Childhood starvation and elderly poverty in rural China: the mediating effect of human capital in adulthood

Childhood malnutrition has well-documented long-term effects on well-being in later life. Understanding how childhood starvation contributes to deficits in adult human capital and elderly poverty is essential for informing life-course strategies to prevent malnutrition and reduce poverty in old age. Data from the 2014 and 2018 waves of the China Health and Retirement Longitudinal Study (CHARLS) were used to examine elderly poverty in rural China, measured using the Alkire-Foster method. Logit regression models assessed the association between childhood starvation and elderly poverty, with propensity score matching used to address observable selection bias and E-values calculated to evaluate potential unmeasured confounding. Stepwise regression and causal mediation analysis were conducted to examine the mediating role of human capital in adulthood. Childhood starvation was positively associated with elderly poverty, and the association remained robust after propensity score matching and E-value analysis. Specifically, in subgroup analyses by gender and birth cohort, stronger associations were observed among men and individuals born in the 1920–1930s and 1940s, but not among those born in the 1950s. Human capital in adulthood accounted for 21.96% of the total effect, with education and health status accounting for 9.45% and 12.51%, respectively. These findings highlight the need for a life-course-oriented approach to strengthening social support systems for individuals affected by childhood starvation and elderly poverty. Integrated life-course interventions—including early nutritional support, adult human capital development, and family-centered services—may mitigate both initial and cumulative disadvantages. Such efforts could help reduce vulnerability to poverty in old age and promote healthier aging trajectories.