The famine described in the song was a consequence of which of the following?

Famine is a catastrophic event, and it has long been known to be associated with increased mortality. Some investigators claim that, in addition to causing an immediate rise in mortality, famine may also have a “long-term” or “sustained” mortality consequence. In a study of the 1974–1975 Bangladesh famine, Razzaque, Alam, Wai, and Foster [1990] showed that the famine-born cohorts continued to have a higher than usual mortality in the second year of life, one year after the famine was over, then followed by a lower than usual mortality between the ages 2 and 5. Kannisto, Christensen, and Vaupel [1997], in their study of the 1866–1869 Finnish famine, reported that the famine cohort had an higher than usual mortality up to age 17 but no cohort difference afterwards.

In both cases, the famine-born cohorts continued to show a higher mortality than the non-famine cohorts after the famine was over; then the cohort difference in mortality either disappeared [in the Finnish case] or even got reversed [in the Bangladeshi case]. Such a pattern, known to demographers as “mortality crossover” [Nam, 1995], was considered as evidence for both “debilitation effect” – a lingering negative impact of poor nutrition and harsh environment on individual health, and “selection effect” – a result of selective frailty processes on cohort-level mortality difference. Debilitation and selection effects may occur in non-famine situations as well. For example, Caselli and Capocaccia [1989] reported a mortality pattern in Italy that was similar to the Bangladeshi case: cohorts that experienced unfavorable conditions early in life tended to show increased cohort mortality up to a certain age, followed by reduced cohort mortality afterwards. The main difference between the Bangladeshi and Italian studies was the timing of the turning point – the crossover point in Bangladesh occurred at age two, while in Italy it occurred at age 45.

Treating mortality crossover as suggestive evidence for debilitation and selection effects represents an important step toward a better understanding of long-term health consequences of famine. Doing so, however, raises several issues that need further discussion. First of all, the above reasoning implicitly assumes that debilitation and selection effects always work against each other – that debilitation increases mortality of the famine cohort while selection decreases it – in determining the observed cohort mortality trend, but not all researchers accept that assumption without reservation [Elo & Preston, 1992]. Second, the nature and dynamics of selection effects, compared to that of debilitation effects, is much less well understood. For example, while debilitation effect has been suggested to be strong at the beginning of the post-famine era and then gets weaker over time, there has been little discussion regarding whether selection effect follows similar or different trends. Without such knowledge, the claim that mortality crossover indicates changes in relative strength of debilitation and selection effects in the post-famine period becomes much less convincing. This leads to the next point. If, for some reasons, no mortality crossover is observed after a famine, what can we say about debilitation and selection?

In this research, I examined long-term mortality consequences of the 1959–1961 Great Leap Forward Famine in China. I first reviewed conceptual and methodological issues in identifying debilitation and selection effects. Then I proposed a statistical approach to isolate selection effect, borrowing strength from the recent developments in multilevel multiprocess latent variable modeling methodology [Lillard, 1993, Panis and Lillard, 1995, Steele et al., 2005]. Using data from a large representative national sample survey conducted in 1988 in China, I [1] identified mortality crossover between the famine and the non-famine cohort; [2] demonstrated that famine may “reduce” mortality level of the famine cohort in the post-famine period by eliminating its frail members first; and [3] showed that both debilitation and selection effects declined with time, and debilitation effect declined faster than selection effect.

Cited by [37]

• 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

  2022, Social Science and Medicine

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  Very limited studies focused on the early-life adversities on infectious diseases. Taking the Great Chinese famine as a natural experiment, this study re-evaluated the long-term effect of prenatal famine exposure on infectious diseases by using nationally representative data.

  Using difference-in-difference [DID] models, we analyzed 215,216 adults who participated in the Second National Sample Survey on Disability in 2006 across 734 counties of China to detect the effects of prenatal exposure to the Great Chinese Famine on the risk of infectious diseases in adulthood. Infectious diseases were ascertained by using the combination of self-reports or family members’ reports and on-site medical diagnosis by experienced specialists, and the severity of famine was measured by the cohort size shrinkage index [CSSI] at the county level.

  All DID estimates of the effects of famine on the probability of infectious diseases were insignificant, with a coefficient of 0.0007 [−0.0024, 0.0026] for all participants and coefficients of 0.0001 [−0.0041, 0.0043] and −0.0002 [−0.0036, 0.0033] for males and females, respectively. That is, the famine cohort dwelling in regions with a greater intensity of famine had similar levels of infectious disease risks than the cohorts with post-famine prenatal exposure experience in less affected famine regions. Furthermore, there were no significant famine and post-famine cohort differences in the DID estimates by examining the variations in subgroups with different types of infectious diseases [trachoma, poliomyelitis, tuberculosis, maternal infections and other infectious diseases].

  No significant impact of prenatal exposure to the Chinese famine was observed on the risk of infectious diseases in adulthood. Famine survivors may be “cured” by the famine and were resilient to adverse environments in their life course because selective mortality may weaken the association between adverse prenatal exposure and later health.

• Differential regulation of the DNA methylome in adults born during the Great Chinese Famine in 1959–1961

  2021, Genomics

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  Extensive epidemiological studies have established the association between exposure to early-life adversity and health status and diseases in adults. Epigenetic regulation is considered as a key mediator for this phenomenon but analysis on humans is sparse. The Great Chinese Famine lasting from 1958 to 1961 is a natural string of disasters offering a precious opportunity for elucidating the underlying epigenetic mechanism of the long-term effect of early adversity.

  Using a high-throughput array platform for DNA methylome profiling, we conducted a case-control epigenome-wide association study on early-life exposure to Chinese famine in 79 adults born during 1959–1961 and compared to 105 unexposed subjects born 1963–1964.

  The single CpG site analysis of whole epigenome revealed a predominant pattern of decreased DNA methylation levels associated with fetal exposure to famine. Four CpG sites were detected with p