Mortality consequences of the 1959-1961 Great Leap Forward famine in China: Debilitation, selection, and mortality crossovers.

Using retrospective mortality records for three cohorts of newborns (1956-1958, 1959-1961, and 1962-1964) drawn from a large Chinese national fertility survey conducted in 1988, this article examines cohort mortality differences up to age 22, with the aim of identifying debilitating and selection effects of the 1959-1961 Great Leap Forward Famine. The results showed that the mortality level of the non-famine cohort caught up to and exceeded the level of the famine cohort between ages 11 and 12, suggesting both debilitating and selection effects. Multilevel multiprocess models further established a more direct connection between frailties in infancy and frailties at subsequent ages, revealing the underlying dynamics of mortality convergence between the famine and the non-famine cohorts caused by differential excess infant mortality. These results provide important new insights into the human mortality process.