documented in the literature as a good predictor of longevity, education and earnings (Behrman and Rosenzweig 2004; Case and Paxton 2008; Strauss and Thomas 1998). The impact of pre-adulthood exposure to conflict on height identified in Akresh et al. (2012) can therefore be viewed as a permanent labor productivity loss for the exposed individuals.

The long-term effect working through human capital formation plays a key role for our study as it is consistent with the relationships between conflict and poverty in the country and regional data. This suggests that the latter are indeed driven by a causal relationship running from conflict to reduced economic capacity that is only slowly recovering. In this interpretation we can rely on a diverse body of evidence which finds large negative effects of armed conflict on education. Ichino and WinterEbmer (2004) for instance estimate the long-run educational cost of World War II. They find that individuals who were 10 years old during the conflict in the most affected countries received less education than individuals with comparable characteristics in less affected countries. Affected individuals also experienced a sizable earnings loss, some 40 years later. Blattman and Annan (2010) use the exogeneity in child military conscriptions into rebel groups in Uganda to provide evidence for the widespread and persistent economic and educational impact of conflicts. They find that schooling falls by nearly a year, that skilled employment halves, and that earnings drop by a third among child soldiers as compared to the control group. Akbulut-Yuksel (2014) exploits the plausibly exogenous region-by-cohort variation in the intensity of World War Two (WWII) destruction as a quasiexperiment and finds that exposure to destruction had long-lasting detrimental effects on the human capital formation, health, and labor market outcomes of Germans who were at school-age during WWII. An important channel for the effect of destruction on educational attainment is the destruction of schools whereas malnutrition is partly behind the estimated impact on health. Minoiua and Shemyakina (2014) use survey data and information on the dates and locations of conflict events to examine the causal impact of the 2002–2007 Ivorian conflict on child health. They find that children from conflict-affected regions suffered significant health setbacks and that victimization in the form of economic losses is the main conflict–impact mechanism.

Conflicts affect aggregate productivity directly through physical health but also indirectly through mental health. Being exposed to violence leads to post-traumatic stress disorder (PTSD) which affects both adults and children. These mental illnesses are characterized by hyper-vigilance, flashbacks and nightmares. Individuals who are exposed to a traumatic event have an increased likelihood of poor self-reported health, morbidity (as indicated by physical exam or laboratory tests), utilization of medical services, and mortality. Li et al. (2011) show that people who experience PTSD are at much higher risk of developing other health problems, including diabetes, heart ailments, depression and addiction. Sibai et al. (1989) study civilians exposed to the civil war in Lebanon and find that patients with severe coronary artery disease had more war-related stress than did either patients with normal arteriographic findings or hospital visitors. Using female Vietnam veterans, Wolfe et al. (1994) show that warzone exposure and PTSD are associated with self-reports of poor health and numerous physical problems. PTSD in early childhood also makes people more vulnerable in later life (The Economist 2015). Rosen and Fields (1988) were among the first to attempt to explain how PTSD could adversely affect physical health. The potential channels can be divided in 3 groups: biological, psychological and behavioral channels (Friedman and Schnurr 1995). From a biological point of view, PTSD can modify cardiovascular reactivity, disturb sleep physiology, enhance thyroid function, etc. Singhal (2019) studies the long-term effects the U.S. war in Vietnam on mental health. He finds that early-life exposure to war negatively affects mental health in adulthood and proposes malnutrition during the war as a significant mechanism.

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