A new study by current and former FEB researchers Rob Alessie , Viola Angelini , Gerard van den Berg , Jochen Mierau and Gianmaria Niccodemi sheds light on the long-term health implications of economic conditions in early life. The study, titled "Using Data on Biomarkers and Siblings to Study Early-Life Economic Determinants of Type-2 Diabetes," finds a correlation between being born under adverse economic conditions and the onset of type-2 diabetes later in life.

In the introduction to their research paper, the authors highlight the well-established notion that adverse conditions in utero and shortly after birth can negatively affect individual health outcomes in adulthood. Fetuses and newborns are particularly sensitive to stressful environments, with early-life circumstances often "programming" individuals to cope with similar conditions later in life. This programming can lead to detrimental health outcomes over the life cycle, especially when there is a significant discrepancy between early-life and later-life environments, such as being born into poverty but living in an affluent society in adulthood.

Utilizing rich data from Lifelines

The research project, a close collaboration between the Faculty of Economics and Business of the University of Groningen and Lifelines, utilizes data from Lifelines, one of Europe's largest population-based biobanks and cohort studies. Lifelines, renowned for its comprehensive collection of health-related data from over 167,000 individuals in the northern regions of the Netherlands, provides a rich dataset for researchers to investigate various aspects of health and disease across multiple generations.

The study builds upon existing research by focusing on milder fluctuations in early-life conditions in more recent eras, expanding our understanding beyond the impact of catastrophic events like famines. By exploiting spatial and temporal variation in unemployment rates at birth as contextual variation in early-life economic conditions, the research team shows that adverse economic conditions in utero and shortly after birth increase the probability of type-2 diabetes later in life.

Using biomarkers to identify diabetes

An important methodological contribution of the study includes the innovative use of biomarkers to identify type-2 diabetes case, enabled by Lifelines’ collection of blood samples. Biomarkers are naturally occurring molecules, genes, or characteristics by which a particular pathological or physiological process, disease, et cetera can be identified. Type-2 diabetes is severely under-diagnosed in the population. Many of those who are affected are unaware of having this condition, leading to underreporting in survey data. In particular, individuals with lower socio-economic status may consult doctors less systematically, and the disease may be asymptomatic in younger and prime-aged individuals. The use of biomarkers allows the authors to detect type-2 diabetes even when people themselves do not realize they have it. Additionally, the research employs a sibling fixed-effects econometric model to address potential selective fertility issues, ensuring robust results.

This study offers valuable insights for policymakers and healthcare professionals striving to address the complex interplay between socioeconomic factors and health outcomes. Understanding the enduring impact of early life experiences on adult health is crucial for developing targeted interventions aimed at reducing the burden of chronic diseases like type-2 diabetes. In this way, the prevention of type-2 diabetes might even be able to start before birth.

More information

The study, "Using Data on Biomarkers and Siblings to Study Early-Life Economic Determinants of Type-2 Diabetes" is now available online at Health Economics.

For further information, please contact Jochen Mierau.