Effects of Prenatal malnutrition on socio-emotional development: Evidence from Young Lives

概述观察到的跨国经济表现差异的一个重要来源是人力资本禀赋的差异（Mankiw、Romer 和 Weil，1992）。特别是，健康已被证明是发展中国家结果的重要决定因素（Bleakley，2010）。越来越多的证据支持胎儿起源假说——母亲在妊娠期间经历的不良营养冲击对后代未来的健康/人力资本结果产生重大影响，从而影响他们未来的收入潜力（Almond、Currie 和 Duque，2018）。虽然对未来身体健康结果影响的证据已得到充分证实，但对心理健康和社会情感能力发展的影响仍然相对未得到探索。该项目将使用 Heckman (2007) 和合著者开发的概念框架对健康资本的发展进行建模，研究子宫内经历的营养冲击对发展中国家青春期后个人的福祉和社会情感结果的影响。为此，年轻生命调查的数据将与客观的区域降雨量和粮食价格数据相结合，这些数据表明对孕产妇营养的外源性冲击。这项研究的总体目标是考虑：在子宫内暴露于营养冲击是否会对未来的心理健康，特别是社会情感功能产生因果影响？这些影响是否在特定的发展阶段表现出来：儿童期、青春期或成年早期？背景现代经济学的贡献解决了对流行病学早期工作的批评，并采用了广泛的假设检验（Paneth 和 Susser，1995）。经济学家已经在健康以外的一系列广泛结果上测试了该假设的预测，包括教育程度和就业前景（Currie 和 Hyson，1999；Oreopoulos 等，2008）、婚姻状况（Vogel、Siow 和 Brandt，2010）以及代际效应（Currie 和 Moretti，2007）；对健康影响的研究主要关注身体健康，最近有一些例外，只有两项研究提供了针对发展中国家的证据。阿德瓦尤等人。 (2014) 评估了加纳出生年份可可价格冲击对经历严重心理困扰的可能性的影响，而 Adhvaryu 等人。 (2015) 重点研究了产前暴露于温度冲击对预测 19 个国家成年人抑郁症状的影响。独特的是，这项研究将强调子宫内经历的营养冲击对社会情感能力的影响，例如同伴关系、自尊、个性和情感功能。影响 这项研究扩展了现有文献，扩大了研究结果的范围，将社会情感能力包括在内，并且通过对数据的重复测量，研究了影响在不同发展阶段的表现方式。研究结果将对公共卫生政策决策具有重要意义：精神健康障碍占全球疾病负担的 13%，仅抑郁症就占全球疾病负担的第三大单一因素（Collins 等，2011）。无论是在医疗保健费用还是对社会发展的影响方面，发展中国家的社会成本最高，但这些国家提供治疗和支持的能力却最差。鉴于社会情感技能和亲社会行为在童年、青春期以及随后在劳动力市场中的重要性（Hay、Payne 和 Chadwick，2004 年），这些发现可能会产生根本性的影响。旨在改善孕产妇营养的简单干预措施可能对降低发展中国家的成本产生重大影响 - 这表明进行干预以改善个人机会的最佳时间是在他们出生之前。

OverviewAn important source of the observed variation in cross-country economic performance are differences in human capital endowment (Mankiw, Romer and Weil, 1992). In particular, health has been shown to be an important determinant of outcomes for developing countries (Bleakley, 2010). There is growing evidence to support the Foetal Origins Hypothesis - that adverse nutritional shocks experienced by the mother during the gestation period have significant impacts on future health/human capital outcomes for the offspring, and hence their future earning potential (Almond, Currie and Duque, 2018). While evidence of the impacts on future physical health outcomes are well established, the impact of on mental wellbeing and the development of socio-emotional abilities remains relatively unexplored.Modelling the development of health capital, using the conceptual framework developed by Heckman (2007) and co-authors, this project will examine the effect of nutritional shocks experienced in utero on an individual's well-being and socio-emotional outcomes later in adolescence in developing countries. For this purpose, data from the Young Lives Survey will be combined with objective regional rainfall and food price data, which indicate exogenous shocks to maternal nutrition. The overall aim of this research is to consider:Does in utero exposure to nutritional shocks have a causal effect on future mental well-being, specifically socio-emotional functioning?Do these effects manifest at a specific stage of development: within childhood, adolescence, or early adulthood?ContextModern contributions in economics addresses criticisms of earlier work in epidemiology, and employ extensive hypothesis testing (Paneth and Susser, 1995). Economists have tested the predictions of the hypothesis on a broad series of outcomes beyond health, including educational attainment and employment prospects (Currie and Hyson, 1999; Oreopoulos et al., 2008), marital status (Vogel, Siow and Brandt, 2010), and inter-generational effects (Currie and Moretti, 2007); subjecting it to rigorous testing.Studies of effects on health are predominantly concerned with physical health, with a few recent exceptions, and only two studies have provided evidence on developing countries. Adhvaryu et al. (2014) assess the effect of cocoa price shocks in Ghana in year of birth on the likelihood of experiencing severe psychological distress, while Adhvaryu et al. (2015) focus on the effect of prenatal exposure to temperature shocks in predicting depressive symptoms from a cross-section of adults in 19 countries. Uniquely, this research will emphasise the effect on socio-emotional abilities such as peer-relations, self-esteem, personality and emotional functions from a nutritional shock experienced in utero. Impact This research expands on existing literature, broadening the scope of outcomes studied to include socio-emotional competencies and -given repeated measurements of data - examines how effects manifest at different stages of development. The findings will carry significance for public health policy decisions: mental health disorders constitute 13 percent of the global disease burden, depression alone representing the third largest single contribution to the global disease burden (Collins et al., 2011). The cost to society is highest for developing countries, both in terms of healthcare costs and the effects on social development, yet these countries are least equipped to offer treatment and support. Given the importance of socio-emotional skills and pro-social behaviour in childhood, adolescence, and subsequently in the labour market (Hay, Payne and Chadwick, 2004), the findings could have radical implications. Simple interventions aimed at improving maternal nutrition could have substantial effect in mitigating costs for developing countries - suggesting the optimum time to intervene to improve an individual's opportunities is before they are even born.