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J Econ Perspect. 2011 Summer;25(3):153-172.

Killing Me Softly: The Fetal Origins Hypothesis.

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Douglas Almond is Associate Professor of Economics and International and Public Affairs, Columbia University, New York City, New York. This paper was written while he was on leave at the Department of Policy Analysis and Management, Cornell University, Ithaca, New York. Janet Currie is Sami Mnaymneh Professor of Economics, Columbia University, New York City, New York. Almond is a Research Associate and Currie is Director of the Program on Children, both at the National Bureau of Economic Research, Cambridge, Massachusetts.


In the epidemiological literature, the fetal origins hypothesis associated with David J. Barker posits that chronic, degenerative conditions of adult health, including heart disease and type 2 diabetes, may be triggered by circumstance decades earlier, in utero nutrition in particular. Economists have expanded on this hypothesis, investigating a broader range of fetal shocks and circumstances and have found a wealth of later-life impacts on outcomes including test scores, educational attainment, and income, along with health. In the process, they have provided some of the most credible observational evidence in support of the hypothesis. The magnitude of the impacts is generally large. Thus, the fetal origins hypothesis has not only survived contact with economics, but has flourished.

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