Fetal Exposure to the 1918 Influenza Pandemic in Colonial Korea and Human Capital Development

By Hong, Sok Chul; Yun, Yangkeun | Seoul Journal of Economics, January 1, 2017 | Go to article overview

Fetal Exposure to the 1918 Influenza Pandemic in Colonial Korea and Human Capital Development


Hong, Sok Chul, Yun, Yangkeun, Seoul Journal of Economics


(ProQuest: ... denotes formulae omitted.)

I.Introduction

The influenza pandemic of 1918 was the deadliest disease disaster in 20th-century human history; the pandemic infected 500 million people and killed approximately 50 million across the world. This traumatic event provides researchers with a quasi-experimental framework for testing fetal origins hypothesis, a widely known theory that the prenatal exposure to negative health shocks has persistent effects on later health and socioeconomic outcomes. Previous studies have analyzed the 1918 influenza pandemic experienced in various countries to identify the causal association between in utero conditions and later socioeconomic outcomes (Almond 2006; Lin, and Liu 2014; Neelsen, and Stratmann 2012; Nelson 2010). For effective identification, studies have used cohort studies that compare outcome variables across birth cohorts and regional variations in pandemic intensity. The studies have consistently found that cohorts significantly exposed to the pandemic in utero experienced lower educational attainment, low wages and income, and poor health conditions in later life.

This current study seeks similar evidence from the historical experience of colonial Korea. Korea, which was under Japanese rule from 1910 to 1945, experienced the influenza pandemic from October to December 1918. The pandemic in colonial Korea occurred over a short period and mortally infected approximately 44.3% of the Korean population. Thus, the experience of colonial Korea provides a useful historical framework for identifying the causal effect of in utero insults as do studies on other countries including Brazil, Switzerland, Taiwan, and the United States.

However, the merits of studying colonial Korea include other aspects. First, colonial Korea experienced various nationwide traumatic events during the years 1919 and 1920 including an independence movement, crop failure, another wave of influenza pandemic, a great flood, and a cholera outbreak. These events were as influential to the health and nutritional status of fetuses and infants as those of the 1918 influenza pandemic. Thus, such turbulent situations are useful in distinguishing the significance of influenza from other comparable events and the significance of fetal exposure to external shocks and exposure in infancy. Second, the educational environment in colonial Korea had distinct characteristics. The country's system and national support for modern education were inferior and highly inadequate throughout the early 20th century. Household resources for education were heavily concentrated on primary education and sons. Thus, this study will advance the understanding as to whether the association between fetal health and lifetime development is distinctive under such inferior educational environments.

Similar to previous studies, we assume that the birth cohort born in 1919 was largely affected by the pandemic in utero (i.e., the first difference) and utilize regional variations in pandemic intensity measured by the influenza death rate (i.e., the second difference). To prove the validity of this approach, we discuss potential selection issues and provide quantitative evidence supporting that pregnant women and fetuses were at high obstetric risk during the pandemic period.

The key finding of this study is that, as people spent the fetal period in provinces severely affected by the pandemic, they achieved significantly lower educational attainment. The gap between the most and least-affected birth provinces amounts to approximately 10% for years of schooling and 8% for literacy rates as a percentage of each outcome variable's sample mean. It is intriguing that the estimated magnitude of the adverse effects is estimated to be more substantial for higher education than primary schooling, and for males than females in colonial Korea. This seems to be closely associated with the distinct educational environment in colonial Korea. …

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