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Exposure to Chinese famine in early life and the risk of sensory impairment in adulthood
  1. Hongguo Rong1,2,
  2. Xiaozhen Lai1,
  3. Elham Mahmoudi3,
  4. Hai Fang1,4,5
  1. 1 China Center for Health Development Studies, Peking University, Beijing, China
  2. 2 Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
  3. 3 Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
  4. 4 Peking University Health Science Center—Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Beijing, China
  5. 5 Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Beijing, China
  1. Correspondence to Hai Fang, China Center for Health Development Studies, Peking University, Beijing 100083, China; hfang{at}


Background Studies have shown that malnutrition in early life has a negative effect on midlife cognitive functions. Little is known, however, about the relationship between early-life malnutrition and visual, hearing or dual sensory impairments in adulthood. This study aims to investigate the association between exposure to the 1959–1961 Chinese famine in early life and sensory impairments in adulthood.

Methods A total of 6347 adults born between 1952 and 1964 surveyed in the 2015 China Health and Retirement Longitudinal Study were included in this study. The presence of sensory impairments was identified by self-reported assessment of visual and hearing functions. The associations between multi-stage early-life famine exposure and sensory functions were estimated using the multiple generalised linear model.

Results Compared with the unexposed group, respondents exposed to famine in the fetal period and late childhood had a significantly higher risk of hearing impairment (OR 1.54, 95% CI 1.06 to 2.24; OR 1.75, 95% CI 1.23 to 2.50) and dual sensory impairments (OR 1.45, 95% CI 1.00 to 2.11; OR 1.55, 95% CI 1.09 to 2.21), respectively. Furthermore, in severely famine-affected areas, the early, mid and late childhood-exposed groups were more likely to have hearing and dual sensory impairments than the unexposed group. Those associations were not observed in less famine-affected areas. However, no significant association was found between famine exposure and visual impairment in early-life famine-exposed group.

Conclusion Exposure to Chinese famine in the fetal period and late childhood was linked to hearing and dual sensory impairments in adulthood.

  • Fetal
  • lifecourse/ childhood circumstances
  • nutrition
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  • Contributors HF designed the study. HR and HF carried out the data analyses. All authors discussed the analysis results, wrote the manuscript, and read and approved the final version of the manuscript.

  • Funding This work was supported by the National Natural Science Foundation of China (grant number 71774006)—awarded to HF and China Postdoctoral Science Foundation (grant number 2019M650392)—awarded to HR.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open-access repository.

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