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

一个重要的来源，观察到的变化，在跨国经济业绩的差异是在人力资本禀赋（曼昆，罗默和韦尔，1992年）。特别是，健康已被证明是发展中国家成果的重要决定因素（Bleakley，2010）。越来越多的证据支持胎儿起源假说-母亲在怀孕期间经历的不利营养冲击对后代未来的健康/人力资本结果产生重大影响，因此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的影响的证据已经很好地建立，但对心理健康和社会情感能力发展的影响仍然相对未被探索。使用Heckman（2007）和合著者开发的概念框架，该项目将研究发展中国家在子宫内经历的营养冲击对个人在青春期后期的福祉和社会情感结果的影响。为此，将把“年轻生命调查”的数据与客观的区域降雨量和粮食价格数据结合起来，这些数据表明产妇营养受到的外来冲击。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对未来的心理健康，特别是社会情感功能有因果关系？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？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）。经济学家已经测试了该假设对健康以外的一系列广泛结果的预测，包括教育程度和就业前景（Currie和Hyson，1999年; Oreopoulos等人，2008年），婚姻状况（Vogel，Siow和Brandt，2010年）和代际影响（Currie和Moretti，2007年）;对健康影响的研究主要涉及身体健康，最近有一些例外，只有两项研究提供了发展中国家的证据。Adhvaryu等人（2014年）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年）则关注产前暴露于温度冲击对预测19个国家成年人的抑郁症状的影响。独特的是，这项研究将强调对社会情感能力的影响，如同伴关系，自尊，个性和情感功能，从子宫内经历的营养休克。影响本研究扩展了现有的文献，扩大了研究结果的范围，包括社会情感能力和-考虑到重复测量的数据-研究如何在不同的发展阶段表现的影响。这些发现将对公共卫生政策决策具有重要意义：心理健康障碍占全球疾病负担的13%，仅抑郁症就代表了全球疾病负担的第三大单一贡献（柯林斯等人，2011年）。发展中国家的社会成本最高，无论是在医疗保健成本还是对社会发展的影响方面，但这些国家提供治疗和支持的能力最差。鉴于社会情感技能和亲社会行为在儿童、青少年以及随后在劳动力市场上的重要性（Hay、Payne和Chadwick，2004年），研究结果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，干预改善个人机会的最佳时机是在他们出生之前。

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.