Early-life exposure to economic stress and metabolic risks in young adulthood: the children of the reunification in East Germany

Background: Research on the long-term health consequences of early-life exposure to economic crises is scarce. We examine for the first time the long term effects of early-life exposure to an economic crisis on metabolic health risks. We study objective health measures, and exploit the quasi-experimental situation of the postreunification economic crisis in East Germany.
Methods: Data were drawn from two waves of the longitudinal German Health Interview and Examination Survey for Children and Adolescents (2003–2006, 2014–2017). We compared 392 East Germans who were exposed to the economic crisis in utero and at ages 0–5 with 1123 of their West German counterparts using propensity score matching on individual and family characteristics. We assessed blood pressure, cholesterol, blood fat and body mass index (BMI); both combined as above-average metabolic health risks and individually at ages 19–30.
Results: Early-life exposure to the economic crisis significantly increased the number of above-average metabolic health risks in young adulthood by 0.1482 (95% CI 0.0169 to 0.2796), which was 5.8% higher compared with no exposure. Among individuals exposed in utero, only females showed significant effects. Early-life exposure to the economic crisis was associated with increased systolic (0.9969, 95% CI −0.2806 to 2.2743) and diastolic blood pressure (0.6786, 95% CI −0.0802 to 1.4373), and with increased BMI (0.0245, 95% CI −0.6516 to 0.7001).
Conclusion: The increased metabolic health risks found for women exposed to the postreunification economic crisis in-utero are likely attributable to increased economic stress. While the observed differences are small, they may foreshadow the emergence of greater health disparities in older age.