The Enduring Demographic and Health Impacts of the Cambodian Genocide on Cambodia’s Population

The Cambodian genocide occurred between April 1975 and January 1979. Over one-third of Cambodia’s population perished, and many survivors suffer physical and mental health consequences. This study examines lasting influences of the Cambodian genocide on Cambodia’s population structure and on adult health and health behavior. To illustrate the legacy of decreased fertility and increased mortality during the genocide, population pyramids (1975, 1985, 2014, 2022) were generated using data from the United Nations Population Division. For comparison, population pyramids for the neighboring country of Thailand were generated. To examine the enduring health sequelae of the genocide, nationally representative Demographic and Health survey data (2014, 2021–2022) were used to compare smoking behaviors and stunted growth of women born shortly before and during the genocide (1972–1979) with women born shortly after the genocide (1980–1987). Cambodia’s population pyramids reveal a long-term paucity of individuals in the 1970s birth cohorts not observed for Thailand. Compared to women born shortly after the genocide, women with early-life exposure to the genocide were more likely to report smoking in adulthood and to have experienced stunted growth. The genocide impacted Cambodia’s population structure and affected the health and health behaviors of early childhood genocide survivors into adulthood. These findings imply life course and intergenerational impacts.