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      The use of a Cohort Size Shrinkage Index (CSSI) to quantify regional famine intensity during the Chinese famine of 1959-1961

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      medRxiv

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          ABSTRACT

          The Cohort Size Shrinkage Index (CSSI) is the most widely used intensity measure in studies of the Chinese famine of 1959-1961. We examined requirements to construct a valid CSSI measure: reliable information on birth cohort size; a stable cohort size trend outside the famine years; and limited migrations. We used census data to examine the cohort size trend and concentrated on the time window of 1950-1970 to exclude events with a large impact on cohort size trends other than the famine. We observed a significant difference in cohort size trends comparing pre-famine and post-famine births. Compared to pre-famine based CSSI (p-CSSI), pre- & post-famine based CSSI (pp-CSSI) tends to overestimate famine intensity at higher mean CSSI levels and underestimate intensity at lower mean levels. In Sichuan province, we demonstrated a less pronounced dose-response relation between famine intensity and tuberculosis outcomes using p-CSSI as compared to pp-CSSI. These observations demonstrates that the CSSI is not a robust measure as had been assumed previously. We recommend the use of p-CSSI and encourage researchers to re-examine their results of Chinese famine studies.

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          Author and article information

          Contributors
          Journal
          medRxiv
          December 27 2021
          Article
          10.1101/2021.12.24.21268375
          6e4590f8-1180-4718-9846-bcf1d17316ef
          © 2021
          History

          Evolutionary Biology,Medicine
          Evolutionary Biology, Medicine

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