Effects of Prenatal malnutrition on socio-emotional development: Evidence from Young Lives

Overview
An important source of the observed variation in cross-country economic performance are differences in human capital endowment (Mankiw, Romer and Weil, 1992). In particular, health has been shown to be an important determinant of outcomes for developing countries (Bleakley, 2010). There is growing evidence to support the Foetal Origins Hypothesis - that adverse nutritional shocks experienced by the mother during the gestation period have significant impacts on future health/human capital outcomes for the offspring, and hence their future earning potential (Almond, Currie and Duque, 2018). While evidence of the impacts on future physical health outcomes are well established, the impact of on mental wellbeing and the development of socio-emotional abilities remains relatively unexplored.
Modelling the development of health capital, using the conceptual framework developed by Heckman (2007) and co-authors, this project will examine the effect of nutritional shocks experienced in utero on an individual's well-being and socio-emotional outcomes later in adolescence in developing countries. For this purpose, data from the Young Lives Survey will be combined with objective regional rainfall and food price data, which indicate exogenous shocks to maternal nutrition. The overall aim of this research is to consider:
Does in utero exposure to nutritional shocks have a causal effect on future mental well-being, specifically socio-emotional functioning?
Do these effects manifest at a specific stage of development: within childhood, adolescence, or early adulthood?

Context
Modern contributions in economics addresses criticisms of earlier work in epidemiology, and employ extensive hypothesis testing (Paneth and Susser, 1995). Economists have tested the predictions of the hypothesis on a broad series of outcomes beyond health, including educational attainment and employment prospects (Currie and Hyson, 1999; Oreopoulos et al., 2008), marital status (Vogel, Siow and Brandt, 2010), and inter-generational effects (Currie and Moretti, 2007); subjecting it to rigorous testing.
Studies of effects on health are predominantly concerned with physical health, with a few recent exceptions, and only two studies have provided evidence on developing countries. Adhvaryu et al. (2014) assess the effect of cocoa price shocks in Ghana in year of birth on the likelihood of experiencing severe psychological distress, while Adhvaryu et al. (2015) focus on the effect of prenatal exposure to temperature shocks in predicting depressive symptoms from a cross-section of adults in 19 countries. Uniquely, this research will emphasise the effect on socio-emotional abilities such as peer-relations, self-esteem, personality and emotional functions from a nutritional shock experienced in utero.
Impact
This research expands on existing literature, broadening the scope of outcomes studied to include socio-emotional competencies and -given repeated measurements of data - examines how effects manifest at different stages of development. The findings will carry significance for public health policy decisions: mental health disorders constitute 13 percent of the global disease burden, depression alone representing the third largest single contribution to the global disease burden (Collins et al., 2011). The cost to society is highest for developing countries, both in terms of healthcare costs and the effects on social development, yet these countries are least equipped to offer treatment and support. Given the importance of socio-emotional skills and pro-social behaviour in childhood, adolescence, and subsequently in the labour market (Hay, Payne and Chadwick, 2004), the findings could have radical implications. Simple interventions aimed at improving maternal nutrition could have substantial effect in mitigating costs for developing countries - suggesting the optimum time to intervene to improve an individual's opportunities is before they are even born.