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Height and living standards in North Korea, 1930s1980s1


By SUNYOUNG PAK, DANIEL SCHWEKENDIEK, and HEE KYOUNG KIM
The adult stature of 6,512 North Korean refugees born from the 1930s to the 1980s was employed as an indicator of living standards in North Korea.The height of North Koreans born before the division of the Korean Peninsula exceeded that of their South Korean peers. All North Korean cohorts born thereafter were shorter than their South Korean counterparts. North Koreans did not experience a meaningful secular increase in height during 60 years of communism. A consistent and positive effect of about 12 cm for high educational status was found when height was regressed on birth decades, education, regional origin, and occupation.
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ince the late 1970s, economic historians have used human stature as an indicator of underlying socioeconomic, nutritional, and epidemiological conditions within society.2 In the mid-1980s, researchers in this eld suggested the term biological standard of living as a separate framework for measuring human well-being.3 Because early environment exerts inuences on human biology, adult stature can capture biosocial aspects of human welfare that conventional economic indicators largely neglect. Time trends in height reect changes in the level and distribution of income, the amount and quality of food consumed, the prevalence of disease, and the extent of physical labour within society. Research on height found that improvements in economic conditions lead to increased growth velocity and increased terminal height.4 The average stature of Europeans and North Americans were found to have increased by 1 cm per decade from the 1880s to the 1980s due to improved nutritional status, the elimination of various infectious diseases, decreased family size, extended medical services, urbanization, and shifts in class structure.5 A study by Hauspie et al. found a secular trend of adult heights among all countries industrialized during the past century, with Japan showing the largest improvement (2.67 cm per decade) after the Second World War.6 Baten and Hira reported a stagnating height trend in China in the mid-nineteenth century.7 Morgan and Liu found a rising average height trend in colonial Taiwan from the early nineteenth century to the 1930s.8

1 2

The authors would like to thank two anonymous referees for suggestions that helped to improve this article. Fogel, Secular changes; Komlos and Cuff, eds., Classics; Steckel, Stature; Strauss and Thomas, Health. 3 Komlos and Baten, eds., Biological standard; Komlos, Stature. 4 Van Wieringen, Secular growth changes. 5 Eveleth and Tanner, Worldwide variation. 6 Hauspie, Vercauteren, and Susanne, Secular changes. 7 Baten and Hira, Anthropometric trends. 8 Morgan and Liu, Japanese colonialism.
Economic History Society 2010. Published by Blackwell Publishing, 9600 Garsington Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA.

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In light of these ndings, this study investigated the secular trend and underlying socioeconomic determinants of adult height in North Korea. Similar research has previously been carried out on the height of Koreans during the Japanese occupation and in South Korea.9 Pyongyang has made very little information available to the world since the political foundation of the two Koreas in 1948 which followed the Japanese occupation (191045) and the aftermath of the Second World War. In contrast to other communist countries, North Korea has never released a statistical yearbook.10 In the post-Cold War era, North Korea remains the most isolated country on earth and is not willing to publish any socioeconomic data. Facing totalitarianism and a statistical void, the authors of this study made use of height measurements obtained from thousands of adult North Korean escapees in order to shed light on the historical development of the biological standard of living in North Korea, which is largely unknown to the outside world. There have been studies on the standard of living of children raised during and after the Great Famine in North Korea from about 1996 to 1999.11 However, limited research has been carried out on the pre-famine period due to the lack of data. A previous study on historical developments of height in North Korea was limited to a descriptive and exploratory analysis. Pak examined the trend of 2,383 North Korean refugees between 20 and 70 years of age who had arrived in South Korea up to 2003.12 When the mean height of North Korean refugees was plotted by age, no noticeable secular height increase among either men or women was found. The height measurements of 6,512 North Korean adults who arrived in South Korea in or before 2007 were analysed in the present study. The study was based on a larger (more than double) sample size than that used by Pak, and more importantly this study investigated underlying determinants of height developments by using socioeconomic background information systematically gathered alongside height measurements through interviews with North Korean refugees. Regression analysis was used to analyse statistically the effects of the birth decades on human stature and quantify the secular trends of height in North Korea previously examined by Pak.13 A set of dummy variables was introduced to examine whether differences in social and economic status mattered for the development of height in North Korea. This article is arranged as follows. The next section discusses health and nutritional issues in North Korea from a historical and qualitative point of view. The third section introduces some methodological issues dealing with old-age height adjustments and discusses some basic characteristics of the data used. The fourth section statistically analyses the data and presents the results. Potential selectivity biases are discussed in section V and the last section summarizes the ndings.

II
Discussing the nutrition and health sector in North Korea is a challenge, due to the lack of reliable data. Information on the biological lifestyle of North Koreans
Kimura, Standards of living; Gill, Stature. Eberstadt, North Korean economy, p. 18. 11 Pak, Growth status; Schwekendiek, Determinants; idem, North Korean standard. 12 Pak, Biological standard. 13 Ibid.
10 9

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Table 1. Selected social indicators for the two Koreas


1938 GDP per capita (in current prices) South Korea North Korea Infant mortality rate South Korea North Korea Life expectancy for males South Korea North Korea Doctors (per 10,000 population) South Korea North Korea Hospital beds (per 10.000 population) South Korea North Korea Outpatient treatment (annual average per capita contacts) South Korea North Korea 1955 1960 1970 1980 1990 2000

300.36 90 85 51.1 46.0 (1.3) 1.5 (1.2) 19.1 35.2 0.1 6.1 3.3

691.63 112.44 43 52 59.8 56.0 5.6 11.7 5.1 104.1 0.2 11.7

2,532.50 557.66 16 32 62.7 62.1 6.7 23.6 10 130.1 0.6 19.4

8,612.24 1,487.87 8 42 67.4 65.6 8.6 27.0 19.2 135.9 0.9 16.7

15,702.27 1,378.95 5 42 71.0 62.9

Notes: Figure for average life expectancy for 1980 refers to 1979; gures for doctors, hospital beds, and annual outpatient treatment for 1990 refer to 1986; empty cells: no data; gures in parentheses refer to the average of the nation prior to the political separation. Sources: GDP per capita from Penn Word tables 6.2 [http://pwt.econ.upenn.edu/php_site/pwt62/pwt62_form.php]; infant mortality rates from the United Nations Statistics Division, 19602000 [http://unstats.un.org/unsd/demographic/sconcerns/mortality/ default.htm]; Life expectancy from the Korean National Statistics Ofce, Comparison (1995, 1996, 1997, 1999, 2000); doctors, hospital beds, and annual outpatient treatments from Eberstadt and Banister, Population, tab. 21, pp. 601.

was gathered from qualitative interviews of the few defectors before the 1990s and visitors who were later questioned extensively by US intelligence services or by South Korean researchers.14 Unfortunately, the periods referred to by the respondents, social background, and even gender are generally not mentioned in these reports (possibly in order to ensure the anonymity of the refugees). It is impossible to get a complete picture of the lifestyles of North Koreans during the last few decades, yet some evidence on living standards in North Korea might be available from these reports. Some health care statistics have been published by Eberstadt and Banister, who received permission to cite data directly from the Central Statistical Bureau of North Korea (table 1).15 Motivated ideologically, and in order to improve labour productivity, the communist government in Pyongyang started improving the public health sector right after the political separation.16 This approach was distinct from the marketeconomy-oriented South Korea, which opted to advance the economy rst and then start to extend the medical welfare programme systematically in the mid-1970s.17 The communist regime focused on lower cost and more efcient preventive methods and gave less attention to the ex-post treatment of illnesses.18 As an example of this, to protect the public from coughs and sneezes, North Koreans were strongly encouraged to wear gauze masks in public places and attended mandatory
14 15

Hunter, Kim Il-Songs North Korea; Lee, Giyeong, Lee, Lee, Kim, Park, and Choi, North Korea home life. Eberstadt and Banister, Population. 16 Hunter, Kim Il-Songs North Korea. 17 Statistisches Bundesamt, Lnderbericht Korea, p. 35. 18 Hunter, Kim Il-Songs North Korea, pp. 22138; Savada, North Korea.
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medical checkups once a year. Possibly because of this, very high numbers of outpatient treatments were reported (table 1): North Koreans saw doctors between six and 20 times per year, versus South Koreans who rarely consulted doctors until the 1980s (after medical insurance was introduced in 1977). More importantly, from the early 1960s, the communist regime initiated national vaccination programmes against epidemic diseases. However, in spite of the regimes emphasis on preventive measures, there have been reports of chronic shortages of medicines and other equipment. Besides preventive measures and prophylaxis, the promotion of extreme cleanliness is another major achievement in the North Korean health sector.19 Public sanitation and personal hygiene were ideologically promoted and enforced in public places by governmental inspectors. North Koreans were expected to carry a sanitation pass when travelling within the country. Since the formation of North Korea, the government increased the number of medical personnel and health care institutions throughout the country (table 1). It also collectivized all private hospitals. Even though there were about 20 times more hospital beds available per person in North Korea than South Korea in 1970 (table 1), the lack of technical equipment and medical specialists became impediments for North Korea. In North Korea, medical research and medical care was largely limited to eastern medicine based on herbal medicine and acupuncture which hindered the treatment of serious illnesses.20 As far as nutrition is concerned (in contrast to South Korea, which resorted to a market system), the communist government introduced a food rationing system where grains were allotted on the basis of physical workload, ranging from high school students who were entitled to 400 grams of grain per day to miners who were allowed 900.21 The daily diet of one defector was reported as follows: breakfast and lunch consisted of grains (rice, corn, and barley) as a main dish complimented by side dishes of spicy cabbage, sh, vegetable soup, wild grasses, and a hot sauce. Dinner consisted of noodles and the same side dishes as before. Another defector mentioned that he also consumed pork and mushrooms as side dishes.22 Defectors extensively interviewed by Lee et al. described the daily main dish as noodles, porridge, rice, and rice cakes.23 It was evident from these interviews that the average North Korean diet contained miniscule amounts of meat and dairy products. It is likely that North Koreans consumed large quantities of animal protein only during the ve national holidays. According to Hunter, the average North Korean today probably eats about the same amount of meat as fty years ago.24 South Korean animal protein intake has largely improved. In 1970, the proportion of animal food consumed by South Koreans was found to be about 8 per cent, 9 per cent in 1980, and 19 per cent in 1990.25 Similarly, the per capita daily consumption of milk and dairy products increased from 5 grams in 1970 to over
19 20

Hunter, Kim Il-Songs North Ibid.; Savada, North Korea. 21 Hunter, Kim Il-Songs North 22 Ibid., p. 167. 23 Lee et al., North Korea home 24 Hunter, Kim Il-Songs North 25 Lee et al., North Korea home
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Korea. Korea, p. 160. life, pp. 17181. Korea, p. 164. life.


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Table 2. Year of arrival of the North Korean refugee sample


Year 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 (Jan.April) Total
Source: see text.

Number 1 3 56 210 330 800 914 1,358 931 1,400 509 6,512

% .0 .0 .9 3.2 5.1 12.3 14.0 20.9 14.3 21.5 7.8 100.0

10 grams in 1980 to 50 grams in 1990. Even though South Korea underwent a nutritional transition, the average South Korean diet is still low in fat while the intake of vegetables and fruits is high. This consumption pattern follows from the retention of traditional foodstuffs and cooking styles in South Korea.26 The North Korean government improved the public health system at an early stage and this should have improved the standard of living. However, because the North Korean diet is low in quantity and quality, and has most likely not changed during recent decades, the welfare of the people was expected to be rather poor. It was assumed that the health provisions and nutritional conditions might have been roughly constant for North Koreans from the states formation until the geopolitical isolation in the 1990s, whereas nutrition (especially animal protein intake) and health services in South Korea have continuously improved.

III
North Korean refugees are subject to physical examinations and interviews upon arrival in South Korea. For this study, stature and basic socioeconomic information (comprising information about education, regional origin, and the former occupation of the individuals) were obtained from government records. The study used 6,512 records of adult North Korean defectors who left their country aged 20 or over, but under 70 years of age at the time of the survey. Table 2 shows the annual arrival of North Korean refugees in South Korea from August 1997 to April 2007. During this period, the majority of the escapees had entered the country in the mid 2000s. More than twice as many females as males escaped to South Korea (table 3). Most of the refugees were 2040 years of age, where the mean age was 36.84 years, and ranged from 20.11 to 69.99 years. The surveyed refugees were born between 1931 and 1986, with a majority (74 per cent) brought up in the 1960s and 1970s; yet all birth decades contain at least 100 individuals. It is unusual for macrohistorical evidence on living standards in North Korea to cover such a long time
26

Ibid.
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Table 3. Demographic characteristics of the North Korean refugee sample


Number Sex Male Female Total Birth decade 19309 19409 19509 19609 19709 19809 Total
Source: see text.

Male height (SD)

Female height (SD)

2,045 4,467 6,512 174 378 621 2,139 2,680 520 6,512

31.4 68.6 100.0 2.7 5.8 9.5 32.8 41.2 8.0 100.0 163.54 165.05 165.57 165.60 166.56 165.55 (6.18) (5.75) (5.19) (5.33) (5.62) (5.83) 151.69 153.43 154.83 155.04 155.28 155.58 (5.05) (5.10) (5.25) (4.96) (5.03) (4.82)

span, from the end of the Japanese occupation through the political foundation of North Korea to the end of the Cold War. This study investigates the whole history of North Korea from its beginning to its economic collapse. Socioeconomic characteristics of the sample are shown in table 4. North Korea consists of nine provinces and three municipalities (Pyongyang, Nampo, and Kaesong being administratively treated as provinces). This study covers all 12 administrative regions in North Korea (table 4). However, two-thirds of refugees escaped from North Hamgyong, which is located at the Sino-North Korean border area. It is also remarkable that the refugee sample represents individuals from all educational and occupational backgrounds (table 4). Some 9.6 per cent of the refugees had a higher education, as dened by whether the individuals held a four-year university degree or not. The majority of refugees (63 per cent) were labourers from factories or farms. This study primarily employs nal adult height, but the age of the subjects might pose a problem for the analysis. Slightly over 11 per cent of the subjects were over 50 years of age (table 3). Height is known to decline with age and is especially noticeably after the age of 50.27 In the rst analysis, the study restricts the age range from 20 to 39 years, as no noticeable reduction is known to occur within these age groups. However, the measurements of older individuals are used to provide unique evidence on long-term secular trends of height from the early formation of North Korea and even before. To address age-related reduction in body stature, the study will systematically adjust the height measurements of those older than 40. Two methods of age adjustment, recently suggested by Morgan, are applied in this article.28 The rst adjustment method is based on Cline et al. This was devised to estimate original maximum height and was previously employed by Morgan, and Prince, and Steckel.29 The other method was suggested by Chandler and Bock, who estimated

Chandler and Bock, Age change. Morgan, Stature. 29 Cline, Meredith, Boyer, and Burrows, Decline of height; Morgan, Stature; Prince and Steckel, Nutritional success.
28

27

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Table 4. Socioeconomic characteristics of the North Korean refugee sample


Number Province origin North Hamgyong South Hamgyong Ryanggang Chagang North Pyongan South Pyongan Kangwon North Hwanghae South Hwanghae Pyongyang Nampo Kaesong Missing Total Higher education No Yes Missing Total Former occupation Farm or factory labourers Ofce workers Professionals Military workers Merchants Students Performing artists Service providers Teachers Unclassied jobs Dependents Unemployed Missing Total
Source: see text.

4,240 687 268 58 213 202 168 90 110 210 57 26 183 6,512 5,825 624 63 6,512 4,124 377 309 148 90 89 77 57 44 838 243 71 45 6,512

65.1 10.5 4.1 .9 3.3 3.1 2.6 1.4 1.7 3.2 .9 .4 2.8 100.0 89.4 9.6 1.0 100.0 63.3 5.8 4.7 2.3 1.4 1.4 1.2 .9 .7 12.9 3.7 1.1 .7 100.0

the rate of decline with age.30 This method was previously applied by Morgan.31 The reported equations used for the adjustment of measured standing height by gender are given below. Both studies were based on longitudinal studies of large samples. Cline et al.: Male adjusted height = measured standing height + 3.277 0.16541(age) + 0.00209(age)2 Female adjusted height = measured standing height + 5.137 0.23776(age) + 0.00276(age)2 Chandler and Bock:

30 31

Chandler and Bock, Age change. Morgan, Stature.


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Age-related adjustment (cm) 4.00 3.50 3.00 2.50 2.00 1.50 1.00 0.50 0.00

149

Figure 1. Comparison of mean age-adjustment of height by birth cohort


Source: see text.

Male adjusted height = measured standing height + 0.0642(age-40) + 0.0017(age-40)2 Female adjusted height = measured standing height + 0.0621(age-40) + 0.0024(age-40)2 The mean amount of age-adjustment of height by ve-year birth cohort for the four modied series is shown in gure 1. Chandler and Bock adjust height more drastically for reduction than Cline et al.32 A South Korean anthropometric report, Size Korea, carried out by the Korean Agency for Technology and Standards (KATS), was used to compare height trends between the two Koreas. Anthropometric measurements were taken from 1 July 2003 to 31 July 2004 throughout South Korea. The average height was reported by sex and by ve-year or 10-year age group.33

The historical trends of height in the two Koreas were rst compared with age-unadjusted raw height. Figure 2 depicts the height of South Korean adults in comparison to those of North Korean refugees by gender and by birth cohort.34 It was assumed that the reduction rates are roughly uniform in both Koreas. Thus, measured height was not adjusted for old age in this direct comparison. The age-related reduction in height might possibly be greater for North Koreans than
Chandler and Bock, Age change; Cline et al., Decline of height. Size Korea (Korean Agency for Technology and Standards, Report, p. 55) made use of a rather unconventional grouping system in which age groups actually start from .5 and end at .49. To compare the North Korean means to the South Korean means, this study made use of the age group classications applied in Size Korea and assigned roughly corresponding birth year periods to the Size Korea data (204 years: 19804, 259 years: 19759, 304 years: 19704, 359 years: 19659, 409 years: 195564, 509 years: 194554, 609 years: 193544). 34 Korean Agency for Technology and Standards, Report.
33 32

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19 30 19 4 35 19 9 40 19 4 45 19 9 50 19 4 55 19 9 60 19 4 65 19 9 70 4 19 75 19 9 80 19 4 85 9 0
Birth year Cline et al. male Cline et al. female Chandler and Bock male Chandler and Bock female

IV

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19 35 4 4

19 45 5 4

19 55 6 4

19 65 9

19 70 4

19 75 9

Birth year North Korean male North Korean female South Korean male South Korean female

Figure 2. Age-unadjusted height in North and South Korea by birth cohort


Source: see text.

for South Koreans because of heavier physical workloads. Unfortunately, currently available adjustment methods are not rened enough to accommodate the workload differentials. What is noticeable is that North Koreans born before the liberation from Japanese rule were taller than their South Korean peers (gure 2). On average, North Korean men born prior to the separation of the peninsula were about 0.5 cm taller and North Korean women about 0.8 cm taller than their South Korean counterparts. However, after the political formation of the Democratic Peoples Republic of Korea, the situation was reversed: all North Korean age cohorts for both males and females born afterwards were shorter than their South Korean peers. Moreover, height discrepancies between North and South Koreans have become pronounced over time, peaking at an 8.3 cm height gap for men and a 5.2 cm height gap for women born in the 1980s. This is a remarkable nding, as it was assumed that the communist North Korean economy surpassed South Korea from the early days of the national foundation until the early 1960s, when higher economic growth rates were gradually achieved in South Korea under the export-oriented leadership of President Park Chung-Hee (196179), and the economic growth of North Korea slowed down because of bottlenecks in transportation, skilled labour, and energy.35 Also, the northern half of the peninsula was more modernized during the Japanese occupation, whereas the South continued to be underdeveloped. For these reasons, North Koreans were thought to have enjoyed better living standards than South Koreans during the rst few decades after the political division of the peninsula. From a biosocial perspective, the results of this study do not support this belief. Second, whereas there is an upward secular trend of height in South Korea, North Korean male height stagnated at around 1657 cm during the six decades of communist rule. While North Korean female height showed an increase of about 2 cm during the period from the 1930s to the 1950s, it seemed to stagnate afterwards. It is interesting to note that the average North Korean male stature seemed to increase slightly in the early 1970s but declined thereafter.
35

Savada, North Korea.


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Table 5. Regression of unadjusted and age-adjusted height of North Korean male refugees
Model 1 Intercept Birth decade 19309 19409 19509 19609 19709 19809 Higher education No Yes Province North Hamgyong South Hamgyong Ryanggang Chagang North Pyongan South Pyongan Kangwon North Hwanghae South Hwanghae Pyongyang Nampo Kaesong Former occupation Labourers Ofce workers Professionals Military workers Merchants Students Performing artists Service providers Teachers Unclassied Dependents Unemployed N Adj Rsq DW F 166.05 -2.42*** -1.23** -0.90** -0.95*** Reference -1.12** Reference 1.63**** Reference 0.30 1.82*** -.12 -2.04**** 0.04 -0.30 -0.75 1.18 1.16* 1.40 2.46 Reference 0.65 0.67 0.77 1.76 0.87 0.52 1.02 0.79 0.17 -0.77 0.55 1,960 0.032 2.047 3.294**** Model 2 165.99 Model 3 166.05 -0.91 -0.42 -0.72* -0.94*** -1.12** 1.65**** 0.30 1.82*** -0.15 -2.03**** 0.03 -0.29 -0.74 1.20 1.16* 1.36 2.45 0.62 0.66 0.76 1.73 0.87 0.52 0.87 0.72 0.17 -.74 0.54 1,960 0.028 2.047 3.033**** Model 4 166.05 0.44 0.59 -0.30 -0.90*** -1.12** 1.67**** 0.31 1.82*** -0.17 -2.05**** 0.03 -0.30 -0.72 1.22 1.17* 1.34 2.42 0.59 0.68 0.75 1.72 0.86 0.52 0.84 0.67 0.17 -0.73 0.53 1,960 0.030 2.013 3.194****

-0.97*** -1.06** 1.91**** -0.07 1.62** -2.01 -1.56* 1.18 -0.33 -0.22 1.21 2.16** 1.20 4.17 0.50 0.12 0.85 1.73 0.71 0.81 1.21 -0.12 1.15 0.93 1,351 0.032 1.962 2.835****

Notes and sources: Model 1, model 3, and model 4 include all male refugees while model 2 restricts the age range to 2039 years. In model 3 and model 4, height was adjusted for old age for those over 40 years of age. Model 3 is based on height adjustment by Cline et al., Decline of height, pp. 41525, and model 4 on Chandler and Bock, Age change, pp. 43340. Statistically signicant coefcients are shaded. Signicance levels are *<.1, **<.05, ***<.01, ****<.001.

Four basic regression models were introduced to test the effect of the birth decade and to investigate the socioeconomic impact on the development of height in North Korea. Each model was applied to both male stature (table 5) and female stature (table 6). Models 1, 3, and 4 make use of the total sample. Model 2 restricts the age range to 2039 years of age in order to avoid the problem posed by age-related reduction of height. Unadjusted adult height was entered into the
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Table 6. Regression of unadjusted and age-adjusted height of North Korean female refugees
Model 1 Intercept Birth decade 19309 19409 19509 19609 19709 19809 Higher education No Yes Province North Hamgyong South Hamgyong Ryanggang Chagang North Pyongan South Pyongan Kangwon North Hwanghae South Hwanghae Pyongyang Nampo Kaesong Former occupation Labourers Ofce workers Professionals Military workers Merchants Students Performing artists Service providers Teachers Unclassied Dependents Unemployed N Adj Rsq DW F 155.11 -3.30**** -1.61**** -0.34 -0.23 Reference 0.29 Reference 1.05**** Reference 0.56** 0.46 -0.79 0.12 0.16 -0.08 -0.26 0.78 0.23 -0.19 -0.29 Reference -0.12 0.24 -0.07 -0.31 1.33 2.45**** -0.36 -0.22 0.09 -0.93*** -1.85** 4,291 0.019 1.957 4.037**** Model 2 155.05 Model 3 155.11 -1.81*** -0.80** -0.22 -0.22 0.29 1.06**** 0.56** 0.48 -0.81 0.14 0.16 -0.07 -0.28 0.78 0.22 -0.18 -0.30 -0.15 0.24 -0.07 -0.34 1.32 2.44**** -0.34 -0.25 0.10 -0.96*** -1.89** 4,291 0.011 1.956 2.730**** Model 4 155.11 -0.03 0.57 0.35 -0.17 0.27 1.07**** 0.57** 0.49 -0.82 0.14 0.17 -0.06 -0.29 0.78 0.21 -0.17 -0.29 -0.19 0.25 -0.08 -0.38 1.32 2.41**** -0.31 -0.31 0.11 -1.01*** -1.93** 4,291 0.009 1.955 2.348****

-0.23 0.29 1.59**** 0.72** 0.42 -0.83 -0.34 0.30 -0.23 -0.19 0.97 0.63 -0.84 -0.38 0.08 -0.21 -0.10 -0.24 0.95 2.51**** 0.00 -0.25 0.25 -0.77* -2.01** 3,269 0.011 1.951 2.468****

Notes and sources: Model 1, model 3, and model 4 include all male refugees while model 2 restricts the age range to 2039 years. In model 3 and model 4, height was adjusted for old-age for those over 40 years of age, where model 3 is based on height adjustment by Cline et al., Decline in height, pp. 41525, and model 4 on Chandler and Bock, Age change, pp. 43340. Statistically signicant coefcients are shaded. Signicance levels are * <0.1, ** <0.05, *** <0.01, **** <0.001.

regression in models 1 and 2. Model 3 was based on age-adjusted height by Cline et al. and model 4 on Chandler and Bock.36 Regression coefcients for the four models are reported in tables 5 and 6. The effects of the birth decade on adult height were rst examined. All of the male cohorts born before and after the 1970s were signicantly shorter than those born during the 1970s (model 1). However, when age-related height adjustments were
36

Cline et al., Decline of height; Chandler and Bock, Age change.


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168 166 164 162 160 158 156 154 152

153

Adjusted height (cm)

19 40 s

19 50 s

Cline et al. female Cline et al. male

Birth decade Chandler and Bock female Chandler and Bock male

Figure 3. Age-adjusted height in North Korea by birth cohort


Source: see text.

made, this effect was found to be statistically signicant only for those born in the immediately preceding and succeeding decades (that is, the 1960s and 1980s). In addition, males born in the 1950s were signicantly shorter than those born in the 1970s (model 3). For females, a signicant effect of the birth decade is only found among the cohorts born in the 1930s and 1940s. Females born in the 1970s were signicantly taller than those born in the 1930s and 1940s when moderate adjustments for old age were made (model 3), while no signicant effect of the birth decades was found when more radical adjustments were made (model 4). A common nding across the models was that males born in the 1970s differ statistically from those born in the 1960s and 1980s. However, the size effect of the birth decades is rather small. Once age adjustments are made, males born in the 1970s seem to be about 1 cm taller than both those born in the 1960s and the 1980s (model 3 and model 4). For four decades, North Koreans made small gains in average height (gure 3). For a further investigation of this, regression estimates of models 2, 3, and 4 are illustrated in gure 4, in which the developments of height by birth decade of the socioeconomic reference group (labourers from North Hamgyong Province without higher education) are shown. A steady increase in height over time is not detected (arguably, except in model 3 for females). As already shown in gures 2 and 3, no growth spurt of height has occurred in North Korea for almost 60 years. An explanation for this could be that the gross nutritional intake in specic areas, such as the consumption of animal protein, has not improved during recent decades. Higher education was signicant in all models and for both male and female stature. North Koreans with higher education are about 12 cm taller than those who did not receive a four-year university education. Contrary to socialist propaganda about the characteristics of an egalitarian society, living standards increased signicantly with higher education, which suggests that there were benets from social status here correlated with higher education, as only politically loyal North Koreans may enter university. Males from Ryanggang and Pyongyang were signicantly taller and those from North Pyongan were signicantly shorter than those from North Hamgyong, which represented the reference group in the models. Among females, only those from South Hamgyong were signicantly taller than those from North Hamgyong.
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19 80 s

19 30 s

19 60 s

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Figure 4. Regression estimates of the trend of height of North Korean refugees


Source: see text.

None of the occupation dummies produced signicant results for the male cohorts in the models. Among females, dependents and the unemployed were signicantly shorter, while performing artists were signicantly and strikingly taller (more than 2 cm) than the reference group consisting of labourers in all models.

V
It must be noted that the data do not allow a thorough investigation of the extent of the possible refugee selection bias in the sample. Because only limited and rather basic socioeconomic background information was available for the study (tables 3 and 4), the exact reasons for defection and the magnitude of a potential refugee bias remain unknown. Also, the limitations of statistical information about North Korea make it quite difcult to crosscheck the sample with ofcial data from North Korea. This section of the article describes how two possible biases in the data were investigated: a survivor bias in the old-age cohorts and a socioeconomic selection bias among the refugees. North Korean males and females born prior to the political division of the peninsula were taller than those born in South Korea in the same period, whereas the situation was reversed for all birth cohorts born thereafter (gure 2). Past studies have documented some evidence of height-related mortality differences.37 According to these studies, taller people on average have a lower mortality than shorter people.This being the case, estimating the mean height of those born in the earlier decades with the old-aged cohort currently alive may bias the mean upward. Fortunately, the survivor bias probably affected old-age cohorts of both the North and the South. The survivor bias will likely cancel out when a cross-comparison is made. However, if sturdier and possibly taller elderly individuals were more likely to attempt to escape North Korea, this could skew the data. NorthSouth differences in adult stature before the liberation from Japanese colonial rule were examined for
37

Steckel, Stature; Waaler, Height.


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the possibility of a bias in the data. Researchers from the Department of Anatomy at Keizo Imperial University conducted a nationwide anthropometric survey of colonial Korea from 1930 to 1932 and the heights of Koreans were compared by province.38 The Koreans in the sample were aged between 20 and 60 years. However, the vast majority of these individuals were under 40 years of age. Only 6 per cent of the Northern Koreans in the sample were older than 50. This study compared male adult height only, as the female sample size was small and not consistently reported for all provinces. Males living in the northern part of the Korean Peninsula were found to be 3.5 cm taller than those living in the southern parts.39 Judging from this, the relative tallness of older North Korean refugees in comparison to their South Korean peers seems to reect real population differences rather than being an artefact of the refugee sample. The second and admittedly more severe problem could be the socioeconomic self-selection of the refugees. It is important to note that the self-selection of North Korean refugees may have affected average heights in both directions. It is reasonable to assume that poorer North Koreans had stronger incentives to leave the country than their better-off peers. This means the average height of the refugees may underestimate that of the North Korean general population. Alternatively, perhaps better-off North Koreans were able to escape in larger numbers, as brokers had to be paid and ofcials bribed to facilitate defection.This would result in the refugee sample providing an overestimate of the stature of the population. It has already been noted that all social strata are represented in the refugee sample (gure 4). The extent and direction of the sample bias is not clear. To investigate the possible bias further, this study compared the educational backgrounds of the refugees to rarely available ofcial data for the North Korean population. In the late 1980s, North Korea, in an unprecedented move, made some population data available to external researchers.40 The data provided does not match data from the sample of refugees in terms of either its date (North Korean population data from the late 1980s, refugee data from 19972007) or the age groups covered (16+ for North Korean population data, 20+ for refugee data), but nonetheless the comparison of the data with the current sample data is enlightening. The average percentage of the adult population, aged 16 years or older, attending or having completed post-secondary education was reported as 14 per cent.41 About 10 per cent of the refugees reported receiving at least a four-year university education. Thus, no large distortions characterize the refugee sample in the area of education level. However, it is possible that labourers are over-represented among the refugees since they comprise 63 per cent of the total sample. Since manual workers are of rather low social status, the mean refugee height could as a result be slightly shorter than the North Korean population average. However, because most of the refugees were living in Hamgyong Province (a major industrial area in the Cold War era) this occupational bias may have been the result of the geographic proximity of North Hamgyong to China, rather than of the social self-selection of the individuals.
Kohama, Anthropometry. Average height in colonial Korea in the early 1930s by region was reported as follows: northern Koreans were on average 166 cm, middle Koreans 163.37 cm, and southern Koreans 162.51 cm tall. 40 Eberstadt and Banister, Population. 41 Ibid.
39 38

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Regardless of the socioeconomic background of the refugees, it is not possible to rule out the possibility that rather taller subjects may have migrated (from all social strata). Previous studies have shown that those who left their birthplace in search of better opportunities tended to be taller than those who remained.42 Even if the refugee group was shorter than the general population of North Korea because of its lower socioeconomic background, the migratory effect may have counteracted the possible decit in stature.

VI
Because the totalitarian system of North Korea makes little information available to the outside world, this study used available data on the stature of adult refugees from the country as a sensitive and established indicator of the living standards of the nation. As adult height is associated with conditions prevailing in the earlier years of life, analysing the adult height of the refugees by birth years in a macrohistorical perspective provides insight into the changes in the North Korean standard of living. In order to understand long-term trends of height in North Korea from the political formation of the country to the end of the Cold War era, this study made use of age-adjusted height for those over 40 years of age, as suggested by Cline et al. and Chandler and Bock.43 However, unadjusted terminal height that restricted the North Korean sample age range from 20 to 39 years was also used in the regression analysis (model 2 in tables 5 and 6). Based on the reasonable assumption that the rate of decline in height with age is uniform in both Koreas, the unadjusted height of the whole sample was used for a direct comparison with South Korean height (gure 2). As both adjusted and unadjusted terminal height produced the same results for the socioeconomic variables in the regression analysis, the methodology of this study should not pose a major problem. However, because evidence in this study was drawn from adult height data measured from North Korean refugees escaping to South Korea, the authors explored possible self-selection biases that might have led to an erroneous estimation of the average stature of the North Korean population. The sample average height may have been slightly shorter than the population average because a large proportion of the refugees were labourers of lower social status. The ndings are as follows. First, the average height of North Korean refugee cohorts born from 1935 to 1944, and raised before the political division of the Korean Peninsula in 1948, exceeded that of their South Korean peers. All North Korean refugee cohorts born thereafter were shorter than their South Korean counterparts, with height gaps becoming more pronounced over time and peaking in the early 1980s. This nding rejects the popular belief that North Koreans enjoyed a better standard of living compared to South Koreans for the rst two decades after the political division. When the age-unadjusted and age-adjusted heights of North Korean males and females were regressed on a set of dummies, the study found a consistent and statistically signicant effect of high educational
42 43

Reviewed by Bogin, Patterns, pp. 3014. Cline et al., Decline of height; Chandler and Bock, Age change.
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status: both male and female refugees with a four-year university education were 12 cm taller than less well educated North Korean refugees. Contrary to the socialist propaganda about a classless society, differences in living standards do exist in North Korean society. Among males, former occupational status was insignicant in determining height in all regression models. Among females, performing artists were signicantly and remarkably taller than labourers by 2.45 cm, whereas dependent and unemployed North Korean refugee women were found to be shorter. As to the provincial dummies, males from Ryanggang and Pyongyang were signicantly taller, and males from North Pyongan were signicantly shorter than North Korean males escaping from North Hamgyong province. Among females, only those from South Hamgyong province were signicantly taller than those from North Hamgyong province. Once height adjustments were made for old-age cohorts, the birth decade dummies became either statistically or historically insignicant (at most 1.12 cm for males and 1.81 cm for females). North Koreans did not experience a meaningful secular increase in height. During 60 years of communism, unadjusted male stature stagnated at around 1657 cm, and unadjusted female stature at around 1535 cm, whereas a secular growth spurt of height has occurred in the southern part of the Korean Peninsula during the same period from 164 to 174 cm for males and 152 to 161 cm for females. Seoul National UniversitySocial Sciences
Date submitted Revised version submitted Accepted 17 June 2008 18 March 2009 27 May 2009

DOI: 10.1111/j.1468-0289.2009.00509.x
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Komlos, J. and Cuff, T., eds., Classics in anthropometric history (St. Katharinen, 1998). Korean Agency for Technology and Standards (KATS), Report on the fth Size Korea national anthropometric survey [Je5cha hangugin inchechisujosasaeop bogoseo] (Gwachon, 2004). Korean National Statistics Ofce, Comparison of socio-economic condition of North and South Korea [Nambukan sahoegyeongjesang bigyo] (Seoul, 1995, 1996, 1997, 1999, 2000). Lee, G., Giyeong, L., Lee, E., Lee, S., Kim, D., Park, Y., and Choi, Y., North Korean home life [Bukanui gajeongsaenghwalmunhwa] (Seoul, 2001). Morgan, S., Stature and economic development in South China, 18101880, Explorations in Economic History, 26, 1 (2008), pp. 5369. Morgan, S. and Liu, S., Was Japanese colonialism good for the welfare of Taiwanese? Stature and the standard of living, China Quarterly, 192 (2007), pp. 9901013. Pak, S., The growth status of North Korean refugee children in China, Korea Journal, 43, 3 (2003), pp. 16590. Pak, S., The biological standard of living in the two Koreas, Economics and Human Biology, 2 (2004), pp. 51121. Prince, J. and Steckel, R., Nutritional success on the Great Plains: nineteenth-century equestrian nomads, Journal of Interdisciplinary History, 33 (2003), pp. 35484. Savada, A. M., North Korea. A country study (Washington, D.C., 1994). Schwekendiek, D., Determinants of well-being in North Korea: evidence from the post-famine period, Economics and Human Biology, 6, 3 (2008), pp. 44654. Schwekendiek, D., The North Korean standard of living during the famine, Social Science and Medicine, 66 (2008), pp. 596608. Statistisches Bundesamt, Lnderbericht Korea, Republik (Stuttgart, 1995). Steckel, R., Stature and the standard of living, Journal of Economic Literature, 33 (1995), pp. 190340. Strauss, J. and Thomas, D., Health, nutrition, and economic development, Economic Literature, 36 (1998), pp. 766817. Van Wieringen, J., Secular growth changes, in F. Falkner and J. Tanner, eds., Human growth: a comprehensive treatise (New York, 2nd edn. 1986), pp. 30731. Waaler, H., Height, weight and mortality. The Norwegian experience, Acta Medica Scandinavica, 679 (1984), pp. 159.

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