Childhood disadvantage strongly predicts costly outcomes

Childhood disadvantage strongly predicts costly adult life-course outcomes

A small segment of the population accounts for a disproportionate share of costly service use across a society’s health care, criminal justice, and social welfare systems – and paediatric tests of brain health can identify these adults as young as age three, new findings out of the University of Otago’s Dunedin Multidisciplinary Study suggest.

The Dunedin Study is an internationally renowned research programme that has followed the progress of 1,000 children born in Dunedin, New Zealand in 1972-73, from birth to midlife. The latest findings are newly published in the international journal Nature Human Behaviour.

With Study members’ permission, the research team analysed government administrative databases and electronic medical records. The team, which included Dunedin Study Director Professor Richie Poulton, found that nearly 80 per cent of adult economic burden can be attributed to just 20 per cent of the Study members.

The researchers determined that this “high cost” group accounted for 81 per cent of criminal convictions, 66 per cent of welfare benefits, 78 per cent of prescription fills and 40 per cent of excess obese kilograms.

Professor Poulton says that they also found that members of this group can be identified with high accuracy when still young children.

At age three, each Study member took part in a paediatric examination that included a neurological evaluation and assessments of verbal comprehension, language development, motor skills, and social behaviour. Looking back at the test results, the team found that scoring poorly on these tests was a good predictor of going on to be in the “high cost” group.

“We also found that members of this group tended to have grown up in more socioeconomically deprived environments, experienced child maltreatment, scored poorly on childhood IQ tests and exhibited low childhood self-control,” he says.

Professor Poulton says that the strong connection between early-childhood development and costly adult outcomes underscores the need for preventive health and education programmes for children and families.

“Those working in social services have long observed that some individuals use more than their share of services, but this is the first evidence that the same group of individuals feature in multiple service sectors and that they can be identified as young children, with reasonable accuracy,” he says.

In their paper, the researchers write that they “are aware of the potential for misusing these findings, for stigmatising and stereotyping. But there is no merit in blaming a person for economic burden following from childhood disadvantage.”

Instead, tackling the effects of childhood disadvantage through early-years support for families and children could benefit all members of a society by reducing costs.

The Dunedin Multidisciplinary Health and Development Research Unit received funding for the study from the Health Research Council of New Zealand and the New Zealand Ministry of Business, Innovation and Employment (MBIE).

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