Biology, Elsevier, vol. 92(C), pages 14-21.
    18. Li, Yanan & Sunder, Naveen, 2021. "What doesn’t kill her, will make her depressed," Economics & Human Biology, Elsevier, vol. 43(C).
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    20. Song, Shige, 2010. "Mortality consequences of the 1959-1961 Great Leap Forward famine in China: Debilitation, selection, and mortality crossovers," Social Science & Medicine, Elsevier, vol. 71(3), pages 551-558, August.

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