The long shadow of World War II

World War II ravaged much of Europe, and its long-term effects are still being felt. A new survey shows that elderly people who experienced the war as children are more likely to suffer from diabetes, depression and cardiovascular disease.

It is estimated that between 62 and 78 million people, or approximately 3% of the world's population at the time, lost their lives prematurely between the years 1939 and 1945, as a direct or indirect result of the Second World War. They died on the battlefield, were killed by aerial bombing or were murdered in death camps. About one-half of them were civilians. The war initiated by German politicians was undoubtedly the most far-reaching upheaval of the 20th century, and represents a radical rupture in the cultural development of the continent. Indeed, its catastrophic repercussions are still with us. The conflict not only left deep scars in Europe's collective memory, it also had an impact on the physical and mental health, and on the quality of life, of every individual who experienced the privations and stresses of the war years. This lasting legacy of the war is documented in a new study carried out by researchers based at LMU Munich and the RAND Corporation in Santa Monica (California), which has just appeared in The Review of Economics and Statistics.

How do people whose childhoods were overshadowed by the hardships and disruptions of the war years, who were witnesses to violent combat or the Nazi terror inflicted on occupied countries like Poland or France, adapt to the demands of normal life in the aftermath? How does one cope with memories of bombing raids, hunger, displacement, flight from invading armies, and early absence or loss of parents? The new study shows that these children, now elderly citizens who live among us, are more likely to be afflicted with physical and psychological problems than those born later or those who grew up in countries that were less severely affected by the war. Epidemiological studies have shown that they are statistically more likely to suffer from diabetes, depression or cardiovascular conditions. On average, they are also less well educated, took longer to complete their schooling and vocational training, were less likely to marry and generally tend to be less satisfied with their lives.

Middle class particularly hard hit

Many of these late-acting effects, such as developing diabetes as a consequence of prolonged malnutrition, are not at all surprising, as Professor Joachim Winter, who heads the Department of Empirical Economic Research at LMU and is one of the authors of the new study, points out. What is new, he adds, is that this type of long-term impact can now be quantified. For instance, the probability of depressive illness among persons who had lived through the war years as children in areas that had seen particularly bitter fighting was six percentage points higher than for an otherwise comparable age cohort. In the questionnaires on which the study is based, those who had come through the war rated their state of health as significantly less good than contemporaries who had been spared similar experiences. Strikingly, long-term consequences of this nature were found to be particularly pronounced among those whose families had belonged to the middle class, but who had, in many cases, spent the whole of their later lives in an unsuccessful attempt to recover this status.

In light of the extent of physical damage done by the Second World War and its significance for Europe's political and economic development, our knowledge of its long-term impact on those who were directly exposed to it must be regarded as comparatively modest," says Joachim Winter. The new investigation is based on an analysis by a team of economists consisting of Winter himself, James P. Smith (RAND), Dr. Iris Kesternich (LMU) and Dr. Bettina Siflinger (now at Mannheim University) of questionnaires completed by approximately 21,000 people who took part in the Survey of Health, Aging and Retirement in Europe (SHARE). The participants were ≥50 years old, with the oldest belonging to the 1929 birth cohort, and were drawn from 12 European countries. In addition to Germany, countries that suffered heavy or even catastrophic losses, such as France and Poland, were represented, as were states that were not directly affected by military violence, and neutral states such as Sweden and Switzerland.