Summary:

• Epigenetics explores how life experiences influence the way genes are expressed without altering the DNA itself.
• Severe adversity, including hunger, chronic stress and deprivation, can leave biological changes that may, in some circumstances, influence the next generation.
• India’s history of famine, alongside persistent maternal undernutrition, gives this science particular relevance.
• Epigenetic changes are not destiny. Many are reversible, making early intervention both possible and important.
• The evidence strengthens the case for investing in maternal health, nutrition and the first 1,000 days of a child’s life.

In 1943, an estimated three million people died in the Bengal Famine. It was not because food had vanished altogether. As economist Amartya Sen later argued, the catastrophe was driven less by an absolute shortage of grain than by a collapse in people’s ability to access it. Wartime inflation, hoarding and failures in distribution placed rice beyond the reach of the very communities that produced it.

Eventually, the famine ended. Markets stabilised, harvests returned and Bengal, in the language of history, recovered.

However, for scientists studying health across South Asia, the story may not have ended there.

Over the past two decades, researchers have begun asking whether extreme deprivation leaves behind more than historical memory. The question is no longer only how famine shaped the lives of those who lived through it, but whether it also left biological traces that could influence the health of their children, and perhaps even their grandchildren.

For generations, the persistence of poverty has largely been explained through social and economic forces: unequal access to education, insecure livelihoods, debt, discrimination and poor healthcare. These remain the principal drivers and there is no evidence that poverty is inherited as a genetic trait.

But a growing body of research suggests there may be another pathway operating alongside them.

The experiences of severe hardship may alter the way genes are regulated, creating biological changes that can affect health long after the hardship itself has passed.

The implications are profound. If deprivation can influence the body during its earliest stages of development, then the opportunity to interrupt that process also comes early, during pregnancy and the first years of life.

To understand why that matters, we first need to understand what epigenetics is — and what it is not.

What Is Epigenetics?

Most of us learn in school that DNA is the body’s genetic blueprint. That is true, but it is only part of the story.

Every cell in the body carries essentially the same DNA, yet a brain cell behaves very differently from a liver cell. The difference lies not in the genes themselves, but in which genes are active and which remain switched off.

Epigenetics is the study of the biological processes that regulate this activity. Rather than changing the DNA sequence, epigenetic mechanisms influence how genes are expressed, determining which genetic instructions are read and when.

One of the best-understood mechanisms is DNA methylation, in which small chemical tags attach to DNA and affect whether particular genes are turned on or off. These changes are shaped not only by normal development but also by the environment. Nutrition, chronic stress, exposure to toxins and conditions during pregnancy can all influence how genes are regulated.

In other words, experiences do not rewrite our genes. They can, however, influence how those genes function.

The Evidence Is Growing

The idea that adversity can leave measurable biological changes is no longer speculative. Over the past two decades, evidence from epidemiology, genetics and developmental biology has steadily strengthened the case.

One influential study by researchers at Northwestern University found that lower socioeconomic status was associated with differences in DNA methylation at more than 2,500 sites across over 1,500 genes, suggesting that prolonged exposure to poverty is reflected in measurable biological patterns. Many of these genes are involved in immune function, nervous system development and metabolism, systems that play a central role in lifelong health.

These findings do not mean poverty creates a different genetic code. They suggest that growing up under chronic adversity may influence how the body’s biological systems develop and respond to the environment.

Research on famine has reached similar conclusions.

People conceived during the Dutch Hunger Winter of 1944–45, when severe food shortages affected pregnant women during the Second World War, were found decades later to have higher risks of obesity, Type 2 diabetes and cardiovascular disease, despite never experiencing famine themselves. Researchers also identified persistent differences in DNA methylation in some of these individuals more than sixty years later.

Other longitudinal studies have found that children exposed to poverty early in life show epigenetic differences that remain detectable into adolescence, some of which have been associated with later mental health outcomes, including depression.

Taken together, these studies suggest that early-life conditions can leave lasting biological signatures, particularly during periods of rapid development.

Perhaps the most remarkable aspect of these findings is that they describe a system that is fundamentally adaptive.

When nutrition is scarce or stress is prolonged, the body adjusts in ways that improve the chances of survival under those conditions. Those adaptations are beneficial in an environment defined by deprivation. They can become less helpful, however, when circumstances change. Biological responses that once protected the body during scarcity may increase the risk of chronic diseases later in life, when food is more readily available.

In that sense, the body is not malfunctioning. It is responding to the environment it was prepared for.

India’s Particular Context

For India, this research carries particular significance.

The Bengal Famine was not an isolated event. Colonial India experienced repeated famines, while maternal undernutrition and childhood malnutrition have remained persistent public health challenges long after Independence. Although the causes have changed over time, the consequences of inadequate nutrition continue to shape millions of lives.

Some researchers have proposed that repeated exposure to famine and chronic undernutrition may have contributed to metabolic adaptations that partly explain why South Asians today experience higher rates of Type 2 diabetes and cardiovascular disease, often at younger ages than many other populations. It remains a hypothesis rather than settled scientific consensus, but it reflects a broader pattern that researchers continue to investigate.

What is beyond dispute is the present-day nutritional burden.

According to the latest National Family Health Survey (NFHS-5), 35.5% of Indian children under five are stunted and 32.1% are underweight. Anaemia affects 57% of women aged 15–49 and 67% of young children, with both figures rising since the previous survey. Maternal anaemia increases the risk of low birth weight and poor fetal development, highlighting how nutritional disadvantage can begin before a child is born.

This is why the science of epigenetics is especially relevant in India. Not because Indian children are biologically different, but because many experience the earliest stages of development under conditions of nutritional stress.

We often think of poverty being passed from one generation to the next through limited education, poor healthcare, insecure livelihoods and inadequate nutrition. Epigenetics suggests there may also be a biological dimension to that cycle, one that operates alongside the social and economic forces we already understand.

This Is Not Destiny

It is important to resist drawing the wrong conclusion from this research.

Epigenetics does not suggest that poverty becomes biologically fixed or that children born into hardship are destined to poorer health. That interpretation is neither supported by the evidence nor consistent with what epigenetics actually describes.

Unlike genes, epigenetic marks are dynamic. They are influenced by the environment throughout life and are particularly responsive during pregnancy and early childhood. Many can change as nutrition, healthcare and living conditions improve.

Researchers themselves remain cautious. While evidence that early-life conditions shape lifelong health is well established, the extent to which epigenetic changes are passed from one generation to the next in humans remains an active area of research. Much of the strongest evidence for transgenerational inheritance still comes from animal studies.

What the science does show clearly is that improving conditions early in life changes outcomes.

Rather than offering a story of biological determinism, epigenetics offers a compelling argument for early intervention.

The First 1,000 Days

Public health experts often describe the period from conception to a child’s second birthday as the first 1,000 days. During this time, the brain develops rapidly, organs mature and many of the body’s regulatory systems are established.

It is also the period when nutrition, maternal health and exposure to stress have some of the greatest influence on long-term development.

This is why investments during pregnancy and infancy consistently produce some of the largest health gains.

Adequate maternal nutrition. Iron and folic acid supplementation. Regular antenatal care. Exclusive breastfeeding. Nutritious complementary feeding in the first two years of life.

Individually, these are familiar public health interventions. Collectively, they help shape the biological environment in which a child develops.

Viewed through the lens of epigenetics, supporting a pregnant woman is not only about meeting her immediate nutritional needs. It is also about creating the conditions in which the next generation can grow, develop and thrive from the very beginning.

That is what makes the first 1,000 days so important. They represent one of the earliest opportunities to interrupt the cycle through which poverty affects health across generations.

Where Smile Foundation Fits In

This is where community-based healthcare can make a meaningful difference.

Smile Foundation’s maternal and child health programmes focus on precisely the period when intervention matters most. Through antenatal care, anaemia screening, nutritional support and health education, the organisation works with expectant mothers during pregnancy and in the critical months that follow childbirth.

Access remains one of the biggest barriers to care, particularly in remote communities. Smile on Wheels brings primary healthcare services to villages with limited medical infrastructure. In Assam’s South Salmara district, Smile on Boat reaches around 27,000 people across 12 riverine islands, delivering antenatal care, child health services and essential medical support to communities that would otherwise struggle to access routine healthcare.

Viewed through the lens of epigenetics, these interventions are about more than treating illness. They help create healthier conditions during the earliest stages of life, when nutrition and maternal health have the greatest influence on a child’s future development.

The science reinforces what public health has long recognised: improving maternal health and early childhood nutrition is one of the most effective ways to reduce inequalities before they become entrenched.

What We Inherit, and What We Can Change

So, can hardship be inherited?

The answer is more nuanced than a simple yes or no.

Poverty is not passed down through genes, nor is it a biological destiny. But growing evidence suggests that severe deprivation, particularly during pregnancy and early childhood, can leave biological changes that influence health across the life course and, in some circumstances, may extend into the next generation.

That makes poverty more than an economic condition. It is also a public health challenge that begins remarkably early.

The encouraging part of this research is that these biological changes are not fixed. Unlike DNA itself, epigenetic marks respond to the environment. Better nutrition, quality healthcare and supportive early-life conditions can improve outcomes, particularly during the first 1,000 days.

The implications are practical rather than abstract.

An iron supplement during pregnancy. A routine antenatal check-up. A nutritious meal. Timely healthcare for a newborn.

These may appear to be ordinary interventions. Yet they arrive at one of the few moments in life when they can influence health for decades to come.

No one can change the hardships of previous generations. But every healthy pregnancy, every well-nourished child and every family that gains access to care has the potential to shape a different future.

That is ultimately what the science of epigenetics offers: not a story of inherited disadvantage, but evidence that early investment in health and nutrition can help break cycles that once seemed impossible to change.

Frequently Asked Questions (FAQs) 

1. What is epigenetics, in simple terms?

Epigenetics is the study of how genes are switched on and off without any change to the genes themselves. Think of DNA as a script and epigenetic marks as the decisions about which lines get read aloud. These marks respond to the environment, including diet, stress and deprivation. A 2019 study linked lower socioeconomic status to such marks at more than 2,500 sites across over 1,500 genes, close to one in ten of all human genes.

2. Can hardship be passed to children biologically?

In some cases, it appears so. The clearest evidence comes from famine studies, where children of mothers who were starving during pregnancy showed higher rates of metabolic disease decades later. Evidence for effects reaching across multiple generations is still debated and much of it comes from animal research, so scientists remain cautious about how far it extends in humans.

3. Does this mean poverty is biologically inescapable?

No, and this is the most important point. Unlike genes, epigenetic marks are changeable. They are written by the environment and can often be rewritten by a better one. This makes the science an argument for early intervention, not a reason for fatalism.

4. What is the first 1,000 days window?

It is the period from conception to a child’s second birthday, when the brain and body develop fastest and epigenetic programming is most sensitive. It is the stage at which good nutrition and maternal health have the greatest lifelong effect, which makes it the key point for intervention.

5. How does Smile Foundation’s work connect to this?

Through its health programmes, including antenatal care, maternal nutrition awareness and doorstep healthcare, Smile Foundation reaches pregnant women and young children in underserved communities during exactly the window when early-life conditions shape long-term health. It addresses the biological root of the poverty cycle, not only its economic symptoms.

Sources:

• McDade, T. W., Ryan, C. P., Jones, M. J., Hoke, M. K., Borja, J., Miller, G. E., Kuzawa, C. W. and Kobor, M. S., Genome-wide analysis of DNA methylation in relation to socioeconomic status during development and early adulthood, American Journal of Physical Anthropology, 2019, 169(1) (Northwestern University)
• Heijmans, B. T., Tobi, E. W., Stein, A. D., Putter, H., Blauw, G. J., Susser, E. S., Slagboom, P. E. and Lumey, L. H., Persistent epigenetic differences associated with prenatal exposure to famine in humans, Proceedings of the National Academy of Sciences, 2008
• Swartz, J. R. et al., An Epigenetic Mechanism Links Socioeconomic Status to Changes in Depression-Related Brain Function in High-Risk Adolescents, Molecular Psychiatry, 2016
• The Long Shadow of Early Poverty: Poverty at Birth, Epigenetic Changes at Age 15 and Youth Outcomes at Age 22, 2024
• Sen, A., Poverty and Famines: An Essay on Entitlement and Deprivation, Oxford University Press, 1981, on the Bengal Famine of 1943
• Sayed, M., Deek, F. and Shaikh, A., The Susceptibility of South Asians to Cardiometabolic Disease as a Result of Starvation Adaptation Exacerbated During the Colonial Famines, 2022
• Sheikh, N., Why South Asian Genes Remember Famine, Scientia News, 2025, on famine-linked methylation of the LEP and ADIPOQ genes and comparative age of diabetes onset; citing Diabetes UK, Risk of Type 2 Diabetes in the South Asian Community
• Vadapalli, P. S., The Genetics of Inequality: Can Our Environments Biologically Shape Our Opportunities?, American India Foundation, 2023
• Learn.Genetics, University of Utah, Epigenetics and Inheritance, for background on DNA methylation and epigenetic mechanisms
• Ministry of Women and Child Development, Government of India, Press Information Bureau release PRID 2119756, on the First 1,000 Days of Life as a key theme of Poshan Pakhwada 2025
• International Institute for Population Sciences (IIPS) and ICF, National Family Health Survey (NFHS-5), 2019-21: India, Volume I, Mumbai: IIPS, 2021, for the Ministry of Health and Family Welfare, Government of India
• Smile Foundation, health and maternal care programmes, including Smile on Wheels and Smile on Boat (South Salmara, Assam)

Summary

• Statistics help NGOs measure real impact, not just activities.
• Baseline and follow-up data reveal whether interventions create meaningful change.
• Data enables organisations to improve programmes through continuous monitoring.
• Quantitative evidence is strongest when combined with qualitative insights.
• Effective impact measurement strengthens accountability, transparency and public trust.

In the development sector, stories often carry the emotional weight of change and we use statistics to measure impact.

A woman who starts her own business after a vocational training programme can change the future of her entire family and clan. At the same time, a child who returns to school after years of absence or a village that gains access to clean drinking water can powerfully illustrate what social interventions often seek to achieve. 

Yet, for organisations working at scale, stories alone are not sufficient. In fact, keeping in sight the scope and expanse of work, NGOs need to turn to statistics as a reporting requirement as well as a tool for understanding whether their work is genuinely transforming lives. Donors seek measurable outcomes, governments demand accountability and communities themselves increasingly expect programmes that respond to their actual needs. This is why over time, the social sector has reshaped the language of social change through the rise of evidence-based development. 

Within this context, statistics have emerged as one of the most important instruments through which NGOs assess effectiveness, refine interventions, demonstrate impact, expand successful programmes and most importantly, strengthen accountability to donors, governments and the communities they serve. 

From activities to outcomes: Statistics to Measure Impact 

Historically, many organisations measured success through outputs, say the number of workshops conducted, beneficiaries reached or resources distributed. In fact, for years these figures have served as the primary indicators of success. But at a time when NGOs operate in an environment where trust is harder to establish and organisations must constantly compete for funding, such numbers alone are no longer enough. While they remain useful, they reveal little about whether people’s lives have actually improved. Contemporary impact measurement therefore distinguishes between outputs and outcomes. 

An NGO working in education, for instance, may report that it trained 500 teachers, but the more meaningful question is whether student learning improved as a result. Similarly, a healthcare initiative that conducts thousands of screenings must ultimately assess whether disease prevalence declined, treatment adherence increased or health outcomes improved over time. 

Statistics and rigorous data analysis enables organisations to answer these questions by moving beyond activity counts to measuring real change. By comparing conditions before and after an intervention, NGOs can track shifts in indicators such as literacy rates, nutritional status, household income and access to essential services. 

This process usually begins with establishing a ‘baseline’, a statistical snapshot of a community’s conditions before a programme is introduced. Without this point of reference, it is difficult to determine whether subsequent improvements can reasonably be attributed to the intervention. Consider a livelihood programme aimed at increasing women’s earnings in rural communities. Baseline surveys may record participants’ average monthly income, employment patterns, savings behaviour and decision-making power within their households. Follow-up assessments months or years later can then reveal whether statistically significant changes have occurred, providing evidence of the programme’s effectiveness. 

Additionally, statistics can also help improve programmes while they are underway. If attendance at a health awareness programme begins to decline or certain demographic groups remain underserved, strategies can be adapted before the project ends. Real-time dashboards and digital monitoring systems allow organisations to track progress continuously and respond to emerging trends. 

Measuring what matters 

While statistics have become indispensable for measuring impact, they are far from neutral. Every stage of the process: deciding what to measure, which indicators to prioritise, determining how data is collected and analysed, in turn, shapes the story an organisation ultimately tells about its success. There is also the danger of reducing complex human experiences to rather direct and ‘neat’ numerical indicators. Development practitioners have long cautioned against this overreliance on metrics that prioritise what is easy to count while overlooking deeper, less tangible dimensions of wellbeing. 

This is so bnecause some of the most meaningful outcomes of social development are usually the most difficult to quantify. While improvements in income, school attendance or healthcare access can be measured numerically, any changes in confidence, agency, social inclusion or community resilience often resist simple statistical representation. Recognising these limitations, many NGOs increasingly rely on mixed-method evaluation frameworks. Quantitative data from surveys and administrative records are complemented by qualitative approaches such as interviews, focus groups, case studies and participant observation, allowing organisations to capture both measurable outcomes and lived experiences. 

Collecting reliable data also presents significant practical and ethical challenges. Ensuring representative samples, protecting respondent confidentiality, training field investigators and avoiding survey fatigue require considerable investment of time, expertise and resources—capacities that smaller organisations may not always possess. Responsible impact measurement, therefore, requires methodological rigour along with transparency about the limitations of the evidence being produced. 

Towards a culture of evidence: Statistics to Measure Impact

In times defined by heightened expectations of transparency and effectiveness, the capacity to measure impact is integral to the pursuit of social change. The increasing use of statistics within the non-profit sector reflects a maturation of development practice because evidence is no longer just a donor requirement but also a means of strengthening programmes and enhancing public trust. 

Yet, numbers should not be mistaken for the entirety of the story. 

They acquire meaning only when interpreted alongside the lived realities they represent and the most effective NGOs understand this balance. They recognise that behind every percentage point lies a person, a household or a community negotiating the possibilities of a different future. Statistics may provide the evidence, but it is human experience that ultimately gives development its purpose.

Frequently Asked Questions (FAQs): Statistics to measure impact

1. Why are statistics important for NGOs?
Statistics help NGOs measure programme outcomes, demonstrate impact, improve interventions and meet accountability requirements.

2. What is the difference between outputs and outcomes?
Outputs measure activities completed, while outcomes measure the actual changes or benefits experienced by beneficiaries.

3. What is a baseline survey?
A baseline survey captures conditions before a programme begins, providing a reference point to measure future impact.

4. Can statistics alone measure social impact?
No. Statistics should be complemented by qualitative methods such as interviews, case studies and focus groups to capture lived experiences.

5. How do NGOs use data to improve programmes?
By monitoring trends and analysing results, NGOs can identify gaps, adapt interventions and make evidence-based decisions during programme implementation.