Barker's Hypothesis Among the Global Poor: Positive Long-Term Cardiovascular Effects of in Utero Famine Exposure

An influential literature on the Developmental Origins of Health and Disease (DOHaD) has documented that poor conditions lead to higher risk of cardiovascular disease at older ages. Evidence from low-income countries (LICs) has hitherto been missing, despite the fact that adverse conditions are far more common in LICs. We find that Malawians exposed to the 1949 Nyasaland famine have cardiovascular health 70 years later. These findings highlight the potential context specificity of the DOHaD hypothesis, with adversity having different health implications among aging LIC individuals who were exposed to persistent poverty.