Conferences at Department of Economics, University of Toronto, RCEF 2012: Cities, Open Economies, and Public Policy

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Influenza, the in-utero environment, and later developmental outcomes in children

Shelley Phipps, Courtney Ward*

Last modified: 2012-08-21


In a well-known demonstration of the “fetal origins hypothesis,” Almond (2006) showed that exposure to the 1918 influenza epidemic in the prenatal period had substantial and long lasting effects on income and educational attainment in adulthood. However, while the historical link for the prominent 1918 epidemic is clear, much less is known about the modern day implications of prenatal exposure to seasonal influenza epidemics. Moreover, these implications may be much broader in scope, possibly contributing to well-known seasonal differences in outcomes over birth quarter, and pointing to inequality in health and ability at the earliest stage of life. Using comprehensive data on influenza epidemics over the last two decades, this paper estimates the effect of prenatal exposure on birth outcomes, and tracks the impact on health and skill accumulation throughout early childhood. Evidence on this relationship is timely, particularly in view of recent literature suggesting that gaps in early developmental status can widen over time, and that the optimum time for investment in child well-being could be at the earliest, even before birth (Almond and Currie 2011; Cunha and Heckman 2010; Cunha, Heckman and Schennach 2010; and Case and Paxson 2010).

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