Using data on biomarkers and siblings to study early-life economic determinants of type-2 diabetes

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We study the effect of economic conditions early in life on the occurrence of type-2 diabetes in adulthood using contextual economic indicators and within-sibling pair variation. We use data from Lifelines: a longitudinal cohort study and biobank including 51,270 siblings born in the Netherlands from 1950 onward. Sibling fixed-effects account for selective fertility. To identify type-2 diabetes we use biomarkers on the hemoglobin A1c concentration and fasting glucose in the blood. We find that adverse economic conditions around birth increase the probability of type-2 diabetes later in life both in males and in females. Inference based on self-reported diabetes leads to biased results, incorrectly suggesting the absence of an effect. The same applies to inference that does not account for selective fertility.

Original languageEnglish
Pages (from-to)1266-1283
JournalHealth Economics
Issue number6
Early online date25-Feb-2024
Publication statusE-pub ahead of print - 25-Feb-2024


  • business cycle
  • developmental origins
  • early-life conditions
  • unemployment

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