Long-Term Mental Health Costs of the Great Chinese Famine

The Great Chinese Famine (1959–61) claimed tens of millions of lives. However, its long-term mental health costs on those who survived remains unexamined. To address this gap, we calculate the famine intensity of prefecture-level regions across China from a rich set of death records and use its variation and data from a recent nationally representative survey to identify the long-term effects of the famine on the mental health of those in rural areas who experienced the famine in the early years of their lives. Difference-in-differences estimates revealed that a one-standard-deviation rise in the experienced famine intensity predicts a 2.3% increase in the probability of severe depressive symptoms (or about 24.8% of the mean). This roughly translates into 3.77 million cases caused by the famine, which is quite likely an undercount. The main mediating channels of this effect include starvation experience, unequal resource allocation, and toxic stress. Our findings shed new light on how large-scale food security failures may impact the mental well-being of the survivors.