The effect of the seasons of the year on malnutrition in North Korea.

North Korea's economic isolation as a consequence of its recent nuclear testing could lead to another famine. In this context, the article investigates health determinants of the last famine. Birth season is a reliable proxy for nutritional and epidemiological circumstances in early life, which in turn can systematically influence later-life health outcomes such as stature. The aim of this study is to assess the effect of birth seasons on the development of heights. Height-for-age z-scores for up to 9934 pre-school children measured in 1997 during the North Korean food crisis in the decade of the 1990 s and measured in 2002, are used for the analysis. Using these data, we have verified a number of earlier studies showing that cohorts born in winter are smaller. We have also found that cohorts born in autumn are taller. Additionally, when we control for sex, birthplace, and birth year, these calendar effects remain robust. Ignoring the humanitarian dilemma of any sort, it may be concluded that in totalitarian North Korea, Pyongyang can easily influence the biological welfare of its people by interfering with the birth calendar, in order to reduce the magnitude of a potentially upcoming famine.