という少し毛色の変わったNBER論文が上がっている。原題は「Historical Origins of a Major Killer: Cardiovascular Disease in the American South」で、著者はオハイオ州立大のRichard H. SteckelとGarrett Senney。

When building major organs the fetus responds to signals via the placenta that forecast post-natal nutrition. A mismatch between expectations and reality creates physiological stress and elevates several noninfectious chronic diseases. Applying this concept, we investigate the historical origins of cardiovascular disease (CVD) in the American South using rapid income growth from 1950 to 1980 as a proxy for socioeconomic forces that created unbalanced physical growth among southern children born after WWII. Using state-level data on income growth, smoking, obesity and education, we explain over 70% of the variance in current CVD mortality rates across the country.


According to the mechanism of developmental programming, the placenta acts as if it contains a small “biological econometrician” who forecasts the future environment for the developing fetus and accordingly tailors the organs such as the heart, kidneys, and pancreas to promote survival at least through the age of reproduction. The forecasting model draws upon not only current nutritional experiences of the mother but also those of earlier generations going back to the great grandmother. Although the precise biochemical mechanisms and strength of intergenerational linkages are subject to debate, medical research has established a useful empirical pattern that economists have applied to understand the long-term outcomes of stressful events such as the 1918 flu pandemic and the Great Chinese Famine of 1958-1962.
Our paper makes two important contributions. First, the analysis confirms or is at least consistent with the developmental origins hypothesis as applied to CVD in explaining regional differences in mortality within the United States in 2010. Second, the impact on mortality of rapidly improving intergenerational conditions during the middle of the twentieth century increases with age across the groups 55-64 to 75-84. This suggests that the penalties of unbalanced physical growth increase when the developing body has less ability to adapt to a new environment. Individuals aged 75-84 in 2010 were born from 1926-1935 and were young adults with fixed biological structures, when dramatic social and economic change transformed the South after 1950.

The traditional southern diet was a disaster for heart disease when accompanied by a decline in physical labor and habits that eschewed recreational exercise. The southern diet is gradually changing but fried foods such as chicken, catfish and hushpuppies remain popular to this day. Pockets of strong dietary tradition linger in many rural regions, a pattern that offers an opportunity to study CVD at the county level. A topic untouched by the evidence analyzed here is the consequence of duration of relative poverty and affluence on CVD mortality. One might reasonably hypothesize that for a given increase in income, children of those women having had longer intergenerational experiences of poverty may have had greater susceptibility. Similarly, for a given duration of poverty, children of women having had greater increases in income would also be more susceptible. Individual-level intergenerational evidence is needed to investigate these interesting questions.