The Intergenerational Transmission of Health in the long-run: Exploring dynamic patterns across Africa

Africa remains the poorest and one of the most unequal regions globally, with limited upward mobility and strong intergenerational persistence of disadvantage. Child health is a key channel of transmission, shaping later outcomes in education, labour force participation, and earnings. This paper investigates long-run trends in the intergenerational transmission of health across 29 African countries over 1975–2015, using 123 rounds of the Demographic and Health Surveys covering more than three million children. I measure child health by under-five mortality and maternal health by adult height. Results show strong persistence: taller mothers have significantly lower child mortality, with effects varying across countries and correlated with development levels. Over time, persistence first increased, then declined from the mid-1990s, consistent with the inverse care law. A dynamic panel analysis reveals that healthcare provision, education, institutional quality, and inequality—rather than GDP alone—explain these heterogeneous trajectories. Convergence tests suggest conditional convergence, with countries clustering into distinct mobility clubs. The findings underscore the role of structural and institutional factors in shaping intergenerational health mobility.